Epidemiology training needs assessment in Vietnam

Abstract

Vietnam is facing numerous health threats, including those imposed by HIV/AIDS, acute diarrhoea, H5N1 and H1N1, and has a shortage of trained preventive medicine staff (PMS). Only 15% of the health workers currently working in the preventive medicine system are trained in this specialty. The system is estimated to require a further 320 and 1400 PMS at national and provincial levels, respectively, in the course of this year. Thus, developing an updated and practical preventive medicine curriculum (PMC) to help to deal with these health threats is a top priority. Epidemiology is an essential component in the PMC. Unfortunately, the epidemiology competencies developed in the traditional PMC are no longer appropriate in training PMS to deal with health threats in the current global context. An epidemiological training needs assessment (ETNA) is a crucial first step for clarifying the competencies needed by PMS. Three stages of ETNA were carried out. Stage 1 used focus group discussion and in-depth interviews with PMS, faculty members and community representatives to identify the competencies needed at different levels of the preventive medicine system. In Stage 2, workshops with key preventive medicine and public health informants and faculty clarified the overlapping and inconsistent competencies identified in Stage 1 and grouped them into 15 main competencies. In Stage 3, 426 PMS were asked to rate these 15 competencies on three dimensions: ‘frequency of use’; ‘importance’, and ‘self-confidence in doing’. In addition, 220 faculty staff were asked to rate these 15 competencies on three dimensions: ‘need’; ‘required skill level’, and ‘self-confidence in teaching’. Different points of view emerged among the different stakeholder groups. Across the 15 competencies, the faculty ratings for ‘need’ and PMS ratings for ‘frequency of use’ differed. Only four competencies were rated similarly; four other competencies were rated one scale higher or lower and the other seven competencies were rated significantly differently by the rater groups. A comparison of faculty ratings for ‘required skill level’ and PMS ratings for ‘frequency of use’ showed that six of the 15 competencies were rated significantly differently. A similar outcome emerged in a comparison between faculty ratings for ‘required skill level’ and PMS ratings for ‘self-confidence in doing’, except for the vector control competency. Although faculty members seem more aware of the need for these 15 competencies than PMS, they were less self-confident using these competencies: 25.84% (± 4.86%) of faculty members felt confident with 15 competencies versus 61.72% (± 9.82%) of PMS. Notably, an average of 27% of PMS did not feel confident in practising the five most frequently used competencies. That there are different points of view among different stakeholders regarding the epidemiology competencies required for PMS is a key point which must be kept in mind when developing the epidemiology component in the PMC. Competencies that PMS frequently use but lack confidence in should be prioritised. Competencies for which the ratings by faculty members and PMS differed should be considered in terms of their content and the time allocated to them. Trainer training for faculty staff in the 15 identified competencies is necessary to prepare faculty members to teach preventive medicine students.