CURRICULLUM CONTENT DEVELOPMENT FOR STUDENT CENTERED

LEARNING

CHE 227SUPERVISED CLINICAL EXPERIENCE (SCE) I

CREDIT UNIT: 3

DURATION: 90 HOURS

Instructional Materials

- Flip Chart
- White Board
- Projector
- Textbooks
- Checklists
- Posters
- Toolkits
- Models
- Diagnostic equipment

Teaching Method
- Lecture
- Demonstration
- Practicum
- Group Discussion using Buzz
- Brainstorming

Assessment
- Assignment – Take home/group
- Quiz
- Multiple Choice Question

Learning Objectives

At the end of the unit, the learners should be able to:

1. Describe requirements for client care including counseling

2. Explain how to carry out simple responsibilities in client care

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1. DESCRIBE REQUIREMENTS FOR CLIENT CARE INCLUDING COUNSELING

1.0. Introduction
The world population has been transformed into a single global village as a result of
improved communication skills and technological advancement in terms of rapid information
dissemination pertaining health and health-related issues. Nowadays, communities from both
urban and rural areas have much concern on safe, qualitative and affordable health care
services. To survive and improve community health in this evolving environment, CHWs as
polyvalent health care providers need to possess all necessary rudiments in order to interact
well while serving their clients.

People who seek health care for a specific problem often feel anxious. Their anxiety may be
increased by fear about potential diagnoses, possible disruption of lifestyle, and other
concerns. With this in mind, the CHWs attempt to establish rapport, put the client at ease,
encourage honest communication, make eye contact, and listen carefully to the client’s
responses to questions about health issues.

Overview of Quality Client Care in Community Health

Quality of care is “the extent to which health care services provided to individuals and patient
populations improve desired health outcomes. In order to achieve this, health care must:
a. Safe- Delivering health care that minimizes risks and harm to service users, including
avoiding preventable injuries and reducing medical errors
b. Effective- Providing services based on scientific knowledge and evidence-based
guidelines.
c. Timely-Reducing delays in providing and receiving health care
d. Efficient-Delivering health care in a manner that maximizes resource use and avoids
waste
e. Equitable-Delivering health care that does not differ in quality according to personal
characteristics such as gender, race, ethnicity, geographical location or socioeconomic
status
f. People-centred-Providing care that takes into account the preferences and aspirations
of individual service users and the culture of their community

1.0. Explain how to establish Rapport and win Clients’ confidence

Who is a Client?
Client is the term most often used as a synonym for a patient who receives health care in an
ambulatory care setting, especially when health maintenance rather than illness care is the
primary service provided.

What is Rapport?
This is one the most important features of unconscious human interaction which is described
as a state of mutual trust and responsiveness between individuals or groups of people.

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In Primary Health Care Setting, rapport refers to a friendly relationship between health care
provider and client based on mutual liking, trust, and a sense that they understand and share
each other’s concerns.

How can CHW establish an Appropriate Rapport and Winning Client’s confidence?
To establish an appropriate rapport on a client involves creating of a friendly relationship
with the patient, by simply greeting, smiling, being sympathetic etc. All these will make the
client to respond accordingly and give appropriate information.

Showing respect for a client’s cultural values and beliefs facilitates rapport and trust. Some
areas of assessment include identifying the ethnic group to which the client relates and the
customs and beliefs he/she holds about illness and health care providers.

The issue of confidentiality in clinical practice is not over-emphasized; no client wants to be

exposed. One of the ethics of medical and health profession is to ensure confidentiality of any
client, to this end; some documents especially the folders are inscribed confidential as a
constant reminder not to divulge the health status of the client.

Steps in establishing Rapport and Winning Client’s Confidence in Health Facility

Greet the client by name and title address of him/her is always best. E.g. Mr/ Ms,
Chief etc.

Introduce yourself, giving your own name .If possible, shake hands with the client. If
this is the first contact, explain your role, including your status as a student and how
you will be involved in the client’s care.

