“The COVID-19 has had a significant impact on skill training in healthcare, especially for nurses, and has essentially brought the attention to two areas of need – infrastructure shortages and skill gaps among the healthcare resources”, mentioned Dr. Srinivasa Rao Pulijala, CEO, Apollo MedSkills, while talking about the impact of COVID-19 on the healthcare industry in India.
Through the FINE (Finishing Skills for Nursing Excellence) program, the Apollo Medskills and TCS iON, want to address just that – the infrastructure shortages in the healthcare sector and the skill gaps of the nurses to make them globally competent.
The FINE programme is developed by Apollo Medskills and digitally delivered by TCS iON through a phygital model. It is a unique, job-linked skilling programme that aims to transform nursing education by providing finishing touches to the academically acquired skills of the nurses by upskilling them as per the industry requirements.
To learn more about the FINE program and how the partnership is going to address some of the critical challenges in nursing education in India, the need for digital skills in healthcare, among others, we conversed with Dr. Srinivasa Rao Pulijala, CEO, Apollo MedSkills, and Mr. Ranjan Choudhary, Head of Partnerships for Vocational Education, TCS iON.
Below are a few excerpts from our conversation. You can watch the full video on our YouTube channel.
Q: What has been the impact of COVID-19 on skill training in the Healthcare industry, especially in training the nurses? What role did technology play in coping with the challenges of training the nurses with limited time but at a large scale?
A: Dr. Srinivasa Rao: COVID-19 has had a significant impact on skill training, especially for nurses, and has essentially brought attention to two areas of need:
- Infrastructure shortages
- Skill gaps among healthcare resources
There was an absolute and urgent need to upskill nurses in certain clinical and administrative areas, and behavioural competencies. Ventilator management was a challenge, so there was a need to train clinicians on ventilators and also get them hands-on experience in using ventilators. These are some of the essential areas that we have concentrated on with respect to training. When it comes to nursing, the gaps in skills that nurses possess and the gaps in continuous medical and nursing education have been significantly highlighted during this period.
There are currently about 28 million nurses in the world, and between 2013 and 2018, this number has increased by 4.7 million. However, there is still a shortage of 5.9 million nurses worldwide at present, with the highest gaps being in regions like Africa, and South East Asia, including India, the Eastern Mediterranean region, and some portions of Latin America. Thus, there is a shortage of nurses on a global scale. Since India has historically been one of the world’s greatest suppliers of nurses, there is a need to scale nursing education, and both the public and private sectors have taken numerous initiatives to expand the infrastructure for nurses’ skilling in India.
Talking about the role of technology in coping with the challenges of training the nurses, Mr. Ranjan Choudhary shared the below points –
Mr. Ranjan Choudhary: COVID-19 marked a turning point where the entire paradigm of learning and acquiring skills and competencies underwent a radical change. What was previously thought of as a brick-and-mortar method of providing education in learning skills and competencies has undergone a significant change as a result of the pandemic. This can be seen both in terms of using technology to provide education and to upskill people and a larger fraternity accepting online medium as a valid means of acquiring education and skills.
The pandemic definitely highlighted the importance of healthcare. Moving forward, this is a sector that rightfully calls for increased focus and funding to provide top-notch educational and skill-building opportunities that would be accessible throughout the country. India is a country with a huge population, so reaching out to everyone while ensuring that the quality of the information or the trainers who will deliver the learning and competencies is not diluted, the hybrid model or phygital model (physical + digital) would be vital and the way forward not only in healthcare but across industries.
Q: What steps are you taking towards addressing a few crucial challenges in nursing education?
A: Dr. Srinivasa Rao – Traditionally, Apollo Medskills has been offering classroom training across 24 Indian states. However, during COVID-19, we came to understand the value of blended learning as it was necessary to train people at a large scale quickly. After all, there was no time to spare. During COVID-19, we trained close to 2,50,000 healthcare professionals in COVID-19 management, and the only way it was possible was through technology and blended learning.
