Professional development in the health sector: How to know what is available and what is required to offer quality training using distance education

Wendy Kitson-Piggott, CAREC

Abstract
PROPOSAL FOR WORKSHOP – double session

Introduction

In 2005 and 2006 an assessment study took place in the Caribbean region in 23 different countries to obtain information on the human resources and technology available and needed in order to plan training for medical laboratory staff in the region using distance education. Key issues were collection of data on the countries’ preparedness/interest in distance education, the training capacity offered/available, the existing connectivity, the skills to be acquired, and the preparedness of the future students to engage in distance learning.

The approach to the workshop

The proposed highly interactive workshop is based on this recent extensive assessment. Participants are expected through discussions based on a real case, to discover how they would go about to design such a study, to carry it out and to make use of the collected data. Emphasis will be on the need for a systematic approach, a high level of understanding of cultural differences, and a real effort to identify priorities, problems and possibilities/opportunities.

The workshop management team will, through group work, share their experiences (positive and less positive ones) with the participants.

During the first hour of the workshop participants are expected to work in a group and creatively reflect on one of the following topics.

• Key indicators for regional collaboration and methods of collecting data on these indicators
• Ways of identifying regional training needs (governmental and institutional)
• Identification of training opportunities, using distance education (governmental and institutional)
• Methods to collect information on training needs of (medical) staff and on their preparedness to engage in distance education learning.

The second hour will be used to present and discuss the outcomes of the group-work in a plenary session.

The last half hour will be used to link what has been presented and discussed by the different groups to the reality of the extensive assessment study the organizers of this workshop have carried out. Focus will be on what lessons have been learned.

Expected outcomes

An increased understanding of the need to carefully and systematically plan “innovations” by involving the various stakeholders. Recognition of the value of an independent coordinating body that can avoid duplication of efforts and ensure a rigid quality control component so that efficient and effective use is made of existing capacity.

INTRODUCTION

This paper has been submitted by the Project Implementation Unit (PIU) of the Caribbean Epidemiology Centre (CAREC). CAREC has been mandated by its twenty-one Caribbean member countries to play a lead role in the reform of medical and public health laboratories within the region. One of the projects being implemented by CAREC addresses the need to strengthen medical laboratory services in the Caribbean with a primary purpose being improved management of, and coordination between, public and private laboratories in the CARIFORUM region, resulting in increased availability of high quality laboratory information.

Global society is gradually moving into the Knowledge Age and governments and societies will be increasingly challenged by the need to develop knowledge and skills as well as effective learning and re-learning experiences. Decision-makers, managers and leaders and all those who are charged with training and education will have to decide on the kind of programmes they will offer, how, to whom, and what media and infra-structure will be used to implement and evaluate programmes. The decisions these leaders take should be guided by the mission of the organization, identified needs of the society at large and those targeted as well as their environmental realities.

The realities of today’s working environments often pressure managers to look at distance training and education to solve institutional and/or organizational training problems. Training at a distance forces an organization or an institution to look at the ways people learn and thus can be effectively trained.

A CHANGING LEARNING LANDSCAPE

Important changes are taking place in training, often based on changes in the economic development of a region or a country. We see, for instance, that monopolies are substituted by competition and that national interests are influenced and even modified by global interests. In the area of training we see that the concept of training as a cost liability is more and more substituted by the concept of training as a competitive advantage. Training programmes with “One size fits all” content are now often replaced by tailored programmes. “Just in case” programmes are also being replaced by “Just in time” programmes. Many employees now demand that their organisation or institution support their learning, especially if it benefits the Organisation. Learners at the workplace have a right to be supported. Although “just enough training” may be useful, Zielinski (2000) draws our attention to the fact that there is no such thing as “just enough learning”.

Institutions and organizations are faced with budgets that continue to be squeezed and managers are often required to do more with less (Berge, 2003). Recognising, however, the importance of training and learning, more and more institutions are encouraging their employees to take control of their own learning throughout their lifetime. Employees, on the other hand, are becoming more and more aware of the fact that they must continue to learn if they want to be, and continue to be, employed in a competitive marketplace. More and more employees have technology systems at home that can support learning, such as computers or audio cassettes. For other prospective learners these systems may be easily accessible in their work-environment.
Distance training and education may be a solution.