Repeat this part of the introduction on subsequent meetings until you are confident
that the client knows who you are.

It is important to be attuned to the client’s comfort. In the office or clinic, be sure

there is a suitable place other than the patient’s lap for coats and belongings.

Move any physical barriers between you and the client, such as desks or bedside
tables, out of the way

Reassure the client about the confidentiality

Give the client your undivided attention. Try not to look down to take notes or read
the chart, and spend enough time on small talk

Move any physical barriers between you and the client, such as desks or bedside
tables, out of the way.

Give the client your undivided attention. Try not to look down to take notes or read
the chart, and spend enough time on small talk

When visitors are in the room, be sure to acknowledge and greet each one in turn,
inquiring about each person’s name and relationship to the patient.

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 Whenever visitors are present, it is important for you to maintain confidentiality. Let
the client decide if visitors or family members should remain in the room, and ask for
his/her permission before conducting the interview in front of them.

Whenever visitors are present, it is important for you to maintain confidentiality. Let
the client decide if visitors or family members should remain in the room, and ask for
his/her permission before conducting the interview in front of them.

N.B: In the health care centre, after greeting the client, ask how the patient is feeling and if
you are coming at a convenient time. Look for signs of discomfort, such as frequent changes
of position or facial expressions that show pain or anxiety.

1.2. .Explain the Balanced Counseling Strategy Plus (BCS+)

Counseling is a process that enables clients to make and follow through on decisions.

What is Client-centered Counseling?

It is a non-directive form of talk therapy, meaning that it allows the client to lead the
conversation and does not attempt to steer the client in any way. This approach rests on one
vital quality: unconditional positive regard. This means that the therapist refrains from
judging the client for any reason, providing a source of complete acceptance and support.

The most notable characteristic of client-centered counseling is the use of the term “client”
rather than “patient.” Therapists who practice this type of approach see the client and
therapist as a team of equal partners rather than an expert and a patient.

Key Qualities Client-centered Counseling

Unconditional Positive Regard: as mentioned above, unconditional positive regard
is an important practice for the client-centered therapist. The therapist needs to accept
the client for who they are and provide support and care no matter what they are
going through.

Genuineness: a client-centered therapist needs to feel comfortable sharing his or her

feelings with the client. Not only will this contribute to a healthy and open
relationship between the therapist and client, but it also provides the client with a
model of good communication and shows the client that it’s okay to be vulnerable.

Empathetic Understanding: the client-centered therapist must extend empathy to the

client, both to form a positive therapeutic relationship and to act as a sort of mirror,
reflecting the client’s thoughts and feelings back to them; this will allow the client to
better understand themselves.

Meaning of Client-centered Contraceptive Services

Client-centered Contraceptive Services are defined as contraceptive care that treats each
person as a unique individual with respect, empathy and understanding. Client-centered
services involve:

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• Providing accurate, easy-to-understand information about contraception based on the
client’s needs and goals

• Asking questions, listening thoughtfully to the client’s answers and responding

appropriately

• Assisting clients in selecting a contraceptive method that is the best match for their personal
preferences

What is BCS Plus?

Balanced Counseling Strategy Plus (BCS+) is a practical, interactive, and client-friendly
counseling approach that uses job aids to facilitate family planning consultations. BCS Plus
was adapted from the original BCS that aimed at improving the quality of Family Planning
consultations, hence the term. The Balanced Counseling Strategy Plus (BCS+) toolkit, were
developed and tested in Kenya and South Africa,

BCS+ toolkit was developed by the population council as an interactive, client-friendly

approach to improve family planning counseling as well as the prevention, detection, and
treatment of STIs including HIV.

BCS+ was adapted from the BCS tool that improves contraceptive method counseling by
addressing a variety of topics relevant to FP including STIs, postpartum maternal and
newborn care, and cervical screening.

