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CHT Remote Onboarding �and Training

Overview of remote workflows with a focus on enabling COVID-19 response

April 2020

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Remote Onboarding and Training Priorities

  • Safety: Best possible option when in-person trainings are not feasible at scale
  • Speed: Time is a critical factor for COVID-19
  • Scalability: Enables a large number of users to be onboarded quickly
  • Measurability: Track completion rates and provide support where needed
  • Adaptability: Functions based on the technology, infrastructure and ecosystem already at hand, and in support of MoH protocols and approved content and messaging

The goal of the remote learning guides and templates are to provide direction and a unified approach to remote onboarding across all contexts and can be adapted and configured to suit the specific needs of partners may have for content, tooling, languages, etc.

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Remote Onboarding and Training Overview

The CHT remote training approaches can be used to onboard CHWs and Supervisors onto SMS and App workflows. We will be able to support onboarding, training, tasking and communication at scale and be able to capture: �

  • Number of users who have completed the training
  • Number of users who have started but not completed the training
  • Percent of CHWs who needed to contact their supervisor for additional support

We can also incorporate assessments into the training to ensure end user understanding.

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User Roles

l

CHWs

Roles: Complete onboarding and training via SMS or app, provide feedback and ask for support where needed.

County & National

Roles: Monitor central analytics regarding onboarding and training completion. Revisit content where needed.

CHW Supervisors

Roles: Verify CHW onboarding and training completion, follow up with those who have not. Complete their own onboarding and training tasks to new workflows.

Sub-County

Role: Review CHW progress on aggregate, support CHW supervisors, and monitor location specific analytics.

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User Devices

l

National Officials

Sub-County Teams

CHWs

Users

Most CHVs will have basic phones (SMS); some smartphones (app)

Smartphone (app)

Laptops, desktops, smartphones to monitor analytics

Devices

Location

Central Offices

Facilities or Local Office

Lives and works at community level

Details

CHW Supervisors

Smartphone (app) and personal phone

Lives at community level, based at facilities

County Teams

Laptop, desktop, smartphone to monitor analytics (app)

District Offices

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Remote Onboarding

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SMS

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Remote Onboarding: SMS Workflow

Option to request for support + Support offered if no action/response for x days

Ready to start?

Yes

Reply with “start” when you are ready

No

Begin training modules

Instructions on how to access workflow training

Manual follow up + instruction to reply with “start” when ready

No answer

Intro message from MoH + language selection (SMS/IVR)

Thank you for serving your community. We’ll guide you on how to use your app.

A draft flow can be found here

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App

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Remote Onboarding: App Workflow

Log into app

Thank you for serving your community. Log into your app as [username] with this magic link

Contact IT support to resend

Bad link?

Supervisor follow up if no action for x days

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Remote Onboarding: App MVP

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Remote Training

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SMS

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Remote Training: SMS Best Practices

  • If language options are included allow users to select their preference before beginning the flow�
  • Use a personalized welcome message before asking users to take actions
  • Keep content brief and relevant to the topic as to not overload the user �
  • Be cognizant of form collisions during assessments (ex. “0=no, 1=yes” if those numbers may also reference workflow codes, or “N=no” if “N” is the code to create a new person)�
  • Use standards in logic where possible (ex. The non-zero value is true; 0=false, 1=true, 0=no, 1=yes) �
  • Sign the first message with the partner’s name, or MOH for visibility�
  • Provide an option for additional remote support
  • If necessary, provide an option to revisit the onboarding again (ex. Text EBS to this number to receive these messages again)�
  • Make sure to capture onboarding completion, so that a supervisor may follow up where necessary
  • Training can be recurring and include refreshers on a set schedule if necessary

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Remote Training: SMS Workflow

Greeting and introduction

Workflow

Details

Topic Education Completion

Thank you for serving your community. Today you will learn...

Explanation of user role

Workflow overview

Training completion logged in CHT

If extra support needed, contact supervisor

If training not complete within x days, take additional action (nudge or follow up)

Add user name in greeting if known

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Remote Training: CHW SMS Example

Greeting and introduction

Workflow

Details

Topic Education Completion

If extra support needed, contact supervisor

If training not complete within x days, take additional action (nudge or follow up)

A detailed flow can be found here �Mockups here

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Remote Training: SMS Assessment Workflow

Greeting and introduction

Workflow

Details

Topic Education Completion

Thank you for serving your community. Today you will learn...

