ASSIGNMENT ON: TRAINING AND EDUCATION IN HEALTHCARE

SIHS
MBA-HHM
1st YEAR
24-Aug-12
HUMAN RESOURCE MANAGEMENT
THAKUR HARSH DEVENDRA PRN-12040141044

Table of Contents IMPORTANCE OF EDUCATION IN HEALTHCARE INDUSTRY 2 IMPORTANCE OF MEASURING COMPETENCE 4 THE PROCESS OF EVALUATING TRAINING EFFECTIVENESS 6 REFERENCES 10

IMPORTANCE OF EDUCATION IN HEALTHCARE INDUSTRY
Education is very important to both your personal and professional life, in a number of significant ways! Depending on the level of success you’re seeking to achieve, the level of education may be relative, but the bottom line is, an education of some sort is often paramount to future success. Completing increasingly advanced levels of education shows that you have a drive and commitment to learn and apply information, ideas, theories, and formulas to achieve a variety of tasks and goals.

Subject Matters:
Probably the most obvious reason education is important is to acquire the subject matter and basic knowledge needed to get by in everyday life. For example: * English and language skills: English and language skills will help you to communicate your ideas more clearly. Communication skills are essential in any role – whether you’re dealing with co-workers, patients, customers, or supervisors, you will need to effectively convey your plans, ideas, goals, and such. * Math and science skills: Although calculators and computers are readily accessible, you still need to learn how to do basic computations and calculations on paper or in your head. If you are calculating dosages, counting surgical supplies, or tallying sales, math skills are imperative for a career, and for life. Cooking, shopping, driving, and many other everyday activities require math skills as well, regardless of your career choice.
The more you LEARN, the more you EARN:
Have you ever noticed that the word LEARN contains the word EARN? Perhaps that is because the higher level of education you achieve, the higher level of income you are likely to command as well. For example, consider the following health careers and the educational requirements as they relate to annual income: * Medical jobs, no college degree: Pay $20,000-40,000 annually, on average * Allied Health Careers, two years of college: Pay from $40,000-60,000 annually. * Nursing Careers, Associate's or Bachelor Degree: Pay $40,000-55,000 on average annually. * Advanced Nursing Careers, Master's Degree required: Pay $60,000-90,000+ annually. * Pharmacist, Bachelor's, + PharmD: Pay $90,000-115,000 annually. * Physician, Medical Doctorate required: Pay $120,000-$500,000+ annually
Clearly, education is important for financial growth in the healthcare field, as with many other careers.

Many Employers Now Require Education for Employment:
Many employers require college level education, even for roles which previously did not require it, such as administrative assistant positions. The fewer years of education you’ve completed, the fewer doors are open to you. It’s that simple.
Educational requirements are a quick and easy way to narrow down the field of applicants, especially in situations where there are more applicants than jobs. When hiring from a field of candidates, employers prefer those who have completed the higher level of education. In working with hiring managers to conduct candidate searches, it seems that the education requirement has become a barrier for entry into many careers, because education allows us to: 1. Learn how to learn. School teaches you how to gather, learn, and apply knowledge. No matter what career you choose, you will need to learn procedures, information, and skills related to your job, and execute tasks based on that information and training. 2. Develop interpersonal skills. School allows you to interact with other people and refine your communication skills, including those of persuasion, conflict resolution, and teamwork. 3. Learn time and task management. Learn how to manage projects, deadlines, and complete assignments efficiently and effectively. 4. Learn from experience of others. By attending school, you are able to learn from the experience and intellect of thousands of people who have gone before you. In just a few years, through your textbooks, research, and class lessons, school gives you a consolidated overview of theories, formulas, ideologies, and experiments conducted by generations of scientists, philosophers, mathematicians, historians, and other experts. While gaining your own personal work experience is helpful too, a formal education is a way to learn from centuries of others’ life and work and academic experience before you.
So as we can see, education is important to everyone, but education is even more important in the healthcare industry. The following are the main reasons for this, * Technology, math and science are key components of many healthcare roles: Healthcare careers often require knowledge and understanding of the sciences, and technology. These fields are always changing and growing with new developments and discoveries. Therefore it’s imperative to have a basic understanding you can build on with continuing education throughout your career, to keep up with the latest changes and new information. * Health professionals have a huge responsibility for the health, well-being, and survival of others. Therefore, health professionals must be particularly adept and relating to other people, learning and gathering information about a patient, and applying it to the treatment and care of that patient based on medical knowledge. * For many healthcare roles, degrees and certifications are required for licensure to practice in a certain capacity. Many allied healthcare jobs require at least an associate’s degree, most nurses need bachelor’s degrees, and physicians and advanced practice nurses must have many years of post-graduate training to include master’s and doctorate degrees.
IMPORTANCE OF MEASURING COMPETENCE