The BCS+ includes a range of components that support the needs of providers and trainers
during use of the tool, as well as clients. It comprises a Trainer’s Guide, a User’s Guide, and
three job aids: an Algorithm, Counseling Cards and Methods Brochures.

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Objectives of Balanced Counseling Strategy Plus (BCS+)
BCS+ provides the information and materials that health-care facility providers need so they
can offer complete, high-quality family planning counseling to clients living in areas with
high rates of HIV and STIs. Objectively, BCS+ focuses on the following:

▪ Promotion of Client-centered counseling

▪ Assurance of privacy and confidentiality during the counseling processes and sessions

▪ Emphasis on the client’s right to make informed and voluntary decisions

▪ Designation of the information and the tools needed to improve the effectiveness and
efficiency of consultations

▪ Simplification of decision-making and responds to the client’s needs and reproductive

intentions in family planning counselling sessions

Discuss the Tools and Job Aids Necessary for offering BCS (including Medical
Eligibility Criteria- MEC)
BCS+ Job Aids are more reliable than memory and designed to minimize trial and error and
to reduce the amount of recall necessary to perform a task.

The BCS toolkit has three main job aids, viz. the algorithm, counseling cards and
brochures as explained below:

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Pre-Choice (4stages)
Method Choice (3stages)
Post-Choice (8stages) including integration of STI/RTI activities within Family
Planning services
These cards are part of a larger publication titled The Balanced Counseling Strategy Plus: A
Toolkit for Family Planning Service Providers Working in High STI/HIV Prevalence
Settings.
The Balanced Counseling Strategy Plus Toolkit includes the following:
• Algorithm

• Counseling cards

• Method brochures

• User’s Guide

• Trainer’s Guide

• WHO Medical Eligibility Criteria Wheel

Steps in Conducting BCS+

Below are the detailed steps of the Algorithm to Guide Implementation of BCS Plus within
FP Clinic:

(a)Pre-Choice
1. Establish and maintain a warm, cordial relationship

2. Rule out pregnancy using the method card with the checklist of questions

3. Display all of the method cards. If the client wants a particular method, go to Step 7

4. Ask all the questions for this sub-section as set out in the Algorithm and set aside method
cards based on the client's response

(b) Method Choice

1. Give information on the methods that have not been set side, in order of their efficacy

2. Ask the client to choose the method that is most convenient for her/him

3. Determine if the method chosen is suitable for the client or not (contraindications), using
the brochure.

(c) Post-Choice
1. Form the client about the method, using the brochure of the method as a counselling tool

2.Determine client’s comprehension and reinforce key information if needed

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3. Make sure the client has made a definite decision and give her/him the method chosen
and/or a referral and back-up method, depending on the client’s needs

4. Discuss RTI/STI/HIV transmission and prevention

5. Conduct HIV/AIDS risk assessment. If RTI symptoms, treat syndromically and advise on
dual protection

6. Discuss and offer client opportunities for counselling and Testing for HIV

7. Give follow-up instructions, condom pamphlet and method pamphlet

8. Complete the counselling session by giving the client a follow-up appointment

1.3. Describe how to take a Medical History and examine a Client

History Taking is a procedure that involves interviewing a patient in a systematic way, in

order to acquire relevant information that will lead to basic understanding of the patient’s
problem(s). The National Standing Orders for community Health practitioners of Nigeria has
stated a systematic format for history taking, which it is based on two (2) categories of
patients and clients i.e.
a. New clients visiting for the first time/ Old client with new presenting conditions
b. Old client that comes for review or follow-up.

