Training of Mentors on ARV Therapy

Training of Mentors on Anti Retro Viral Therapy

Training of Mentors on Anti Retro Viral Therapy Training Report

Dr. Shabnum Sarfraz Global Fund Project Office Fatima Memorial Hospital, Shadman, Lahore, Pakistan

Fatima Memorial Hospital | Introduction

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Training of Mentors on Anti Retro Viral Therapy Contents Introduction ............................................................................................................................................ 3 Objective of Training ........................................................................................................................... 3 Specific objectives ............................................................................................................................... 3 Desired outcome of the training .......................................................................................................... 3 Selection of Audience .............................................................................................................................. 3 Defining content of Training .................................................................................................................... 4 Selection of Trainers ................................................................................................................................ 4 Training Methodology ............................................................................................................................. 6 Agenda of the Workshop ......................................................................................................................... 7 Work Shop Proceeding ............................................................................................................................ 9 Session Outline .................................................................................................................................... 9 Session 1: The Multidisciplinary Adherence Team Referral Networking to enhance ART Adherence by Dr. Tayyaba Rashid........................................................................................................................................ 9 Session 2: Demystifying HIV & AIDS - A Global Issue by Prof. Dr. Aman Ullah Khan .................................. 9 Session 3: Overview of individual presentation preparation; Assigning of topics by Dr. Shabnum Sarfraz 9 Session 4: What is Adherence? Identifying Barriers and Facilitators to Adherence by Dr. Noreen Hashmi 9 Session 5: Counseling for ARV Adherence and Psychological Management of PLHIV by Dr. Imran Ijaz Haider ................................................................................................................................................... 10 Session 6: When to start ARV? What is the first line therapy? When to Switch ART Second and Third line Regimen? by Dr. Ashraf Ali Khan ............................................................................................................ 10 Session 7: Managing the side effects and complications during ARV Therapy Lab Monitoring by Dr. Ashraf Ali Khan ...................................................................................................................................... 10 Session 8: ART for HIV/Tuberculosis co-infection by Dr. Faisal Sultan ..................................................... 10 Session 9: ART for HIV/HBV co-infection by Dr. Faisal Sultan ................................................................. 10 Session 10: PPTCT- District Model- An overview by Dr. Saira Azhar ....................................................... 11 Fatima Memorial Hospital | Introduction

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Training of Mentors on Anti Retro Viral Therapy Session 11: ART for Pregnant Women by Dr. Hammad Nazeer .............................................................. 11 Session 12: Microteach and discussions ................................................................................................ 11 Objective ........................................................................................................................................... 11 Topics of Microteach ......................................................................................................................... 12 Evaluations and Panel of Evaluators ................................................................................................... 12 Top five Mentors ............................................................................................................................... 13 Comments of Participants ..................................................................................................................... 14 Annexure............................................................................................................................................... 15 Annexure 1: List of Participants ......................................................................................................... 15 Annexure 2: Trainer’s Evaluation Form .............................................................................................. 16 Annexure 2: Trainer’s Evaluation Form .............................................................................................. 16 Annexure 3: Pictures.......................................................................................................................... 17

Fatima Memorial Hospital | Introduction

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Training of Mentors on Anti Retro Viral Therapy INTRODUCTION Objective of Training

The Training of Mentors is primarily focused on developing Mentors of Anti Retro Viral Therapy who can then further train health care providers on ART, acting as individual knowledge centers. The workshop also attempts at building a network/ liaison of health care providers who are experts in ART.

Specific objectives

This three-day intensive training covers all aspects of ARV Therapy. By the end of this training, participants will be expected to have knowledge of following topics: 1.

When to start ARV

2.

What is the first line therapy?

3.

When to switch ART-Second and Third line Regimen

4.

Managing the side effects and complications during ARV Therapy

5.

Laboratory monitoring

6.

ART for HIV/tuberculosis co-infection

7.

ART for HIV/HBV co-infection

8.

ART for Pregnant Women

9.

Counseling for ARV Therapy

Desired outcome of the training

At the end of this three-day training, the participants are expected to come out as Mentors of ART, equipped with the right knowledge, tools and material to take up further trainings of health care providers. They also have a network of ART expert specialists to fall back upon and refer to, should the need present itself.

