On-site Coaching Research Articles

Health professionals' experience on District Health Information System (DHIS2) and its utilization at local levels in Gandaki province, Nepal: A qualitative study.

DHIS2 is a web-based platform primarily used in developing countries, ensuring reliable data and aiding decentralized decision-making. The Ministry of Health and Population has greatly emphasized using DHIS2 for data entry and reporting. However, studies regarding health workers' experiences on DHIS2 and the utilization of data at the local level remain limited. Therefore, this study aims to investigate the usage and practical experience of DHIS2 at the local levels of Gandaki province, Nepal. An exploratory qualitative study was conducted in the Gandaki province from February to August 2023. We conducted twenty in-depth interviews among the DHIS2 users at local levels, health posts, and provincial health directorate using in-depth interview guidelines. The study participants were selected purposively. Thematic analysis was conducted to analyze the data, and NVivo was used to facilitate data analysis. Health professionals demonstrated dedication and commitment to use DHIS2 for reporting. DHIS2 has facilitated timely reporting, data storage, data analysis and visualization, feedback and communication mechanisms, and service delivery. Users' self-motivation and support from the local and provincial levels and regular review and program-specific review meetings were major facilitators for DHIS2 use. Similarly, technical issues, poor internet connectivity, power outages, and inexperienced health professionals were the significant challenges to using DHIS2. The basic and refresher training needed improvement at all levels, and learning materials were unavailable in health facilities. In addition, the data utilization at the local level in various actions was unsatisfactory despite sufficient data. Health professionals have been facilitated by DHIS2 in various actions. Capacity building of health professionals on data analysis and interpretations, continued onsite coaching, reliable internet connectivity, availability of learning materials, and improved server capacity are needed to enhance the performance of DHIS2 at the local level.

Design of a Blended Learning Course for Training Community Healthcare Providers on eHealth-enabled Newborn Hearing Screening

Objectives. We present in this article the design and evaluation of a blended learning approach for training community healthcare providers in performing newborn hearing screening (NHS).Methods. We developed a blended learning course for training community healthcare providers on eHealth-enabled NHS, following Bloom’s revised taxonomy of educational objectives. The training involved three components: computer-based training (CBT), face-to-face (FTF) training, and on-site coaching. We used surveys and post-training interviews following Level 1 Kirkpatrick’s training evaluation model to get initial feedback on the training program.Results. Thirty-one community healthcare providers from five rural health units and a private hearing screening center, with a mean age of 42.2 ± 12.0 years, participated in the pilot. 93.5% of the participants agreed that the program content met stated objectives and was relevant to their practice. The length of the course was perceived to be adequate. Overall satisfaction with the program was rated at 8.5 ± 0.9 (with ten as the highest). The majority expressed that the CBT and FTF course were satisfactory at 93.5% and 100%, respectively. All participants agreed that the course enhanced their knowledge of newborn hearing screening and telehealth. Positive reviews were received from participants on the use of CBT to improve theoretical knowledge before FTF training. Participants declared that FTF training and on-site coaching helped improved NHS skills and implementation.Conclusion. Competent community healthcare providers are critical to strengthening the performanceof the health system, and advances in the education and technology sectors offer promising potential inupskilling local healthcare providers. The increasing access of Filipino healthcare providers to improvedinformation and communications technology (ICT) is a significant catalyst for pedagogical innovation, like the use of blended learning in the continuous professional development of health practitioners. As ICTs gradually penetrate the health sector, the challenge we now face is not whether but how we can use innovations in education strategies to benefit healthcare providers.

Novel on-site follow-up and enhancement program (FEP) improves knowledge, clinical skills and enabling environment of skilled birth attendants in Nepal.

