MINILAPAROTOMY (ML/LA) TRAINING COURSE
(Standard Course: 10 days, 20 sessions)

DAY 1

DAY 2

DAY 3

A.M. (3 hours)

Welcome

Introductions

Overview of the course

• Goals
• Objectives
• Schedule
• Course materials

Identify participant expectations

Precourse Questionnaire

Discussion: Current status of FP nationally, including rationale for VS

Exercise: How People Learn

Demonstration: Using the ZOE model

• Pelvic model
• Photoset

Precourse Skill Assessment

A.M. (3 hours)

Agenda and opening activity

Discussion: Preparing to observe surgery

Exercise: How to use the learning guides (counseling, clinical and verbal anesthesia)

Demonstration by trainer: Standard minilaparotomy method using local anesthesia (ML/LA) with client

Exercise: Review trainer's demonstration

A.M. (3 hours)

Agenda and opening activity

Discussion/Demonstration: The role of the nurse/technician in surgery

Review key steps in:

• Pre-operative assessment
• Client preparation
• Standard ML/LA technique

OR Practice: Divide into 3 groups (2 physician/nurse teams/group)

Group 1: Assist/perform ML/LA

Group 2: Practice client counseling, pre-op assessment and client preparation

Participants assess each other's performance using learning guides; practice ML/LA

Group 3: Observe IP practices before and after surgery

LUNCH

LUNCH

LUNCH

P.M. (3 hours)

Exercise: Review individual and group learning needs

Discussion: Fundamentals of minilaparotomy under local anesthesia (ML/LA)

Demonstration: Interval minilaparotomy

• Photo set
• Pelvic model

Review of day's activities

Tour of the operating room

P.M. (3 hours)

Discussion: Key features of ML/LA, including:

• Client assessment
• Indications and precautions

Discussion: Pain management

Demonstration: Standard technique for local anesthesia using photo set and model

Classroom Practice: Physician/nurse teams practice ML/LA using pelvic models and learning guides

Review of day's activities

P.M. (3 hours)

Review of cases

Discussion: Family planning counseling

• Counseling skills
• Method-specific counseling
• Informed consent

Role play: Divide into teams to practice:

• Counseling ML/LA acceptor
• Verify informed choice and consent

Participants assess each other's performance using learning guide

Review of day's activities

DAY 4

DAY 5

A.M. (3 hours)

Agenda and opening activity

Review key steps in:

• Counseling
• Pain management

OR Practice:

Group 2: Assist/perform ML/LA

Group 3: Practice client counseling, pre-op assessment and client preparation

Participants assess each other's performance using learning guides; practice ML/LA

Group 1: Observe IP practices before and after surgery

A.M. (3 hours)

Agenda and opening activity

Discussion: Being prepared for emergencies

Review: recognizing and managing intraoperative problems

OR Practice:

Group 3: Assist/perform ML/LA

Group 1: Practice client counseling, pre-op assessment and client preparation

Participants assess each other's performance using learning guides, practice on model

Group 2: Observe IP practices before and after surgery

A.M. (3 hours)

Agenda and Opening Activity

Discussion: Pharmacology of drugs for pain management

OR Practice

Groups 1 and 2: Perform ML/LA

Group 3: Observe/assist

• Setting up procedure room
• Traffic flow in OR
• Surgical attire
• Decontamination of instruments/gloves
• Handling contaminated wastes

Trainers assess performance using competency-based checklist

LUNCH

LUNCH

LUNCH

P.M. (3 hours)

Review of cases

Demonstration: IP overview (videotape)

Discussion: Infection prevention for ML/LA services

Demonstration/Exercise:

• Handwashing, surgical scrub, gloving
• Surgical attire
• Handling of sharps
• Traffic flow in OR
• Setting up procedure room

Review of day's activities

P.M. (3 hours)

Review of cases

Discussion: Postpartum ML/LA

• Comparison with interval ML/LA
• Counseling and client assessment
• Recognizing and managing intra-operative problems

Demonstration: standard technique for PP ML/LA using model

Practice: PP ML/LA using model

Review of day's activities

P.M. (3 hours)

Review of cases

Demonstration/Exercise:

• Decontamination of instruments and gloves
• Handling contaminated wastes
• Instrument, glove, needle and syringe processing

Practice Session

Discussion: Postoperative recovery and followup care

Review of day's activities

DAY 7

DAY 8

DAY 9

A.M. (3 hours)

Agenda and Opening Activity

Discussion: Chapter 10

OR Practice

Groups 1 and 3: Perform ML/LA

Group 2: Observe

• Setting up procedure room
• Traffic flow in OR
• Surgical attire
• Decontamination of instruments/gloves
• Handling contaminated wastes

Trainers assess performance using competency-based checklist

A.M. (3 hours)

Agenda and Opening Activity

Discussion: Quality Service

OR Practice

Groups 2 and 3: Perform ML/LA

Group 1: Observe

• Setting up procedure room
• Traffic flow in OR
• Surgical attire
• Decontamination of instruments/gloves
• Handling contaminated wastes

Trainers assess performance using competency-based checklist

A.M. (3 hours)

Agenda and Opening Activity

OR Practice

Groups rotate according to needs of participants

Trainers assess performance for qualification using checklist

LUNCH

LUNCH

LUNCH

P.M. (3 hours)

Review of cases

Discussion: Management of complications

Discussion/Demonstration: Cardiopulmonary resuscitation (CPR)

• Video

Midcourse Questionnaire

Review of day's activities

P.M. (3 hours)

Review of cases

Discussion: Organizing and managing a VS service

• Facilities
• Equipment and supplies
• Record keeping
• Reporting
• Evaluation

Review results of Midcourse Questionnaire with group and individual participants

Review of day's activities

P.M. (3 hours)

Review of cases

Discussion: Organizing and managing a VS service

• Assessing and improving quality of VS services
• Medical standards for mobile ML/LA services

Trainers review qualification process with individual participants and plan any followup activities needed

Review of day's activities

DAY 10

A.M. (3 hours)

Agenda and Opening Activity

OR Practice

Groups rotate according to needs of participants

Trainers assess performance for qualification using checklist

LUNCH

P.M. (3 hours)

Discussion: Problems and constraints to VS service delivery in participant's own clinic setting

Course summary

Course Evaluation by participants

Closing Ceremony