SELECTION OF AUDIENCE Fatima Memorial Hospital | Introduction

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Training of Mentors on Anti Retro Viral Therapy A stringent criterion was established, in order to ensure that only capable, qualified and sincere participants make it to the final workshop. The participants were required to have a background in medicine and/or allied sciences, a post-graduate degree or diploma and preferably some experience in HIV/AIDS. Invitations were sent to the Principle’s Offices in Medical colleges all over Pakistan, Heads of Nursing institutions and health academies, and the CHBC centers. The final participants included Senior Doctors and Nursing Staff, belonged to the Public and Private Sector Health Institutions (Annexure: 1 List of Participants).

DEFINING CONTENT OF TRAINING Since the program was meant to inculcate the latest and most appropriate knowledge on management of an HIV-positive patient, through the stages of HIV to AIDS, the content was designed to provide a holistic approach towards the management of PLHIV and hence included the following areas: i.

In-depth knowledge of the HIV regimens

ii.

In-depth knowledge about second and third line regimens, times and indications to switch

iii.

Management of side effects and complications during ART

iv.

ART treatment along with the co-infections

v.

Specific treatment of Anti Retroviral Therapy for Pregnant Women

vi.

Role of counseling of PLHIVs

vii.

Need of Adherence in PLHIVs

SELECTION OF TRAINERS The intensive 3 days Training of Mentors on Anti Retroviral Therapy required leading experts from the Infectious Diseases background with hands on experience of managing PLHIVs and may have spoken about HIV and ARV on various forums. After an extensive research, Fatima Memorial Hospital managed to arrange the following trainers: Dr. Faisal Sultan, CEO & Consultant, Shaukat Khanum Memorial Cancer Hospital & Research Center MBBS, Diplomate American Board of Internal Medicine & Infectious Disease Fatima Memorial Hospital | Defining content of Training

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Training of Mentors on Anti Retro Viral Therapy Dr. Faisal Sultan is currently working as the Chief Executive Officer and Consultant at SKMCH&RC. He is one of the leading names among Infectious Diseases experts in Pakistan. At the moment, he is actively involved in managing PLHIVs associated with a CHBC Center in Lahore.

Dr. Syed Hammad Nazeer, Consultant, Shaukat Khanum Memorial Cancer Hospital & Research Center MBBS, Diplomate American Board of Internal Medicine & Infectious Disease Dr. Hammad is a Consultant Infectious Diseases at SKMCH&RC with hands on experience of managing PLHIVs with specific interest in managing Pregnant Women on ART. Before SKMCH&RC, he had been associated with Fatima Memorial Hospital in a similar capacity.

Dr. Ashraf Ali Khan, Consultant, Shaukat Khanum Memorial Cancer Hospital & Research Center MBBS, Diplomate American Board of Internal Medicine & Infectious Disease Dr. Ashraf Ali Khan is working as Consultant at the Internal Medicine Department in SKMCH&RC. He has extensive experience of both managing in PLHIVs here and back in USA. Dr. Noreen Rahat Hashmi, Head - Community Medicine Department, Rahbar Medical & Dental College MD, Diplomate American Board of Internal Medicine, MPH Dr. Noreen Rahat Hashmi is an expert of Internal Medicine and has dealth extensively with PLHIVs in the US during her tenure as Internist as John Hopkins. She has recently moved to Pakistan and is currently serving Rahbar Medical & Dental College as the HOD for Community Medicine Department.

Prof. Dr. Aman Ullah Khan, Technical Advisor, Nur Center for Research & Policy B.Sc., MBBS, DPH, MPH & TM, FCPS, PhD, FRSTM&H, FAPHA Prof. Dr. Aman Ullah Khan has served as the dean of College of Physician and Surgeons of Pakistan before joining Fatima Memorial Hospital. He has also served as the Professor of Institute of Public Health Pakistan. He has been involved in miscellaneous research activities on HIV/AIDS in Pakistan and abroad. He is the author of many publications.

Dr. Tayyaba Rashid, Treatment Coordinator, Punjab AIDS Control Program MBBS

Fatima Memorial Hospital | Selection of Trainers

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Training of Mentors on Anti Retro Viral Therapy Dr. Tayyaba Rashid is the lead facilitator of all the activities of Punjab AIDS Control Program. She is currently working on the model of multidisciplinary adherence through teams and referral networking to enhance ART adherence in liaison with all the ART Centers in Punjab.