Although great strides have been made in maternal and newborn health in Nepal, the maternal mortality ratio (MMR) is still high at 186 per 100,000 births. Many maternal deaths are preventable if there is access to a skilled birth attendant (SBA). The Ministry of Health and Population of Nepal launched the in-service SBA training program in 2007 and has trained over 10,000 SBAs to date. Evidence shows that one episode of training is not enough to retain skills. Therefore, the Nick Simons Institute (NSI) in collaboration with National Health Training Center (NHTC) devised a Follow-Up and Enhancement Program (FEP) in 2011 where the knowledge, clinical skills, and working environment of SBA graduates were assessed directly at their worksites. FEP allows on-site coaching and feedback so that graduates may continue to improve upon any gaps in their knowledge, skills, and working environment. This study aims to assess the effectiveness of FEP. We used a mixed-methods research design. A total of 73 SBAs who had a pre-FEP assessment in 2016 were followed up for a post-FEP assessment in 2017. We also collected data from 3 additional districts (115 SBAs) that had not previously had FEP, to compare SBAs in FEP versus non-FEP districts. Qualitative data was collected from 16 health facilities on the perceptions, motivation, and satisfaction of stakeholders. Of the total 188 SBAs that were sampled, a one-time FEP increased knowledge scores by 9%, clinical skills scores by 29%, and enabling environment scores by 7%. The number of deliveries conducted improved with a one-time FEP, although this increase was not statistically significant. We found a trickle-down effect of working in a facility that has had prior FEP, with SBAs that have never had FEP improving their clinical skills. FEP was found to be a highly accepted program and is beneficial to SBAs, trainers, and the Hospital Management Committee (HFOMC). However, a one-time FEP is not sufficient in retaining clinical skills and knowledge. FEP is a highly effective program by both quantitative and qualitative evaluation. Our study suggests that FEP should be frequent and continuous to retain the knowledge and clinical skills of SBAs, motivate them through on-site coaching, and improve their working environment through direct feedback to the Ministry of Health and Population.

Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021.

Although there has been a significant focus on improving maternal and newborn health and expanding services in Nepal, the expected positive impact on the health of mothers and newborns has not been achieved to the desired extent. Nepal not only needs to focus on improving access to and coverage of services but also the quality to achieve Sustainable Development Goals (SDG) by 2030. In this context, we aimed to analyze Basic Emergency Obstetric and Neonatal Care (BEmONC) service availability and readiness in Health Facilities (HFs) of Nepal. We analyzed data from nationally representative Nepal Health Facility Survey (NHFS), 2021. BEmONC service availability and readiness in HFs was measured based on the "Service Availability and Readiness" manual of World Health Organization (WHO). We measured service availability by seven BEmONC signal functions. The readiness score was calculated for three domains- guidelines and staff training, essential equipment/supplies, and essential medicines on a scale of 100, and the average score for the three domains was the overall readiness score. We performed weighted descriptive and inferential analysis to account complex survey design of NHFS 2021. We summarized continuous variables with descriptive statistics like mean, standard deviation, median and interquartile range whereas categorical variables with percent and 95% confidence interval (CI). We applied simple, and multivariate linear regression to determine factors associated with the readiness of HFs for BEmONC services, and results were presented as beta (β) coefficients and 95% CI. Of total 804 HFs offering normal vaginal delivery services, 3.1%, 89.2%, 7.7% were federal/provincial hospitals, local HFs, and private hospitals respectively. A total of 45.0% (95% CI: 34.9, 55.6) federal/provincial hospitals, 0.3% (95% CI: 0.2, 0.6), local HFs (district hospital, primary health care centers, health posts, urban health centers) and 10.5% (95% CI: 6.6, 16.4) private hospitals, had all seven BEmONC signal functions. The overall readiness of federal/provincial hospitals, local HFs, and private hospitals were 72.9±13.6, 54.2±12.8, 53.1±15.1 respectively. In multivariate linear regression, local HFs (β = -12.64, 95% CI: -18.31, -6.96) and private hospitals had lower readiness score (β = -18.08, 95% CI: -24.08, -12.08) compared to federal/provincial level hospitals. HFs in rural settings (β = 2.60, 95% CI: 0.62, 4.58), mountain belts (β = 4.18, 95% CI: 1.65, 6.71), and HFs with external supervision (β = 2.99, 95% CI:1.08, 4.89), and quality assurance activities (β = 3.59, 95% CI:1.64, 5.54) had better readiness scores. The availability of all seven BEmONC signal functions and readiness of HFs for BEmONC services are relatively low in local HFs and private hospitals. Accelerating capacity development through training centers at the federal/provincial level, onsite coaching, and mentoring, improving procurement and supply of medicines through federal/provincial logistic management centers, and regular supportive supervision could improve the BEmONC service availability and readiness in facilities across the country.