General Procedures of History Taking

1- Establish rapport by welcoming and greeting the client.
2- Self introduction
3- Talk with the client friendly.
4- Use simple and clear words according to educational and cultural state of the client
5- Listen to the client with interesting by using your body language such as facial
expression.
6- Keep confidentiality of the client
7- Follow the format of recording information accordingly

Types of Health History

• Complete health history
• Focused health history

Components of health history

Personal history/ biographical data
Chief complaint
Present history
Review of other systems
Previous history
Family history
Socio-economic history
Gynecological and obstetric history for woman

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 Checklist for Client Medical History Record

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1.3. Describe how to use Simple Diagnostic Tools

Overview of the Concept of Use of Simple Diagnostic Tools

The primary purpose of screening tests is to detect early disease or risk factors for disease in
large numbers of apparently healthy individuals.
The purpose of a diagnostic test is to establish the presence (or absence) of disease as a basis
for treatment decisions in symptomatic or screen positive individuals (confirmatory test).
Some of the key differences are tabled below
Diagnostic tools have the potential to support the diagnostic process. In particular, by
supporting the individuals involved in the diagnostic process and the tasks to improve
diagnostic performance and reduce the potential for diagnostic errors. Diagnostic medical
equipment and supplies help CHW to measure and observe various aspects of a client’s
health so that they can form a diagnosis. Once a diagnosis is made, the CHW can then
prescribe an appropriate treatment using standing orders.
Important Diagnostic Tools used by Community Health Workers
a. Stethoscopes are probably the most recognizable of all medical diagnostic tools. They
are used to listen to heart sounds, the lungs, and even blood flow in the arteries and
veins. Stethoscopes help diagnose:
 Pneumonia
 Bronchitis
 Heart palpitations
 Heart disease
 Arrhythmia
 Heart valve issues
 Blood pressure

b. Sphygmomanometers: evidence-based medicine has proven that the measurement of

blood pressure is important in determining the overall health of a person. The
sphygmomanometer can help diagnose:
 Diabetes
 High or low blood pressure2
 Artery hardening
 Arterial plaque
 Hypotension

c. Ophthalmoscopes are handheld tools that allow a Community Health Worker to see
into the fundus of a patient's eye. Ophthalmoscopes can help diagnose:
 Bacterial infections
 Detached retinas
 Glaucoma

d. Otoscopes are handheld devices that allow physicians to look into the ear canal and
view the tympanic membrane through the magnification lens. They help diagnose:
 Ear infections
 Tinnitus (ringing in the ears)
 Causes of vertigo or dizziness
 Meniere’s disease

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 Swimmers ear

e. Thermometers: are used in all areas and levels of care, from routine physical
exams to emergency department triage to inpatient care. There are now electronic
thermometers that shorten the time necessary to measure a patient's temperature. The
electronic ones can be set for the specific part of the body being measured, such as the
mouth, under the armpit, rectally, or the ear.

f. Malaria Rapid Diagnostic Tests ( RDTs)

Malaria rapid diagnostic tests (RDTs) assist in the diagnosis of malaria by providing
evidence of the presence of malaria parasites in human blood. RDTs are an alternative to
diagnosis based on clinical grounds or microscopy, particularly where good quality
microscopy services cannot be readily provided.

Variations occur between products, such as targets and formats, though the principles of
the tests are similar. Malaria RDTs detect specific antigens (proteins) produced by
malaria parasites in the blood of infected individuals. Some RDTs can detect only one
species (Plasmodium falciparum) while others detect multiple species (P. vivax,
P. malariae and P. ovale). Blood for the test is commonly obtained from a finger-prick.

RDTs are lateral flow immuno-chromatographic antigen-detection tests, which rely on

the capture of dye-labeled antibodies to produce a visible band on a strip of nitro-
cellulose, often encased in plastic housing, referred to as cassettes. With malaria RDTs,
the dye-labeled antibody first binds to a parasite antigen, and the resultant complex is
captured on the strip by a band of bound antibody, forming a visible line (T - test line) in
the results window. A control line (C- control line) gives information on the integrity of
the antibody-dye conjugate, but does not confirm the ability to detect parasite antigen.
RDT cassette

Inside the cassette is a strip made of filter paper and nitrocellulose. Typically, a drop of
blood is added to the RDT through one hole (A; sample well), and then a number of
drops of buffer usually through another hole (B; buffer well). Buffer carries the blood
along the length of the RDT.