Dr. Imran Ijaz Haider, Associate Professor, Head of Psychiatry Department, Fatima Memorial Hospital MBBS, DPM, MRCP Dr. Imran is the clinical psychiatrist at Fatima Memorial Hospital and one of the key people to set up an independent psychiatry unit. He is an expert in his area with hands on experience of managing PLHIVs. Dr. Saira Azhar, PPTCT Coordinator, Services Hospital Limited MBBS Dr. Saira is the PPTCT Coordinator on behalf of Punjab AIDS Control Program. She is responsible for the effective implementation of PPTCT model throughout the Punjab.

TRAINING METHODOLOGY The training sessions were interactive and participants were encouraged to reflect on the concepts and knowledge shared by the veteran trainers. With two and half days packed with these sessions, the latter half of the third day focused on micro presentations by the participants. The participants were allocated topics via blind balloting on the first day of the workshop, and briefed on the rules to follow. On the last day, they had to present their topics to a panel of seasoned professionals and they were judged on the basis of relevance, organization, preparation, class room presence and effectiveness. The ratings by the panel of judges were tabulated in real time, with the results being revealed right after the last participant’s presentation. On the basis of this evaluation the top five Mentors were chosen.

Fatima Memorial Hospital | Training Methodology

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Training of Mentors on Anti Retro Viral Therapy AGENDA OF THE WORKSHOP Day One: Friday October 5 2012 First day focused on ‘Basic Information on Adherence and ARV Therapy’ Facilitator

Session Name

Time (Name and Qualification)

Inaugural Ceremony and Group Photograph

9:00 –10:00 am

Session #1: The Multidisciplinary Adherence Team 10:00 –11:00 am

Referral Networking to enhance ART

Dr. Tayyaba Rashid

Adherence Tea/Coffee Break

11:00 –11:30 am

Session #2: Demystifying HIV & AIDS - A 11:30 –12:45 pm

Global Issue Jumma Prayers + Lunch

Prof. Dr. Aman Ullah Khan

12:45 - 02:30 pm

Session #3: Overview of individual presentation preparation;

02:30 –03:00 pm

Dr. Shabnum Sarfraz

Assigning of topics Session #4: What is Adherence?

Identifying Barriers and Facilitators to

03:00 –04:00 pm

Dr. Noreen R. Hashmi

Adherence DAY TWO: Saturday October 6 2012 Second day focused on Management of Patients on ARV Therapy Session #5: Counselling for ARV Adherence and Psychological Management of PLHIV

09:00-10:00am

Dr. Imran Ijaz Haider

Fatima Memorial Hospital | Agenda of the Workshop

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Training of Mentors on Anti Retro Viral Therapy Session #6: When to start ARV? What is the first line therapy? When to Switch ART 10:00-11:25am

Second and Third line

Dr. Ashraf Ali Khan

Regimen?

Tea Break

11:25-11:45am

Session #7: Managing the side effects and complications during ARV Therapy Lab

11:45-01:00pm

Dr. Ashraf Ali Khan

Monitoring Lunch Break

01:00-02:00pm

Session #8: ART for HIV/Tuberculosis co02:00-03:00pm

infection Tea Break

Dr. Faisal Sultan

03:00-03:10pm

Session #9: ART for HIV/HBV co-infection

03:10-04:00pm

Dr. Faisal Sultan

Day 3: Sunday October 7 2012 Third Day Focused on ARV Therapy in Pregnant Women and Children and Participant Evaluation for mentorship

Session #10: PPTCT- District Model- An 10:00-11:15am

overview Tea Break

Dr. Saira Azhar

11:15 am -11:30 am

Session #11: ART for Pregnant Women

11:30-01:00pm

Session #12: Microteach and discussions

Dr. Syed Hammad Nazeer Panel of Evaluators

02:00-03:30pm

Dr. Haroon Ihsan, Dr. Ali Razaque and Ms. Maha Rehman

Certificate distribution and Closing Ceremony

03:30-04:00pm

Fatima Memorial Hospital | Agenda of the Workshop

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Training of Mentors on Anti Retro Viral Therapy WORK SHOP PROCEEDING Session Outline

SESSION 1: THE MULTIDISCIPLINARY ADHERENCE TEAM REFERRAL NETWORKING TO ENHANCE ART ADHERENCE BY DR. TAYYABA RASHID The session primarily highlighted various aspects of ART adherence with respect to team referral networking. The role of adherence support workers was emphasized upon. Their role in improvement of patient adherence, knowledge, and understanding; provision of education and counselling in the patient's own language allows nurses and doctors to focus on other technical and clinical aspects of the patients’ treatment.

