Training Of Health Professionals Research Articles

Cultural beliefs versus professional health training: implications for healthcare delivery to persons living with intellectual disabilities in Ghana

ABSTRACT Background In most African countries, disability is explained by cultural beliefs. This has implications for healthcare delivery for persons with intellectual disabilities. Methods With the aid of a qualitative approach, we explore the interplay between cultural beliefs and the training of health professionals and their implications for the healthcare delivery to persons living with intellectual disabilities in the Asokwa and Oforikrom Municipalities. Findings Findings revealed that cultural beliefs about intellectually disabled people include the idea that their facilities are forbidden and that pregnant women who pass by them may have a child with a disability. Further, health professionals received little intellectual disability training. As a result, healthcare professionals lack knowledge of the needs and care of this group. Conclusion This study recommends that professionals should take comprehensive intellectual disability courses in training schools. Also, health professionals should attend periodic workshops on the range of intellectual disabilities to raise awareness of their needs and care.

Gamification: Basic concepts and applications in radiology

Gamification is the use of elements from games in non-game environments, such as education. It is an alternative educational focus that promotes students’ motivation and participation in the learning process. Gamification had proven effective in training health professionals and can play an important role in diagnostic radiology training, both at the undergraduate and postgraduate levels. Gamification activities can be carried out in real environments, such as classrooms or session rooms, but there are also interesting online modalities that favor remote access and user management. The possibilities of gamification in virtual worlds to teach undergraduate students radiology are very promising and deserve to be explored in training residents. This article aims to review general concepts in gamification and to present the main types of gamification used in medical training, pointing out its applications and advantages and disadvantages and emphasizing experiences in radiology education.

The impact of interprofessional education interventions in health professional student clinical training: A systematic review

The impact of interprofessional education interventions in health professional student clinical training: A systematic review

The Use of Open-Source Online Course Content for Training in Public Health Emergencies: Mixed Methods Case Study of a COVID-19 Course Series for Health Professionals.

The onset of the COVID-19 pandemic generated an urgent need for credible and actionable information to guide public health responses. The massive open-source online course (MOOC) format may be a valuable path for disseminating timely and widely accessible training for health professionals during public health crises; however, the reach and effectiveness of health worker-directed online courses during the pandemic remain largely unexplored. This study investigated the use of an open-source online course series designed to provide critical COVID-19 knowledge to frontline health workers and public health professionals globally. The study investigated how open-source online educational content can be optimized to support knowledge sharing among health professionals in public health emergencies, particularly in resource-limited contexts. The study examined global course enrollment patterns (N=2185) and performed in-depth interviews with a purposive subsample of health professionals enrolled in the course series (N=12) to investigate the sharing of online content in pandemic responses. Interviewed learners were from Ethiopia, India, Kenya, Liberia, Malawi, Rwanda, Thailand, Uganda, the United Arab Emirates, and the United States. Inductive analysis and constant comparative methods were used to systematically code data and identify key themes emerging from interview data. The analysis revealed that the online course content helped fill a critical gap in trustworthy COVID-19 information for pandemic responses and was shared through health worker professional and personal networks. Enrollment patterns and qualitative data illustrate how health professionals shared information within their professional networks. While learners shared the knowledge they gained from the course, they expressed a need for contextualized information to more effectively educate others in their networks and in their communities. Due to technological and logistical barriers, participants did not attempt to adapt the content to share with others. This study illustrates that health professional networks can facilitate the sharing of online open-source health education content; however, to fully leverage potential benefits, additional support is required to facilitate the adaptation of course content to more effectively reach communities globally.

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

Vaccination coverage against Human Papillomavirus (HPV) is low compared with uptake of other vaccines in many countries, including Brazil. The aim of this study was to examine the main reasons provided by parents or guardians of a target population that did not have the first dose of HPV vaccine in a small rural Brazilian municipality, and to verify the factors associated with the reasons for non-vaccination. This is a cross-sectional study with interviews based on the Health Belief Model (HBM), conducted with parents and guardians of 177 unvaccinated children or adolescents. The outcome of interest was the main reason for not vaccinating the child/adolescent. The exposure factors of interest were knowledge about HPV and its prevention as well as sociodemographic characteristics. The main justifications for not vaccinating were lack of information (62.2%), fear or refusal (29.9%), and logistical issues (7.9%). The justifications associated with adolescents' sex, fear, or refusal were mentioned by 39.3% (95% CI: 28.8-50.6%) of parents or guardians of girls and by 21.5% (95% CI: 13.7-31.2%) of parents or guardians of boys. The main barrier to HPV vaccination is lack of information. Further training of health professionals in clarifying the benefits of vaccination and differentiating the risks between boys and girls could encourage uptake.