What is competence ?
Competence refers to a person’s underlying characteristics that are causally related to job performance. Competence is defined in the context of particular knowledge, traits, skills, and abilities. Knowledge involves understanding facts and procedures. Traits are personality characteristics (e.g., self-control, self-confidence) that predispose a person to behave or respond in a certain way. Skill is the capacity to perform specific actions: a person’s skill is function of both knowledge and the particular strategies used to apply knowledge. Abilities are the attributes that a person has inherited or acquired through previous experience and brings to a new task, they are more fundamental and stable than knowledge and skills. Why healthcare organizations should measure competence ?
There are many good reasons for measuring competence:
Healthcare reform:
The increasing complexities of healthcare delivery and changing market conditions have forced health policy-makers to promote the assessment of initial competence of students and new graduates and the continuing competence of experienced and certified practitioners. Organizational performance:
Healthcare organizations need to assess individual and organizational performance periodically to assess the efficacy of their services. The results help healthcare organizations determine whether they need to design training and/or continuing education interventions for improving provider performance.
Liability and ethics:
Healthcare organizations are responsible for the quality of care their staff provides and providers’ competence periodically enables healthcare organizations to meet this crucial responsibility.
Risk management:
Competency assessments can be used to monitor organization-wide knowledge of policies and procedures related to high-risk areas. Feedback from these assessments can be used for training and continuing education of providers and to improve overall organizational performance.
Certification and recertification of providers:
Competency assessment is an integral part of the certification a recertification processes of service providers. For example, recertification programs in the U.S. use examinations and performance assessments as “snapshots” of competence every seven to ten years. Documenting competence is becoming essential—not optional—and is likely to become mandatory in the near future for initial and continuing licensure and certification, and perhaps even for employment.
Planning for new services:
Competency assessment can help managers identify providers who are competent to provide a new clinical service, providers who need improvements in specific knowledge or skill areas when anew service is offered, and providers who are ready to act as mentors of newly trained providers.
Measuring training outcomes:
Competency assessment can determine the efficacy of training interventions inclosing knowledge and skill gaps and to assess and improve training. Low scores on competence assessments after training may indicate that the training was ineffective, poorly designed, poorly presented, or inappropriate. Trainers can use this information to improve training content or delivery. If the assessments aim to improve specific components of training, the trainer may be able to determine where more information is needed, which exercises require clarification, or if more time is required to cover a topic.
Selection of new staff:
Competency assessment is useful when recruiting new staffs to ensure they can do the job. They are hired to do or could do it with reasonable orientation/training.
Individual performance improvement:
Competency assessment can play an important role in an organization’s performance improvement initiatives. Assessment results can identify gaps in knowledge and skills, and guide managers in setting appropriate training or other remedial interventions targeting individual providers or groups of providers.
Supervision:
Competency assessments can guide healthcare managers in providing performance improvement feedback to healthcare providers.

