Tanzania Clubfoot Care Organization offers training with practice-based learning outcomes, direct supervision, and multiple opportunities for the clubfoot providers to demonstrate competency in practice over time.
In this, the training is designed to occur in a 1 to 4 (trainer to provider) model to allow providers adequate participation and supervised practice in assessment and treatment.
Training offered by TCCO
The BPC is a two days course provided by TCCO with a focus on adult learning techniques for the training of novice providers in the treatment of idiopathic clubfoot in children less than 2 years of age.It contains clearly defined content and learning objectives for the development of required skills for the novice provider.
The training includes an introduction to clubfoot and the Ponseti method, foot anatomy and definitions, pathoanatomy, method of manipulation, applying casts, tenotomy, maintenance using Foot Abduction Braces, and identification of common problems. There are practical sessions within the training, which generally include manipulation and casting using clubfoot models and treatment demonstrations with patients where possible.
After the accomplishment of the course, Providers of the Ponseti method of clubfoot treatment will be able to:
- Explain the clubfoot deformity and the method of correction using the Ponseti technique;
- Demonstrate practical skills in treating a child under 2 years presenting with an idiopathic, previously untreated clubfoot;
- Identify more complex cases, when treatment is not progressing as would be expected and when to seek guidance with these cases.
The APC is a two days course designed to build on the knowledge, competence and opportunities for mentoring that were developed through the BPC.
The training includes refresher and advanced Ponseti for Idiopathic clubfoot, common errors in clubfoot management, recognition and treatment of atypical clubfoot, recurrent clubfoot, treating older children, secondary clubfoot, parent education, and support, and clinic quality monitoring and improvement. Practical sessions generally include refresher manipulation and casting (idiopathic clubfoot), modified manipulation and casting for atypical clubfoot, and treatment demonstrations with patients where possible.
The main objectives of this training include:
- To refresh understanding and skills in basic Ponseti treatment, and to add advanced knowledge to these
- To develop understanding and skills in non-surgical management of challenging cases such as atypical, recurrent, neglected, and secondary clubfoot
- To facilitate the exchange of knowledge through case discussion of challenging cases
- To establish a common approach to measuring and improving quality of care in clinics, to encourage reflection on what is and what is not working well in own practice/clinic setting, and to identify priority actions
- To promote consideration of how parents can be supported to promote treatment adherence during clubfoot treatment.
The Ponseti method of clubfoot correction includes the surgical transection of the Achilles tendon to correct for the equinus deformity. The Tenotomy Practice Model is designed for Physicians and Orthopaedic surgeons and Medical doctors, trained in the Ponseti Method, to practice the necessary steps involved with the tenotomy procedure. The model is designed to accurately identify anatomic landmarks both positionally and palpably.
The Parent Education and Support training is a two days training that was developed to address the need felt throughout our programs to better support parents and families in order to improve the adherence to treatment for their children with clubfoot. Through focus group discussions in Tanzania, it became clear that parents did not understand many aspects of treatment. Although parents felt encouraged when coming to the clinic, many indicated that they did not feel supported by the staff when they were worried or faced problems.
The main objective of this course is to offer solutions on how to integrate parent education into daily clinic activities for improved treatment adherence.
Supportive supervision and mentoring ‘on the job’ are needed to meaningfully build on initial skills gained in training.
- The Fellowship program is a short-term opportunity lasting from a few days to several weeks with a focus on the professional development of the fellow. In this aspect therapists who are new to the program are given the opportunity to participate in guided learning through practice in a training hospital.
- These Training are sponsored by a Tanzania clubfoot care organization seeking to expand therapists in the field.