The challenges of training health personnel during a pandemic

During the Covid-19 pandemic and the spread of its many strains (most recently, Omicron), we have seen how the healthcare landscape has changed and how healthcare workers (HCWs) have adapted to these changes.

Healthcare has always been fast, now more than ever, and needs healthcare workers to receive continuous, good quality training.

Healthcare workers share equal responsibilities to ensure patients receive the best treatment, care and support. One of the ways healthcare workers can ensure this is to participate in ongoing training throughout their careers.

So how do healthcare workers get trained?

Health workers working in Malaysia received formal and informal training. As part of formal training, medical and dental healthcare workers can enroll in a master’s degree program if they wish to further specialize in their respective fields.

Additionally, healthcare workers may also participate in external training programs, such as conferences or courses, to develop their skills on a variety of topics.

In addition to these formal training opportunities, healthcare workers also receive informal on-the-job training. Examples include on-the-job learning by observing colleagues and mentoring by experienced health workers.

Although less structured than the formal training, these informal sessions complement and reinforce their existing knowledge.

As with every other industry, the Covid-19 pandemic has been a huge disruptor to healthcare education as a whole. The burden of dealing with the pandemic while simultaneously maintaining essential care means fewer resources are available to support training and human resource development.

Unfortunately, the lack of training does not only affect healthcare workers. As end users of the healthcare system, patients are particularly affected.

The competence of health care workers will affect the quality of care received. For people living with non-communicable diseases (NCDs) such as diabetes and high blood pressure, it is important to receive high quality care.

Even in the era of Covid-19, NCDs still cause the majority of disabilities and deaths in Malaysia. We know that people living with NCDs are at higher risk of poorer outcomes, such as severe illness and hospitalization, following Covid-19 infection.

Therefore, efforts should focus on gaps in how we diagnose, treat and care for this disadvantaged group of people. Continuous training ensures that health workers are better equipped to care for patients with noncommunicable diseases.

This includes following the latest guidelines and expert advice, knowing how to prevent and manage complications in patients with NCDs, as well as keeping up with evolving technologies and techniques. These initiatives allow healthcare workers to effectively care for their patients.

NCD Malaysia recently released a report outlining the challenges and barriers faced by healthcare workers in caring for people living with NCDs. The results of the 513 healthcare workers who participated in the study all had a common thread that connected them, namely the training component.

In terms of resources, chronic shortages in all areas (e.g. trainers, lack of staff, facilities and time) in addition to increased workload, have limited the capacity of health workers undergo regular training related to NCD care.

The sad truth is that these problems have been present before and have worsened during the pandemic.

Healthcare workers who participated in the study also expressed disappointment with the training options available. Their complaints included unequal access to training opportunities, which were more accessible to senior managers and people living in urban areas, particularly the Klang Valley.

The result is that patients in rural areas cannot receive the same quality of care. Health workers who are driven to learn and advance in their careers also have an automatic incentive to seek work in urban areas where more training is available.

Health workers also responded that the training programs available were neither updated nor innovative. They noted that not much had changed despite advances in technology, but acknowledged that this could be an issue of budget constraints.

In one example, paramedic health care workers noted that continuing professional development programs were often more relevant for medical health care workers, even though paramedic health care workers were required to attend these meetings. Training programs need to be updated to also target the knowledge and skills required for different allied health workers.

With these challenges in mind, here are two recommendations for consideration by relevant public and private sector stakeholders.

First, there is a need to update and strengthen all training frameworks. Current programs have been criticized as being too general and therefore lacking in applicability for allied healthcare workers when encountering patients.

There is also marked variability in these sessions between the public and private sectors. A streamlined course would allow healthcare workers to receive the same level of training regardless of the sector they are in.

The next recommendation is that broader training and specialization pathways be offered to healthcare workers. As the health care system progresses and expands, new roles for health care workers are increasingly being added.

The current training system needs to be updated to produce an adaptive and dynamic health workforce capable of caring for an aging population.

Health workers expressed the hope that an inclusive, comprehensive and standard training structure would be instituted in the Ministry of Health, the Ministry of Education and even in the private sector, dealing with specific specialties of NCDs, both for medical and paramedical personnel.

Health care workers are the backbone of our nation’s health care system. Appropriate measures should be taken by the government and other relevant stakeholders to address the challenges and barriers faced by health workers in caring for patients with NCDs.

A strong health workforce can bring us one step closer to closing the gaps that prevail in the care of people living with NCDs.

The above challenges and recommendations are further described in NCD Malaysia’s report titled “NCD and the Healthcare Worker: An Introspective Look into the Malaysian Care Landscape for Non-Communicable Diseases”.

A summary of the report can be here.

Michael A. Bynum