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Position
Paper
Introduction
The Institution
It also comprises:
Current Programmes Offered
Plans are underway to offer new programmes in Echocardiography and Cytotechnology. Discussions have also recently been initiated with the Ministry of Health and the University of the West Indies to collaborate in the training of Radiation Therapists for the new Oncology Centre. Graduates of these programmes are para-professionals, operating at the technologist/mid-managerial level. An increase of skilled workers operating at this level has been identified by recent labour market studies as critical to the country's future social and economic development.
Like all other social services in the country, sustainable development and improvement of the health care system are fundamentally constrained by a limited national human resource base which is simultaneously responsible for the delivery of health services, ongoing organisational transformation and the training and development of the future class of health care workers.
As the primary national training provider for basic nursing and allied health sciences, the College has been asked to contribute to the alleviation of the chronic shortages in key health care personnel by increasing our enrollment, upgrading some of our programmes to bachelor's level and developing programmes in new areas. While the departments are ready and able to take on this challenge, the nature and the design of our training programmes are such that the existing deficiencies within the health care system pose a great risk for the quality of the training that we can provide.
All of the health care programmes offered by COSTAATT comprise a significant clinical training component. We would like to take the opportunity of this public consultation to highlight the dangers inherent to sustainable quality health care, in maintaining the loose/unstructured and informal arrangements that currently govern the clinical components of training programmes delivered by the College.
CLINICAL TRAINING AND SUSTAINABLE QUALITY HEALTH CARE
Clinical training is an integral part of education and training in all disciplines serving health care. Graduates of health care programmes are expected to perform competently upon entry into the workplace. In order to do this, they must also be trained on site, at the workplace. Indeed, the clinical, on-site training is intended to develop the skills and attitudes, which will be necessary in the workplace. Its value is not only in obtaining the required skills, but also in the inculcation of the attitudes that are facilitative of the critical appraisal and decision-making skills required of the professionals and para-professionals in the health services. Research has shown that supervised practice increases confidence which further promotes competence. The clinical training environment should be welcoming and student-oriented in order to maximise the breadth and depth of learning and increase confidence and competence.
Clinical training can only be carried out in the hospital facilities where the specific disciplines are practiced by formally trained professionals with considerable experience in their craft.
Clinical training needs comprise:
CURRENT STATUS OF CLINICAL TRAINING ARRANGEMENTS
Lack of Formal Agreements - At present, students are allowed to participate in clinical training activities, not as a matter of course, but as a favour to the College, the individual lecturers or on a personal basis between staff at the health facilities and lecturers from the relevant departments.
Many of the staff have requested that they be paid fees for training the students. Some staff members humiliate and embarrass the students when fees are not paid. As a result, we have been obliged to remove students from this type of learning environment and they lose the necessary clinical exposure which is required to make them workplace ready.
In instances where the College has managed to allocate a modest sum to pay fees for clinical training, the issue of who should be paid further complicates implementation of this solution. The clinical instructor has been identified as the person who will accept delegated responsibility from the College for the students while in the clinical environment. This is the person with whom the College liaises to ensure congruence between the theoretical and clinical modules of the programme. However, in some instances, other hospital workers are involved in the delivery of clinical training. In such circumstances, it is difficult to (a) pay all participants in the clinical training activities, and more importantly (b) ensure that all participants have a shared understanding of the quality teaching/learning goals and performance indicators established in the curriculum.
Quality of Clinical Teaching and Supervision - It is further recognised that high quality clinical supervision is not a given. In the past, the College endeavoured, through the delivery of workshops, to orient hospital staff to the requirements of the clinical component. However, participation is once again, on a voluntary basis, and there are no pecuniary or work-related benefits to participating, outside of a sense of satisfaction at one's personal and professional development.
RECOMMENDATIONS
APPENDIX 1: The Radiological Sciences Department of COSTAATT offers:
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