Box 2.6

Answering tough questions: practice does make a difference

By Amy Corneli, Stella Kirkendale, Monique Mueller, and Christina Wong, Family Health International

Before the FEM-PrEP trial launched, we developed fact sheets explaining the trial and major concepts, such as pre-exposure prophylaxis (PrEP). During our regular staff trainings, initial CAB trainings and subsequent refresher trainings at our FEM-PrEP sites, we review these fact sheets as a group. We ask staff and CAB members if anyone can explain certain concepts mentioned in the fact sheets—such as randomization and risk-reduction counseling—and we answer any questions that come up.

However, we have found that reviewing the fact sheets is not enough for staff to truly absorb the material. Therefore, we developed a series of additional training techniques to help them practice answering difficult questions and to get feedback from their colleagues.

Identifying questions, trying out answers. After they review the fact sheets, we give each person a worksheet with a list of difficult questions (e.g., “By giving women this product to use, are you discouraging them from using condoms?“). After writing down their answers on the worksheets, they read their answers aloud, while the others in the group provide feedback. The group discusses what was answered well, what may be incorrect, and what information should be included if the same question is asked in the future.

Practicing answers in small groups. The staff divides into groups of three and practices answering questions from our list of “Thirty Tough Questions” (see Appendix 2.3 for the full list). The list of questions is cut into strips of paper, with one question on each strip, and placed in a bag or a hat. One participant chooses a question from the bag and asks the question (acting like a community member), one person answers the question, and the third person observes and provides constructive feedback. The observer refers to the fact sheets to ensure that information on that topic is covered by the person who answers the question.

Perfecting answers in the large group. Staff members practice answering the questions in front of the group. Each individual is encouraged to come to the front of the group at least once to choose a question out of the bag and respond.

After these exercises, the answers improve tremendously. Getting feedback from their peers helps people refine their answers. With practice, all staff and CAB members think about how to break down the complexity of the trial concepts and develop simple ways to remember all the details and answer a question comfortably. Over time, the answers become clearer and more comprehensive.