| Adult learning |
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| Adults want to know why they need to learn something. |
Lessons on foundations of adult learning, to help participants understand the strategies behind the curriculum design Practical, performance-based content for technical, operational, and adult-learning topics
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| Adults need to learn experientially. |
Interactive small group work Activities to apply knowledge Minimal theoretical lectures
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| Adults approach learning as problem solving. |
Daily sessions to review content from the trainer’s point of view, such as tips for explaining confusing content Scenario-based exercises and role plays
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| Adults learn best when the topic is of immediate value. |
Use of local examples and data Action planning: developing field training plans Handling challenging situations handout to support trainers when managing problem participants
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| TOT |
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| Method of training must be experiential and reflective |
Interactive sessions, simulating the work environment Teachback sessions to provide the opportunity to practice teaching in a safe-fail environment and receive constructive feedback from master trainers and peers Participant individual development plans, to self-reflect and develop a plan to improve their teaching skills Multiple training events at the health facility level, which reinforced training skills while diffusing the knowledge
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| Training content and delivery method must be open to reinterpretation |
Participant and instructor training materials provided in easily editable format, while at the same time adhering to national immunization policy standards Class discussions to identify ways to localize content Guidelines to help trainers choose best training delivery strategy
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| Expertise must be diffused through the system |
Peer and mentor feedback during and after the workshop Participant action plans for delivery to health facility level National, regional, and district-level supervision and mentoring Accountability to next level of the system via field reports
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| Involve a cross-section of stakeholders |
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| Decentralize responsibilities within the cascade structure |
Responsibilities diffused as TOT was rolled out; ultimate responsibility was at the district level Periodic and on-demand support from national and regional Expanded Programme on Immunization experts Distance-based support by adult learning expert
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