Explanation of �user role

Workflow overview

Training completion logged in CHT

If extra support needed, contact supervisor

If training not complete within x days, take additional action (nudge or follow up)

Lessons and Assessments

Lesson

Assessment

Overview of correct answers

Add user name in greeting if known

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Remote Training: CHW SMS Assessment Example

Greeting and introduction

Workflow

Details

Topic Education Completion

If extra support needed, contact supervisor

If training not complete within x days, take additional action (nudge or follow up)

Lessons and Assessments

A detailed flow can be found here

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App

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Remote Training: App Best Practices

  • Start SMS with a greeting, sign it with partner name or MOH. Include instructions to sync and complete upgrade task
  • Use visuals in the training modules where it may help CHWs to understand content
  • Keep content brief and relevant to the topic as to not overload the user
  • Include assessments if necessary to gauge content mastery
  • Track onboarding task completion via targets and CHW profile; notify supervisor to follow up within X days if not complete
  • Allow users to provide feedback on training content on Summary page as well as gauging their confidence levels
  • Provide a way for users to revisit content and include instructions on the summary page on how to access it again
  • Training can be recurring and include refreshers on a set schedule if necessary

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Remote Training: CHW App Overview

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Remote Training in CHW App: Sync for new training tasks

In order for CHWs to receive new training or onboarding material in the app, they will need to sync.

This can be accomplished by sending an SMS with instructions to sync the app and complete the training task.

Allow an affordance to contact supervisor or other for help additional support.

Hello, [CHW Name]. Thank you for serving your community. Your CHW app has an update. Please sync and then complete the training task. If you have any issues, contact your supervisor.�

- [Partner signature]

COVID-19 Education

Training module

Due today

No more tasks

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Remote Training in CHW App: Topic overview and modules

Introduce each topic with an overview page, outlining what the CHW will learn.

Use as many modules as necessary per topic, and visuals where possible to help CHW understanding.

Training

Learning Objectives

Know effective hand hygiene practices


Know the correct way to handle infected secretions from the nose, eyes, and mouth


Know good household hygiene practices


Know when to self-distance and self-quarantine


Know when to report a patient with suspected infection to the local health authorities

COVID-19 Education

Next >

Training

If you returned from an area where COVID-19 is spreading, stay at home for 14 days and avoid contact with others. If you experiencing any symptoms, or contact your supervisor.

Self-Quarantine

Next >

< Prev

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Remote Training in CHW App: Optional assessments

Assessments may be included in the in-app onboarding and training modules.

Answers to assessments may be displayed conditionally in context, on the next page, or in the summary.

There are psychological costs to making decisions. Since choosing can be difficult and requires effort, long sessions of decision making can lead to poor choices.

For longer training modules, consider telling the CHW if their answer is correct or incorrect immediately for better retention.

Training

Can COVID-19 can be prevented by washing our hands frequently with soap and running water or hand sanitizer?

Assessment

True

False

Next >

< Prev

Training

Assessment

Next >

< Prev

You are correct

Washing hands regularly is very important to protect yourself and others.

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Remote Training in CHW App: Summary

If a CHW completes the training with errors in their assessment, the task is regenerated and must be repeated. Allow CHWs to request assistance from supervisor if needed.

If a CHW completes the training without errors, congratulate them and provide instructions on how to revisit the content as a refresher.

We may want to ask CHWs how confident they feel in their abilities after completing the training (to provide feedback to MoH or partner) and provide additional support and follow up from supervisor on request.

Training tasks may be sent out on a schedule to refresh CHW knowledge with optional follow-up quizzes in 1 week to 1 month to gauge information retention.

Training

Submit

< Prev

Be sure you Submit to complete this action.

Thank you

Good start, but you only answered 1 out of the 2 questions correctly.

We’ll generate another task for you to go through the workflow again.

Thank you for your persistence, educating ourselves and our communities is the best way to stop covid.

Training

Submit

< Prev

Be sure you Submit to complete this action.

Thank you

You’ve answered all the questions correctly! You may review this content on your profile page.

How confident do you feel in your mastery of this content?

Extremely confident

Very confident

Somewhat confident

A little confident

Not confident at all

Will you be able to effectively perform these tasks?

Yes

No

Do you have any other questions or feedback on this topic? (Optional)

Your supervisor will follow up

Do you need assistance with this topic? (Optional)

Yes

No

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Remote Training in CHW App: Targets and Refresher Content

Adapted workflow

No

Update Summary

Yes

Training

Medic ID

65421

Age

24 years

CHW Name

Gender

Female

Phone

+123456789

Profile

Adapted workflow

Training module

Tasks

COVID-19 Education

Onboarding and training content completion are tracked as a target.

If a CHW does not complete the onboarding/ training, a notification should be sent to their supervisor to follow up.

CHWs may retake onboarding and training modules actions via their profile page.

Training modules completed

All time

Goal 100%

33%

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How To Configure

The training modules configuration consists of four main parts:

  • Forms - Content that the user will interact with.
  • Tasks - How forms are presented to user/how and when user accesses the forms for input.
  • Targets - Shows the progress of the user.
  • Contact Summary - Gives a highlight of the modules completed by the user.
  • Context - What forms are available to fill from the user’s profile.

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Forms

Forms (XLSForms) are the spreadsheets created that determine the questions/content that the user will view.

XLSForms are a simplified method of setting up form configs using Excel (or Libre Office Calc, Google sheets etc)

App forms are created in the project-folder>forms>app directory of a project.