Exploring the benefits and challenges of being a consumer educator in nursing education: A scoping review.

WHAT IS KNOWN ON THE SUBJECT?: The mental health needs of individuals are increasing following the COVID-19 pandemic, with a need to focus on the education of nurses to be equipped to respond. Stigma around mental health still exists for nursing students, with the implementation of mental health education by an individual with lived experience having a known positive effect on stigmatizing attitudes. Research on consumer involvement in nursing education identifies that the consumer role is often varied and casual, with no existing review on the consumer experience. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study emphasizes the importance of consumer involvement in nursing education. Alongside the literature focussing on the student benefits, this review highlights both the benefits of being an educator, and the challenges of being an educator from the consumer's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE: The knowledge around the consumer perspective mapped in this review has the potential to impact and transform education protocols for consumer involvement in education. This can maximize on the meaningful contribution that lived experience has within mental health nursing education. This review enforces the need for an awareness of the challenges consumers face in their role as an educator, and highlights the need for further understanding of how to overcome these challenges. There is also an opportunity to capitalize on the benefits identified by consumers in their role within nursing education and sharing their lived experience. ABSTRACT: Introduction While the mental health needs of populations are increasing, the targeted training of mental health professionals, specifically nurses, is required. Stigma surrounding mental health from nursing students exists, highlighting educational gaps. To address this, the involvement of consumers in undergraduate education has resulted in a positive effect on the stigmatizing attitudes of nursing students. There is still a limited understanding, however, of the consumers experience in this process. Aim To explore the experiences of individuals living with mental illness in educating nursing students. Methods The Joanna Brigg's Institute's (JBI) methodology for scoping reviews was used to search CINAHL, Medline, PsychInfo, Web of Science and Scopus including grey literature. The eligibility criteria for participants included individuals (a) diagnosed with a mental illness; (b) over 18 years of age; and (c) who participated in the educating of nursing students surrounding mental health in any context. Articles were only considered that were in the English language, and no time constraint was enforced during the search strategy for article selection. The search yielded 2640 results, of which 26 articles were included. Results Results found two prominent categories, including both benefits and challenges of being the educator from the consumer perspective. The benefits included: (a) the person behind the diagnosis; (b) reciprocal relationships; (c) positive effects on well-being; (d) unique contribution; and (e) purpose in storytelling. Challenges identified included: (a) vulnerability; (b) voyeuristic; (c) lack of preparation; (d) negative effects on well-being; (e) support; (f) not a real consumer; (g) variation of involvement; and (h) acknowledging consumer perspective. Discussion As consumer-led education for mental health nursing curriculum becomes mandated, amplifying the voice of the consumer in nursing education is crucial. While the benefits and challenges voiced by consumers in their involvement in mental health nursing education have been outlined here, further knowledge focussed on the consumer's experience as an educator outside the classroom setting, and in clinical practicum, alongside consumer involvement in specialized mental health education sessions, could aid in transforming consumer involvement. Implications for practice This review offers an incentive for nurse educators to capitalize on the benefits of educating for consumers to promote a meaningful contribution, while also practicing with an awareness of voiced challenges.

Incentivizing community health workers for scaling up mental health care in rural communities in India: A critical look at principles that work.

Given the low availability of trained mental health professionals, there is evidence on task sharing where basic mental healthcare can be provided by trained community health workers (CHWs). A potential way to reduce the mental health care gap in rural and urban areas in India is to utilize the services of community health workers known as Accredited Social Health Activists (ASHAs). There is a paucity of literature that have evaluated incentivizing non-physician health workers (NPHWs) vis-à-vis maintaining a competent and motivated health workforce especially in the Asia and Pacific regions. The principles around what works and does not work in terms of a mix of incentive packages for CHWs, while providing for mental healthcare in rural areas have not been adequately evaluated. Moreover, performance-based incentives which are receiving increasing attention from health systems worldwide, though evidence on the effectiveness of these incentives in Pacific and Asian countries is limited. CHW programs that have shown to be effective rely on an interlinked incentive framework at the individual, community, and health system levels. Drawing learnings from the past eight years in implementing the SMART (systematic medical appraisal, referral and treatment) Mental Health Program in rural India, we critically examine some of the emerging principles in incentivizing ASHAs while scaling up mental healthcare in communities using a systems approach.