It is not enough, however, that organizations and institutions encourage their employees to learn – they should, themselves, play an effective role in shaping the increasingly networked learning landscape of the 21st century. They must conceive of themselves as learning organizations and focus on the profound human (as contrasted with bureaucratic) mission that is inherent to fostering learning (J. Visser, 2003). Providing training at a distance forces us to reflect on the ways people learn and are trained (Albright and Post, 1993).
Those responsible for planning and implementing distance education may face important questions such as “Is the organization ready for distance education?” and equally important “Are the learners ready for distance education?” Distance education is not something that can be easily implemented. The basic conditions have to be available otherwise distance education may not be able to fulfill its promise of making quality training and education available to many. Key planning and implementation steps must be thoroughly discussed and agreement by key organizational stakeholders to accept the challenge of implementing distance education should be obtained. Project management should come as a first step, and should be carefully laid out, followed by programme management as a second step - and not the other way around (Schreiber, 1998).

THE BACKGROUND OF THE WORKSHOP PROPOSAL

Health has been recognized as a key ingredient for economic development and medical laboratory services are fundamental to effective and efficient health systems. Medical laboratories often provide the information on which doctors base or confirm their diagnoses. The steep increase in chronic and communicable diseases and the threat of diseases such as HIV/AIDS, diabetes and cancers, for example, makes the need for high quality laboratory care even more urgent. In fact, an outbreak of a serious communicable disease in the Caribbean region would not only jeopardize the health of the national populations and by extension, the still fragile economies, but also affect the tourism industry on which many countries in the region depend heavily.

In an attempt to get more information about the quality of medical laboratory services in the Caribbean region, a laboratory quality management baseline evaluation was carried out by CAREC in April 2003. The analysis provided ample evidence that the quality of the testing and the analysis of the results could and should be improved. CAREC identified training as key to the development of skilled and effective laboratory managers and leaders and by extension to the improvement of medical laboratory services. In a review of the training provided by regional institutions, it was seen that, although the core content was similar across programmes, there was great variety in the quality of training.

CAREC conducted a follow-up assessment study “ Distance Education Situation and Needs Analysis” in the Caribbean region in 2005 and 2006. Close to twenty countries were approached in order to obtain information on the human resources and technology available in the region to support distance training and to get data on the preparedness of prospective students to learn and be trained via distance education. In addition, information on the training gaps was sought from prospective students, health managers and trainers. The prospective students involved in the assessment study were in the main medical laboratory technologists (MLTs) working in medical laboratories and facing challenges as a result of a lack of adequate preparation and training, and in many cases a lack of re-training. Additionally, key issues researched were the countries’ preparedness or interest in training via distance education, training capacity offered or available nationally and regionally, existing national and regional connectivity, MLT training needs identified by hospitals and other medical institutions and the views of future students on skills to be acquired and their interest in and preparedness to engage in distance learning.

Setting up such an assessment study was not an easy task. Team members of the Project Implementation Unit (PIU) of CAREC first visited seven countries in the Caribbean region in order to get information that could be used to ensure that such an assessment study would be well designed and would provide the information necessary to advise the region on the feasibility of using distance education to upgrade, train and retrain medical laboratory technologists. Discussions in the various countries focused on the need to obtain detailed information on the existing regional needs (governmental and institutional) and on the training needs as identified by medical staff. Contacts were made to establish which institutions could offer learning materials and student support in general. In addition, a systematic effort was made to identify priorities, problems and possibilities or opportunities. There are important differences between and among the CARIFORUM countries In the Caribbean region as there exists a great variety of cultures and languages The Distance Education Situation and Needs Analysis had to be conducted in countries where - English, Spanish or Dutch, were recognised as the primary language.

Based on the information obtained during the above described visit to seven countries in the region, a series of questionnaires was designed and developed, each aimed at a different target group including senior government or public sector administrators, senior hospital administrators, private and public medical laboratory staff - prospective students, education providers, connectivity providers, and also human resource managers at the various medical and educational institutions. These questionnaires were formatively evaluated, adapted and prepared. A team of country coordinators was established whose main task was to distribute the questionnaires to the various target groups that had beforehand been identified, and after completion collect the questionnaires. The country coordinators were provided with an extensive guide as to how to carry out their tasks and were, through two general teleconferences and follow-up communication, prepared for their tasks.

