"Elevating Healthcare Excellence: The Crucial Role of Academic and Training Initiatives in Hospitals"

Demographic changes, technological and scientific advances like Artificial intelligence, and continued cost pressures necessitate a re-examination of how health professionals are prepared for newer challenges in patient care. The changing environment of health care will have multifold consequences that can be expected to affect the education of health professionals. Firstly, the patients will have a greater stake in influencing their treatment decisions, both because they will bear the costs of care and because they will be faced with making more choices as technology expands treatment options. Secondly, there will be an increased call to measure and manage care as costs increase in the face of concerns about quality and access and as information technology makes it more feasible to do so. Thirdly, improving health will require a broader view in which the discoveries of science and the new biology combine with those of the social and behavioral sciences to affect the determinants of health and illness. For example, in the near future analysis of disease at the molecular level will move diagnosis to that level as well (Pollard, 2002). Clinicians will require skills in differentiating genetic, other, and combined sources of illness. This requirement will alter the skills needed for diagnosis; moreover, treatments will have to be individualized to accommodate expected responses to treatment given a patient's genetic profile.

To prepare health professionals for all these challenges, the clinical experience becomes a priority area for urgent redressal. It is not enough to say what should be taught as part of on-the-job training; it is also necessary to consider the context in which it is taught, the approaches used, and how knowledge, skills, and attitudes are both acquired and taught by these health workers.

Marjolein Berings et al (2008) in their study w.r.t on job training in healthcare setting, mentions that ‘learning by doing one’s regular job should be related to learning by reflection, since one mainly learns by thinking over these regular work experiences’.

It was also indicated many times that reflection often takes place in social interaction as ‘joint reflection’. Thus, on job training in Healthcare becomes vital to understand the mechanisms of health and illness, how to treat patients and their diseases more effectively, and how to provide healthcare to a community more effectively.

Just to give you an example, at ACCF the need for on job training has been an integral part of our long-term vision. The training is not just limited to nurse, as doctors, technicians and even support staff like GDAs and housekeeping have been included in the scheme of things. Let us look at the training and academic activities in last one year.

When we look at academic program, even before the inauguration of our 7 Hospitals, we started with 3-year Onco Path fellowship and Surgical Onco fellowship for our specialist doctors. This year,4 Onco path fellows are going to complete their fellowship. In addition, academic session for clinicians is a routine affair with monthly clinical sessions taken by senior oncologists. In addition, Palliative training for GDMOs has also been started. Similarly, the Nursing fellowship program is running with its 4th and 5th Batch of 191 nurses.? Furthermore, academic sessions for radiation safety officers, Medical physicist is also undergoing on monthly basis with 22 sessions in FY 22-23.

?On top of these, recently the review of the existing NFP syllabus has been completed successfully with inputs from clinicians and other stakeholders. For example, inputs in form of more focus in chemotherapy, management of side effects, interpretation of Neutropenic etc. have been incorporated post revision exercise.

Apart from NFP, as part of Continuous nursing education, biweekly sessions for nurses have been scheduled from April 2023.

These academic sessions include not only clinicians but also includes separate dedicated sessions for RSO/Medical physicist ,RTT , Housekeeping /GDAs etc.. Some of the major topics that were taken up in the last few months are:

CME Program has been envisaged as an integral part of our academic calendar. ACCF has successfully conducted CMEs at Dibrugarh, Tezpur and Barpeta cancer centers. Recently we successfully organized the first ever Northeast Oncology Summit, NEOS 2023. The summit - symbolically conducted in the hinterland with a theme of 'Local Challenges and Global Solutions', has been able to draw the attention of pioneers in the field of oncology to focus on the high incident rate of cancers in the Northeast.

Furthermore, we have been able to successfully register our presence across various academic platforms not just within India but also internationally. For examples our clinical team has represented ACCF at Japan, Switzerland, Thailand, etc.

In spite, of all these, we plan to add more training and academic programs at ACCF. Few of the aspirational things on our future agenda include starting of specialty and super-specialty DNB programs in medical/surgical/Radiation oncology, Nuclear medicine, Gynecological oncology. Furthermore, there are long term plans to start many more fellowship programs in branches like interventional radiology, Head and neck oncology, Onco-anesthesiology, palliative medicine, Haematoncology, Pediatric Oncology, to name a few. In addition, the plan to start nursing colleges across all our 7 centers has already got approval and will further bolster the academic environment within ACCF. We should also look at starting of few training programs for clinicians (radiation/radiology/lab), phlebotomists etc.

In next few years ACCF can be expected to demonstrate leadership in the design and development of educational approaches for Oncology professionals throughout the continuum of education. With the continued focus on oncology as evident by the upcoming 17 ACCF Cancer Hospital, South Asian cancer research centre at Guwahati and the research facility at IIT Guwahati, there will be higher spurt in the demand for Oncology trained professionals. We at ACCF are geared up to take a leadership role in meeting these challenges. Our teaching environments will need to provide a sound base of knowledge that includes not only the emerging sciences in oncology, such as tumor microbiology, molecular oncology, or cytogenetics, but also the social, behavioral, and other sciences that are important to improving health. Providing a broad-based scientific and humanistic foundation will require that all teaching environments reexamine the content, methods, and approaches used at all levels of clinical education.

Given these trends and directions, we need to continue our endeavor towards delivering the best of the knowledge and training to prepare the healthcare professions for tomorrow and the key to ensure this is by having a mix of three strategies a) interdisciplinary approaches that ensure a broader view of health, b) Latest tools and methods for managing information, and c) training in real hospital settings.

Thus, would like to finish my write-up by leaving you with the thought of changing the landscape of job/academic market due to AI (Artificial intelligence). As robots, automation and artificial intelligence perform more tasks and there is massive disruption of jobs, experts say a wider array of education and skills-building programs will be created to meet new demands.

In this ever-accelerating race alongside AI tools, we healthcare professionals must arm ourselves with strategies that go beyond the ordinary. This entails embracing powerful tools such as on-the-job training and academic development. These immersive training environments are essential to foster and refine our distinct human abilities, those that elude artificial intelligence and machines.

At the uppermost tiers, our capabilities must encompass the art of seamless networking, adept public relations management, an acute sense of intercultural sensitivity, masterful marketing skills, and what acclaimed author Dan Goleman aptly terms as 'social' and 'emotional' intelligence. It is in these uniquely human attributes that we will find our edge in this race for excellence."

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