Review article

The training of trainers for the rehabilitation based on Community: distinctive features

Odilkys Cala Hernández^{1  *} 
http://orcid.org/0000-0003-4616-3131

Xiomara Sánchez Valdés² 
http://orcid.org/0000-0002-4518-2333

Tania Yakelyn Cala Peguero² 
http://orcid.org/0000-0003-1172-9182

¹ Centro Provincial de Genética Médica en Pinar del Río. Cuba

² Universidad de Pinar del Río "Hermanos Saíz Montes de Oca". Cuba

ABSTRACT

The role of the relationship between the university and society is decisive for the accomplishment of Sustainable Developments Goals. The Community- Based Rehabilitation project for children and young people with severe and deep intellectual disability in five municipalities of Pinar del Rio province (2001-2018), sponsored by the non-governmental organization Humanity & Inclusion, which is a standard for the inclusion of the university in the process of instruction for Community- Based Rehabilitation trainers, however, a great theoretical allocation on the subject has been observed. The present review is aimed at characterizing the instruction process for Community- Based Rehabilitation trainers as a starting point for the generalization of this experience in other parts of the country. A content analysis was carried out in the documents extracted from primary sources with the help of Google Academic and Redalyc. The keywords instructions for trainers and Community- Based Rehabilitation were used for this purpose. As a result, the main features of the instruction process for community-Based Rehabilitation trainers were determined and the relationships between them, deepening on the instruction process for Community- Based Rehabilitation trainers, different views of the Community- Based Rehabilitation trainers and people to whom the training process was aimed were analyzed.

Keywords: disability; community-based; rehabilitation; Humanity & Inclusion; instruction for trainers; university

Introduction

The necessary commitment of universities with society, within the framework of the centenary of the Reformation of Cordova, before a sociopolitical and economic more complex scenario, places the formative processes as standard in achieving the 17 objectives of Sustainable development of Agenda 2030, especially the objective four , related to ensuring a just, equitable, inclusive quality education and promote learning opportunities for life "for all"^{(OEI, 2010)}.

In close relationship, objective 11 demands to achieve cities and human settlements more inclusive, secure, resilient and sustainable ^{(OEI, 2010)}. The fact of the objectives to meet to be "for all" and in different community, contexts exposes the reality of the most vulnerable sectors and makes visible the role of higher education as a factor of social transformation, a public good, strategic, a duty of the State, a human right.

In Cuba, "the social responsibility of universities involves constant innovation of its management models (...), in order to achieve its impact on communities, society and the environment contribute increasingly to the progress, welfare and the sustainable and inclusive human development"^{(Diaz Canel , Alarcon & Saborido , 2020, p. 3)}.

The University of Pinar del Río "Hermanos Saíz Montes de Oca", encourages the university management of knowledge and innovation for sustainable local development, which calls for I + D + ia projects to integration and training in a pyramid to the extent of the needs of local development. One of the needs identified in the Pinar del Río context is the systematization of the experiences of community-based rehabilitation of children and young people with severe and profound intellectual disabilities; a reality that has been an essential objective of an intersectoral and interdisciplinary project sponsored by the non-governmental organizationHumanity & Inclusion (formerly Handicap International), with permanence in Cuba since 1998.

The project Rehabilitation Based in the Community (RBC) , children and youth with severe and profound intellectual disabilities in five municipalities of Pinar de Rio (2001-2018), acknowledges that it has had an impact on the training of trainers, with experience that are shared with other provinces such as Granma and Holguín; thus, it champions the incorporation of the University from the analysis of common objectives of the indicators in the initial training processes, with the insertion of the contents related to CBR in the curricular mesh of the Special Education and Speech Therapy Education careers.

Professionals from the Special Education department of the University of Pinar del Río "Hermanos Saiz Montes de Oca" have also contributed to training for CBR in postgraduate studies in different specialties and to training community leaders. However, when making an analysis of the training of trainers as part of CBR projects in Cuba ^{(Licourt, Valle and Cala, 2019)}, there is no evidence of a defined theoretical position of the term, not is it described how to carry it out methodologically in different municipalities, dissimilar local contexts, nor the role of the university in this process.

