Tips for Designing Cascade Training

We have identified five factors to consider in the design of awareness building and training events using the Frailty360 resources.  

These are: mix of learners, group size, expected outcomes, style of the event (including duration and facilities) and finally the number and background of the trainers & facilitators:

 1. Mix of learners: 

  • Tier 1 -> Tier 3
  • Single staff group -> multi-professional
  • Narrow experience band -> wide grade range
  • Single organisation -> multi-agency
  • Single care setting -> cross-sector
  • Local area -> regional

 The vast majority of the training to date has been delivered to multi-disciplinary groups, with participants frequently coming from different local organisations.  The design of the modules aims to encourage collaboration and integrated working, as well as providing opportunities for individuals with different backgrounds to network and gain insight into other parts of their health and care systems.  Whilst the training will benefit single discipline teams from one organisation, the impact is even greater when events are run with more diverse local groups.

The Frailty360 modules have been developed for use with both tier 1, tier 2 and in some instances tier 3 practitioners as defined in the Draft Frailty Core Capabilities Framework. 

2. Group size:

  • Learner led / solo learning (e.g., 1)
  • Team-based or small group (e.g., up to 12)
  • Workshop / classroom (e.g., up to 50)
  • “Lecture theatre” (e.g., 50 - 100+)
  • Conference style (e.g., 100++)

Sessions have been run for groups of 2 to around 50, although the presentational materials are suitable for larger audiences as well.  The interactive nature of the modules means they lend themselves to group working, whilst FrailtySIM has been developed to support 'learner led' training.

3. Expected outcome:

  • Awareness and knowledge building
  • Understanding and application
  • Analysis, synthesis and evaluation

 The Frailty360 modules directly support many of the capabilities within the Draft Frailty Core Capabilities Framework.   Local Trainers are encouraged to familiarise themselves with the Core Capabilities Framework when putting together their cascade training.  In particular they should consider what tier their participants represent, the capabilities that need developing and hence the outcomes that they are aiming to achieve.

4. Style, Duration & Facilities:

  • “High tech” or “low tech”
  • Level and nature of interactivity
  • Level of contextualisation or localisation required
  • “Drop in” sessions -> whole day events

The Frailty360 resources have been used  have been used to deliver a wide variety of training and awareness building sessions, from 30-60 minute immersive introductory sessions using FrailtySIM and/or the quiz, through to whole day events designed for “Local Champions”.  Two, three and four hour formats have also been used. Sessions have been run from care home lounges to large conference facilities.  The modular nature of the resources and mix of high and low tech methods means that the approach can be customised to meet the local training opportunity and facilities.

5. Trainers & facilitators:

  • Number and experience
  • Internal or external
  • Level of Subject Matter Expertise

Local Trainers have come from a wide range of backgrounds.  Most work directly with older people and had an existing interest and focus on frailty.  However, the resources are designed to make it as easy as possible for training staff who may not have the same level of direct experience of supporting older people with frailty to deliver the presentational aspects and facilitate the interactive sessions and exercises.  Matching trainer / facilitator experience and expertise to the participants is important to ensure that the trainer feels confident they will be able to handle most questions that are likely to be raised.


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