Essuman et al. Human Resources for Health (2023) 21:74 Human Resources for Health https://doi.org/10.1186/s12960-023-00859-9 RESEARCH Open Access Self-reported continuing professional development needs of medical laboratory professionals in Ghana Mainprice Akuoko Essuman1, Nii Armah Addy2, Samuel Essien‑Baidoo1, Irene Esi Donkoh1, Felix A. Botchway3, Justice Afrifa1, Prince Agyeman4, Leticia Awontayami Amaama1, Samuel Amoah5, Felix B. K. Sorvor6 and Richard K. D. Ephraim1* Abstract Background Because of the essential nature of the work of medical laboratory professionals, continuing develop‑ ment in knowledge and skills is indispensable. The study aimed at identifying and prioritizing the development and training needs of medical laboratory professionals in Ghana. This is expected to help in developing focused con‑ tinuing professional development (CPD) that meets the needs of practitioners as well as the changing medical trends. Methods An online cross‑sectional survey in February 2022 using a structured questionnaire was conducted. Respondents were asked questions that collected demographic and work‑related data about them, their partici‑ pation, preference, and challenges in being part of CPDs. Finally, a list of topics based on (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, (iv) pathophysiology, and (iv) data interpretation and research were asked with the option to rate them on a 3‑point scale (most, moderate, and least) in order of importance. Results A total of 316 medical laboratory professionals participated in the study. Overall, the most frequently selected topics for training based on domains for CPD training and ranking as most important were (i) quality man‑ agement systems, (mean = 80.59 ± 9.024; 95% CI = 73.04–88.13); (ii) pathophysiology, data interpretation, and research (mean = 78.0 ± 6.973; 95% CI = 73.97–82.03); (iii) technical competence (mean = 73.97 ± 10.65; 95% CI = 66.35–81.59); and (iv) laboratory management, leadership, and coaching (mean = 72.82 ± 9.719; 95% CI = 67.44–78.2). The factors affecting the choice of training needs included the medical laboratory professionals’ current place of work, years in service, the reason for attending CPD activities, the period for attending the last CPD, being in a supervisory role, and the number of staff being supervised. Face‑to‑face presentations, training workshops, and hands‑on workshops were the most preferred modes of CPD delivery with financial implications and workload/time constraints being the main challenges impeding CPD participation. Conclusion The identified needs will help in developing CPD programs that address what medical laboratory professionals prioritize as training needs. Stakeholders should incorporate these training needs into future pro‑ grams and address the challenges highlighted in this study to have more relevant training for medical laboratory professionals. *Correspondence: Richard K. D. Ephraim rephraim@ucc.edu.gh Full list of author information is available at the end of the article © The Author(s) 2023. 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The Creative Commons Public Domain Dedication waiver (http://creativecom‑ mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Essuman et al. Human Resources for Health (2023) 21:74 Page 2 of 11 Keywords Continuing professional development, Medical laboratory professionals, Healthcare, Online survey, Training needs Introduction and capacities, and learning and change requirements Advances in global health and medicine mainly due to [4]. Unfortunately, the strategies designed to promote the emergence of new diseases, the discovery of advanced health workers’ CPD do not always consider these diagnostic techniques and facilities, and increased needs [15, 16]. demand for laboratory services necessitate that medi- It is well-accepted that current trends in healthcare cal professionals consistently maintain their competen- such as the emergence of COVID-19 have exposed cies more than ever [1, 2]. It is therefore noteworthy that loopholes in our healthcare system [1, 2], not only in a pragmatic review of the knowledge and skills needs of the lack of medical facilities but in the gap in knowl- medical professionals including medical laboratory pro- edge and skills. It follows then, that a pragmatic review fessionals (MLPs) must be a rational precursor to the of the knowledge and skills needs of MLPs must be a development of any training program directed at solving rational precursor to the development of any training these needs [3, 4]. program [3, 4]. Moreover, if a reliable occupational Continuing professional development (CPD) embod- profile of MLPs could be obtained, then there would ies a lifelong process of active participation in learning be a sound foundation on which to identify and define activities that assist in developing and maintaining con- the core competencies, which would form the basis of tinuing competence, enhancing professional practice, basic laboratory education in a variety