On the one hand, the term training of trainers is understood from the role of universities in the training of future teachers and of those responsible for training processes as analyzed in the works of^{Díaz, Haapakorpi , Sarkijarvi - Martínez and Virtanen (2015)};^{Ferrada -Sullivan (2017)};^{Jiménez-Mayorga and González-Ocampo (2018)} among others. On the other hand, a distinction is made between initial or undergraduate training and permanent or postgraduate training beyond teaching institutions, which includes companies and other objectives ^{(Tejada, 2002}; ^{Moreno, 2007};^{Aznar, Ull, Piñero and Martínez-Agut, 2017)}. Other theoretical position draws attention to the role in this of innovation and projects ^{(Vaillant, 2002)}; the role of international teams; of the training of researchers ^{(Moreno, 2007)} or focused on non-formal contexts ^{(Souto, s / f};^{Souto-Seijo, Estévez, Iglesias, and González- Sanmamed, 2020)}.

Based on the theoretical starting assumptions of each author and their interests in practice, it also differs as to who the trainer is and to whom the training process is directed, what is the methodology, the routes used, the obstacles to overcome and the influence of the context on the variability of position taking. Given the multiple views towards the category of training of trainers and the practical need to improve this process as part of the CBR in Pinar del Río, the present review work is carried out that aims to characterize the training of trainers for rehabilitation, community - based starting point for improving the experience lived in five municipalities of Pinar de Rio, necessary for their progressive generalization.

Developing

Diversity of views on training: a higher category

It is the consensus of several authors ^{(Figuerola, 2016}; ^{González, 2016)}the limitations, interpretation and even reductionism ^{(González, 2016)} in which the definition of the training category is found. It is not the essential objective of this work to solve this theoretical controversy; However, given that it constitutes a superior category from which the category formation of trainers emanates, cacophonic and somewhat tautological in itself, it is necessary to take a position with respect to its definition and dimensions, as a starting point to fulfill the objective provided.

With its appearance registered in the year 1206, the term training first arises within philosophical ideas and later it is welcomed as a pedagogical category ^{(González, 2016)}. Sometimes, it appears correlated with education and its systemic character is identified in the influence of the most transcendent personality traits of all members of a society ^{(Álvarez, 1998)}. For ^{Chávez (2002)}, more linked to the regularities of the educational process that is at its base, draws attention to the conditioning of the human being and the community with a conditioned historical character.

For their part, ^{López, Esteva, Rosés, Chávez, Valera and Ruíz (2003)}situate training as "the orientation of development towards the achievement of educational objectives" (p.58). These positions offer mobility in the analysis of the training category; they provide a constant process of social commitment, historically conditioned and contextual.

From this analysis, the Cuban authors identify "(…) as a determining factor the educational action in the environment: family, school and the entire social context, which in very different ways influence the being in training" ^{(López,et al., 2003)}. This argument positions and defends the bio psychosocial character of the human being , at the same time that it reveals the non-formal possibilities of training, outside of educational institutions, but with an externality revealed as it is a category subordinate to education; the end, as such, then requires an intention, without disregarding the subjective complex that is woven within individuals and that are the result of the human work that has preceded it in all its historical-cultural dimension.

However, rethinking the complexity of the educational process, from the transforming needs, both individual and collective, it suggests analyzing education-training as dialectical categories that are conditioned on the Educative praxis, also called fact, act or educative phenomenon. For ^{Ferrada-Sullivan (2017, p.9)}, "the educational act or the dialogical encounter between teachers and learners does not question but the foundations that must be looked at again in education in the 21st century".

Given this complexity institutionalized nuances (school and extracurricular) training in educational processes designed in some way as the historical moment, the ruling class, the period of development in which the individual and coexistence are, not always peaceful, of an influence on the outskirts of this conception with a cultural diversity are revealed.

In this interaction, training manifests itself dialectically with development ^{(López,et al., 2003)}; in this way, the formation with "surnames" ^{(Díaz, 2003)} appears, sometimes trapped, which on the one hand reduce, but on the other allow the study and deepening of a stage. From this perspective, a process can be modeled and objectives measured, without disregarding that the training category transcends a moment, stage or period of development.

Thus, there is initial or undergraduate training, permanent or postgraduate training^{(Horruitiner, 2008)}, university ^{(Figuerola, 2016)}, training in and for the company ^{(Tejada, 2002)}, among others; However, assuming the training process in a permanent, conscious and continuous way must systematically include initial training, for employment and postgraduate training. From this analysis, it is significant not to reduce training to the result, to the culmination of a stage that is expressed in certificates or degrees issued, or to the value induced of the training process from external influence; can the active role of the subject be hyperbolized, nor can we ignore it. It is about unraveling the object, the subject and the result in the training category, in line with ^{González (2016)}.