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Mode of Action of Common Malaria RDT Format
1. The first step of the test procedure involves mixing the patient’s blood with a lysing
agent in a test strip or well. This ruptures the red blood cells, releasing more parasite
protein.

2. Dye-labeled antibody, specific for target antigen, is present on the lower end of
nitrocellulose strip or in a plastic well provided with the strip. Antibody, also specific for
the target antigen, is bound to the strip in a thin (test) line, and either antibody specific
for the labeled antibody, or antigen, is bound at the control line.

3. Blood and buffer, which have been placed on strip or in the well, are mixed with
labeled antibody and are drawn up the strip across the lines of bound antibody.

4. If antigen is present, some labeled antibody-antigen complex will be trapped and

accumulate on the test line. Excess-labeled antibody is trapped and accumulates on the
control line. A visible control line indicates that labeled antibody has traversed the full
length of the strip, past the test line, and that at least some free antibody remains
conjugated to the dye and that some of the capturing properties of the antibodies remain
intact.

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 5. The intensity of the test band will vary with the amount of antigen present, at least at
low parasite densities (antigen concentration), as this will determine the amount of dye
particles which will accumulate on the line. The control band intensity may decrease at
higher parasite densities, as much of the labeled antibody will have been captured by the
test band before reaching the control.

g. Glucometer is an instrument for measuring the level of glucose in the body system.
People with diabetes can also use this test to manage their condition. A blood sample is
collected either by using finger pricking or inserting a needle into the vein and drawing
it. Glucometer is used for Fasting Blood Sugar (FBS), Random Blood Sugar (RBS) Tests
as well as 2Hour Post Prandial. During the FBS, the client is instructed to fast for 12
hours before blood collection while in RBS the blood is collected after meal. The
procedure involves pricking the client’s finger and putting the blood on a glucose meter
strip. The strip is usually already inserted into the machine. The result will show on the
screen in 10 to 20 seconds. Depending on the condition and the timing of the test, client
blood sugar levels should be in the target ranges listed below:

Blood Sugar Levels in diagnosing Diabetes

Plasma Glucose Test Normal Prediabetes Diabetes

Below 11.1 mmol/l N/A 11.1 mmol/l or more

Random
Below 200 mg/dl 200 mg/dl or more
Below 6.1 mmol/l 6.1 to 6.9 mmol/l 7.0 mmol/l or more
Fasting
Below 108 mg/dl 108 to 125 mg/dl 126 mg/dl or more
Below 7.8 mmol/l 7.8 to 11.0 mmol/l 11.1 mmol/l or more
2 Hour Post-Prandial
Below 140 mg/dl 140 to 199 mg/dl 200 mg/dl or more
STUDENT ASSIGNMENT

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With the aid of the Practical Assessment Log book for training CHEW and other

relevant checklists the tutor should supervise students while conducting practicum on:

a. how to establish rapport and win the clients’ confidence examples in

a family planning clinic

b. medical history taking and examining a client

c. the use diagnostic equipment such as sphygmomanometer,

thermometer, Otoscope, ophthalmoscope, RDT and glucometer

2. SIMPLE RESPONSIBILITIES IN CLIENT CARE

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2.0. Overview of the Concept of Simple Responsibilities in Client Care

Responsibility refers to a duty, an obligation or liability for which someone is held

accountable.

Care stands for the treatment of those in need

Evidence-based Practice is defined as a problem-solving approach to the delivery of

healthcare that incorporates the best available evidence, clinicians’ expertise, and patient
values and preferences.

What are the Simple Responsibilities of CHW in Client Care?

