• Course information

    Place of training
    In your mission/project
    Duration
    5.5 days (with possibility to add two to three weeks of post training clinical mentoring)
    Dates
    To be agreed on between mission and SAMU during the request process
    Number of participants
    20 maximum
    Language
    English or French (according to mission context)
    Target group
    Exclusively medical doctors, clinical officers and nurses
    Application

    To your SAMU mission HIV/TB adviser (focal point) or the SAMU learning unit clinical coordinator at ian.proudfoot@joburg.msf.org 

  • Background

    By offering an on-site training in a mission:

    • We can offer a “tailor-made” training based on specific needs of the project/mission
    • We contribute to greater access to training opportunities (especially national employees)
    • We use the project context and field work as a learning place (eg. clinical ward rounds)
    • We use programmatic data to illustrate challenges faced and ways to overcome them
    • We harness the provision of learning on-site in a project to maximise the transfer of theory to practice in the workplace
    • By doing this we speed up participant’s learning process
    • We use and build synergies from existing project and team dynamics

    We sustain learning and good practices and increase opportunities for a positive impact for the project

     A two to three week clinical mentoring/bedside teaching (with a SAMU ID specialist, Dr. Rosie Burton) can be attached to this one week training to follow and accompany participants in their learning in the workplace. This option can be made on request from the mission/project and will be assessed according to SAMU resources available.

    Who can apply?

    Currently this training is available to any projects/mission providing HIV/TB care, in both vertical HIV/TB programmes and programmes with HIV/TB integrated activities.

    • This is currently available in both English and French speaking projects/missions

    Target Group:

    This course is offered exclusively to doctors, clinical officers and nurses employed by MSF and MoH with clinical responsibilities in HIV/TB in public facilities within MSF-supported projects. It is offered to selected staff within the project/mission with the option of inviting a few applicants from within the country/region as long as they have similar clinical experience.

    • At least four months current clinical experience in HIV management (not just TB) is required
    • English or French fluency (at least level B2 according to the standard MSF fluency guide) is essential according to the language in which the course is being conducted

  • Objectives

    General Objective:

    • This HIV & TB clinical training, in the field, contributes to provide quality HIV and TB care within a resource limited context.

    Intermediary Objective:

    • To increase clinical knowledge and competencies in HIV-related disease seen in primary care clinic and district hospital settings, through classroom-based study.

  • Content

    This is primarily a clinical not a programmatic course. However, where appropriate to the clinical learning, programmatic elements can be incorporated.

    Drawing from a large database of training materials, a default package has been designed, based on the current needs and training experiences in the MSF HIV projects.

    The main added value of on-site training is to propose tailor-made content adapted to the project context and to the participants’ needs. Therefore, modification of this standard package will be made according to a needs analysis, and the content will be streamlined according to identified priorities. In addition to defining the learning objectives, this analysis will also choose the target group of clinicians for the training.

    This will be a collaborative work, well in advance, between the HIV/TB managers of the mission/project, the intended participants and the SAMU HIV/TB advisor.

    Basic (default) package modules

    • Advanced disease patient systematic exam and main OI’s
    • Neuro - red flags, including confusion, and a persisting headache
    • When to refer?
    • Renal disease
    • Dermatology
    • TB diagnostic difficulties – adults and children
    • Treatment failure – clinical and programmatic elements
    • IRIS
    • PMTCT – clinical and programmatic elements
    • Drug-induced liver impairment
    • Liver - drug-drug interactions, hepatitis

    Opportunistic infections (including TB)

    • Smear negative TB
    • Drug resistant TB
    • Complications of combined HIV & TB treatment

    Systems HIV disease

    • Neurology (Space occupying lesions, meningitis, encephalitis and dementia, vasculitis  ,peripheral neuropathies)
    • Respiratory (PCP, Bacterial pneumonia)
    • Hepatology (Hepatitis B, drug induced liver impairment)
    • Gastroenterology (acute vs chronic diarrhoea)
    • Nephrology (including HIVAN)
    • Haematology (cytopaenias)
    • Dermatology (severe adverse drug reactions)
    • Ophthalmology optional  (common presentations including ophthalmic zoster and CMV retinitis)

    Antiretroviral therapy (ART)

    • Serious ART toxicities (especially nevirapine-related)
    • Immune reconstitution inflammatory syndrome (IRIS)
    • Recognition of adherence vs drug resistance problems and appropriate management
    • Managing complex adherence issues

    Paediatrics (restricted)

    • TB in an HIV positive child
    • Acute pneumonia (including PCP) in HIV positive child
    • Initiation of ART in a child
    • Management of adherence challenges in paediatric  ART

    Radiology

    • Recognition of chest X-ray features of TB, PCP, LIP, KS and pneumonia in HIV positive adults and children.

  • Facilitators and Methodology

    Trainers:
    The course is overseen only by the SAMU HIV/TB advisor and, when needed, the SAMU training coordinator. Trainers are chosen in collaboration with the on-site team where the training is occurring. The options comprise the SAMU clinical training coordinator, the SAMU HIV/TB advisor, experienced local staff, and other experienced external specialist clinicians when possible.

    Pedagogic Approach:

    • Interactive methodologies, clinical case history review, group and individual work.
    • The core of the training week is interactive learning in a classroom but bedside or outpatient teaching should be incorporated into the training whenever possible. The group as a peer to peer source of learning, and the presenters as learning facilitators are also important pillars of the proposed teaching method.