of local contexts and supporting the achievement of career goals [5]. CPD to meet current trends. These could be further used to activities can take the form of traditional classroom face- inform national and regional education curricula and to-face sessions to online learning with the same goal care standards, accredit topics for future CPDs, and of creating a qualified workforce capable of successfully consequent integration into our mainstream health- meeting the needs of the populations they serve [6]. care education. It is similarly essential to identify skill Because of the enormous benefits CPD has on patients deficits and underperformance in existing roles so that care and the professional development of health workers, CPD can be devised in a manner that would directly it is important to promote the continuing professional address areas of suboptimal clinical performance [3]. development of health workers [7–9]. CPD contributes to Given the above information, self-reported train- improving the quality of care and health outcomes, such ing needs and experiences of MLPs regarding their as reducing the likelihood of patients dying or the odds of CPD may provide insight into the complexity of MLPs’ failure to rescue them [10]. It also promotes motivation, involvement (or lack thereof ) in CPD. This would also commitment, and satisfaction among professionals [9] help identify their needs to consider when design- and, as a consequence, their retention and performance ing programs that realistically support CPD. To this [7]. Like many other countries [3, 11, 12], CPD is a man- end, this study was undertaken to highlight the chal- datory requirement for the renewal of a license to prac- lenges the Ghanaian MLP faces in accessing CPDs, and tice as a medical laboratory professional in Ghana. When to identify and prioritize the training requirements of not properly structured to meet the needs of workers and medical laboratory professionals in Ghana. Addition- patients, it would be difficult to derive the needed benefit ally, we also explored the factors that are associated CPD is supposed to have on our health care system. with training needs prioritization by laboratory profes- It is reported that self-motivation, relevance to prac- sionals. This would help to develop a focused and sys- tice, preference for workplace learning, strong ena- tematic continuing professional development module bling leadership, and positive workplace culture are that meets the needs of practitioners. key factors that optimize the impact of CPD among health workers [13]. Meanwhile, in the rapidly chang- ing healthcare context, it is reported that health work- Methods ers participate in CPD when they have reasons to do Study design so [14]. It is key, therefore, that strategies aimed at A cross-sectional survey was employed and used an promoting the participation of health workers in CPD online questionnaire survey tool to reach MLPs across address their real needs [10]. Human resource needs the country. A well-structured survey tool designed are said to revolve around existing and expected pro- using google forms was delivered online over 20 days fessional practice requirements, enabling competence (3rd to 23rd February 2022). E ssuman et al. Human Resources for Health (2023) 21:74 Page 3 of 11 Study population gender, cadre in the medical laboratory profession, num- The target population in this study included MLPs ber of years they have worked, and the location of their working in health care settings (government, private or current place of work. Cadre type in medical laboratory quasi-government), non-governmental organizations, practice was reported in terms of academic qualification regulatory organizations, research, and academic insti- as laboratory assistant (2-year certificate), technician tutions in Ghana. The inclusion criteria were full- or (3-year diploma), or scientist (4/6-year bachelor’s degree). part-time MLPs with a license from the Allied Health Participants were asked to indicate whether they are in a Professions Council—the main regulatory body for supervisory role and if answered “Yes” asked to provide training of medical laboratory personnel, issuance and the number of personnel under their supervision. renewal of licenses, and approval of CPDs. Participants Questions were asked to elicit information about par- were required to have a minimum of one year of post- ticipants’ participation in CPDs. First, participants were qualification working experience at the time of the study. asked to indicate the last time they attended a CPD event from three options (less than 1 year, 1–3 years, or more Sampling technique than 3 years) and to indicate their main reason for par- Snowball sampling, a nonprobability sampling approach ticipating in CPD events. For this, they were made to that samples clusters of connected participants, was choose among three options (to maintain and improve used to recruit participants. The recruitment of partici- knowledge and