We divided our learning components into knowledge and competencies for healthcare learning and realised that the knowledge component of the course could be imparted digitally. Wherever practical skills training and competency were required, we utilized our infrastructure of simulation labs and the network of hospitals for training. We will be able to address the scale required in a short period by using the blended learning models, which are the models of the future.
Q: How is the partnership between TCS iON and Apollo Medskills going to address the training challenges faced by nurses through the phygital model?
A: Mr. Ranjan Choudhary: The Apollo has had a legendary reputation in India’s healthcare sector for many years and has a huge national presence. TCS’s role is to make use of Apollo’s expertise in terms of content, instructors, and pedagogy and expand the reach of these learning programs across the nation by utilizing our platform.
Apollo adds knowledge and sectoral competence, whereas TCS contributes its technology and platform expertise. Moreover, by working together, we would make this available to nurses all around the country through various nursing programs, nursing colleges, and other training institutions. Nursing education is available everywhere, but Apollo and TCS want to make a difference by giving them the knowledge, skills, and competence that will enable them to advance from being a good nurse to great nurse.
Q: What makes the Apollo MedSkills FINE programme delivered through the phygital model different? What are the ways in which it can improve the career prospects of a nurse through upskilling and continuous learning?
A: Dr. Srinivasa Rao: The FINE stands for Finishing Skills for Nursing Excellence, therefore the program’s vision includes excellence. A highly thorough nurse training course was specially created for new-hire nurses. It will equip nurses who are graduating from nursing schools to face real-world hospital situations. For the delivery of healthcare, it is crucial to train nurses because they play an important role in clinical delivery and clinical outcome in hospitals.
There are about four learning gaps in their graduate nursing course:
- Clinical competencies: Nurses have to be sharp and quick learners so that they are readily deployable
- Healthcare quality: Most hospitals are accredited by organizations like the Joint Commission International (JCI), the National Accreditation Board of Hospitals (NABH), or the Quality Council of India (QCI). Therefore, nurses should be made aware of these quality standards and process excellence.
- Grooming and administrative skills: Nurses usually spend most of their time with patients in the hospital, therefore, they should be endowed with particular behavioural features, such as how to manage patient attendance, reassure patients, and instil confidence in them.
- Emerging digital technologies: The emerging digital technologies and digital skills in healthcare are equally crucial.
This FINE program curriculum has been thoughtfully designed and developed based on these four areas. The knowledge component of the program is delivered digitally via the TCS iON Learning Management System, which is a user-friendly system. The skills components are delivered via simulation labs through a network at various locations across India.
The competency components are delivered through training that is meticulously structured using a skill log book that is provided to the students at the time of training. This is how the program is set up, and the goal is to have a significant impact on the number of nurses in India. This will benefit both newly graduated nurses and hospitals alike by making it much easier for the human resource departments to onboard new employees into the hospitals after they graduate.
Also read: The need for an industry-integrated curriculum in nursing education in India – https://www.nationalskillsnetwork.in/the-need-for-an-industry-integrated-curriculum-in-nursing-education-in-india/
Q: What role does TCS iON play in transforming nursing education in India (through technology) and how is it improving the overall healthcare ecosystem, especially in rural areas?
A: Mr. Ranjan Choudhary: This is not just a program that exists to transfer knowledge; the impact that we aim to generate is throughout the nation, and the majority of it is in semi-urban and rural areas. The course heavily emphasizes on developing skills and competencies in a real-world setting, which is handled through Apollo’s hospital network. Our objective is to reach out to nursing colleges and nursing institutions not only in cities but also in semi-urban areas, so along with Apollo, we are bringing this to nursing schools across the nation. We have already held one seminar in Telangana and will soon be holding more seminars in various other southern and northern states of India. We also have a team that is actively working on the ground across many states connected to different institutions who will be reaching out to nursing colleges and institutions.
Q: In this model, are students entitled to sufficient clinical experience/ exposure? What kind of resources can a student get access to? How are assessments done?
A: Dr. Srinivasa Rao: Firstly, in theoretical sessions, classes will be taken on key knowledge gaps that we have identified. As a result, they have access to some of the top nursing trainers in India. There are academic nurses and clinical nurses, and it is crucial to have a mix of the two because academic nurses focus on the knowledge aspect while clinical nurses focus on the practical aspects of the hospital setting and how the knowledge learned in the classroom is applied in the real-world hospital setting.
