The Challenges Of Training The Health Care Workforce During A Pandemic

A strong health care workforce can close the gaps that prevail in the management of people living with NCDs. 

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

Health care has always been fast-paced, now more than ever, and needs HCWs to receive good quality and continuous training. 

HCWs share equal responsibilities in ensuring that patients receive the best treatment, care, and support. One of the ways that HCWs can ensure this is by participating in continuous training throughout their careers. 

So how do HCWs receive training? 

HCWs working in Malaysia received both formal and informal training. Under formal training, medical and dental HCWs can enrol in a Master’s programme if they wish to specialise further in their respective fields.

Besides that, HCWs can also attend external training programmes, e.g. conferences or courses, to grow their skill sets on a variety of topics.         

Apart from these formal training opportunities, HCWs also receive informal training at the workplace. Examples include learning on the job by observing colleagues and mentoring by senior HCWs.

While less structured than 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 on health care training as a whole. The burden of dealing with the pandemic while simultaneously maintaining essential care has meant that fewer resources are available for supporting training and human resource development. 

Unfortunately, the lack of training does not only affect HCWs. As end users of the health care system, patients are especially affected.

The competency of HCWs will impact the quality of care received. For people living with non-communicable diseases (NCDs) such as diabetes and high blood pressure, receiving high-quality care is important. 

Even in the era of Covid-19, NCDs still cause the majority of disabilities and death in Malaysia. We know that people living with NCDs are at a higher risk for poorer outcomes, such as severe disease and hospital admission, following a Covid-19 infection. 

Hence, efforts should focus on addressing gaps in how we diagnose, treat, and care for this group of disadvantaged people. Continued training ensures that HCWs are better equipped to care for NCD patients.

This includes following the latest guidelines and expert advice, knowing how to prevent and manage complications in NCD patients, as well as keeping up with changing technology and techniques. These initiatives ensure that HCWs can care effectively for their patients.      

NCD Malaysia recently published a report describing the challenges and barriers faced by HCWs in managing people living with NCDs. The findings from the 513 HCWs who participated in the study all had a common thread linking them together, which was the training component. 

In terms of resources, chronic shortages in all areas (e.g. trainers, staff shortages, facilities, and time) in addition to increasing workload, has limited the ability of HCWs to attend regular training related to NCD care.

The sad truth is that these issues were already present before, and became worse during the pandemic. 

The HCWs who participated in the study also expressed disappointment with the training options available. Their complaints were particularly about unequal access to training opportunities, which were more accessible by senior staff and those living in urban areas, especially the Klang Valley.

The result is that patients in rural areas are unable to receive the same quality of care. HCWs who are driven to learn and progress in their careers also are automatically incentivised to seek work in urban areas where more training is available. 

HCWs also responded that the training programmes available were not updated or innovative. They remarked that not much has changed despite technological advancements but acknowledged this might be an issue of budget constraints.

In one example, allied HCWs have commented that continuous professional development programmes were often more relevant to medical HCWs, despite allied HCWs having to be present at these meetings. Training programmes need to be updated to target the knowledge and skills required for different allied HCWs as well. 

With these challenges in mind, here are two recommendations for the relevant stakeholders in both the public and private sectors to consider. 

Firstly, there is a need for updating and strengthening all training frameworks. The current programmes have been criticised as being too general, and hence lacking applicability for allied HCWs when they meet patients.

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

The next recommendation is that wider training and specialisation pathways are offered to HCWs. As the health care system advances and develops, new roles for HCWs are increasingly added.

The current training system needs to be updated to produce an adaptive and dynamic health care workforce that is capable of caring for the ageing population.

HCWs have expressed hope that an inclusive, comprehensive, and standard training structure would be instituted at the Ministry of Health, Ministry of Education, and even the private sector, dealing with specific NCD specialities, for both medical and allied health staff. 

HCWs are the backbone of our country’s health care system. Appropriate actions have to be taken by the government and other relevant stakeholders to address the challenges and barriers that HCWs face in caring for NCD patients.

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

The challenges and recommendations above are described in more detail 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. 

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