Proctoring System of Pediatric Laparoscopic Surgery for Choledochal Cyst.

Background: Endoscopic surgery also has been becoming widespread in the field of pediatric surgery. However, most disease treated by pediatric surgery in a single institution are small number of cases. Besides, the variety of operative procedures that need to be performed in this field is quite wide. For these reasons, pediatric surgeons have limited opportunities to perform endoscopic surgery. Therefore, it is difficult to introduce advanced endoscopic surgery at a single local hospital. To educate pediatric surgeons in local hospitals, for widespread advanced pediatric endoscopic surgery safely, and to eliminate the need for patient centralization, we have introduced a proctoring system. We compared the surgical results of our institution, a center hospital, with other local institutions, to investigate the feasibility of our proctoring system. Methods: The experienced pediatric surgeon of our institution visits local hospitals to provide onsite coaching and supervises pediatric surgeons on the learning curve. All patients who underwent laparoscopic cyst excision and hepaticojejunostomy for choledochal cysts, one of the advanced pediatric endoscopic surgeries was retrospectively reviewed. Results: Thirty-four cases were evaluated (14 cases in our institution, 20 cases in 9 other institutions). The procedures of all 34 cases were performed by surgeons with 0-2 cases of experience in the procedure. There were no open conversion cases. There was no significant difference in the operative date. There was 1 case (6.7%) of postoperative complications during hospitalization at our institution and 3 cases (14.3%) at other institutions (P = .47). Two cases of late complications (13.3%) occurred at our institution, whereas 6 cases (28.6%) occurred at other institutions (P = .28). Conclusion: With the proctoring system, the performance and completion of advanced pediatric endoscopic surgery at local institutions was feasible. This has important implications given the ever-growing demand for pediatric endoscopic surgery and the increasing need for competent pediatric endoscopic surgeons.

P46 A step toward zero leprosy: experiences of Nepal in leprosy data verification

Abstract Records and reports are the sources of data for health programme planning, monitoring and evaluation. Accurate and timely data are crucial to ensure quality leprosy services, including drug supply, complication management and disability prevention. Data verification and validation are the initial steps to achieve the global goal of zero leprosy. The objectives of leprosy data verification were to strengthen the reporting system, to update personal health records and to provide onsite training to leprosy focal persons. Leprosy data verification was conducted in 15 endemic districts of Nepal by a team of national leprosy programme managers, leprosy focal persons, statisticians, dermatologists, paramedic health workers and World Health Organization consultants. The team visited health facilities that provide leprosy services and their corresponding municipalities from August 2021 to December 2021. The team examined the completeness and accuracy of data and information on the patient card, treatment register and monthly reporting form. Data were then compared with the municipal and national database, and edited, cleaned and verified for duplications, and onsite coaching was provided to the leprosy focal persons. Verification of 1210 health records of 15 districts from four provinces was conducted. The number of new leprosy cases was found to be under-reported by 5.5%. Likewise, under-reporting was observed in released-from-treatment cases (19.2% variation) and transfer-out cases (21.4% variation). Over-reporting was observed in re-treatment cases (7% variation), defaulter cases (10.6% variation) and new paediatric cases (38% variation). Common reasons for data variation were error in counting while reporting, error in compiling data from health facilities and a lack of training of focal persons in data recording and reporting. A limitation of the data verification study was that it was conducted in the selected 15 endemic districts and municipalities only. The study suggested that verification, validation and on-site coaching are effective approaches to obtaining quality data on leprosy. Such programmes can be conducted routinely or even during the integrated monitoring and supervision visits of experts from the centre to the local health facilities but should be carried out at the data entry site.

