Training in a hospital is the need of hour
Ram Nath Prasad

Before we discuss the subject ’Training’ in details, let us understand the concept of HRD - Human Resource Development, in brief. The term HRD was first used by Dr Leonard Nadler in 1969. He defined HRD as an organised learning experience in a definite time period to increase the possibility of improving job performance. The people working in an organisation are assets with unlimited potential and such a positive view should form the core of the human resource system and similarly, the core of HR should be development of human beings or HRD.

Larsen & Toubro Ltd is the first company (in India) which understood the importance of HRD and carried out HRD exercise in its set-up. A team studied various aspects of performance appraisal, potential appraisal, employee counselling, career development and planning & training. Various changes were introduced thereafter and they produced remarkable results. In a hospital, HRD is of utmost importance because it is a place where continuous interaction is taking place among various parties - patients, doctors, hospital staff and outside parties (such aspharmacists, medical representaives, suppliers of equipment etc).

In today’s world where there is greater degree of awareness, there is a stronger need for hospitals to develop its human resources. Training is considered an integral part of HRD. No HRD initiative can be conclusive without invlolving training at one or other stage.

Definition & scope

Training in an organisation is concerned with acquisition or development of those knowledges, skills, techniques and experiences which enable an individual to make his most effective contribution to the combined effort of the team of which he is a member.The scope of training should include the following five areas:

• Knowledge
• Skills
• Techniques
• Experience
• Attitude

Knowledge means to understand and to remember facts, informations, principles etc. An ophthalmologist will be understood to have knowledge of the diagnostic equipment ’Slit Lamp’ if he can answer following questions satisfactorily:

a) What is name of the equipment?

b) What are its different parts?

c) What is/are the function/functions of slit lamp/its different parts?

d) What is the principle behind its working?

e) What result does it produce?

f)How to operate it? and sets of similar questions like above.

Skills is physical act or action. It is application of knowledge. After having known the slit lamp, an ophthalmologist has to learn how to operate it and it is nothing but leaning skills. So mere knowledge will not suffice, its practical demonstration and thus development of skills is equally important.

Technique is the application of both knowledge and skills in a dynamic situation. Examination of the patient by an ophthalmologist using slit lamp is a dynamic situation. He has to use his knowledge about the slit lamp and apply his skills by correctly operating it. So, he is demonstrating his techniques.

Exerience means applying the knowledge, skills and technique over a peiod of time and in various situations. Experience gives strength the process of learning.

The right attitude of an ophthalmologist while using diagnostic equipment/surgical operating equipment, will encourage him/her to take all precautions/safety measures to avoid any damage to the equipment or life. It is very difficult to change attitude of a person.

Training - need & importance

Let us discuss it section/departmentwise.

Administration: Most of the hospitals in our country are being managed by personnel who are professionally not qualified to carry out the jobs. Senior doctors are designated as hospital superintendent/hospital administrator and are given the jobs of day-to-day administration. The results are not encouraging. Most of the hospitals are in bad state. Doctors are given the administration job but there is no training programme to equip them with requisite knowledge and skills to carry out the job in the efficient manner. The theory of ’learning by doing’ is prevalent. So what can be learnt in a very short period of time by means of training, takes years to do and the learning becomes a phenomenon largely dependent on experience. Similarly, public relation is another area which needs urgent attention in a hospital.

The qualified and well trained public relation personnel(such as reception staff, counsellors) will immensely add to the satisfaction of the patient and it will enhance the reputation of hospital, too. It is such an area where a lot of things needs to be done.

Clinics(Medical personnel/doctors): Once they complete their MD/MS (Master’s programme) and register themselves with Indian Medical Council or State Medical Council, only a small percentage of them are lucky to keep themselves updated with the latest developments in their respective fields by attending seminars, conferences or technical training programme. Also, there is no system of review/verification to confirm whether the doctors are still competent to practice in their respective fields of medicine without violating a minimum standard or their techniques have become obsolete with passage of time. If such criteria are to be followed, the hospitals will be compelled to have an annual training programme for their doctors and it will help doctors to keep themselves abreast of the latest happenings in their fields. Apart from the above, the doctors need to be trained about handling of patients, too. They may require training for developing their human skills. Very few hospitals in our country are having a elaborative programme for training of their human resources including doctors.

Nursing staff: They till date remain the most neglected ones. We have acute shortage of trained nursing staff. However, we have never bothered to fill the gap. We do not have adequate number of schools/colleges which conduct courses/training programme in nursing. Also, nursing is not looked upon as a prestigious career option. Due to these reasons, we have always faced the shortage of trained nurses/sisters. Neither government nor private sector has paid attention to it. The lack of post recruitment training programme has made the matter worse. Hospitals are recruiing untrained nursing staff and thereafter they are left to their fate. There is hardly any concern for their career development and planning.

Staff/sweepers: Most of them are illiterate. They are responsible for the cleanliness/hygiene factor in the hospital but very few of them understand its importance. In goverment run hospitals, situation is worse. Nosocomial infections are very prevalent there. There is need to train these sweepers/cleaners, too. They must know about the importance of their jobs. How important are they for the hospital - need to be put into their mind. It will be motivational factor for them.

(To be continued)

(The author is an alumni of IIT, Kharagpur and is working as hospital administrator at Sankalp Hospitals Pvt Ltd, Jam Nagar and can be reached at shpl eye@ad1.vsnl.net.in)