According to this perspective, the concept must be analyzed from different observation points; to do this you need to identify the fundamental dimensions. The considerations that appear below are made based on the publications of the aforementioned authors, without taking into account the field of action in which they work within the training process, only their theoretical position.

There is a coincidence to consider as the first dimension the instructive one, referring to the domain of a branch of knowledge ^{(Álvarez, 1998)}, to the knowledge necessary for professional performance^{(Horruitiner, 2008)}, the acquisition of knowledge, skills and their correspondence with the training needs; although it also appears as an informative dimension^{(Vaillant, 2002)}; as a pedagogical dimension and as aspects or cognitive dimension ^{(Aznar, Ull, Piñero and Martínez-Agut, 2017)}.

There is a uniformity to the need to take into account what an individual must know, in a given time, for a specific purpose (given the accumulation and production of current knowledge and the state of need), access to it and sustainability, an important criterion because it refers to the continuity of the process.

Secondly, by coincidence of criteria, there is the development dimension, understood as a process and result of training capable men ^{(Álvarez, 1998)}; Its essence is the link between study and work ^{(Horruitiner, 2008)} and a more specific variant is the developer dimension in research that is linked to the effectiveness in professional performance and the impact on the activities carried out by the trainer in their contribution to the transformation of an innovative environment . Related to this position of the theoretical-practical, investigative link,^{Vaillant (2002)}calls the practical dimension to the transfer of knowledge for the understanding and resolution of concrete situations.

On the other hand,^{Aznar, Ull, Piñero and Martínez-Agut (2017)}propose a procedural dimension that refers to how to do, mastery of techniques, methods, the level of application of knowledge and the skills developed. From different ways of seeing, there are coinciding points that are related to the application of knowledge and skills in concrete practical situations to be solved, know-how necessary for the satisfaction of needs and for the innovative transformation of the object in which one interacts.

Another dimension exposed is the educator ^{(Álvarez, 1998)}, understood as a process and a result of forming in men their spirit, feelings and convictions; or educational dimension, related to educational work, which must encompass the entire system of influences that is exerted on the young person in the period under analysis^{(Horruitiner, 2008)}, without forgetting its axiological value.

Another position is that of^{Vaillant (2002)}, who calls personal appropriation the transformation in meaningful learning of the knowledge generated by both the informative and practical dimensions;^{Aznar, Ull , Piñero and Martínez- Agut (2017)}use the attitudinal dimension that includes attitudes, values in the case of the former and the level of perception, as well as the level of affective-emotional signification.

The need to penetrate inside the subject in the training process coincides; Apparently there is no uniformity in which are the specific indicators, which are closely related to the object of the training, but it is necessary to establish a must be and know how to be in the process.

It is considered important to highlight that the dimensions related to the content of the training lead, in different ways, to the recognition of the knowledge, skills and values that in non-formal spaces are generally associated with the participatory action research method and the contribution of community education ^{(Cedeño de Veracierto, 2020)}.

From this point of view, it is considered important to pay attention to the study of the context in which the training process takes place, since this can vary significantly within institutions (in school or extracurricular activities) or in less formal training environments (family, work, community).

The use of contexts becomes an element to take into account to particularize the process in non - formal settings and carry out community - based rehabilitation. In the particular case of Pinar del Rio province, the leading group of training has a scientific background typifying the Operative Provincial Group (GOP), when being constituted by graduates in education, in rehabilitation, doctors in general medicine, and specialists, Masters, among others. The challenge is replication municipal and local-community contexts in the role of training of trainers.

Formation of trainers: definition and subjects involved

From the study carried out, it can be seen that the training of trainers is assumed from different points of view, which influences their approach to the definition, which is not entirely explicit in some of the articles consulted. Most of the articles place it in the field of training professional training, future teachers of different branches and educational levels. The works of ^{Tejada (2002)};^{Díaz, Haapakorpi, Sarkijarvi-Martínez and Virtanen (2015)};^{Aznar, Ull, Piñero and Martínez- Agut (2017)};^{Ferrada-Sullivan, J. (2017)};^{Jiménez-Mayorga and González-Ocampo (2018)}are emphasized; sometimes it is closely related to adult education, as is the case of ^{Moreno (2007)}. On the other hand, less systematized is the training of researchers ^{(Moreno, 2007)} and that which is carried out in community, occupational ^{(Marcelo, 1999)}, local settings, more related to social transformation^{(Rojas and García, 2018)}.