SESSION 2: DEMYSTIFYING HIV & AIDS - A GLOBAL ISSUE BY PROF. DR. AMAN ULLAH KHAN The session focused on the global and local spread of the disease todate. The disease stages along with the modes of transmission were also discussed briefly. The stigmas associated with PLHIVs were also shared in detail and the ways to remove such taboos were identified.

SESSION 3: OVERVIEW OF INDIVIDUAL PRESENTATION PREPARATION; ASSIGNING OF TOPICS BY DR. SHABNUM S ARFRAZ This was a short session outlining the guidelines and rules for the micro teach presentations. The topics for individual presentations were assigned to the participants via blind balloting. It further detailed about the expectations of the panel of evaluators and the outcome i.e. selection of five participants as Mentors for further trainings of Health Care Providers.

SESSION 4: WHAT IS ADHERENCE? IDENTIFYING BARRIERS AND FACILITATORS TO ADHERENCE BY DR. NOREEN HASHMI The session primarily focused on the importance of level of commitment towards adherence and the consequences in case of non-compliance. Effective strategies to encourage adherence and ways to counsel patients about adherence were also discussed in detail. Adherence issue of PLHIVs in Pakistan Fatima Memorial Hospital | Work Shop Proceeding

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Training of Mentors on Anti Retro Viral Therapy were also a part of discussion. The session included a group activity where participants were asked to present on various dimensions of ARV adherence and counselling.

SESSION 5: COUNSELLING FOR ARV ADHERENCE AND PSYCHOLOGICAL MANAGEMENT OF PLHIV BY DR. IMRAN I JAZ HAIDER The psychological management of PLHIVs were brought up for discussion in this session. The trainer shared the counselling aspects like listening, respect for the client, confidentiality, questioning, self decisions and help for other services, in relation to PLHIVs. The confidentiality and privacy of a PLHIV was also discussed at length.

SESSION 6: WHEN TO START ARV? WHAT IS THE FIRST LINE THERAPY? WHEN TO SWITCH ART SECOND AND THIRD LINE REGIMEN ? BY D R. ASHRAF ALI KHAN The session conferred evidence-based recommendations for ARV Therapy, identification of most effective first-line, 2nd line and subsequent regimens. The time of initiation of treatment and the importance of careful decision making for ARV initiation with evidence based timing and regimen selection were also discussed. The access of ARV Therapy in low-income countries like Pakistan was also the part of the session.

SESSION 7: MANAGING THE SIDE EFFECTS AND COMPLICATIONS DURING ARV THERAPY LAB MONITORING BY DR. ASHRAF ALI KHAN The clinical and laboratory monitoring of drugs, important toxicities, complications and adverse effects of ARV Therapy was the core of this session. Management of drug toxities were also shared by the trainer in detail.

SESSION 8: ART FOR HIV/TUBERCULOSIS CO -INFECTION BY DR. FAISAL SULTAN This session was primarily focused on HIV/TB co-infection as TB is responsible for 13% of deaths in HIV patients. The progression of HIV infection from latent to active TB was discussed in detail along with the clinical approach of TB co-infected PLHIV. The application of latest drug regimens for such co-infection was shared.

SESSION 9: ART FOR HIV/HBV CO-INFECTION BY DR. FAISAL SULTAN Fatima Memorial Hospital | Work Shop Proceeding

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Training of Mentors on Anti Retro Viral Therapy The session aimed for the finding of HIV/HBV co-infection. The aspects of counselling the patient for avoidance of alcohol, vaccination against hepatitis A (if not immune), advice on methods to prevent HBV transmission and evaluate severity of HBV infection was the main highlights of this session. The recommended testing for such co-infected patients was also discussed in detail along with the latest regimens for treatment.

SESSION 10: PPTCT- DISTRICT MODEL- AN OVERVIEW BY DR. SAIRA AZHAR This session focused PPTCT - District Model as the common modes of HIV/AIDS spread in females were the point of discussion. The trainer further elaborated about the functioning and impact of PPTCT – District Model adapted by Punjab AIDS Control Program in Punjab Province. The achievements to date of this model were also shared.

