App-based Versus Slide-based Inter-grader Agreement (IGA) Test for Trachoma Graders

Trachoma graders are currently trained using either slide- or app-based testing systems. The investigators want to formally assess whether the app-based training and testing system leads to better field-based diagnosis than the slide-based training and testing system. The investigators will also ask participants for their views on acceptability of the two systems and conduct a cost-consequences analysis of the two systems. Objectives and approach: 1.1 To compare the two classroom IGA tests (app-based and slides-based) in terms of their ability to predict trainee success in the field IGA test. 1.2 To assess whether the kappa score threshold for the classroom IGA tests is appropriate. 1.3 To conduct a cost-consequences analysis of the training systems in order to effectively target the use of an app-based assessment and training system. 1.4 To investigate whether grader trainee characteristics have an impact on trainee performance in the IGA tests. 1.5 To obtain feedback on the app-based system's usability and acceptability. 1.6 To compare the two classroom IGA training methods (app-based and slides-based) in terms of classroom IGA test (app-based and slides-based) outcome and field IGA test outcome.