Developing Training Modules for Foreign Trained Health Professionals and Unregulated Health Workers

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Four Ontario public health organizations (Toronto Public Health, City of Hamilton Public Health Services, Sudbury & District Health Unit and the Ontario Public Health Association) recently collaborated on an initiative to e-learning modules intended to build capacity in and increase familiarity with the Ontario public health system. The modules introduce key public health topics, theory, concepts and practices, as well as the links between them. Module topics cover:training-modules-1

  • Mapping the public health system;
  • Social determinants of health;
  • Advocacy and healthy public policy; and
  • Building partnerships and collaborations.

Once the pilot testing of these modules is complete and feedback from participants incorporated into these modules, they will be disseminated to broader public health and academic communities.

The modules were developed to meet the needs of two quite different target populations:

  • Internationally trained professionals, who have a professional degree, post secondary diploma or trade certificate from a country outside of Canada, and
  • Unregulated health workers who are hired by the health unit for public health work but who may not have any formal public health training and may not have a post-secondary degree.

The development process began with a literature review to determine best practices for developing web based learning for target populations who may not have English as their first language. An additional challenge was posed by the potential different levels of education of the two target groups.

The modules build on learners’ knowledge as their public health experience grows (using the constructivist theory of learning), and include learning objectives at the beginning of each section, exercises to enhance understanding of the concepts, self-tests at the end or each module and optional enrichment exercises for more in-depth learning.

Design features specific to the target population included decreasing distractions by placing references and websites that support content at the end of each module and minimizing navigational tools.

The pilot process included recruiting learners from the target communities, and collecting demographic information, baseline and learning outcomes data via surveys and a post-learning interview. Collected information examined what participants liked and disliked about the modules and their content, whether they felt that the information was useful to their daily work, and suggestions for improvement. This information was used to further develop the modules prior to launching to a wider audience.

Best Practices in Developing Web Based Learning Modules for Low English Literacy

Write Actionable Content

  • Put the most important information first
  • Write in plain language
  • Use the first person voice - “you”
  • Limit paragraph size to under three sentences; use bullets and short lists
  • Use meaningful headings
  • training-modules-2
  • Use at least a 12 point font
  • Use white space and avoid clutter Use bold colours and contrast
  • Avoid dark backgrounds

Organize content and simplify navigation

  • Use labels to reflect words users know
  • Easy-to-access home and menu pages
  • Use linear information paths
  • Use previous and next buttons
  • Include simple search options
  • Limit links
  • Use visual features to keep interest and help navigation
  • Avoid dense text
  • Avoid scrolling
  • Use previous and next buttons

Lessons Learned

The project team recommended the following for future projects:

  • Assessing literacy levels of the target groups (using tests such as the Rapid Estimate of Adult Literacy in Medicine or the Wide Range Achievement Test) prior to developing content.
  • Working with literacy or communication experts.
  • Educating reviewers about how low-literacy writing differs from academic writing.
  • Understanding that content development, achieving software familiarity and dissemination take time.
  • Designing the learning software to assist with development and understanding how learners use the modules.
  • Recruiting members of the target audience can be full of unforeseen challenges.
  • Marketing the project has to be tailored to the needs of each health unit.
  • Involving the advisory committee at a greater level of participation.

The project is currently examining the pilot project results and is in the process of finalizing the modules for wider dissemination.

Reference: Cava, Maureen and Parker, Heather. Building Public Health Capacity for Unregulated Health Workers (UHW)/Internationally Trained/Educated Health Professionals (ITHP). Exchange Working Paper Series, Volume 3, Number 2. University of Ottawa, Ottawa, Canada. Available