SESSION 11: ART FOR PREGNANT WOMEN BY DR. HAMMAD NAZEER The session emphasised upon the goals of Anti Retroviral Therapy to prolong life and improve quality of life, to suppress HIV below the limits of detection or as low as possible and to preserve or restore immune function with a special consideration on pregnant women. The prevention of mother to child transmission was discussed in detail along with the latest/suggested regimens of drugs for treatment purposes.

SESSION 12: MICROTEACH AND DISCUSSIONS This was the culmination of the workshop, where each participant presented on a topic allocated to him/her on day 1 of the workshop.

Objective The primary motive of the Microteach was to: a.

Give each participant a taste of being a trainer

b. Increase the interest of the participants in the workshop c.

Understand the grasp of each participant over the area he/she was allocated to present on.

The underlying objective was to see the comfort level of each participant with the position/role of a facilitator, the potential to take up future workshops in the capacity of a trainer and the effectiveness of the participant as a presenter.

Fatima Memorial Hospital | Work Shop Proceeding

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Training of Mentors on Anti Retro Viral Therapy Topics of Microteach Name

Topic

Dr Haroon Abbas

HIV/AIDS- An Introduction

Mr Afsar Ali

The Psychological impact of HIV/AIDS on Individual, Society and Family

Dr Misbah ul Arfeen Brief Introduction to ART Dr Atif Masud

When to Start ART

Dr Bushra Sana

First Line ART

Dr Fatima Rahman

Second and Third Line ART

Dr Inam ul Haq

Managing Patients with HIV TB Co Infection

Dr Khalid Mahmud

Managing Patients with HIV Hepatitis Co Infection

Ms. Saba Watto

Nursing Care for patients on ART

Dr Bushra Phool

Pregnancy and ART

Dr Safia Khan

Patient Follow-up and Monitoring ART

Dr Ayesha Nauman

Basics of Adherence

Dr Shehnila Zafar

Drug Adherence and Strategies for Compliance

Dr Fatima Imran

ARV Medications in Pakistan

Evaluations and Panel of Evaluators Presentation Evaluation was done in the latter half of the third day. Following expert judges were part of the panel of evaluators. 

Dr. Ali Razaque

(Senior Project Officer, PACP)



Dr. Haroon Ihsan

(CEO, NCRP)



Ms. Maha Rehman

(Technical Advisor, NCRP)

Fatima Memorial Hospital | Work Shop Proceeding

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Training of Mentors on Anti Retro Viral Therapy Top five Mentors Top five participants were to be chosen as the Mentors for further trainings of Health Care Providers. On the basis of the criteria mentioned earlier, five of the fourteen were awarded Mentor of the training certificates.

86

78

72

66

66

64

60

59

54

53

53

51

46

Fatima Memorial Hospital | Work Shop Proceeding

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Training of Mentors on Anti Retro Viral Therapy COMMENTS OF PARTICIPANTS Following are the comments of the participants on the concluding day, collected anonymously:

This workshop should have been over two days and should have a more detailed session about HIV basics/clinical symptoms and diagnostics involved. Videos from real life interaction of HIV patients and doctors can also be the part of this training

Overall the workshop was informative and productive

Good and valuable experience

Excellent way to express a boring looking topic but I enjoyed a lot regarding post lunch session ... a participant’s comment about Dr. Noreen R. Hashmi session on October 5, 2012

Fatima Memorial Hospital | Comments of Participants

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Training of Mentors on Anti Retro Viral Therapy ANNEXURE Annexure 1: List of Participants Name