CHW’s responsibilities are numerous and depend on the unique needs of the client at a time.
The following are some basic responsibilities of CHW in client care:

a. Communication with client

In PHC, lots of people visit in a day either from rural or urban areas. People who are not
educated required more consultation care as compared to educated ones because it’s a matter
of someone’s health. For this purpose, effective communication in the healthcare system is
necessary that can improve outcomes in the healthcare environment. CHW has the
responsibility of communicating with the patient and clears their doubt because if the
communication is not effective, the healing process will be inhibited.

b. Taking care of client safety

CHW play a vital role in patient safety through proper diagnoses and management of client
using standing orders including timely referral services.

c. Caregiving
CHW take care of their client like a mother take care of their children. The care afforded
depends on the needs & requirements of a patient. The care delivered to a client/ patient
depends on the stage of illness.

d. Acting as Teachers to client

CHWs teach clients about their health and medications including certain steps and procedures
in the management schedules

e. Acting as client‘s advocates

The use of adequate, effective, efficient available resources is among the principles of
Primary health care. This is to ensure that all clients are served with honour, respect and
dignity regardless of their cultural and socio-economic backgrounds.

2.1. Explain how to monitor the Progress of a Client

Meaning of Progress Monitoring of a Client

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Monitoring implies a continuous check of client health conditions to ensure achievement of
sound health and well-being.

Progress Monitoring refers to regular assessment of client/ patient health stutus during
therapy/ services (e.g., hourly, daily, weekly, bi-weekly, monthly etc.) with clinically sound
instruments and procedures. It increases the efficiency of services by allowing clients to get
better faster and by allocating sessions based on client/ patient need. Its measures tend to be
brief, routinely administered scales that permit CHW to evaluate and improve client
outcomes. It may help CHW to be aware of their strengths and weaknesses and to optimize
their continuing education. In PHC, when used in clinical supervision, progress monitoring
increases trainee improvement as well as client rate of change.

How to monitor the Progress of a client in Health Facility?

Health Status of a client can be monitored using pathological and clinical measures and
usually observed using instruments and procedures. The essential items used for monitoring
client progress in health facility are as follows:

 Signs: are usually assessed through vital signs, classical features of diseases and
others

 Symptoms- are evaluated via the application of disease specific checklists, standing
orders, WHO/ CDC/ NCDC case definition and management guides etc.

 Co-morbidity- using Charslon Index, ICED-index of comorbidity, adverse events

(pain, bleeding, readmission, complications)

Vital signs are physical signs that provide baseline and critical information about the
health status of a client. They are important indicators of the body’s response to physical,
environmental, and psychological stressors. Vital signs include:
▪ Temperature
▪ Pulse
▪ Respirations
▪ Blood Pressure
▪ Oxygen saturation
▪ Pain

Standing orders are a set of specific guidelines arranged by age group, disease
conditions, findings, clinical judgment and actions, which define how clients should be
cared for at the Primary Health Care Facilities. The main goal of the use of standing
orders is to ensure that quality of care at PHC level is standard, safe, uniform and cost-
effective across the nation.

Checklists for taking Vital Signs

Time allowed 10 minutes

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 TAKING TEMPERATURE, PULSE Marks Marks Remarks
AND RESPIRATION Obtainable Scored
1 Create a good rapport and Explanation of 1

purpose and procedure

2 Preparation of equipment and hand 2

washing with soap and drying

3 Preparation of site and thermometer, and 3

proper insertion.