skills, to facilitate license renewal, and pants was performed online, mainly through WhatsApp to interact and exchange expertise with colleagues). Fur- platforms. Because of the possibility of having people thermore, participants were asked to select their prefer- who do not meet eligibility criteria filling the forms, the ences for delivery of CPD activities from a list of seven forms were not shared on Facebook, Twitter, and other options, namely face-to-face presentations, live video open-spaced social networking platforms. The use of conferences, hands-on workshops, journal club at the online surveys is described to be an innovative tech- workplace, training workshops, and directed learning nique with the advantage of not only being cost-effective in the workplace followed by a quiz and internet-based and time efficient but being able to enable access to large learning. Participants were also asked to indicate the and geographically distributed populations [17]. The challenges they face in attending CPD training from 6 study instrument used for the study was user-friendly, options provided with the chance to indicate any other participant-specific, and ethically sensitive with multi- challenge which was not listed. ple responses being avoided in line with earlier recom- The study instrument used to assess the study needs mendations [17]. Initially, some laboratory professionals of participants included 46 items organized into 5 key who were administrators for WhatsApp pages of vari- domains related to laboratory practice, namely (i) quality ous laboratory groups were conveniently identified by management systems (8 items); (ii) technical competence the research team. These administrators were contacted (10 items); (iii) laboratory management, leadership, and and provided with information about the study, includ- coaching (15 items); (iv) pathophysiology, data interpre- ing the survey link, and were asked to share the link on tation and research (14 items). Participants were asked to their platforms. In addition, the researchers conveniently rank their self-perceived training needs using a 3-point created a broadcast list of eligible laboratory profession- scale in order of importance (most, moderate, and least). als on their contact and disseminated messages to them to complete the forms and circulate to other laboratory Data processing and analysis professionals they know. Data collected from the online survey were first entered into Microsoft Excel, double-checked, and analyzed Questionnaire development and survey process using IBM SPSS version 26.0 (Statistical Package for the The survey questionnaire and its content were developed Social Sciences, Chicago, IL USA) with GraphPad Prism based on a review of studies on similar subject [3, 18] 8 (GraphPad Software, San Diego, CA, USA) being used with some modifications to suit the context of medical to generate figures. Demographic and work-related char- laboratory practice in Ghana. To get a desirable outcome, acteristics of participants were summarized using mean the questionnaire was shared among immediate col- and standard deviations for continuous variables, and leagues as the target audience to scrutinize the accessibil- numbers and percentages for categorical variables. The ity, clarity, and relevance of the survey questions. validity and reliability of the domains used to access The first section of the questionnaire elicited general training needs were checked using Cronbach’s alpha as information about participants and their professional follows; quality management systems (α = 0.808), tech- practice. Participants were asked to provide their age, nical competence (α = 0.824), laboratory management, leadership, and coaching (α = 0.894), pathophysiology, Essuman et al. Human Resources for Health (2023) 21:74 Page 4 of 11 data interpretation and research (α = 0.914). The Kol- The online survey was accessed by 89 people (27% of mogorov–Smirnov and Shapiro–Wilk tests were used the total number) in the first 24  h, and 187 (57%) by to verify the normality of scale variables such as the the end of the third day. A total of 316 responses that ages of participants and their years in service. Differ- met the inclusion criteria and had complete data were ences in preference for training needs among groups analyzed for this study. The mean age of the respond- were assessed by the Chi-square or Fisher exact test for ents was 33.05 ± 6.33 with 250 (79.1%) being males, 63% categorical variables. Topics to be included in CPD pro- being medical laboratory scientists, and 45.6% working grams to be developed were prioritized as follows: top- with Ghana Health Service. The youngest respondent ics are given the most importance rating by ≥ 80% of the was 22 years old, while the oldest was 56 years old. The respondents (priority 1); 70–79% (priority 2); 60–69% respondents had varying years of work experience, rang- (priority 3); and ≤ 59% (priority 4). Associations were ing from one year to over 30  years of