Academic journal article Adult Learning

Family Caregivers as Lay Trainers: Perceptions of Learning and the Relationship between Life Experience and Learning

Academic journal article Adult Learning

Family Caregivers as Lay Trainers: Perceptions of Learning and the Relationship between Life Experience and Learning

Article excerpt

Abstract: This article describes an initiative to train lay people, predominantly parents of children and youth with special health care needs (CYSHCN), to teach Bridge to Independence--a care coordination curriculum--to other family caregivers of CYSHCN. Using a model based on Kirkpatrick and Kirkpatrick's levels of evaluation, the goal was to discover how well lay people liked the process of learning how to teach, the extent to which these Lay Trainers gained knowledge and skills from the training sessions, and what changes in Lay Trainer caregiving application resulted from the learning process. The Bridge to Independence curriculum design is based on self-directed learning principles and served as the framework for Lay Trainer learning. This article presents the study's methodology, findings, and discussion, and adult education practice implications. Two themes emerged from this evaluation study: Lay Trainer perceptions of learning the curriculum and the relationship between life experience and learning. The study provides implications for two aspects of adult education practice: training the trainer and adult learning.

Keywords: adult learning, learning how to teach, life experience, train the trainer

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Caring for children and youth with special health care needs (CYSHCN) requires parents and other family caregivers to navigate a complex maze of health care providers, services, and community agencies. Learning skills to navigate the health care system can benefit family caregivers by making it easier to manage their children's care. We developed the Bridge to Independence care coordination curriculum to teach family caregivers (adult learners) to safely care for their CYSHCN. The current project was an initiative to train lay people, themselves parents of CYSHCN, to teach the care coordination curriculum to other family caregivers. The purpose of the study was to discover how well lay people liked the process of learning how to teach, the extent to which the Lay Trainers gained knowledge and skills from the training sessions, and what changes in Lay Trainer caregiving application resulted from the learning process. This article describes the Bridge to Independence curriculum as the framework for Lay Trainer learning, self-directed learning as a personal attribute, and the study's methodology and findings. We conclude the article with implications for training the trainer and adult learning.

Framework for Lay Trainer Learning

The Bridge to Independence curriculum provided the content and framework for Lay Trainer learning. We developed the curriculum with the support of a Maternal Child Health Bureau Grant (R40 MC 08960-03) using a family-centered care approach, health literacy principles, and adult education strategies to draw attention to important points (Conceigao, Colby, Juhlmann, & Johaningsmeir, 2011). Bridge to Independence has 12 modules addressing key areas of care coordination for CYSHCN (Emergency Planning, Equipment and Supplies, Common Health Problems, Communication, Health Benefits, Community Resources, Child's Health Condition, Routine Treatments, Personal Health Records, Appointments, Advocacy, and Transitions). Rather than simply providing information about specific conditions, the emphasis is on participants learning skills. For example, the module on health benefits teaches caregivers the skills to assess their individual needs for benefits, evaluate different insurance plans, and apply for the right programs. The curriculum includes tools and forms to keep track of information, give alternate strategies, and find resources.

Study's Theoretical Framework: Evaluation of Training

This study used Kirkpatrick and Kirkpatrick's (2006) evaluation of training as the theoretical framework. The "Four Levels" Model, as it is known, is characterized by "a sequence of ways to evaluate programs" (p. 21). According to Kirkpatrick and Kirkpatrick, each level must be used in sequence to provide valuable information:

* Level 1--Reaction: how participants in a program react to the program

* Level 2--Learning: the extent to which program participants change attitudes, improve knowledge, and/or increase skills after participating in the program

* Level 3--Behavior: the extent to which program participants changed behavior because they attended the training program

* Level 4--Impact: the final results that occurred because program participants attended the training

For Level 1 evaluation, our goal was to determine how well Lay Trainers liked the learning process and whether there was a need for clarification before moving on. …

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