Nurses must gain some simulation experience before entering a real environment, and in the simulation labs, they have access to three types of simulation. They have access to nursing trainers, thanks to technology because this is delivered online on TCS iON LMS and trainers from anywhere can teach the students remotely.
Apart from these, they also have access to:
- Mannequin: Have access to a mannequin with a human anatomical structure so the nurses will have a similar tactile experience of a human being, which is a tactile simulation. The benefit of using a simulation in this learning is that it is safe. For example, putting a rising tube in the nose is a painful procedure if you have to do it on a real patient. Additionally, we instruct them in drawing and how to catheterize a bedridden patient, and also how to draw blood.
- Environment: We create fictional environments for an Intensive Care Unit (ICU) and ward of an emergency room, and we role play so that the students undergoing training can experience what an ER (Emergency Room) will be like. An instructor will be present to observe and brief them on how they are performing.
- Animation: Animation is utilized in training through digital simulations. Recently, we installed an Artificial Reality (AR) and Virtual Reality (VR) facility in our simulation labs, which will be accessible in cities.
We have a network of hospitals that includes Apollo hospitals and hospitals partnered with both Apollo Medskills and TCS iON. These hospitals will serve as training facilities for the on-the-job training of nurses. The On-the-job training is important because it is very immersive learning in a real environment. They will gain access through this learning and have an observership to hospitals in Tier 1, Tier 2, and Tier 3 cities as well as urban and rural areas. So, before they are accessed and certified, they have to complete this on-the-job training and have an assessment done based on the submission of their assignments and simulation, and on-the-job training. These assignments that are guided through a log book, and a final assessment is an online assessment that includes MCQ and clinical-based assessment. The students have to clear both to get certified.
Q: How are you going to take this partnership forward? How can other academic/ training institutions in the Healthcare sector collaborate?
A: Mr. Ranjan Choudhary: The collaboration we see with Apollo through the FINE program is just one of the initiatives we are starting, but we believe it has the potential to have a significant impact.
We are confident that as time goes on, the program will be expanded to include more job categories for those who work in hospitals and related healthcare facilities. But in terms of the FINE program, it will involve a combination of virtual and live seminars with nursing institutes, in addition to the outreach efforts by our ground sales team to institutions in their respective regions.
In addition to the learning program, there is also an assessment that would be very thorough industry-recognized certifications, and most importantly, Apollo and TCS iON will work together to make sure that every student who completes this program successfully is placed more effectively through our network.
Dr. Srinivasa Rao: Apollo Medskills and TCS iON conducted workshops with the stakeholders to get their initial impressions of this program. The workshops were primarily attended by senior nurse leaders from academia and hospitals. And I believe everyone was overwhelmed upon hearing about this particular course. They emphasized the need for such a program and how most of the challenges they are currently facing in the hospitals and also at nursing institutes can be addressed through this program.
The nurses, hospitals, and institutions, as well as all the other stakeholders, are partners in this. The nurses themselves are partners because we need a commitment to learning from them because it is not simple for them. Therefore, they are also pleased that the nurses trained on this, who would join them would be more knowledgeable, have better skills, be safer and reduce their onboarding time as well.
Q: Is there anything else you would like to say?
A: Dr. Srinivasa Rao: I would like to say that this program is necessary at this time because it is robustly covered, and many new fields are developing, especially in the field of geriatrics. In the clinical world, we are facing three types of challenges: the first is from communicable diseases, such as the pandemic that we have experienced; the second is from non-communicable diseases, such as hypertension, diabetes, and stroke; and the third is from trauma or traffic accidents. We have added technological components like Artificial Intelligence, clinical decision support systems, and remote monitoring, particularly in-home care, to the curriculum.
Click here to know more about programs offered by TCS iON in technical and vocational education – https://learning.tcsionhub.in/hub/ve/
For more information about TCS iON phygital model for vocational education, please email at firstname.lastname@example.org