experience. One explored between a set of indicators relating to demo- hundred and forty-six respondents reported being in graphic and work-related characteristics and preference supervisory roles; 67 (45.9%) supervised 1–5 laboratory for training needs using logistic regression models. P val- staff; while 45 (30.8%), and 34 (23.3%) supervised 6–10, ues less than 0.05 was considered statistically significant and more than 10 laboratory staff, respectively (Table 1). in all analysis. Attendance of continuous professional development Results activities Respondent characteristics When asked the last time they attended a CPD activity, This study received 328 responses; however, 12 responses the majority indicated that they had been part of a CPD were excluded because of missing and incomplete data. activity within the last year, with a few indicating that the Table 1 Demographic and work‑related characteristics of medical laboratory professionals recruited for the study Variable Categories Frequency Percentage Age group (years) 20–30 131 41.5 31–40 143 45.3 41–50 38 12 More than 50 4 1.3 Gender Female 66 20.9 Male 250 79.1 Cadre type Medical laboratory assistant 10 3.2 Medical laboratory technician 73 23.1 Medical laboratory scientist 199 63 Laboratory manager 31 9.8 Othersa 3 0.9 Current place of work Ghana Health Service 144 45.6 Mission hospital 74 23.4 Teaching hospital 42 13.3 Private hospital/laboratory 38 12 Teaching/research institution 18 5.7 Years in service 1–5 143 45.3 6–10 92 29.1 11–15 45 14.2 More than 15 36 11.4 Supervisory role No 170 53.8 Yes 146 46.2 Staff supervised Non 170 53.8 1–5 67 21.2 6–10 45 14.2 More than 10 34 10.8 a Others refer to professionals working with non-governmental organizations, regulatory, research, and training institutions Essuman et al. Human Resources for Health (2023) 21:74 Page 5 of 11 last time they participated in a CPD activity was between 1 and 3 years and more than 3 years (Fig. 1a). Most labo- ratory professionals attend CPD activities to maintain and improve their knowledge and skills. However, a few of them participate in CPD activities with the purpose of facilitating license renewal and exchanging expertise with colleagues in the field (Fig. 1b). The most preferred mode of CPD delivery by Ghanaian laboratory professionals is face-to-face presentations, training workshops, and hands-on workshops (2a). It is interesting to know that just a few laboratory professionals believe CPD is not necessary. However, most laboratory professionals cited financial implications and workload/time constraints as the main reasons impeding their participation in CPD activities (Fig. 2). CPD training preferences, ranking, and prioritization by medical laboratory professionals in Ghana Table  2 details the ranking of selected knowledge and skills topics by medical laboratory professionals in Ghana. The results indicated that for the whole sample, all 47 items were rated most important by respondents with an average most important rating of 75.93 ± 9.21% (95% CI = 73.20–78.65) and a range of 70.3–82.6% sug- gesting that the respondents perceived themselves to have knowledge and skill deficits in all the top- ics and that these topics are essential for their practice. Fig. 2 Responses provided by medical laboratory professionals Overall, the most frequently selected topics for train- on a preferred mode for CPD activities and b the major challenges ing based on domains for CPD training and ranking impeding participation in CPD programs as most important were (i) quality management sys- tems, (mean = 80.59 ± 9.024; 95% CI = 73.04–88.13); (ii) pathophysiology, data interpretation, and research Fig. 1 Responses provided by respondents on a the last time they attended a CPD program and b their major reason for attending CPD programs Essuman et al. Human Resources for Health (2023) 21:74 Page 6 of 11 Table 2 Ranking of CPD training topics by medical laboratory professionals, n = 316 Training needs Ranking Most important Moderate Less important No response n (%) importance n (%) n (%) n (%) Quality management systems Quality system essentials for medical laboratory 274 (86.7) 31 (9.8) 5 (1.6) 6 (1.9) Implementing a quality management system 277 (87.7) 31 (9.8) 4 (1.3) 4 (1.3) Techniques to identify and control sources of errors in laboratory procedures 281 (88.9) 29 (9.2) 2 (0.6) 4 (1.3) Management of non‑conformances in laboratory services 196 (62.0) 104 (32.9) 11 (3.5) 5 (1.6) Use of external quality assessment to improve testing procedures 247 (78.2) 53 (16.8) 8 (2.5) 8 (2.5) Internal quality control and Westgard rule 253 (80.1) 51 (16.1) 4 (1.3) 8 (2.5) Laboratory accreditation: principles and processes 237 (75.0) 68 (21.5) 8 (2.5) 3 (0.9) Clinical laboratory safety 272 (86.1) 37 (11.7) 4 (1.3) 3 (0.9) Technical competence Evidence‑based laboratory medicine 273 (86.4) 34 (10.8) 2 (0.6) 7 (2.2) Evaluation and selection of analytical methods and equipment 259 (82.0) 48 (15.2) 1 (0.3) 8 (2.5) Definition, establishment, and use of