THE PROCESS OF EVALUATING TRAINING EFFECTIVENESS

A large number of organisations are setting up their own training facilities. They are also inviting outside faculty to conduct in-company courses for executives at all levels. This trend will continue because new orientation in managerial and technical areas is necessary for effectively responding to the changing environment of business.
Training is expensive if it does not serve the purpose for which it is given. The training should be able to improve the capabilities of individuals and, collectively that of the organisation. If the programme of training does not contribute to the building of organisational capabilities, and, reflect, over a period of time, in improved performance, the loss to the organization is far greater than the money spent on training. The organisation could lose its competitive edge and its market position. Hence training has to serve identified purposes for the organisation based on a systematic analysis of its own capabilities and the demands upon it that the future scenario may make. The organisation has to identify what skills, attitudes, behaviour, knowledge, conceptual and operating capabilities are needed and which of these can be developed through training and which of these require re- orientation in policy and management practices. In our experience very few organisations spend enough time to analyse the situation with care before launching on training programmes. We have seen that even some of the best managed companies set out vague goals such as ‘training for leadership or ‘team building’, etc. without seriously questioning what they expect from ‘leaders’ or ‘team effort’. In many organisations some management practices have to be changed in order that leader or team-building exercises in training can give the desired results. Without clarity of purpose training effectiveness is difficult to measure.
Another critical area for deriving expected benefits from training is the measurement of training effectiveness–how well the training inputs are serving the intended purpose. This aspect is often neglected by organisations, saying that measurement is difficult. We believe that the techniques in social sciences have developed sufficiently to measure most important aspects of training that contribute to its effectiveness. Here we will discuss the techniques that we have used in our work, and found satisfactory to improve upon training inputs.
There are three kinds of training outputs that organisations need to measure. They are: * Relating to course planning, relevance, comprehension and whatever goes on in the teaching programme and the environment. * The utilisation of what is learnt on the job, i.e. transfering the classroom learning to the job in terms of skills, competencies, decision making, problem-solving abilities and relationships and the like. * The changes in the mind set such as work related attitudes, values, interpersonal competencies and personal attributes.
Measures
All measures are devised to assess the difference between pre and post- training. There are no absolute measures. The measures compare the effect of training interventions with some other comparable data. Hence, the organisation must obtain pre-training data or some benchmark on the same dimensions as expected from training interventions. The second consideration is that the trainer has to be clear about two things, (i) that the objectives of training are specific, i.e. the outcome expected and (ii) that the training material and the methodology are capable of achieving the stated results.