As the areas of application of the term are diverse, so are the definitions found: for ^{Marcelo (1999, p.35)} the training of trainers includes "(…) all those training activities and processes aimed at training trainers in the knowledge and pedagogical and specialized competence …" and ^{Tejada (2002, p.95)} refers to a"… strategy or need for this purpose".

The definitions above focus on consider forming as activities, training, strategies , which is considered very reductionist, limiting or processes; This coincides with the position assumed from the category of formation and the understanding of a process as a systematic transformation, subject to the law of a phenomenon, passing from it to another phenomenon, which denotes development ^{(Rosental and Iudin, 1973)}. From this perspective, the training of trainers is directed as a consciously planned educational process.

A look at the bibliography consulted so far allows us to recognize the use of the term training of trainers in formal spaces or not, given the social responsibility of the institution in question. In this sense, they agree to accept the use of training of trainers in three contexts: formal (university, training institutes), non-formal (companies, educational institutions for teaching practices) or informal (family, community contexts) as from different analyzes, authors such as^{Souto (s/f)},^{Vaillant (2002)} and^{Tejada (2002)}contemplate ; where the role of the family, the community agents in concrete contexts, central elements of "Freire's theory of liberation" is re-dimensioned, which, although it must be critically analyzed in the Cuban reality, constitutes a "legacy that facilitates access to self-awareness, a fact that allows pedagogy to suggest keys to rebuild processes" ^{(Pallarés, 2019, p.85)}.

The distinctive analysis between the non-formal and informal does not seem to be in the context but in the characteristics of the educational influence (category of education containing community pedagogy: ^{Fernández, (2012)}. As a complement to this approach,^{Souto- Seijo, Estévez, Iglesias, and González- Sanmamed (2020)}coincide when they state that non-formal education "(…) comprises all those activities organized by different institutions outside the formal educational system. These are designed to meet the training needs of certain population groups, so that the learning provided is better adapted to the individual and their peculiarities" (p. 95).

From the position that is defended, the neighborhood community ^{(Fernandez, 2012)}is demarcated and organized in cities, towns, neighborhoods, towns, rural areas and reaches its greatest representation in the actions of the popular councils, elements that are in account for the CBR in Pinar del Río.

Consistent with the transforming power of the theory-praxis relationship , the approach of the different fields from which the training of trainers should be seen is interesting ^{(Souto, s/f)}, which includes a "field of practice" "(…) oriented towards social, economic, political, cultural, labor values and needs in social and psychological representation of the actors. It provides for the participation, in the field of practice, of a network or networks of training resources from different sectors, meaning an integrated training system with varied characteristics" (p.27).

Note that the social need appears as the first element of living contemplation in an oriented scale of values and that the intersectoral character that participates in the training is recognized, with a systemic character, which permeates it with diverse characteristics, features that are recognized as important when modeling the training of trainers' process.

Intersectoriality is also highlighted in countries that have implemented projects element of RBC as Argentina, Colombia, Cuba, Chile, El Salvador, Honduras and other countries. In the Chilean context, interdisciplinary is a requirement that professional teams subordinate to the rehabilitation knowledge and practice underlying the coordination, families and community organizations ^{(Guajardo-Córdoba, Recabarren -Hernández, Asún -Salazar, Zamora-Astudillo and Cottet -Soto, 2015)}.

On the other hand, it is precisely in the practice field where the main publications referring to CBR are found. It is necessary to state that it constitutes a community development strategy for the rehabilitation, equalization of opportunities and social integration of all people with disabilities. CBR is carried out through the combined efforts of people with disabilities themselves, their families and communities, and the corresponding health, educational, social and labor services^{(Licourt, Cala y Valle, 2019)}.

