“We need quality learning programs, comparable and competences-based”

-What are the criteria of university policy to adapt training to the professional needs of health sector?

All higher education institutions are concerned about students acquiring knowledge and skills during the training period that are essential for their professional praxis, when they graduate and access the workplace. This statement applies to all disciplinary areas, although it is also true that in health curricula this concern has been, and still is, more evident and for longer. Among other reasons, because health studies are very professionalizing, ie they are identified with very specific professions of high social impact while, actually, the majority of graduates want to exercise them vocationally.

In Catalonia, this was not the traditional fact in University studies and, certainly, the need to adapt them to the European Higher Education Area in the mid 2000s represented a real and theoretical change of the training and learning model. Since then, it is common to speak of ‘competences’ instead of ‘knowledge’, defined as a dynamic combination of attributes in relation to the attainment of knowledge, skills, attitudes and responsibilities that have to show the learning outcomes of an educational program toward the ability to carry out activities in a profession or job. And all this, focused on the efficient learning of the students and not in the teacher figure.

-Can you detail the most required needs in the training of future health professionals?

Undoubtedly, one of the main concerns of those responsible for the training of future health professionals should be training them making them assume and internalize that medical and health knowledge double every 5-10 years and, consequently, their initial training received has a date of expiry. It extends to all areas, but in health it is essential the paper that conducts life-long learning and the need for periodic accreditation based on current adapted skills.

Answering the question, I think it is growing in all stakeholders and, therefore, also in education, the concern for the safety of the patient in the hospital and outpatient setting. In my opinion, this question concerns the efficiency of the initial university studies, especially the practical training of students, and if it is sufficiently preparing the graduates who will have to face the health profession. Secondly (although we are slowly improving digital skills of our society, particularly among the youth), it also concerns the adaptability of health professionals in ICT and the intensive use of these tools in practice.

In this sense, the simulation is an emerging tool which, besides ensuring an efficient and continued form of training, protects patient safety. In Catalonia we suffer a certain delay in the integration of these techniques in the training of health professionals. However, it is true that it requires technologically advanced facilities and innovative educational methodologies that have proven to be efficient without jeopardizing the patient. Speaking of learning through simulation, I mean a self-review of all actions taken (and, therefore, the essential knowledge and skills to carry them out) during a clinical experience conducted by a professional that gives the opportunity to learn by correcting the own and all kinds of mistakes in the daily clinical praxis.

-On what principles should be inspired the upcoming reform of the educational processes on health?

I think that many people who work in this field have the aim to generate learning programs with a higher quality of the received education, most comparable to the international standards of the leader education systems and further based on future professional competences. Through the imaginative use of ICT, we want to enable new flexible and creative professionals, while at the same time to overcome the health professions’ configuration that enormously limited the work in multidisciplinary teams in certain professional settings.

We have to better adapt to the local needs and problems and also take more advantage of the global resources, knowledge and experiences, from the international arena, which are indispensable in the initial stages of the formative cycles. It is essential to move in the world (also for University students) and personally know how others –probably in a better and more efficient way– solve the same problems that we have in our institutions.

We need to be more persistent in values education too. It goes beyond knowledge of ethical codes and good praxis, as they have to incorporate the development of value judgments for their contextualized application. And, obviously, we need to continue putting emphasis on those essential non-technical skills such as teamwork, leadership, communication between professionals and patients and their relatives...

Our main challenge is the development of our teachers, who should be able to evolve towards more flexible and internationalized structures, more adaptable to the changing needs, with better quality and with teaching and research profiles more suited to international standards.

-What should be the fit of the different centres involved in health education?

As the question implies, it is unthinkable to imagine a learning process suitable for health professions that do not deem and involve institutions with different purposes.

Universities (faculties and health sciences schools), hospitals and health institutions are indispensable for mastering. It has been acknowledged the need to make the learning processes available all along the professional live, involving representative institutions of care professionals and associations in the education path. However, more recently, it has gained importance the need to build and strengthen structures that provide more value to the collaboration and coordination in the building and knowledge transfer.

Surely, this involves the centres of fundamental research applied in the life sciences and health, public and private organizations working to enable a greater transfer of technologies and knowledge and, also crucial, an involvement with all the schools, public and private, that are innovating in processes, both training and applied to research and development. This type of diverse and institutional centres that create knowledge have been increasingly relevant. Also the networks that have woven all these institutions and their teams.

-What is your assessment about the Catalan health training institutions and R&D in the international context?

There are several scientific areas in which Catalonia plays an important role in the European context. Science of life and health is one of them, where we have University faculties, healthcare institutions, public and business R&D centres, teaching and research human resources, as well as some learning programs and R&D projects highly competitive internationally. This is guaranteed for the results accrued throughout this network of people and organizations in various competitive calls for projects, the impact factor of scientific publications of certain research teams, and the success by attracting talented highly qualified researchers and staff with training abroad through international calls. The very positive assessment of some of these research centres (CERCA centres) with unique characteristics in the R&D system have enabled them to achieve outstanding levels of excellence. Their flexible governance, an attractive environment and a commitment to scientific excellence, strengthened by international scientific advisory committees and regular assessments, are some of these features.

To continue improving in the majority of public health schools and centres we should transform their governance as much as possible. This will make the qualitative leap reached by research centres and facilitate the achievement of better verifiable results.

*Josep Ribas is formed in medicine and is specialist in digestive system. He is Deputy Director of Universities at the Universities and Research Secretary of the Economics and Knowledge Department of the Government of Catalonia.