GD02 (P46) A step towards zero leprosy: experiences of Nepal in leprosy data verification

Abstract Records and reports are the sources of data for health programme planning, monitoring and evaluation. Accurate and timely data are crucial to ensure quality leprosy services, including drug supply, complication management and disability prevention. Data verification and validation are the initial steps to achieve the global goal of zero leprosy. The objectives of leprosy data verification were to strengthen the reporting system, to update personal health records and to provide on-site training to leprosy focal persons. Leprosy data verification was conducted in 15 endemic districts of Nepal by a team of national leprosy programme managers, leprosy focal persons, statisticians, dermatologists, paramedic health workers and World Health Organization consultants. The team visited health facilities that provide leprosy services and their corresponding municipalities from August 2021 to December 2021. The team examined the completeness and accuracy of data and information on the patient card, treatment register and monthly reporting form. Data were then compared with the municipal and national database, edited, cleaned and verified for duplications, and on-site coaching was provided to the leprosy focal persons. Verification of 1210 health records of 15 districts from four provinces was conducted. The number of new leprosy cases was found to be under-reported by 5.5%. Likewise, under-reporting was observed in released-from-treatment cases (19.2% variation) and transfer-out cases (21.4% variation). Over-reporting was observed in re-treatment cases (7% variation), defaulter cases (10.6% variation) and new paediatric cases (38% variation). Common reasons for data variation were error in counting while reporting, error in compiling data from health facilities and lack of training of focal persons in data recording and reporting. A limitation of the data verification study was that it was conducted in the selected 15 endemic districts and municipalities only. The study suggested that verification, validation and on-site coaching are effective approaches to obtaining quality data on leprosy. Such programmes can be conducted routinely or even during the integrated monitoring and supervision visits of experts from the centre to the local health facilities but should be carried out at the data entry site.

Empowering the tourism community in Gunungkidul using English online and on-site coaching

Tourism is one of a country's potential revenue streams. Gunungkidul district in Yogyakarta province has many natural tourist spots. The locals are thought to be more knowledgeable about the state of tourism, but they cannot speak English. To empower the tourism community after the pandemic, online and on-site coaching for the tourism community was conducted under Dinas Pariwisata of Gunungkidul. SWOT and need analysis were investigated to contribute insightfully to Dinas Pariwisata for future tourism development. In addition, video creations were executed, which consisted of simple expressions and practices with native speakers who are expected to give examples of how to communicate with foreigners. The practices in some potential tourism spots were carried out to encourage the tourism communities to develop their English skill. The results indicated that the tourism communities improved their English skills and confidently communicated with foreigners.

Preliminary Investigation on the Telemedicine Infrastructure Construction Project for Remote Areas

<p>隨著科技導入及資訊化程度提升，遠距醫療已是多數國家醫療發展之趨勢，在全球疫情及法規放寬管制下更加速其擴展。衛生福利部（以下稱衛福部）於110年投入「偏遠地區遠距醫療建置計畫」（以下稱本計畫），藉由提供全國14個急重症轉診網絡適切的遠距醫療設施設備，增加遠距會診服務、優化區域聯防之轉診後送機制，期改善偏遠地區醫療資源不足問題。本文主要介紹由衛福部委託財團法人醫院評鑑暨醫療品質策進會（以下稱醫策會）就本計畫四大策略（包含遠距會診、綠色通道、安全轉診及區域聯防）進行之實地輔導暨盤點作業，並分享專家委員對於醫療機構合作模式及執行困難點之建議內容，希冀更多醫療機構合作參與本計畫，針對偏遠及醫療資源不足地區投入相關資源，共同提升偏遠地區醫療服務之量能及品質與可近性。</p> <p> </p><p>The increasing technological involvement and informatization in medical practice has contributed to the development of telemedicine in medical industries worldwide. Such development has been further accelerated and expanded as the COVID-19 pandemic receded and related regulations eased globally. Taiwan’s Ministry of Health and Welfare launched a telemedicine infrastructure construction project for remote areas (hereafter “the Project”) in 2021. In the Project, telemedicine infrastructure was established for 14 emergency and critical patient transfer networks across Taiwan to increase the availability of remote consultation services, optimize the medical evacuation mechanism for transfers in regional care networks, and address the insufficient medical resources in remote areas. The purpose of this study is to introduce the onsite coaching and assessment conducted by the Joint Commission of Taiwan in relation to the Project’s four major strategies (remote consultation, green corridors, safe transfers, and regional care networks). Another focus of this study is to share experts’ thoughts on the challenges medical institutions face in their collaboration models and execution of plans. The study is expected to encourage medical institutions to participate in the Project and offer medical resources in remote areas and areas with inadequate medical resources, thereby improving the medical capacity, quality, and accessibility in remote areas.</p> <p> </p>

