Assessment of clinical practical training in Tanzania health training institutions

Background: The process of producing competent human resource for health by using Competence-Based Education and Training (CBET) approach requires plentiful investment of resources in teaching at the classroom and practical/clinical setting. The achievement of clinical competence is acquired in stepwise starting from classroom teaching to skills laboratory teaching, finally to the clinical setting. In addition, World Health Organization (WHO) advocates for skilled and motivated health workers in providing quality health care services and increase performance of health systems. Moreover, Primary Health Care Development Program of 2007-15 needs the Nation to strengthen and expand health services at all levels. This can only be achieved when the Nation has adequate, appropriately trained and competent work force that can be deployed in the health facilities to facilitate the provisions of quality health care services.

In the CBET approach, the goal of becoming competent is achieved through imparting hands-on practical experience and the use of activating methods in interaction between facilitator and students.

The purpose of this study is to assess clinical practical training in Tanzania health training institutions: mainly the clinical skill laboratory and clinical rotation training 

Methods: Cross sectional study was conducted at two purposively selected health training institutions (HTIs), involving HTI students in medical laboratory and clinical medicine program at NTA level 4, 5 and 6. The convenience sampling method was used and data were collected immediately after breather period. The medical laboratory and clinical medicine students were used in assessing clinical skill laboratory and clinical rotation training respectively.

Results: A total of 258 HTI students were recruited and all consented to participate in this study, 124(48%) were medical laboratory students while 134(52%) were clinical medicine students.

Focusing on HTI students’ characteristics observed; Sex ratio was 1:1, mostly (98%) aged between 18-28 years while nearly half (49%) were in NTA level 5. More than half 68(55%) students had high knowledge on skill laboratory training.

The study finds out that, most of students agreed that all HTI students should attend skill laboratory and also most ofstudents attended skill laboratory regardless of their NTA level

Majority 111(83%) of students had high knowledge on clinical rotation training. Most of essential personal protective equipment (PPE) for clinical rotation were available.  Clinical rotation schedules were not available in all departments where clinical rotation was conducted. Nevertheless, students were supervised at least twice in all departments and more than three times in two departments.

Conclusion: There some challenges in implementation of clinical practical training in HTIs; requirements, supervision. Ministry of health should ensure proper implementation of clinical practical training; skill laboratory training and clinical rotation