Designation

Department

Organization

Dr Atif Masood

Senior Registrar

Medicine

Sir Ganga Ram Hospital

Dr Ayesha Nauman

Consultant

Gynaecology

Fatima Memorial Hospital

Dr Bushra Phool

Senior Registrar

Gynaecology

Fatima Memorial Hospital

Dr Bushra Sana

Assistant Professor

Medicine

Sir Ganga Ram Hospital

Dr Fatima Imran

Senior Registrar

Paediatrics

Fatima Memorial Hospital

Dr Fatima Rahman

Post Graduate Trainee

Paediatrics

Services Hospital Limited

Dr Haroon Abbas

PG Trainee

Medicine

Fatima Memorial Hospital

Dr Inam-ul-Haq

In charge Special Clinic

Medicine

Mayo Hospital Limited

Dr Jamal Nasir

Counselor

Medicine

Treatment Center, Children Complex

Dr Khalid Mahmud Khan

Associate Professor

Medicine

Sir Ganga Ram Hospital

Dr Misbah ul Arfeen

Senior Registrar

Family Medicine

Fatima Memorial Hospital

Dr Safia Khan

Senior Registrar

Paediatrics

Fatima Memorial Hospital

Dr Shehnila Zafar

Senior Registrar

Gynaecology

Fatima Memorial Hospital

Mr Afsar Ali

Nursing Instructor

Nursing

Saeeda Waheed FMH College of Nursing

Ms Saba Watto

Nursing Instructor

Nursing

Saeeda Waheed FMH College of Nursing

Fatima Memorial Hospital | Annexure

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Training of Mentors on Anti Retro Viral Therapy Annexure 2: Trainer’s Evaluation Form

TRAINERS EVALUATION FORM Training Title: Training of Mentors

Dates: October 5, 2012

Venue: Conference Room, 4th Floor, FMH College of Medicine & Dentistry, Shadman, Lahore

Training

Training of Mentors on Anti Retro Viral Therapy

Venue

Fatima Memorial Hospital, Lahore

Date

October, 2012

We are interested in developing and honing the training for future use.

Please take a minute to rate Dr. XYZ as a trainer.

Strongly

Statement

Agree

Agree

Disagree

Strongly Disagree

The trainer was knowledgeable about the subject The trainer was well-prepared about the subject Explanations were clear and concise The trainer solicited questions and had the answers The trainer was interested in sharing information and knowledge The trainer’s presentation style was interesting and effective The trainer motivated, inspired and instilled confidence Comments if any:

Fatima Memorial Hospital | Annexure

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Training of Mentors on Anti Retro Viral Therapy Annexure 3: Trainers’ Evaluation Actual

Dr. Tayyaba Rashid 15 10

Strongly Agree

5

Agree

Disagree

0 The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

The trainer motivated, inspired and instilled confidence

Strongly Disagree

Dr. Aman Ullah 15 10

Strongly Agree Agree

5

Disagree

0 The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

15

The trainer motivated, inspired and instilled confidence

Strongly Disagree

Dr. Noreen R. Hashmi

10 Strongly Agree

5

Agree

0 The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

The trainer motivated, inspired and instilled confidence

Disagree Strongly Disagree

Fatima Memorial Hospital | Annexure

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Training of Mentors on Anti Retro Viral Therapy

Dr. Imran Ijaz Haider 15 10

Strongly Agree

5

Agree

0 The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

The trainer motivated, inspired and instilled confidence

Disagree Strongly Disagree

Dr. Ashraf Ali Khan 15 10

Strongly Agree

5

Agree

0

Disagree The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

The trainer motivated, inspired and instilled confidence

Strongly Disagree

Dr. Faisal Sultan

15 10

Strongly Agree

5 0

Agree The trainer was knowledgeable about the subject

The trainer was well- Explanations were clear The trainer solicited The trainer was The trainer’s The trainer motivated, prepared about the and concise questions and had the interested in sharing presentation style was inspired and instilled subject answers information and interesting and confidence effective knowledge

Disagree

Strongly Disagree

Fatima Memorial Hospital | Annexure

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Training of Mentors on Anti Retro Viral Therapy

Dr. Saira Azhar 15 10

Strongly Agree

5

Agree

0 The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

The trainer motivated, inspired and instilled confidence

Disagree Strongly Disagree

Dr. Syed Hammad Nazeer 15 10

Strongly Agree

5

Agree

0

Disagree The trainer was The trainer was Explanations The trainer The trainer was The trainer’s presentation knowledgeable well-prepared were clear and solicited interested in about the about the concise questions and sharing style was subject subject had the answers information and interesting and knowledge effective

15

The trainer motivated, inspired and instilled confidence

Strongly Disagree

Training Program/workshop

10 5

Strongly Agree

0

Agree Objective of this Subject matter was Training will greatly Training session Participants were Facillitator(s) have training program appropriate for assist you in your duration was encouraged to good presentation adequately met your background profession/area of adequate to cover share information skills/styles, and experience work all relevant and experiences knowledge and materials grip over the subject

Disagree Strongly Disagree

Fatima Memorial Hospital | Annexure

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