Onsite coaching: supporting prospective teachers to enact and appropriate instructional strategies in their field placements

ABSTRACT Coaching supports have been used in the past few decades with practicing teachers in professional development programs seeking to improve teachers’ and novice teachers’ practice. Prospective teachers experience the complexity of teaching when they start their field experiences. In some cases, prospective teachers struggle to enact what they learned in university coursework in real classroom settings. In an effort to bridge this gap, this paper provides an innovative approach to onsite coaching in the form of modelling, along with dialogic feedback to support prospective teachers’ development of their teaching practice in their field experiences. Onsite coaching supports as described in this study, have implications on teacher learning to promote prospective teachers’ enactment and appropriation of instructional strategies from university course work in field experiences. Findings suggest that field supervisors use this onsite coaching model to support prospective teachers in developing their teaching practices in the context of practice by taking a clinical stance. This paper unpacks the appropriation cycle and provides coaching moves (e.g., types of feedback in lesson plans, planning sessions, debriefing sessions, and onsite coaching moves) by sharing representative stories of prospective teachers facilitating literacy and mathematics in general education classrooms, and by differentiating instruction for emergent bilinguals.

The Role of Professional Development in Bridging High-Quality Social-Emotional Learning in Laboratory and Community Preschools

The current study presents an exploratory model of comprehensive professional development that provides early childhood education and care teachers with opportunities to enhance their skills in social-emotional learning (SEL). Skills development strategies include a combination of workshops, observations of high-quality university laboratory preschool classrooms, consultation with master educators, on-site coaching, and communities of practice. The study found statistically significant improvements in content knowledge, knowledge of evidence-based strategies, and self-efficacy to implement new strategies in the classroom for participants of the Promoting Prosocial Behavior workshop. Teachers and administrators who participated in observations, coaching, and/or communities of practice reported value in each component of professional development. Results of this project suggest that a multipronged approach of supporting SEL in the classroom has a positive impact on teachers’ self-regulation and modeling skills.

Investigation of technical quality of antenatal and perinatal services in a nationally representative sample of health facilities in Nepal

BackgroundAccess to routine antenatal and perinatal services is improved in the last two decades in Nepal. However, gaps remain in coverage and quality of care delivered from the health facilities. This study investigated the delivery of technical quality antenatal and perinatal services from health facilities and their associated determinants in Nepal.MethodsData for this study were derived from the Nepal Health Facility Survey 2015. The World Health Organization's Service Availability and Readiness Assessment framework was adopted to assess the technical quality of antenatal and perinatal services of health facilities. Outcome variables included technical quality scores of i) 269 facilities providing antenatal services and ii) 109 facilities providing childbirth and postnatal care services (perinatal care). Technical quality scores of health facilities were estimated adapting recommended antenatal and perinatal interventions. Independent variables included locations and types of health facilities and their management functions (e.g., supervision). We conducted a linear regression analysis to identify the determinants of better technical quality of health services in health facilities. Beta coefficients were exponentiated into odds ratios (ORs) and reported with 95% confidence intervals (CIs). The significance level was set at p-value < 0.05.ResultsThe mean score of the technical quality of health facilities for each outcome variable (antenatal and perinatal services) was 0.55 (out of 1.00). Compared to province one, facilities of Madhesh province had 4% lower odds (adjusted OR = 0.96; 95%CI: 0.92, 0.99) of providing better quality antenatal services, while health facilities of Gandaki province had higher odds of providing better quality antenatal services (aOR = 1.05; 95% CI: 1.01, 1.10). Private facilities had higher odds (aOR = 1.13; 95% CI: 1.03, 1.23) of providing better quality perinatal services compared to public facilities.ConclusionsPrivate facilities provide better quality antenatal and perinatal health services than public facilities, while health facilities of Madhesh province provide poor quality perinatal services. Health system needs to implement tailored strategies, including recruiting health workers, supervision and onsite coaching and access to necessary equipment and medicine in the facilities of Madhesh province. Health system inputs (trained human resources, equipment and supplies) are needed in the public facilities. Extending the safe delivery incentive programme to the privately managed facilities could also improve access to better quality health services in Nepal.