* Measures of the first training output have been used for many years. They consist of two kinds of instruments:
(a) Detailed questionnaire that solicit responses of participants on various dimensions of the programme, relevance, evaluation of each session on a 3, 5 or 6 point scale, instructor effectiveness, overall evaluation of the programme, etc. There are many variations in the items and the scales.
(b) Identifying the concepts or the ideas that the participants have found useful and how they would employ them at work. The responses give an overall assessment of the content and delivery of the programme and the usefulness of the programme for the participants. Both kinds of instruments are often used by training institutions. * The second concern has to do with how has the participant applied the concepts or the ideas that he may have learnt in the training programmes. Some measures are developed in the class-room situation in respect to certain identifiable areas. More often the measures have to seek data from post-training work situation. These data are obtained from the participant concerned, his peers and supervisors. The type of data ranges from questionnaires to ‘incidents’ relating to the participant. At times, open ended data are obtained from the peers and supervisors. There are many variations of this data. In-company programmes are able to obtain such data; open programmes have difficulty in obtaining reliable data in post-training work situations. * Data about mind set, attitudes, values and other person-related factors have to use indirect methods to assess training. The nature of changes in the mind set take place ‘within’ the individual and the processes that induce changes are not visible. It is often mentioned that any changes that might occur within the individual will show up in the post training behaviour of the participant. The difficulty is that such changes are slow and, in many cases, observable over a period of time. This being so, it is difficult to distinguish the contribution of training and that of other factors that may have contributed to the behavioural change. And without the assessment of the contribution that training may have made to the change process, where applicable, it is not possible to assess the effectiveness of the training. Hence two kinds of measurements are necessary to evaluate training that aim at modification in person-related behaviour:
(a) Measuring the changes within the individual that the training may have initiated. These processes are not manifest or observable.
(b) Actual behaviour changes at work.
(i) Measures of Changes within the Individual
The measurement of internal (or intra-person) processes is possible by the insights gained in the theory of psycho-dynamics i.e. the causal relationships between behaviour and the inner processes that cause them. It is argued that the choices that an individual makes to deal with a situation are guided by his personal orientation (set of beliefs, values, perceptions, etc.). Changes in the personal orientation are necessary if the individuals’ choices leading to decision making have to change.
The instrument to measure the impact of training would have to identify the factors that the individual uses to deal with a live problem before and after training. If the training has an impact on the participant, he would employ different factors to analyse the situation compared to factors he may have used before training. For this purpose we have used what is in literature mentioned as Field Force Diagram postulated by Kurt Lewin. The logic is simple: an event at a given time represents a balance of positive forces pushing in one direction and a set of negative forces pushing the particular event in the opposite direction. The event at that time occurs because the positive and the negative forces are equal. In case the balance has to be altered, the equilibrium of the two sets of forces must be disturbed. The participants in the programme are required to identify the forces that they would manipulate to alter the situation. They have to give reasons for the choice. The before and after training exercise would indicate if any change in the participants’ approach has occurred.
We have also used certain ‘projective tests’ to understand the “inner dynamics of the person. We used three pictures, for example, for the participants to construct a story (a variant of the Thematic Apperception Test) and analysed these stories to identify if any ‘process” changes have occurred.
Some other methods used for this purpose are the following: * The evaluator poses a problem and requires the individual to solve it and then identify the factors that he/she took into consideration in arriving at the decision. * Analysing a series of incidents in which the individual is involved at work. * Observation over a period of time and analysing the behaviour of the individual. * Analysing the level of learning by in-depth interviews by a consultant with counselling background or a clinical psychologist.
The measures that indicate the changes ‘within’ the individual due to training have been used by many trainers. All the measures used for this purpose have to be ‘projective’, i.e. provide an index of the process within the individual. From the perspective of a trainer, the results on these tests are invaluable for knowing the impact of training.
(ii) Measuring Changes in Behaviour
Post training changes in behaviour of a participant can be assessed only at the place of his work. Many organisations identify certain critical dimensions of change so that specific data on these aspects are available. Life Insurance Corporation, for example, identified four areas—decision making, problem solving, supervisory skills and relations with others. The rationale for choosing these areas was that these tasks require assimilation of data from varied sources and employs the individual’s overall competence in dealing with the situation.
The trainer has to obtain data in these areas from people with whom the participant interacts the most. In this exercise pre-training data are not necessary because the respondent provides these data in the interview. The problem in this measurement is that it is difficult to reconcile the data from respondents in case of discrepancies in their reporting. The methods of quantifying the responses are also crude. However, the trainer can get the trends and the direction and, in most cases, these could serve his/her purpose adequately. The interviewer can seek concrete examples of the changes. The incidents reported by respondents can be subject to content analysis.
The behavioural changes on account of training inputs have to be assessed within a short time after training. If the exercise is delayed the respondents may find it difficult to recall post and pre-training behaviour of the trainee. Consequently the data obtained in the interviews could be impure. Organisations use questionnaires to be filled by the trainee and his colleagues, including the supervisor. We have, however, found it necessary to obtain data from personal interviews at least from a sub-sample of the population.

REFERENCES

* Measuring the Competence of Healthcare Providers by Neeraj Kak, Bart Burkhalter, and Merri-Ann Cooper * Human resources in Organizations by Dr Deepak Dogra