CBR as a project began in Cuba in 2002 in Granma. It was later implemented in the provinces of Pinar del Río and Holguín, with the aim of taking action in areas such as promotion, prevention, comprehensive care, rehabilitation, and job placement, among others. The systematization of CBR on Cuban soil recognizes the need and value of training trainers for CBR ^{(Licourt, Cala y Valle, 2019)}; However, it does not explain how to carry it out based on the structure of international projects in each province, nor the adjustments due to the context, users, sectors involved, their professionals, participation of leaders and selection of volunteer activists, dimensions , among other variables that enrich the study and allow its replication and sustainability.

With this theoretical-practical gap, its implementation is left to the initiative and imprint of each territory, which, although it has a methodological value from the systematization of the experiences lived in each context, in training actions and training as overall process, the organization of the process is necessary to form concrete, planned, targeting towards a particular purpose.

Both responding to different sectors, as well as the basic training of each professional involved, influence the theoretical platform that supports the process of training trainers. That is why it is necessary to take into account the "field of knowledge", which, based on Souto's criteria (s/f), refers to "(…) the theoretical complexities that emanate from the practice from where they are built and at the same time calling attention to the basic training that underlies the trainer of trainers and can generate confusion in the specific object of knowledge" (p.27).

The theoretical perspective that is defended is supported by the Leninist theory of knowledge itself "… from living contemplation, to abstract thought…" (Lenin, 1987); At the same time, it recognizes social power in the generation of knowledge and its need as a tool for social movements in the construction of a good society^{(Borón, 2018)}.

From the experience of international CBR projects in Cuba, there is a theoretical-practical coherence when writing the theory and supporting the practices from "the local to the national level" ^{(Licourt, Cala y Valle, 2019)}, a fact that explains the need to organize and publish the contextual variants in the training of trainers.

Another necessary analysis lies in the role of the university in this field of knowledge, as it is the institutional responsible for the training of teachers and other professionals involved in the training of trainers. Although it is true that many universities in the world face a crisis of critical thinking and the generation of a science within social reach, to the point of needing a "university revolution" ^{(Borón, 2018)}, Cuban universities are increasingly reinforcing their commitment social, its link with municipal governments and its responsibility in local development^{(Díaz-Canel and Fernández, 2020)}.

The balance between the knowledge that is generated from academic environments and the use of experience in contexts, with inter and transdisciplinary approach, a dialogical critical spirit allows providing the educational phenomenon with greater sensitivity. In this way: "Education can generate a true culture by learning and teaching the real meaning of experience, sharing knowledge and jointly building new perspectives for new dialogues" ^{(Ferrada-Sullivan, 2017, p. 15)}.

However, the university, as an institution, does not officially belong to the CBR model in Latin America, nor in the Cuban experience (2001-2018) ^{(Licourt, Cala y Valle, 2019)}. Despite this, it should be noted that, in Cuba, as a subcomponent of the matrix, universities have participated from the beginning in the implementation of the CBR project, in the preparation of materials, in voluntary participation and, more recently, in the elaboration and implementation of undergraduate programs with a CBR approach, which requires further study and study for further investigation.

Consistent with these sermons, scientific knowledge cannot be generated by itself, research and innovation support the process; it is therefore the need to have into account "the research field" of^{Souto (s/f)}, an area that is discovered "in relation to the construction of knowledge and the detection of unsolved problems from of the study of the practices, the subjects and the institutions involved" (p.27).

Attention needs to be paid to the analysis of the subjects in the training of trainers' process: who are the trainers? Who should attend the training? Should it discuss about trained?

There is a close relationship with the conceptions exposed so far. For^{Vaillant, (2002)}"The trainer of trainers is one who is dedicated to the training of teachers and professors and performs various tasks, not only in initial and ongoing teacher training, but also in innovation plans, advice, planning and execution of projects in areas of formal, non-formal and informal education" (p.9).

The criteria exposed, resulting from the author's intention, given the context of his research, are limited to the vision and scope of teacher training. Consistent with this position, all those who have the function of training in different areas and levels stand out, acting in diverse spaces of pedagogical intervention, in contexts of permanent education, of social learning in a broad sense. The figure of the trainer can be related to new trainers, to update existing ones or to perfect those who are in practice^{(Souto, s/f)}.