Can virtual replace in-person coaching? Experimental evidence on teacher professional development and student learning

Virtual communication holds the promise of enabling low-cost professional development at scale, but the benefits of in-person interaction might be difficult to replicate. We report on an experiment in South Africa comparing on-site with virtual coaching of public primary school teachers. After three years, on-site coaching improved students’ English oral language and reading proficiency (0.31 and 0.13 SD, respectively). Virtual coaching had a smaller impact on English oral language proficiency (0.12 SD), no impact on English reading proficiency, and an unintended negative effect on home language literacy. The top-performing students consistently benefited most. Classroom observations show that on-site coaching improved teaching practices, while virtual coaching led to larger crowding-out of home language teaching time. Implementation and survey data suggest technology itself was not a barrier to implementation, but rather that in-person contact enabled more accountability and support.

Practice what you teach: Onsite coaching and dialogic feedback to promote the appropriation of instructional strategies

This study explores the ways in which onsite coaching during classroom observations, and dialogic feedback in debriefing sessions, supported prospective teachers’ enactment and appropriation of instructional strategies in their field placements.In this study onsite coaching provided a real-life representation of practice in the context of prospective teachers developing their teaching practice.Dialogic feedback through questioning fostered reflective dialogue and made salient and visible aspects of teaching that are sometimes overlooked by prospective teachers. Questioning also allowed prospective teachers to reflect on areas of improvement and work toward a plan to overcome difficulties they encountered in their teaching.

Positive Effect of a Successfully Implemented Model of Care on Unplanned Transfers to Hospital

Models of care have shown effectiveness in reducing unplanned transfers in nursing homes (NHs) from 11.7% to 6.1%. These include coordination of care and access to skilled medical providers such as geriatricians, specialist nurses or registered nurses with additional training. A hybrid type-2 effectiveness-implementation project (INTERCARE) was developed to improve intervention uptake and to understand the mechanisms behind results. INTERCARE consisted of six core elements and was rolled-out to 11 Swiss NHs with a stepped-wedge design allowing all NHs to receive the intervention. 942 residents were recruited (June 2018 -January 2020). INTERCARE showed a significant reduction of unplanned transfers during the intervention period compared with baseline. The successful implementation of INTERCARE relied on the use of implementation science, building on stakeholder input and careful theory-driven contextual adaptations. INTERCARE’s success was driven by registered nurses with expanded roles, on-site coaching, and the use of tools for clinical decision making.

Adapting the preschool environment to the needs of children on the autism spectrum in Sweden: A quasi-experimental study

Background Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment. Aim This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff. Material and methods In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period. Results The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant. Conclusions and significance In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI.

The community mathematics project: Using a parent tutoring program to develop sense-making skills in novice mathematics educators