The feasibility of a digital health approach to facilitate remote dental screening among preschool children during COVID-19 and social restrictions.

Tele-dentistry can be useful to facilitate screening of children, especially those living in rural and remote communities, and during the COVID-19 pandemic. This study evaluated the feasibility of tele-dental screening for the identification of early childhood caries (ECC) in preschoolers using an app operated by their parents with remote review by oral-health therapists. This cross-sectional study was a sub-project nested in ORIGINS Project, a longitudinal birth cohort study in Western Australia. Initially, children were visually examined by a paediatric dentist (gold standard). Subsequently, dental photographs were taken by parents using a smartphone camera. Two trained oral health professionals asynchronously evaluated dental photographs. The presence of dental caries was recorded as per the International Caries Detection and Assessment System-II classification. The diagnostic accuracy and reliability of the tele-dental screening and the gold standard dental examinations were then compared. Forty-two children aged <4 years were enrolled in the study. Twenty-five per cent of examined children had dental caries (mean dmfs=0.7). A total of 370 dental photographs were obtained. Parents were able to take good-quality photographs, with 90% of photographs rated as good to fair quality. Tele-dental screening demonstrated high specificity (>=95.5%) for both reviewers compared to the gold standard dental examination. However, the sensitivity scores for the two reviewers varied, ranging from 44% to 88.4%. Tele-dental screening for ECC was shown to be a feasible approach following a brief training for primary caregivers. This approach can offer a potential low-cost and sustainable alternative for visual dental examinations for young children, particularly in times of COVID-19-related restrictions.

Risks of snakebite and challenges to seeking and providing treatment for agro-pastoral communities in Tanzania.

Continuous occurrence of snakebite incidences and the vulnerability of some communities remain a critical problem in sub-Saharan Africa. Despite causing permanent disability to almost half a million people annually and numerous deaths, snakebite and associated complications are still largely neglected. This study aimed at elucidating risk factors associated with snakebite cases, treatment availability and case management practices for vulnerable agro-pastoralist communities in Northern Tanzania. Data was collected in the Monduli (Arusha region) and the Simanjiro (Manyara region) districts in Tanzania. Interviews with 101 snakebite victims or their guardians and 13 health professionals from 3 health centers in the districts were conducted. Additionally, case records of patients admitted between 2007 and 2019 to the Meserani Snakebite Clinic were obtained. This study showed that appropriate treatment for snakebite including anti-venom, is difficult to access and that snakebite incidences were significantly linked to factors such as gender, age, socio-economic activity, season of the year, and whether being at home or out in the fields. Anti-venom and trained health professionals were only available at the Meserani Snake Park Clinic. Men were bitten most often (χ2 = 62.08, df = 4, p-value < 0.0001). Overall, adults between the ages of 18 and 60 years (χ2 = 62.08, df = 4, p-value < 0.0001) received most bites, usually while outdoors herding cattle in the dry season. A significant majority of victims looked for traditional treatment first (52.7%, χ2 = 29.541, df = 2, p-value = 0.0001). The results of this study present crucial information on what is needed to improve the accessibility to appropriate treatment after a snakebite among agro-pastoral communities. The situation regarding morbidity and mortality due to the inaccessibility of common treatment for snakebite in northern Tanzania is challenging. Reliance on traditional medicine exacerbates the situation. There is dire need to involve affected communities, researchers, the government, clinicians and the public in general, to work together and take part in the global snakebite initiative. Communities and health professionals recognise the underlying challenges and have valuable suggestions on how to improve the situation.

Female genital mutilation in high-income countries: knowledge and experience among health professionals.

