01 SES 04 B, More Than an Education Professional: Teachers Spanning Therapy and Health
Recognizing that in the 21st century more flexible, multi-skilled and team-oriented health professionals are at the heart of health systems, the UN WHO emphasizes that in order for health professionals to meet these current needs of health systems, it is necessary to focus on the education of health professionals (WHO, 2016). The training of health professionals must be transformative, of high quality, lifelong, all health professionals should have the skills to meet the health needs of the population, and they should be able to work to their full potential (WHO, 2018). Meanwhile, as the WHO notes, all countries, regardless of their socio-economic level, have difficulties with health worker education, and the goal is to adopt transformative strategies to scale-up health worker education by 2030 (WHO, 2016). The problem is even greater with the education of health workers to work with people with disabilities. Research studies suggest that health workers have poor knowledge, skills and preparation for providing services to persons with disabilities (e.g.Boyce, Devinsky & Meskis, 2020; Lalive d’Epinay Raemy & Paignon, 2019). Therefore, scientists emphasize the need to improve the health workers’ preparation or additional training to address the needs of people with disabilities and provide them high-quality patient-centered healthcare (e.g.Brown & McCann, 2019; Stransky, Jensen, & Morris, 2018; Kurowski-Burt & Haddox, 2018).
As for Lithuania, there is little known about the mentioned problem in Lithuania. Analysis of the legal framework for the preparedness of health students to work with people with disabilities shows that the documents regulating studies themselves and processes related to them pay little attention to the mentioned problem (Ratkevičienė, M., 2020). Several aspects of the problem were described by I.Baranauskiene (2020) in her book about situation of people with disabilities in health system. One earlier study (Česnauskienė & Gintilienė, 2011) revealed that a significant number of Lithuanian health students had at that time a clinical approach to the phenomenon of disability and fear of meeting patients with disabilities in real professional activities. However, there is an insufficient understanding of how Lithuanian health workers are prepared to work with people with disabilities currently. In order to gain more understanding in this regard, the present paper focuses on health workers’ preparedness to work with people with disabilities, based on self-reported information from health workers about their experience. Questions to be asked: Do health workers in higher education study a special module or subject, purposefully aimed at increasing their understanding of working with PWD? Is preparation for work with PWD integrated into various modules, subjects? Do health workers improve their qualifications to work with PWD in training courses and other events funded by the state/private workplace and at their own expense? Do they learn informally from colleagues, friends, reading articles, watching YouTube, etc.? Do they learn from their own experience? How do the answers to the above questions and the specialties of health professionals (doctors, nurses, physiotherapists, social workers providing health services) relate?
Our study used a subset of data from the 2019-2020 national survey aimed to understand the situation of people with disabilities in the healthcare system. A convenience sample of 664 health workers: 16.1% physicians (n = 107), 32.8% nurses (n = 218), 15.5% physical therapists (n = 103) and 35.5% social workers (n = 236). In order to assess how health workers were being prepared to work with PWD, the respondents were asked to answer one multiple answer question and choose those answers that reflect their preparation to work with PWD: *had a special module, subject in the study process, *such preparation was integrated in the study process by studying various modules or subjects, *did not study it at all during the study years, *studied in training courses and other events funded by the state or a private workplace, *studied independently in various courses and events at their own personal expense, *learned informally from colleagues, friends, reading articles, watching YouTube, etc., *learned from their own experience. Data analysis was performed using SPSS.22. Chi square test was carried out to evaluate whether there is a significant association between the health worker groups’ readiness to work with PWD. Standardized residuals (z-score) were used as a post-hoc analysis for Chi-square test.
The study revealed that Lithuanian health workers were mostly trained to work with PWD (people with disabilities) during the in-service education (through training courses funded by the workplace or personal funds, learning informally from colleagues, friends, reading articles, watching YouTube, etc.) and partly in pre-service education (preparation was integrated in the study process by studying various modules, subjects). The study also revealed the differences in physicians’, nurses’, physical therapists’ and social workers’ preparation to work with PWD. Overall, a little less than a half of respondents reported that they had studied working with PWD in training courses and other events funded by the state or a private workplace (45.6%), and that such preparation was integrated in the study process by studying various modules, subjects (41.4%), while less than a quarter responded having had a special module or a subject in the study process (21.1%). The research has revealed that about one third of healthcare workers learned from their own experience (38%) and informally from colleagues, friends, reading articles, watching YouTube, etc. (32.1%), about a quarter reported that they had studied independently in various courses and events at their own personal expense (23.2%). There were healthcare workers who had not studied it at all during the study years (9.9%). Interferential statistics showed statistically significant differences in health care workers’ preparedness to work with PWD among health care workers. These results are consistent with the studies carried out by other scientists (e.g., Devkota et al, 2017; Shakespeare & Kleine, 2015; Sorensen et al., 2017). The authors of this article, like other scholars, encourage policy makers and academic community to address the health workers’ needs to develop their skills and competencies to provide quality health care service for PWD.
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