4 Counting and recording pulse 2

5 Counting and recording of respiration 2

6 Removing and correct reading of 2

thermometer

7 Proper recording of temperature 2

8 Interpretation of result to the client 3

9 Follow-up instruction 2

1 Returning of equipment for safe keeping 1

Sub-Total 20

Time allowed 10 minutes

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 BLOOD PRESSURE ESTIMATION Marks Marks Remarks
Obtainabl Score
e d
1 Create a good rapport and Explanation of 1

purpose and procedure

2 Preparation of equipments and hand 1

washing with soap and drying

3 Testing of Sphygmomanometer and 1

Stethoscope

4 Correct connection of the tube to the 1

measuring part of the apparatus

5 Proper positioning of the client and the 2

instrument

6 Using of appropriate side of the 2

stethoscope

7 Correct taking and reading of blood 2

pressure

8 Correct recording of blood pressure 3

9 Appropriate Interpretation of result to the 3

client

1 Follow-up instruction 2

1 Returning of equipment for safe keeping 2

Sub-Total 20

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 Checklist for the Use of Standing Orders

GUIDELINES FOR EXAMINERS

Student’s No:_________________
Examiner’s Name_______________
Signature______________________
Date _________________________
Time allowed: 20 minutes
MANAGEMENT OF COMMON Marks Marks Remarks
COMPLAINTS USING STANDING Obtainabl Scored
ORDERS e
1 Create a good rapport and Explanation of 2
purpose and procedure
2 Taking complaint and opening to appropriate 3
section and page
3 Adequate history taking and recording 2

4 Hand washing with soap and water and 1

proper drying
5 Competency in the use of examination 3
instruments(diagnostic set)
6 Competency in examination and recording 6

7 Appropriate clinical judgment and action 6

from Standing Orders
8 Appropriate education on findings 5

9 Prescription of correct drugs and dosage 3

1 Appropriate instruction on medication 4

0
1 Completeness of record i.e. Signature, date 2
1 and designation
1 Instruction on follow-up visit 3
2
SUB-TOTAL 40

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2.2. Describe how to reassure a Client
A committed CHW is expected to act as a good counselor while interacting with the client.
Therefore, in order to achieve success in reassuring client, he/she must possess all required
qualities of effective communication and skills for interpersonal communication.

Effective Communication
It is a two-way traffic as each message deserves a feedback and such feedback should be
appropriate to the initial message. It requires skill to avoid misunderstanding or
misrepresentation. Hence, the message itself must be complete, concise, clear, convincing
and capable of being implemented i.e. 5 C’s’’ of communication.

Characteristics of Effective Communication

 Intonation: the pitch and volume of the sound pattern of phrases and sentences from
the communicator should have appropriate variations in the voice.

 Calmness: CHW should exhibit self-control with a calm voice so that the receiver
will think along the process of communication

 Confidence: there is feeling of trust, a belief in one’s own ability with self-assurance
so that the receiver believes the information being expressed.

 Sympathy: CHW shares the feelings, assesses the situation and cultivates affinity
towards the receiver before expressing the required message.

 Empathy: CHW develops the power of understanding and imaginatively enters into
the receiver’s feeling which will help for appropriate message transmission for the
expected feedback

 Clarity: CHW should provide clear, precise expressions for easy comprehension and
appropriate action.

 Diligence: CHW should be tolerant, even-tempered and enduring because sometimes

it takes time to convince a receiver, especially when it comes to replacing bad habits
with good ones as lifestyles are not easy to change.

Interpersonal Communication Skills have been defined as ability to work well with
people, and involve your acceptance of others, without prejudice. This does not always
mean that you like the person, but you are able to overcome your dislike in order to
achieve your tasks.