Female genital mutilation (FGM) is a cultural practice with numerous negative health consequences. Due to migration from countries where FGM is prevalent into high-income countries, there is increased awareness within non-practising communities, with emphasis on FGM's illegal nature and the negative impacts on women. It is therefore vital for health professionals to be knowledgeable to provide adequate patient care. This review aimed to synthesise literature to report the understanding and experiences of health professionals caring for females affected by FGM in high-income countries. A systematic search was conducted on three databases: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Inclusion and exclusion criteria were applied to select the papers. Findings from included papers were synthesised using thematic synthesis. Eight articles met the criteria. Four themes were generated: FGM knowledge, training, attitudes and caring for FGM patients. Health professionals' knowledge and experiences of FGM tend to be varied. This review highlights the need of training for health professionals in high-income countries to strengthen their FGM knowledge.

Using Poverty Simulations to Drive Student to Address Social Impediments in Health Care

ABSTRACT Understanding poverty and related social determinants is an important component of health profession training so that students understand how to care for under-resourced communities. This study assessed the impact of poverty simulations on students’ self-efficacy to practice in vulnerable communities. We used a retrospective study to evaluate the influence of a poverty simulation students’ knowledge, skills, and intent to serve in under resourced communities. Data analysis (n = 650) demonstrated significant improvements around care team collaboration and how a patient’s background impacts their overall health care. The project identified an effective strategy to help students build self-efficacy to practice in under-resourced communities.

Interprofessional education during international electives: Perceptions of health professions students from selected institutions in Africa

ABSTRACT Although international electives provide important opportunities for the development of interprofessional education and collaboration practice skills, there is limited literature that describes students’ perceptions in various training institutions in Africa. This study aimed to address this gap by establishing the student’s perceptions of interprofessional education during international electives from four African health professional training universities. This was a cross-sectional quantitative study. Data were collected online using the Readiness for Interprofessional Learning Scale from 135 student participants. Linear regression and multilinear regression were used to establish relationships between socio-demographic characteristics and the student’s perception of interprofessional education during international electives. There was a high overall positive perception (76 SD± 8.1) among the student participants of interprofessional education during international electives. Almost all the students (88.9% n = 120) thought interprofessional education during international electives would help them become better team workers during future practice and enhance their communication skills. There were high mean scores regarding positive perceptions of teamwork and collaboration (39.5 SD± 4.9), positive professional identity 17.6 (SD± 2.6), and understanding roles and responsibilities (7.4 SD± 2.0). There is a generally positive perception of interprofessional education during international electives among health professions students from various African university institutions.

Interventions and Programs to Promote Breastfeeding in Arabic-Speaking Countries: A Scoping Review.

Low prevalence of exclusive breastfeeding in the Arab world is concerning and suboptimal breastfeeding is a leading child health risk factor in several Arab States. Breastfeeding education has the capacity to improve breastfeeding knowledge and practice, thus positively impacting infant and maternal health. The purpose of this review is to identify and examine the impact of breastfeeding promotion interventions across the Arab world. A scoping review of the literature was conducted across seventeen databases for relevant publications published through October 2021 to find studies in Arab countries, that involved breastfeeding as an intervention component. Twenty-one articles met inclusion criteria and were reviewed. Individual and community based educational interventions offer the opportunity to positively impact the knowledge, attitudes, and practices of breastfeeding in new mothers in Arab countries. Increased breastfeeding has the potential to lead to improved neonate and maternal health. In addition to significant benefits found across individual and community-based interventions in a variety of Arab countries, there is also evidence that interventions that improve the knowledge of health care professionals and/or the practices of a health care system can contribute to subsequent increases in breastfeeding rates. Breastfeeding education is a low-cost and high-impact public health tool that can impact infant and maternal health and potentially increase breastfeeding adherence in the Arab world.

Service user and carer involvement in online interprofessional learning during the COVID-19 pandemic

Patients, service users and carers are now expected to contribute to teaching health and social care students in all professions. This follows policy directives driven by a review of failings in NHS standards for patient involvement in all aspects of health and social care. Patient and carer contributions to interprofessional education hold fast to values for patient/carer-centred care. This article discusses the context to service user and carer involvement in health professions education, drawing on current evidence and with considerations for midwifery students. A case study of a well-established carer's session is presented, drawing on the input of a mother, which was continued online during the pandemic. It was ensured that this important learning was not lost when teaching became remote, relying on technology-enhanced learning methods. These adaptations depend on long-standing patient partnerships between faculty in higher education institutions and patients/carers who must feel safe and trust the teaching context where they contribute to student learning. Effective learning can be maintained in online environments to ensure the patient voice remains central to health professions training.

Culture, religion and gender: considerations in facing migration related health inequalities in Italy.

