1

Introduction Training and education in healthcare are above all others in healthcare promotion, program and service-based planning, development and implementation. These constituent or elements also serve as the basis for general and specialized knowledge and practice within the medical field. However, knowledge acquisition and knowledge attainment alone do not necessarily assure competence (HENOD, 2011). In fact, education without application limits its scope and applicability. It constrains learning to fact memorization and promotes knowledge silos. Understandably then, competence extends from knowledge application and knowledge deepening (UNESCO, 2008). It informs and infuses the healthcare and medical knowledge bases through knowledge creation, deep analysis and the synthesis of research and practice. Therefore, many healthcare professional training programs have engaged simulation and clinical practice and devised competency goals (Smith, et.al., 2007; Perkins, Hulme & Bion, 2002, p. 698). Measuring knowledge acquisition and knowledge deepening through competency attainment not only helps these institutions assess professional knowledge it help student and educational deficiencies and will effectively improve their educational programs but also increases the level of care their graduates deliver (UNESCO, 2008; HENOD, 2011). Education Nearly every career in the healthcare field among us today requires certain education and training. With the emergency of more specializations, knowledge bases and the increasing division of labor within the medical division, many presentations focus on the necessary courses, satisfying accreditation boards, preparing students for certification exams within the institutions that help these colleges and technical schools prepare the curriculum (HENOD, 2011). Accordingly, several forces determine what should be learned and taught, but few people and

institute of higher or professional learning concern themselves with competencies, the attainment of such, or levels thereof (2011). Rather, coursework and exams quantify learning, but such measurements frequently assess knowledge acquisition (Smith, et.al., 2007, p. 901). This is where the problem lay. After all, healthcare is much more than a body of knowledge. It is a practice, a subordinate element of art and science. Competency and its Importance Every program for healthcare intervention or promotion, research and analysis make necessary competency (HENOD, 2011). Notably, these competencies do not necessarily reflect to the facts but accurately lengthen the theoretical application into the healthcare setting through delivery assessment and evaluation (2011). Therefore, education and training supply the fundamental or specialized knowledge upon which students build skills and practice. Yet, knowledge is still required in order to build competence (UNESCO, 2008). To make a long story short, for example, a healthcare professional knows that healthcare beliefs and practices are different with populations and merely engages someone to communicate a message, this may not demonstrate competence. The translator may speak the language but lack the cultural competence. If the translator is not familiar with the culture, its nuances, and its historical elements, he or she will fail to establish or build a relationship or connection because of this. This demonstrates suboptimal cultural competence. Likewise, healthcare providers in an emergency lack competency training, Although they meet their requirements or achieve certification, they do not have the skills or experience and competency levels to deliver care. Their knowledge is academic. Countless studies verify such assertions. In fact, the 2007 Smith, et.al., Intensive Care Medicine article, Undergraduate training in the care of the acutely ill patient: a literature review

reveals suboptimal training among Undergraduates and junior physicians (p. 901). Smith, et.al., (2007) contends that these graduates, despite their education lack knowledge, confidence and competence in all aspects of care including the basic recognition and management of the acutely ill patient (p. 901). Given these findings, education and training must do more to promote skill cultivation, knowledge deeper to decrease the associative patient risks, such deficiencies pose (p. 901). While Smith, et.al., (2007) substantiates results of other healthcare delivery studies and the correlation between education, training and competency levels or lack thereof, Smith, et.al., (2007) also illuminates the persistent argument over pedagogies and learning through doing (p. 901). For centuries, many philosophers and educators have contended that learning through doing, applying knowledge to build skill or using curiosity to drive knowledge, skill and experience build meaningful relationships between facts and applicability. This relationship also promotes competency. Establishing, tracking and evaluating competencies Although healthcare delivery extends from competency, developing core competencies, the measurement and tracking such progress toward acceptable levels has been problematic. Because of all the educational constraints imposed by belief or reliance, agencies of certification, and the institutional requirements themselves, competency often gets lost in educational attainment. To address this expression and the divide between academic and clinical knowledge in order to develop more competent healthcare professionals, several institutions and agencies have developed and implemented different programs (Perkins, Hulme & Bion, 2002, p. 698). Notably, these include integrating peer-level training, computer and situation-based simulations (p. 698).

Additionally, many more programs are building earlier clinical rotations and training into their current curriculum (Smith, et.al., 2007, p. 901). In acute care, for example, Smith et.al., (2007) reveals that many more programs are using the clinical approach to lessen competency deficiencies. Through the integrated approach, education exposes the students to life support and clinical skills much earlier and the couples this training with (Smith, et.al., (2007) later exposure to more complex acute care topics. This integrated approach builds confidence and skill. It also promotes knowledge acquisition and deepening and facilitates the connection between academic or theoretical knowledge and applied knowledge. Because of these additions, establishing competencies, tracking and assessing them has also become mandatory. Yet, the assessment and evaluative measures engaged more accurately reflect those engaged in healthcare programs and service planning, evaluation and continuous improvement (Issel, 2009, p. 73). After all, the initial additions to the coursework are based on data, target the core competency deficiencies, contrast, and compare measures before and after such training initiatives (p. 72-75). Based upon the results and the input from the clinical practitioners and students, the coursework and amount of clinical integration can be revised. Conclusion Although training and education in healthcare are paramount in healthcare promotion, program and service-based planning, development and implementation, establishing, tracking and measuring core competencies has been problematic. This has often resulted in increased patient risks, lack of healthcare professional confidence, knowledge and skill. For understandable reasons, more integrated training, earlier clinical exposures and peer led training have alleviated many of these inadequacies. Yet, like the healthcare institutions that employ continuous

improvement programs based on competencies and its outcome , the educational institutes themselves have had to develop and implement similar methods in order to assure quality.

References

Issel, M. L. (2009). Chapter 3: Planning for Health Programs and Services. Health program planning and evaluation: A practical, systematic approach for community health (2nd ed.). Sudbury, MA: Jones and Bartlett. Retrieved from http://books.google.com/books?id=J59RZB8JKRQC&dq=LINKEDDATA&ie=ISO8859-1&source=gbs_gdata Healthcare Education network of Delaware, [HENOD]. (2011). Responsibilities & competencies for health educators. Retrieved from http://www.henod.org/ competencies.html Perkins, G. Hulme, J. & Bion, J. (2002). Peer-led resuscitation training for healthcare students: a randomised controlled study . Intensive Care medicine, Vol. 28 (6): 698-700. Retrieved from http://www.springerlink.com/content/8vbfmmdy7q61lmkr/ Smith, C.M. , et.al. (2007). Undergraduate training in the care of the acutely ill patient: a literature review. Intensive Care medicine, Vol. 33 (5): 901-907. Retrieved from http://www.springerlink.com/content/ar286213m743v17g/ United Nations Educational, Scientific and Cultural Organization, [UNESCO] (2008). ICT competency standards for teachers. Retrieved from http://unesdoc.unesco.org/ images/0015/001562/156207e.pdf