Graduate health assistants' perceptions of their preparedness for practice in Bhutan

Abstract

Objectives: 1. To determine graduates perceptions of their preparedness for practice. 2. To determine supervisors expectations of what the graduates are able to do. 3. To identify strengths and weaknesses in other aspects of the training program. Study design: a Cross-sectional Descriptive study Setting: Health centers across Bhutan. Research methodology: 140 health assistant graduates from 1999 to 2003 and their 50 supervisors were surveyed using a self completion questionnaire. They were asked to rate their perceptions of the importance, adequacy of training and preparedness for practice in 63 tasks under eleven key competency areas. An arbitrary criterion of 70% was used to determine importance, adequacy and preparedness in a task. Results: Response rate for graduates was 97% (138) and 100% for supervisors. Mean age of graduates was 25.31 years and 53% were females. All graduates and supervisors felt all tasks were important. More than 70% of graduates felt unprepared in 40 of 63 tasks. 30% but more than 70% of supervisors felt graduates were prepared in only 13 of the 63 tasks. More males felt prepared than female graduates. There was no definite trend over the years. Areas of inadequate preparation were identified by both groups. The greatest weakness was short duration of the training, inadequate practical experiences and poor supervision and guidance. Conclusion: Graduates felt adequately prepared in most of the tasks but supervisors perceive that graduates are inadequately prepared in most areas. The truth maybe somewhere in between. It would be reasonable to assume that the HA training program at the Royal Institute of Health Sciences is relevant but does not adequately prepare its graduates for practice in their diverse roles as primary health care workers. Potential improvement strategies recommended are increasing the duration of training, introduce a program of internship, improve supervision of students during clinical or filed work and focus on practical experiences and training in actual practice settings