Programs that provide underserved populations with access to high-quality mathematics through workshops, clubs, and classroom observations (Civil, Stoehr, & Salazar, 2019; Civil & Bernier, 2006; Diaz-Palomar, Menendez, & Civil, 2011; Jimenez-Castellanos, Ochoa, & Olivos, 2016; Muir, 2011, 2012; Quintos, Civil, & Bratton, 2019) are vital. The community mathematics project (CMP) is one such program that takes a holistic approach to transforming mathematics education. Through partnerships with local institutions, the CMP pairs a prospective teacher (PT) with a parent for online mathematics tutoring sessions. This study describes how PTs in the CMP supported parents’ mathematics development of sense-making (Odden & Russ, 2017) in mathematics by providing relevant tasks, employing multiple strategies, using virtual manipulatives, and questioning in one–one-one tutoring sessions. Findings suggest that this type of field experience with an explicit focus on a sense-making approach supported PTs in learning mathematics, engaging in partnerships with parents and members of the community, and attending broader issues of social contexts of learning. Further, PTs attended to individual considerations such as sequencing and scaffolding, relevancy of the content, task development, and building towards common mathematical practices. Finally, onsite coaching and tutoring experiences were formative in developing essential skills for teaching mathematics in elementary school in the following areas: content and pedagogical content knowledge, development of core pedagogical practices, funds of knowledge approaches and collaboration with families, and dispositions toward (teaching) mathematics such as reframing mistakes, emphasis on sense-making, and co-construction of knowledge.

An innovative intervention to improve respectful maternity care in three Districts in Ethiopia

BackgroundMistreatment of women during facility-based childbirth is a major violation of human rights and often deters women from attending skilled birth. In Ethiopia, mistreatment occurs in up to 49.4% of mothers giving birth in health facilities. This study describes the development, implementation and results of interventions to improve respectful maternity care.As part of a national initiative to reduce maternal and perinatal mortality in Ethiopia, we developed respectful maternity care training module with three core components: testimonial videos developed from key themes identified by staff as experiences of mothers, skills-building sessions on communication and onsite coaching. Respectful maternity care training was conducted in February 2017 in three districts within three regions.MethodsFacility level solutions applied to enhance the experience of care were documented. Safe Childbirth Checklist data measuring privacy and birth companion offered during labor and childbirth were collected over 27 months from 17 health centers and three hospitals. Interrupted time series and regression analysis were conducted to assess significance of improvement using secondary routinely collected programmatic data.ResultsSignificant improvement in the percentage of births with two elements of respectful maternal care—privacy and birth companionship offered— was noted in one district (with short and long-term regression coefficient of 18 and 27% respectively), while in the other two districts, results were mixed. The short-term regression coefficient in one of the districts was 26% which was not sustained in the long-term while in the other district the long-term coefficient was 77%. Testimonial videos helped providers to see their care from their clients’ perspectives, while quality improvement training and coaching helped them reflect on potential root causes for this type of treatment and develop effective solutions. This includes organizing tour to the birthing ward and allowing cultural celebrations.ConclusionThis study demonstrated effective way of improving respectful maternity care. Use of a multipronged approach, where the respectful maternity care intervention was embedded in quality improvement approach helped in enhancing respectful maternity care in a comprehensive manner.

Coaching Virtually to Support Professional Learning

Virtual coaching is emerging as a feasible method of providing ongoing, job-embedded, personalized professional learning to educators. This manuscript details how virtual coaching is different from on-site coaching in education. It describes field-tested strategies and technologies a coach can use to be successful when coaching virtually. There are key steps in the process for fully understanding an educator’s context, the students they support, building relationships, identifying locus of control, setting goals, choosing interventions, implementing change, tracking data, and engaging in reflection that are unique to coaching online. Specific technology tools can help facilitate each of these steps in the process. In this manuscript, we describe technology tools that virtual coaches used in their literacy coaching work. We organize these tools around a virtual coaching model, which was built specifically to coach educators in virtual spaces. We include a description of each phase, the technology that can be used to facilitate progress, a field-based example of its use, the time typically spent in each phase, and sample questions coaches may ask educators to support progression through the phases. In addition, we highlight current research on professional learning and virtual coaching.

An Adaptation of Multitiered Systems of Professional Development to Support Teacher Implementation of Tier 2 Behavioral Supports

General education teachers encounter challenges with behavior management that are compounded by limited experience and training on implementing targeted behavioral supports. One research-based method to support teacher implementation of behavioral interventions is on-site coaching. Unfortunately, coaching can be a time- and resource-intensive approach to professional development. The purpose of this article is to provide intervention team leaders with a step-by-step process for providing feasible coaching support to teacher implementers of Tier 2 behavioral supports.