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2.3. Practicum on Monitoring the Progress of Patients and how to reassure the Client
Checklist for Family Planning Counseling
Student ID No…………………. Date……………………….
Task/ Skill Satisfac Unsatisfa Not
tory ctory Observed
GETTING READY
1.A counseling room is available
2.Ensure privacy and confidentiality during the counseling
session
3.Is respectful of the client and non-judgmental
4.Is knowledgeable about family planning
5.Listens to the client actively; gives the client complete
attention
6. Uses body language to show interest in and concern for
client
7.The client is given information on the range of family
planning methods available
8.Is brief; gives only important points about the methods
9.Uses audiovisual aids during the counseling session
10.Uses language that is easy for the client to understand
11.Encourages/ allows the client to ask questions during the
counseling session
12.Asks questions appropriately
13.Allows the client to make the choice of which method to
use
14.Once a method is chosen , takes a reproductive and
medical history
15.Performs only those physical examinations necessary for
the chosen method as a condition for receiving that
method( for example, a pelvic examination is not performed
when client selects oral contraceptives unless he/ she agrees
to one for his/her general well-being)
16.Explains/ demonstrates how to use the chosen method,
with specific, concrete instructions
17.Gives information on side effects and their management
for the chosen method
18.Instructs the client on danger signs for the chosen method
and what to do
19. Asks the client to repeat key information to ensure his/her
understanding
20. Encourages the client to return to the clinic at any time,
for any concern
21. Schedules a return visit as indicated by the chosen method
22. Records information on method chosen and provision in
the client’s chart
COMPETENCY PERFORMED SATISFACTORILY
Tutor’s Name & Signature…………………………………………..Date………………

CHE 227 SCE I SCL WFH 2020 Page 21

 STUDENT ASSIGNMENT

With the aid of the Practical Assessment Log book for training CHEW Training and

other relevant checklists the tutor should supervise students while conducting

practicum on:

a. taking client’s vital signs

b. attending to client’s conditions using standing orders

c. counseling client on family planning

References

CHE 227 SCE I SCL WFH 2020 Page 22

Canadian Psychological Association (2018) Outcomes and Progress Monitoring in
Psychotherapy. Retrieved from hppts: cpa.ca/docs/file/Task_Forces/Treatment%20
Progress% and % 20 outcome

Community Health Practitioners Registration Board of Nigeria & National Primary

Health Care Development Agency (2015). National Standing Orders for
Community Health Officers/ Community Health Extension Workers, 2015 revised
edition

CHPRBN (2015). Practical Assessment Log book for Community Health Extension Workers

DePietro M.,& Higuera V.,(2019). Blood Sugar Test. Retrieved from https://
www.healthline.com/health/blood-sugar-test# sources

Dennis M.O.A.,(2011). Dennis’s Guide for Community Health & Primary Health Care
Practice, Volume 2,1st Edition

Imarisha M., (2020). Application of Balanced Counseling Strategy (BCS) Plus in

Family Planning Consultation - PowerPoint PPT Presentation. Accessed from
https:www.slideserve.com/maris/strategy

National Primary Health Care Development Agency (2012). National Guidelines for
Development of Primary Health Care System in Nigeria, 4th Revised Edition

Nnamdi A.,(2011). CHS 409 CLINICAL SKILLS I Course Material for National Open
University of Nigeria

Rogers C.R., Lyon H. C., & Tausch R., (2013). On Becoming an Effective Teacher: Person-
centred Teaching.Psychology,Philosophy and Dialogues with Carl R. Rogers.
Routledge.p.23.ISBN 978-0-415-81698-4

United States Agency for International Development & Advancing Health in Bauchi &
Sokoto (2014). Compendium of Checklists for the Training of Medical Students,
Students of Midwifery, Nursing & Community Health in Sokoto State, Nigeria

World Health Organization (2017) 10 Ways to improve the quality of care in health facilities.
Retrieved from htpps: www.who.int/news-room/feature-stories/ detail/10-ways-to-
improve- qualiti…

WHO (2020). What is Quality of Care and why is it important? Retrieved from https://
www.who.int/maternal_child _adolescent/topics/ quality -of -
care/definition/en

WHO (2020).How malaria RDTs work. Retrieved from https// www.

who.int/malaria/areas/diagnosis/rapid-diagnostic-tests/about-rdt/en

Youngkin, E. Q., & Davis, M. S.,(2004). Women’s health: a primary care clinical guide (3rd
ed.). Upper Saddle River, NJ: Prentice Hall.

CHE 227 SCE I SCL WFH 2020 Page 23