Derived from this, in a generic way , the term trainer has several meanings ^{(Marcelo, 1999)} or semantic dispersion ^{(Vaillant, 2002)}; It can be synonymous with a teacher dedicated to education at different levels, as well as a teacher, who works at the university level and includes teaching functions in undergraduate and graduate degrees; to tutors who continue the training work in companies and teaching units; tomentorswho coach beginning professionals; to teacher advisers; researchers ^{(Moreno, 2007)}; But the occasional trainer is also recognized, who becomes a multiplier of what has been learned and experienced to other teachers; as well as "people who are natural members of a community with the capacity to lead specific animation actions, organized into projects of different types to satisfy needs and demands"^{(Souto, s/f, p. 28)}.

There are also less personalized analyzes of the term trainer, considering that readings, circumstances, accidents in life, the relationship with others, are also mediation that make formation possible. For its part,^{Tejada (2002)}recognizes in the tutor (coaching, mentoring, instructor, among other terms used) the projection of environments, cyber centers, virtual fields; a fact that does not oblige the presence of the training process and offers the leading role to the target subject of the training process.

It agrees with^{Vaillant (2002; p.16)}when he states that "(…) the trainer is a mediator between knowledge and the people who must acquire it (…). The learning mediator must show coherence between discourse and practice, must personally assume the values that he intends to transmit; he must live the commitment to the profession". From this criterion, the axiological value of the trainer, his commitment to transformation and the objectives to be met are reinforced.

Among the distinctive characteristics of the trainer,^{Vaillant (2002, p.9)} states that "he must have a great teaching experience, rigorous scientific and didactic training, be aware of the main lines of learning that support it".

From this position, it is vitally important that the trainer be prepared with teaching and didactic tools, what ^{Tejada (2002, p.100)} calls: "immediately know the device, its applications and the competency scheme necessary for him to enter the scheme of learning for work". Consistent with the analysis carried out, the trainer assumes a commitment with the social transformation, it is the main actor in educational action and uses research and innovation for this.

From the experience of the implementation of the RBC project in Cuba, the former belongs to the Operative Provincial Group (GOP) and is a member of the health sector, education, Ministry of Labor and Social Security, culture, sport or of the training team of the associations of people with disabilities ^{(Licourt, Cala y Valle, 2019)}, taking into account the conditions of the context and the objective of the CBR. However, despite the fact that most of the roles of the educational sector are based on sensitizing students of the Special Education, Speech Therapy Education , Medicine, Rehabilitation careers , participating and organizing courses, with an impact on interdisciplinary and intersectoral work, It is not argued how is the selection process of the professionals involved, their characteristics and their preparation for collaborative, intersectoral and interdisciplinary work in the achievement of common objectives.

The GOP is replicated at the municipal level in the Committee of Municipal Re adaptation (CRM), which as in international experiences guarantees Intersectoriality in the implementation of CBR strategy, but does not specify whether it can do so in the process of training of trainers.

In the Cuban context, it is interesting that at the municipal level, in achieving local development that includes social inclusion, equity, social justice and respect for diversity, knowledge management, formal training is established in the Municipal University Center (CUM) "that arrived with the universalization of the country to become key scenarios of the new university and agglutinating axes of human and innovative capital in the different territories"^{(Rojas and García, 2018, p.23)}.

In order to identify the trainer as the protagonist and manager of the training and innovative process in the territories, of the social transformation that is required, the traits that should characterize the trainer are socialized:

1. Knowledge of the environment

2. Ability to reflect on practice

3. Self-critical attitude and professional evaluation

4. Ability to adapt to changes (flexibility)

5. Tolerance to uncertainty, risk and insecurity

6. Initiative and decision-making capacity

7. Power and autonomy to intervene

8. Teamwork

9. Will to self-improvement

10. Ethical - professional commitment (Tejada, 1998, cited by ^{Tejada, 2002}, p.101)

The foregoing leads to deepening the recipient of the training of trainer's process.

Subjects involved. Who is the trainer? Who is the training for?

Souto (s/f) highlights the double referential, that existing between the trainer and the subject a basic trainer, but in the position of "formed". However, the implicit relationship established between a former and one formed could point to an active pole, the trainer, and a passive pole, the one that is formed. It seems that the term "formed" confers the position of the object in the process, but it is not assumed that way, it is agreed that "whoever teaches learns by teaching and whoever learns teaches by learning" ^{(Freire, 2004, p. 8)}.

Regarding the implementation of RBC in Latin America, Colombia recognizes the action about formed groups and informed groups. The distinction is that the target group are the agents of change that promote CBR and those informed include the entire population to whom, through different channels, knowledge about disability and specific issues related to prevention and management of disability as a social phenomenon are offered.