Once the forms are setup with content, the forms are converted to XForms and then uploaded using the medic-configurer with the following command:

Medic-conf --instance=<instance> convert-app-forms upload-app-forms -- <form1> <form2>

Guidelines to create medic mobile XLSForms/XForms can be found here.

Example forms from the demo can be accessed here

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Tasks

Tasks are a set of actions available to a specific type users from the task tab, which open up a form that completes a workflow, and are available within a given timeframe.

Tasks are defined in a tasks.js file under the project folder, with each task following the task schema described here.

The required properties of a task include:

Name - unique identifier of the task

Title - displays the workflow to be completed for a contact

AppliesTo - determines if task is emitted per contact or report

ResolvedIf - conditions to mark a task as resolved/completed

Events - specifies the timeframe of a task

Actions - specifies the forms and allows injecting content from previous submissions

The following command is used to compile and upload the applications settings (tasks, targets, contact-summary, form properties)

Medic-conf --instance=<instance> compile-app-settings upload-app-settings

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Targets

Targets are a visual representation of the progress and goals of the user. These are app analytics accessed through the targets tab.

Similar to tasks, targets are defined in a targets.js file under the project folder, with each target following the targets schema described here.

The required properties of a target include:

Id - unique identifier of the target

Translation_key - title displayed for the widget

Type - type of numeric representation i.e. count/percentage

Goal - denotes how much the user should achieve

appliesTo - Determines whether a contact or a report is counted

appliesIf - condition to check whether contact or report should be counted (not required)

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Contact Summary

Contact summary displays basic information about a contact, with 3 main outputs: context, cards and fields

Contact Summary is defined in contact-summary.templated.js file under the project folder as described here.

Cards created to display completed modules. Required properties of a card include:

Label - title of the card

Fields - content of the card

Field name- title of field

Field value - value displayed for field

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Contact Summary - context

Context provides context information to app forms which are initiated from the contact's profile page

context is defined in contact-summary.templated.js file under the project folder and can be utilized in a form by defining a <form>.properties.json file for a form.

The expression on the <form>.properties.json file determines when to show the form in the "New action" menu on a contact’s profile, and can access this context information via the variable summary.

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App Adapted Workflow

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Adapted Workflow: App Best Practices

  • Start SMS with a greeting, sign it with partner name or MOH. Include instructions to sync and complete upgrade task
  • Include an Update Summary task that captures all the changes or protocol updates made to workflows
  • Track completion of Update Summary via targets and CHW profile; notify supervisor to follow up within X days if not complete
  • Update guidance in each and every protocol where new guidance is needed (ex. A reminder not to enter patient's homes without PPE should be added to child health assessment and family planning assessment protocols)

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Adapted Workflow: CHW App

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Adapted Workflow: Sync for new training tasks

In order for CHWs to receive adapted workflows and updated protocol information, they will need to sync.

This can be accomplished by sending an SMS with instructions to sync the app and complete the training task. Allow an affordance to contact supervisor or other for help additional support.

Once synced, a new training module appears in the task list.

Update summary

Training module

Due today

No more tasks

Hello, [CHW Name]. Thank you for serving your community. Your CHW app has an update. Please sync and then complete the training task. If you have any issues, contact your supervisor.�

- [Partner signature]

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Adapted Workflow:

Update summary

Introduce the update with an overview page, outlining the new protocol/workflow changes the CHW will learn.

Use as many modules as necessary per protocol (ex. Following up with PPE, without PPE, Over the phone) and visuals where possible to help CHW understanding.

Training

COVID-19 care protocols

Overview and introduction text goes here.

Update summary

Next >

Training

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

Protocol with PPE

Next >

< Prev

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Adapted Workflow: Summary

Congratulate the CHW for completing their training and provide instructions on how to revisit the content.

When a CHW completes the onboarding successfully it is captured in their targets. Status for all training material should be captured here.

If a CHW does not complete the onboarding/training, a notification should be sent to their supervisor to follow up.

Training

Submit

< Prev

Be sure you Submit to complete this action.

Thank you

Great job, you’ve completed the training for the Update Summary..

This content is available for you to review on your profile page.

If you have any additional questions or feedback, please contact your supervisor.

Training modules completed

All time

Goal 100%

33%

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Adapted Workflow:

Updated protocols

Once Update Summary task is completed, the adapted workflows with updated protocols should appear in the task list.

No more tasks

Nathan Northrup

Growth Monitoring

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Adapted Workflow:

Adapted Tasks

Tasks with adapted protocols, especially concerning CHW safety and well-being should provide guidance where possible.

For example, if a CHW is following up in person without PPE they should receive guidance to not enter the house and to ensure a safe distance from others.

Training

How are you following up?

Follow up

In person without PPE

By phone

Next >

< Prev

In person with PPE

Training

Your safety is important

Care protocol

Next >

< Prev

When assessing your patients in-person without PPE please do not enter the house.

Ensure a safe distance of 2 meters and follow no-touch protocols.

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Appendix

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Appendix