SUSHRUTA
Journal of Health Policy & Opinions
Love in the time of Cholera - How does education and training survive
in the face of a Pandemic?
Indranil Chakravorty PhD FRCP
St George’s University Hospital, London
Twitter @indranilc
Key words
SARS Cov2, Covid19, education, healthcare workforce
Cite as: Chakravorty I. Love in the time of Cholera - How does education and training survive in the face of a
Pandemic? Sushruta 2020 (March) vol13; issue 1:
Introduction
inducting medical and nursing students to
complement the challenges and rapidly depleting
Gabriel Garcia Marquez created a timeless
workforce and to return retired healthcare staff
narrative of love blossoming in the face of malady,
back in to duty as a national healthcare emergency
of trust and betrayal and eventually decades later,
is being declared. (4,5) As of 20 March, all schools
‘true love’ flourishing between Fermina and
are closed indefinitely and all examinations
Florentino in the autumn of their lives. There are
cancelled or postponed.
several similarities one can draw from the
Marquez’s world of fantasy in Columbia to 2020.
How does an organisation educate and train
One that is wildly infectious, has been a pandemic
healthcare staff during such critical times? What
since 2010, affects millions of people worldwide
may be negative impact of such lost
and causes between 30-130,000 deaths. (1)
opportunities? How do organisations take charge
of educating the public they serve for high impact
As the world rushes to find a vaccine for the novel
actions during such periods? This article explores
corona virus SARS-CoV2 causing Covid19 (2), the
the evidence from previous pandemics and draws
essential message for containment is still as simple
on what methods might be suitable for
as avoiding contact, social distancing and washing
organisations to adopt.
hands frequently with soap-water or sanitising
using alcohol gel. John Snow developed his
In recent years, there has been a heightened focus
epidemiological techniques of contact tracing and
on the development challenges faced in contexts
isolation back in 1854, working in London; many of
of protracted crises, however, there is a lack of
which form the corner stone of current strategies.
robust evidence on how to effectively translate
(3) In the first few weeks of the discovery and
this interest into practice. In the field of
rapid spread of the novel corona virus, health
educational research, this is further compounded
systems in every country of the world are
by the comparative lack of academic capacity on
examining their preparedness. In the United
to explore ‘education in times of crises. (6)
Kingdom, the cash-strapped and workforce-
challenged National Health Service which seems
1. Enhancing understanding of the role of
to be perpetually in the throes of ‘winter crisis’
education and learning in responding to
feels unprepared for coping with this new malady.
and fashioning novel ways for coping
The government is rapidly moving from its
and/or transforming opportunities and
prevention to delay strategy. There are calls for
outcomes in crisis settings, particularly
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those in the longer-term and including
education reform, from design to
natural as well as man-made crises.
implementation.
2. Building the evidence base of how
education and learning take place and are
At the Oslo Summit for Education and
affected during and through crisis
Development(7), the report from Overseas
situations, including particular attention to
Development Institute
(ODI) recommended a
the importance of local context and
governance structure including a top-level
practice in this regard, and what
oversight body that includes the most powerful
implications this entails for learning and
and influential
influencers
to
assume
communities.
responsibility of education. In a way, the UK
3. Investigating how crises particularly affect
already has an arm’s length body, Health
the education and learning of healthcare
Education England (HEE), the deanery in Scotland
staff and their families of hidden
or the Health Board in Wales to provide a unified
populations, marginalised people including
and strategic 4 nation approach to healthcare
girls and women, and populations on the
education and strategy. There are national
move.
committees working on specialist areas such as
Technology enhanced learning, the eLearning for
Although the World Bank report(6) on global
Health to support the adoption of a unified
learning crisis refers to universal education the
educational regime, norms and platform of
principles and recommendations are equally
support for education of all staff.
applicable in the healthcare setting.
Amidst the rapidly evolving global health crisis of
•
Firstly, there is a need to assess learning,
COVID-19, the UNESCO held its first virtual
so it can become a measurable goal. In the
meeting on 12 March 2020 where there was
context of healthcare setting, the
consensus on the importance of UNESCO’s
imperative of assessing and reporting on
Futures of Education initiative(9). Numerous
outcomes remains critically important. The
participants in the meeting expressed concerns
findings however stark, will help to focus
about inequalities deepening and emphasized the
attention on learning, inform policy
importance of collaboration and solidarity—
choices, track progress, and shine a
particularly in ensuring that educational
spotlight on areas which may be lagging
opportunities reach the most vulnerable and
behind.
marginalised. Within healthcare education and
•
Secondly, it is necessary to attract
training sector, there are vast inequalities in
innovative minds into teaching and keep
provision, financial resources and capacity in
them motivated by targeted teacher
different countries around the world. Even in the
training, deploy adaptable technologies
UK, under the watchful eye of General Medical
that help teachers to teach in the clinical
Council’s (Quality ssurance Framework)(10) HEE
setting preferably during the real-time
has struggled to provide for parity across the
management of patients and strengthen
country(11). In the face of crisis, it is perhaps
governance.
inevitable that these inequalities of variable
•
Thirdly, there is a dire need to use
educational and supportive environment will
information and metrics to motivate staff,
widen. Areas that have struggled to provide for a
increase accountability, and create the
stable environment and positive approach are at
political will for educational reform. The
risk of shelving any attempts to improve quality.
WHO recommends reaching out to
The consequences are often direct on trainee
stakeholders, including patients and the
morale, and indirectly in patient related
wider community, in all stages of
outcomes.
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Yet, while the healthcare leaders are calling for re-
addition to the change in social culture, a
purposing of the workforce to face the crisis,
phenomenal expansion is being enacted in
providing refresher training to equip many retired
education and learning. The artificial barriers are
/ returning healthcare workers (12) or those that
being broken down as universal access to
have not been in patient facing roles in the recent
education is being delivered. When the world
past, and increasing specific capacity for intensive
emerges from this pandemic, human civilisation
care(13) as appears to be the need of the hour-
and along with education would have been
there is no better time for education and training
transformed for ever.
faculty to innovate and reach for the most radical
of solutions.
References
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