# Training of the trainer for health professionals: sharing experience from Turkey to Tanzania

## TL;DR

This paper describes a successful trainer development program for Tanzanian physicians to improve disaster management training using a structured approach.

## Contribution

A role-adapted train-the-trainer program for physicians in low-resource settings using the ADDIE framework.

## Key findings

- Participants achieved high post-training scores and valued scenario-based learning.
- Emergency medicine specialists prioritized leadership skills while general practitioners emphasized educational strategies.
- The program was feasible and well-received but requires follow-up to assess long-term impact.

## Abstract

Effective disaster management requires healthcare professionals to function not only as responders but also as trainers who can disseminate knowledge and skills. In low-resource settings such as Tanzania, structured train-the-trainer (ToT) programs tailored to physicians remain limited. This study aimed to design, implement, and evaluate a trainer development program for Tanzanian emergency medicine physicians using the ADDIE instructional design framework to transparently link needs assessment to role-adapted objectives, learning activities, and evaluation.

A mixed-methods design was applied, combining pre-training surveys, post-training assessments, and thematic feedback analysis. The program, conducted on 21–22 November 2024 at the Urla International Emergency Disaster Training and Simulation Centre, followed the ADDIE model (Analysis, Design, Development, Implementation, Evaluation). Twenty Tanzanian physicians (mean age 35.9 years, 60% female, mean experience 8.2 years) participated. Participants were grouped as Emergency Medicine Specialists/Medical Officers (n=8) and General Practitioners/Resident Physicians (n=12), with tailored objectives focusing on leadership, teamwork, disaster planning, and trainer skills.

Participants achieved a mean post-training MCQ score of 17.68 out of 20, corresponding to an overall correct response rate of 88.4%. Scenario-based and interactive learning methods were highly valued, while insufficient training duration and limited technical infrastructure were identified as challenges. Emergency medicine specialists prioritized leadership and coordination skills, whereas general practitioners and residents emphasized educational strategies and program development.

The program was feasible and well received, and participants achieved high immediate post-course knowledge scores and reported strong perceived value of scenario-based and trainer-focused learning activities. The findings support role-adapted ToT models for physicians; however, objective measurement of educator and leadership competencies and follow-up assessment of cascade training implementation are needed to determine sustained trainer development.