The presence in Italy of a significant foreign population (5-6 million including both formally residents and not officially registered ones) introduces significant transformations in the Italian demography with important challenges on ensuring fundamental rights including work, education and above all, health. Access to healthcare. Issues common to the entire migrant population concern the difficulty of accessing the health system of the host country due to the lack of knowledge of its rules and its functioning, the linguistic and cultural barriers and the distrust towards a system that is not recognized as his own, as well as the difficulties and misunderstandings encountered in the relationship with health professionals. Religion, culture and gender may even increase these difficulties. Conlusion and future perspective. Culture and religion should be taken into account when designing and implementing healthcare services and healthcare workers need to be trained in acknowledging these challenges. The National Health Service should become more sensitive to the increasing cultural and religious pluralism of patients starting with investing more in the training of health professionals.

Exploration of meaning, motivation, and preparedness to care amongst the one-child policy generation in China.

In China there is a cultural expectation (Xiao, -filial piety) that offspring should provide care for their parents. However, the sustainability of this is threatened by the impact of the One-Child Policy (OCP) (1979-2015), which has resulted in a diminution in numbers of children available to care, rapid urbanisation and increase in the number of women in employment. In this context, the objective was to explore the motivations, meaning, and preparedness for future caregiving of offspring affected by the OCP. We adopted a constructivist position using a hermeneutic phenomenology approach and interviewed eight current and prospective caregivers aged 20-35years about future caregiving responsibilities. Data were obtained through in-depth interviews, analysed using reflective Thematic Analysis. Three prominent themes: (i) Caregiving beliefs, (ii) Caregiving conditions and (iii) Contextual factors were identified under an overarching theme "Competing pressures-meanings, motivation and preparedness". Despite the inherent stress, participants envisaged providing or organising care in the future to fulfil Xiao, and most viewed long-term care settings as unviable. Ultimately, the findings suggested that the actual performance of caregiving would not always measure up to ideal expectations, resulting in 'filial discrepancy' that is, a gap between societal expectations for caregiving to older relatives and actual caregiving performance. This could adversely impact the caregivers and quality of care provided. The findings highlighted the urgent need to develop culturally attuned services, including education and training for family caregivers, health and social care professionals.

Building Rural Primary Care Research by Connecting Rural Programs.

Both research and medical education make substantial contributions to rural primary care and health. An inaugural Scholarly Intensive for Rural Programs was conducted in January 2022 to connect rural programs within a community of practice focused on promoting scholarly activity and research in rural primary health care, education, and training. Participant evaluations confirmed that key learning objectives were met, including stimulating scholarly activity in rural health professions education programs, providing a forum for faculty and student professional development, and growing a community of practice that supports education and training in rural communities. This novel strategy brings enduring scholarly resources to rural programs and the communities they serve, teaches skills to health profession trainees and rurally located faculty, empowers clinical practices and educational programs, and supports the discovery of evidence that can improve the health of rural people.

N09 Exploration of medication adherence interventions in Inflammatory Bowel Disease, Multiple Sclerosis and Rheumatoid Arthritis: A Scoping Review of Randomised Controlled Trials

Abstract Background The inflammatory diseases of inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) have recognised medications to maintain remission.Yet between 53–75% of people with IBD, 30-80% with RA and up to 50% with MS do not take medications as prescribed. Recognising and improving adherence in IBD, MS and RA is a primary treatment goal to keep symptoms quiescent. This scoping review aims to identify effective adherence interventions for IBD, MS and RA. As there were few studies in IBD, MS and RA were included to learn lessons from other conditions. Methods Randomised controlled trial (RCT) medication adherence interventions for IBD, MS or RA conducted between 2012-2021, were identified in six electronic databases. Critical Appraisal Skills Programme assessed study quality. Results 3024 participants were included across 24 RCTs; 8(33.3%) investigating IBD, 12(50%) RA and 4(16.7%) MS. Nine RCTs (37.5%) significantly improved medication adherence; all were rated high quality with five being delivered face to face and 1:1; all involving tailored education, advice or counselling by trained health professionals (HPs). IBD interventions were varied; the two significantly effective were web-based; one offering education modules and “red flag” monitoring, with follow up testing versus telephone education. The other used text message reminders with tailored feedback. Four of five effective RA interventions used psychological, behaviour change approaches. Three integrated educational and artificial intelligence-based methods through telephone-education, viewing disease progression on a computer system or text messages. Of the four MS interventions, only a Bluetooth bottle cap with mobile phone reminders and MI based telephone counselling led to significant adherence improvements. Interventions using artificial intelligence were most significantly effective (see Table 1). Tools such as diaries, calendars and advice sheets were also effective in increasing adherence. Only 10 interventions were theory based. Conclusion Tailored, face to face, 1:1 interaction with HPs can provide personalised, adherence support. Integration of several therapeutic approaches can be effective, but it can be difficult to identify cause of any impact. To improve adherence in inflammatory conditions, theoretically informed interventions should be developed and evaluated. Online routes of intervention delivery must be accessible, user-friendly, and functional to promote self-management. However, an adherence intervention which minimises costs, provides patient-centred, value-based care through implementation of evidence-based strategies will no doubt be welcomed by patients, HPs and services alike.