In the particular case of Chile, the evaluation of the implementation of CBR pointed to greater demands in the formation of knowledge "that surpass soft skills and transfer technical skills required by a socio-community model" ^{(Guajardo-Córdoba, Recabarren -Hernández, Asún -Salazar, Zamora-Astudillo and Cottet -Soto, 2015, p.48)}. By soft skills refers to learning good deals, warm and close, not enough for the development of technical knowledge, which vary from one case to another and require sometimes a scientific treatment in training.

In Cuba, the faculty at full or part time of the CUM as formers, contributes to that the formers perform as catalyst of changes in context, in the solution of local problems to transform the medium^{(Rojas and Garcia, 2018)}. Special attention must be paid to the level of knowledge, skills and values they possess to act as a mediator of the process.

In a similar position to the^{Souto (s/f)} and^{Tejada (2002)}, the target group "is made up of the group of professionals who, at one time or another, assume training functions" (p.106) and highlights that both parties already have practical knowledge that underlies the training process. However, in the training process, the acquisition, updating, improvement of knowledge, skills, attitudes, remain in development, especially looking for levels of specialization, as is the case of the implementation of CBR given the diversity that can lead to disability.

It should be understood that at different levels, depending on the roles that are assumed, both the trainer and the recipient or "trained" subject constitute agents of change and social transformation. At the same time, the formative process transforms them themselves. Derived from this analysis, the term "trained" should not be understood in the process of training trainers, from a reductionist position, by enclosing a limited time of intervention and offering a finished vision of the process that will positively rise to higher levels and will require new competencies that require feedback from ongoing training, for the entire life of which it is part.

From the experience of the implementation of CBR, the recipients of the training of trainers seek to reach all people with disabilities, their families and communities; for which they try to unite the entire system of influences that is exerted on them in their empowerment without taking away their self-determination. It is deemed valid, then the approach of Planning Centered the disabled Person (PCP)^{(Cuervo, Church and Fernandez, 2017)}, with few results described at Community level.

Towards this end, most countries include community leaders, parents of people with disabilities, and professionals involved in CBR; However, another figure appears as a mediator in the CBR strategy, with different names: the promoter (Paraguay, Nicaragua); the community health worker (Mexico), the monitor or facilitator (Chile), the volunteer (Nicaragua).

In Cuba, the mediator between the CRM and the person with disabilities and their family, in the implementation of the CBR project, is the activist, who is understood as the "Person who voluntarily participates in early detection, referral and follow-up, collection of data and information, awareness, motivation, defense of the rights of people with disabilities, family and community as well as establishing links with other sectors"^{(Licourt, Cala, Valle, 2019, p.24)}.

As activists you can find professionals from different sectors, members of the community, leaders, people with disabilities, family members who carry out the actions in stages, without remuneration. In their actions, they become in multiplier of knowledge and learning, which makes the training of trainers for the RBC process enriched starting in formal training, conducted by professionals and multiplied to reach areas Non-formal training, carried out by volunteer personnel who not only become key figures of social transformation, but also promoters of the improvement of the training of trainers, of which they are part.

Up to this point, the succession-feedback relationship that the training of trainers for CBR and retraining has been revealed based on new needs that emanate from the activist's work in the communities. They also show that the relationship is not entirely hierarchical, pyramidal, as could be seen in the Cuban structure based on a GOP, which is replicated in a CRM, which is supported by the work of activists, professionals, people with disabilities and their families; Rather, it functions horizontally, having the popular council, as the basic cell of RBC's work.

Conclusions

At the present time, where inclusive theory is sometimes spoken of, with a variety of scope, the training of trainers for CBR constitutes a path that suggests community empowerment and positive transformations at the level of popular councils. Among the characteristics that distinguish the process are the need for scientific, conscious, planned, contextualized and organized in projects, as well as intersectorial participation of agents and agencies that promote empowerment level People`s Councils, local communities, of the most vulnerable sectors, and promote social transformation in achieving promotion, prevention, assistance and comprehensive care. The role of the university as the institution in training and CUM as agencies promoting exchange and local development is recognizes. Thus, not only the quality of life of all rises, but goes one-step further to the achievement of opportunities of learning for life, for all.

Referencias bibliográficas

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Received: September 07, 2020; Accepted: January 18, 2021