Although the analysis of the more than 1000 questionnaires is still in progress, a number of conclusions can already be drawn. The data revealed that:

  • Medical technologists across the region have had very limited exposure to distance education
  • While many of the respondent MLTs claimed to have computer access at home, follow-up questions seemed not to be in synchrony with their responses. This result needs further exploration.
  • Although many laboratories do have computers, the technologists may not be allowed to use them for training purposes
  • Lack of time is the greatest challenge to engaging in a training programme. In addition, future students expressed a serious concern about the possibility of being granted time off to study.
  • There are important differences among countries relative to their training needs
  • Education providers do not always have the same opinion, or may even lack understanding about the difficulties distance education learners may have.
  • There are countries with almost 100% access to landline telephones, while in other countries it is less than 70/80%
  • Monthly charges for Internet Access vary widely in the Caribbean Region.

A comprehensive analysis of the data obtained will be published in the Fall of 2006 and will give detailed information on Distance Education Capacity in the Caribbean Region.

The CAREC Project Implementation Unit (PIU) has learned and is learning much from the above described experience and from designing and implementing such an extensive regional assessment project. In order to share these experiences and to help others to identify and discover useful methods and approaches for application in their own circumstances, a workshop was proposed during the Fourth Pan Commonwealth Forum on Open Learning.

THE WORKSHOP

Preamble

The workshop is based on the idea that there is no separation between knowing and doing. Participants construct new ideas or concepts based on their current/past knowledge and individuals go beyond the information given. Discussion plays an important role in learning.

Structure

The workshop participants will be given a paper on an imaginary case, written for this workshop and based on the experiences of CAREC’s Project Implementation Unit while designing and implementing a Distance Education Situation and Needs Analysis. This case will be analyzed and discussed by the workshop participants and recommendations on how to deal with the problems mentioned in the case will have to be made. A plenary session will be used to discuss the outcomes of the group work.

Overall objective

The overall objective of the workshop is to create awareness of the need to carefully reflect on the best approaches to collecting key information in a systematic way prior to initiating training interventions. This includes not only how information should be gathered, but also will explore what types of information would be useful to and would support the realization of the determined training goals.

Content

Using the case as described above workshop participants will explore the design, development and implementation of a distance education situation and needs analysis. Participants will not only decide on strategies for identifying regional training needs, but will also examine the importance of collaboration. Emphasis will thus be on the importance of a systematic approach that will support the effective and efficient delivery of technology-enhanced programmes. Potential barriers to successful implementation will be identified and solutions proposed. Discussions and group-work are essential ingredients of this highly interactive workshop.

Expected outcomes

Participants will, after having participated in this workshop, demonstrate an increased understanding of the importance of carrying out a needs and audience analysis. They will be able to explain why a systematic approach to resolving identified problems is crucial. Finally, participants will, after they have attended the workshop, be able to describe at least three methods for collecting information on training needs, explain the various advantages and disadvantages of these methods and defend their choices based on valid arguments.

REFERENCES

Albright, R.C. and Post, P.E. (1993). The challenges of electronic learning. Training and Development, 47(8), 27-29

Berge, Z.L. (2003). Planning and managing distance training and education in the corporate sector. In: M.G. Moore and W.G. Anderson (Eds.) Handbook of Distance Education (pp. 601-613). Mahwah, N.J.: Lawrence Erlbaum

Schreiber, D.A. (1998). Organizational technology and its impact on distance training. In D.A. Schreiber and Z.L. Berge (eds.) Distance training: How innovative organizations are using technology to maximize learning and meet business objectives (pp. 3-18). San Francisco: Jossey Bass

Visser, J. (2003. Global Issues and Concerns. In: M.G. Moore and W.G. Anderson (Eds.) Handbook of Distance Education (pp. 793-810). Mahwah, N.J.: Lawrence Erlbaum Associates

Zielinski, D. (2000). Can you keep learners online? Training, 17(3), 64-75

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