Yarning about pain: Evaluating communication training for health professionals at persistent pain services in Queensland, Australia.

Providing cultural education to health professionals is essential in improving the quality of care and outcomes for Aboriginal and Torres Strait Islander patients. This study reports the evaluation of a novel training workshop used as an intervention to improve communication with Aboriginal and Torres Strait Islander patients of persistent pain services. In this single-arm intervention study, health professionals undertook a one-day workshop, which included cultural capability and communication skills training based on a clinical yarning framework. The workshop was delivered across three adult persistent pain clinics in Queensland. At the end of the training, participants completed a retrospective pre/post evaluation questionnaire (5 points Likert scale, 1 = very low to 5 = very high), to rate their perceived importance of communication training, their knowledge, ability and confidence to communicate effectively. Participants also rated their satisfaction with the training and suggested improvements for future trainings. Fifty-seven health professionals were trained (N = 57/111; 51% participation rate), 51 completed an evaluation questionnaire (n = 51/57; 90% response rate). Significant improvements in the perceived importance of communication training, knowledge, ability and confidence to effectively communicate with Aboriginal and Torres Strait Islander patients were identified (p < 0.001). The greatest increase was in the perceived confidence pre-training mean of 2.96 (SE = 0.11) to the post-training mean of 4.02 (SE = 0.09). This patient-centred communication training, delivered through a novel model that combines cultural capability and the clinical yarning framework applied to the pain management setting, was highly acceptable and significantly improved participants' perceived competence. This method is transferrable to other health system sectors seeking to train their clinical workforce with culturally sensitive communication skills.

"Burnout felt inevitable": Experiences of university staff in educating the nursing and allied health workforce during the first COVID-19 waves.

Maintaining progress in the face of looming burnout during the first 2 years of the COVID-19 pandemic was crucial for the health workforce, including those educating the next generation of health professionals. The experiences of students and healthcare practitioners have been explored to a greater degree than the experiences of university-based health professional educators. This qualitative study examined the experiences of nursing and allied health academics at an Australian University during COVID-19 disruptions in 2020 and 2021 and describes the strategies that academics and/or teams implemented to ensure course continuity. Academic staff from nursing, occupational therapy, physiotherapy, and dietetics courses at Swinburne University of Technology, Australia provided narratives regarding the key challenges and opportunities they faced. The narratives highlighted the strategies generated and tested by participants amidst rapidly changing health orders and five common themes were identified: disruption; stress; stepping up, strategy and unexpected positives, lessons, and legacy impacts. Participants noted challenges related to student engagement in online learning and ensuring the acquisition of discipline-specific practical skills during periods of lock-down. Staff across all disciplines reported increased workload associated with converting teaching to on-line delivery, sourcing alternative fieldwork arrangements, and dealing with high levels of student distress. Many reflected on their own expertise in using digital tools in teaching and their beliefs about the effectiveness of distance teaching for health professional training. Ensuring students were able to complete required fieldwork hours was particularly challenging due to constantly changing public health orders and conditions and staffing shortages at health services. This was in addition to illness and isolation requirements further impacting the availability of teaching associates for specialist skills classes. Solutions such as remote and blended learning telehealth, and simulated placements were rapidly implemented in some courses especially where fieldwork could not be rescheduled or amended at the health settings. The implications and recommendations for educating and ensuring competence development in the health workforce during times when usual teaching methods are disrupted are discussed.