BHP-KITSO is dedicated to working with program faculty in Botswana and around the world to create innovative teaching tools to aid in training Botswana’s health professionals in HIV and AIDS care. These teaching tools include a curriculum flexible enough to accommodate the evolving needs of the country, an advanced care and treatment module, interactive CD-ROMs, a video cassette series, pill charts, pediatric dosing charts, a handbook which is ready to go to press, and other appropriate materials.
Course Binders
To assist with the implementation of AIDS Clinical Care Fundamentals and other courses BHP-KITSO produces course binders for each training that include the entire complement of lecture slides, as well as course appropriate supplementary materials such as a pill chart and pediatric dosing charts. These materials aid in the training, but also serve as valuable reference tools following the completion of the course. The pill chart has proven to be a useful tool for patient education in ARV clinics and the pediatric dosing charts aid health professionals when working with children on ARV therapy. During the period between July of 2003 and December 2004 1,094 AIDS Clinical Care Fundamentals, 297 Laboratory Fundamentals, 383 HIV and Biosafety, 55 Introduction to AIDS Clinical Care, and 18 Medication Adherence Counseling course binders were distributed to BHP-KITSO training participants. Course lectures also provide an invaluable teaching tool for the KITSO AIDS Training Program. Suggestions from previous training evaluations coupled with the requests from the Botswana Ministry of Health prompt faculty to continually evaluate and update their lecture content.
CD-ROMs
KITSO has developed three instructional CD-ROMs that are teaching tools as well as tools for distance education. Lessons from Botswana: A Comprehensive Instructional Guide on HIV and AIDS Medicine for Health Professionals was a comprehensive multi-media CD-ROM with lecture transcripts, and PowerPoint presentations linked to audio recordings of lectures delivered during early KITSO course implementations. The second CD-ROM, AIDS Clinical Care Fundamentals provides twelve PowerPoint lectures and their accompanying audio recordings. The third CD with PowerPoint lectures was produced and distributed to preceptors who implemented on-site BHP-KITSO training. Following the finalization and approval of the newly revised National ARV Guidelines, a new CD ROM will be produced for general distribution.
Case Studies
KITSO faculty members have developed case studies to reinforce course material and help participants connect their newly gained knowledge to the treatment of patients living with HIV and AIDS. These case studies are interactive exercises used to stimulate group discussion and underscore the relevance of the course material to the participants’ practice of HIV and AIDS medicine.
Pill Charts and Pediatric Dosing Charts
During 2002, under the direction of the BHP-KITSO Clinical Training Coordinator, pediatric dosing charts were developed to verify calculating correct dosages of ARV therapy for children. A pill chart pictorially depicting the first, second and third line ARV therapies outlined in the 2002 Botswana Guidelines for ARV Therapy National Program was also developed by the BHP-KITSO team. The pediatric dosing charts and pill chart are reviewed and revised by faculty regularly and are given as handouts to all participants of KITSO trainings. During the eighteen month period of July 2003-December 2004 1,132 pill charts and 1,110 pediatric dosing charts were distributed to BHP-KITSO training participants. (Appendix E: Pill Chart, Appendix F: Sample Pediatric Dosing Chart)
Teaching Tools Under Development
Handbook
KITSO will produce a handbook on HIV and AIDS care and ARV therapy that follows the twelve lectures that comprise AIDS Clinical Care Fundamentals. This handbook is currently a final draft document, due to be produced and distributed after the release of the revised national guidelines. This resource will provide a reading supplement for the AIDS Clinical Care Fundamentals course, and serve as an ongoing reference.
Continuing and Distance Education
Once trained, health professionals need regular opportunities to update their knowledge of HIV and AIDS care practices and new developments in ARV therapy. In most developed countries this on-going training is available through Continuing Medical Education (CME) programs. A future responsibility for KITSO will be to support the development of a continuing medical education program for Botswana’s health professionals.
KITSO Reference Corners and Resource Distribution
KITSO Reference Corners have been established at each of the four original ARV sites in Botswana in an effort to make up-to-date resources available to faculty and participants. KITSO Reference Corners are areas located in hospital libraries and ACHAP Resource Centers that include KITSO course materials and valuable learning, teaching, and research materials. The goal of the KITSO Reference Corners is to make resources available to trainers and health professionals to improve local care, training, and research efforts and to assist all health professionals to remain current in their field of practice. The Boston-based staff collects, reviews, procures, and distributes new materials. (Appendix G: BHP-KITSO Resource Distribution List)
Case Conference Calls
With the Botswana National ARV Program well underway, there was a need to establish a forum for health professionals involved in HIV and AIDS care to share ideas, information, and experiences. To address this need, BHP-KITSO has initiated HIV and AIDS case management conference calls for staff involved in the provision of ARV therapy in Botswana. (Appendix H: PowerPoint Presentation of Case Conference Calls)
This teleconferencing allows real-time participation and discussion on difficult case management issues and serves as a valuable means for disseminating new information on HIV and AIDS treatment, management, and care issues. Case presentations are faxed between the ARV sites beforehand—along with pertinent readings, x-rays, and laboratory reports—and discussed a few days later by conference call linking together clinicians from two or more ARV sites. Sites share the responsibility for presenting cases and leading the discussion. These calls link physicians at the ARV implementation sites with their colleagues throughout the country for Botswana-specific case discussion. These case conference calls have the potential to strengthen the uniformity of the national program, while developing the clinical acumen of physicians involved in HIV and AIDS care and ARV therapy. During this one-and-one-half year period 12 conference calls were held involving eight sites and as many as 30 physicians. To facilitate these calls, BHP-KITSO has purchased and distributed speaker phones to all operational MASA sites that provide ARV therapy in the National ARV Program (Appendix I: BHP-KITSO Paediatric Case Conference Calls Nov/Dec 2003)
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