reference ranges 245 (77.5) 61 (19.3) 5 (1.6) 5 (1.6) Health informatics 193 (61.1) 103 (32.6) 11 (3.5) 9 (2.8) Point‑of‑care testing 163 (51.6) 118 (37.3) 28 (8.9) 7 (2.2) Statistics in laboratory medicine 221 (69.9) 81 (25.6) 5 (1.6) 9 (2.8) Specimen management 254 (80.4) 49 (15.5) 3 (0.9) 10 (3.2) Molecular diagnostic methods and genetics 235 (74.4) 66 (20.9) 6 (1.9) 9 (2.8) Laboratory and disease surveillance 235 (74.4) 64 (20.3) 6 (1.9) 11 (3.5) Equipment maintenance 259 (82.0) 42 (13.3) 6 (1.9) 9 (2.8) Laboratory management, leadership, and coaching Customer care 259 (82.0) 44 (13.9) 4 (1.3) 9 (2.8) Competence assessment 264 (83.5) 41 (13.0) 3 (0.9) 8 (2.5) Ethics and professionalism 279 (88.3) 32 (10.1) 1 (0.3) 4 (1.3) Supervision and delegation 239 (75.6) 65 (20.6) 3 (0.9) 9 (2.8) Preceptorship and mentorship 206 (65.2) 92 (29.1) 9 (2.8) 9 (2.8) Data management, report writing, and presentation skills 255 (80.7) 49 (15.5) 6 (1.9) 6 (1.9) Basic cost accounting for clinical laboratory services 179 (56.6) 120 (38) 8 (2.5) 9 (2.8) Management of resources and supplies 227 (71.8) 75 (23.7) 6 (1.9) 8 (2.5) Monitoring and evaluation 230 (72.8) 72 (22.8) 3 (0.9) 11 (3.5) Team building 248 (78.5) 48 (15.2) 8 (2.5) 12 (3.8) Strategic planning 229 (72.5) 67 (21.2) 5 (1.6) 15 (4.7) Rational selection of tests 215 (68.0) 86 (27.2) 4 (1.3) 11 (3.5) Medical tariffs (billing and coding) 173 (54.7) 119 (37.7) 17 (5.4) 7 (2.2) Cost of laboratory tests and procedures 202 (63.9) 92 (29.1) 13 (4.1) 9 (2.8) Career prospects 247 (78.2) 54 (17.1) 6 (1.9 9 (2.8) Pathophysiology, data interpretation, and research Case studies in clinical microbiology 265 (83.3) 38 (12) 4 (1.3) 9 (2.8) Case studies in clinical chemistry 276 (87.3) 31 (9.8) 1 (0.3) 8 (2.5) Case studies in hematology 275 (87.0) 30 (9.5) 1 (0.3) 10 (3.2) Case studies in medical parasitology 260 (82.3) 45 (14.2) 1 (0.3) 10 (3.2) Case studies in blood transfusion science 266 (84.2) 39 (12.3) 0 (0.0) 11 (3.5) Case studies in cytology and histology 228 (72.2) 67 (21.2) 12 (3.8) 9 (2.8) Case studies in immunology 261 (82.6) 39 (12.3) 6 (1.9) 10 (3.2) Molecular and immunodiagnostic techniques 245 (77.5) 52 (16.5) 7 (2.2) 12 (3.8) Semen analysis 250 (79.1) 49 (15.5) 7 (2.2) 10 (3.2) Research proposal development and operational research 247 (78.2) 53 (16.8) 6 (1.9) 10 (3.2) E ssuman et al. Human Resources for Health (2023) 21:74 Page 7 of 11 Table 2 (continued) Training needs Ranking Most important Moderate Less important No response n (%) importance n (%) n (%) n (%) Grant proposal writing 222 (70.3) 73 (23.1) 10 (3.2) 11 (3.5) Manuscript preparation 212 (67.1) 83 (26.3) 9 (2.8) 12 (3.8) Basic computer skills 210 (66.5) 83 (26.3) 12 (3.8) 11 (3.5) Use of statistical and programming tools 235 (74.4) 64 (20.3) 8 (2.5) 9 (2.8) (mean = 78.0 ± 6.973; 95% CI = 73.97–82.03); (iii) techni- important ranked individual topics were: techniques to cal competence (mean = 73.97 ± 10.65; 95% CI = 66.35– identify and control sources of errors in laboratory pro- 81.59); and (iv) laboratory management, leadership, and cedures (88.9%), ethics and professionalism (88.3%), and coaching (mean = 72.82 ± 9.719; 95% CI = 67.44–78.2). implementing a quality management system (87.7%). The least ranked topics were: point-of-care testing (51.6%), Prioritization of training needs of medical laboratory medical tariffs (billing and coding) (54.7%), and basic professionals cost accounting for clinical laboratory services (56.6%) We have used ratings based on the most important to (Table 3). prioritize training needs into four domains as detailed in Table 3. A total of 19 out of 47 training items have been Factors associated with CPD training need prioritization prioritized as the number one need of laboratory profes- by medical laboratory professionals sionals based on ranking as most important by more than The factors associated with the prioritization of train- 80% of respondents. Based on priorities, the three most ing needs among the four domains of CPD included Table 3 Prioritization of CPD training topics by medical laboratory professionals in Ghana Priority 1 Priority 2 Priority 3 Priority 4 ≥ 80% 70–79% 60–69% ≤ 59% 1. Quality system essentials 1. Use of external quality assessment 1. Management of non‑conform‑ 1. Point‑of‑care testing for medical laboratory to improve testing procedures ances in laboratory services 2. Basic cost accounting for clinical 2. Implementing a quality manage‑ 2. Laboratory accreditation: princi‑ 2. Health informatics laboratory services ment system ples and processes 3. Statistics in laboratory medicine 3. Medical tariffs (billing and coding) 3. Techniques to identify and con‑ 3. Definition, establishment, and use 4. Preceptorship and mentorship trol sources of errors in laboratory of reference ranges 5. Rational selection of tests procedures 4. Molecular diagnostic methods 6. Cost of laboratory tests and pro‑ 4. Internal quality control and West‑ and genetics cedures gard rule 5. Laboratory and disease surveil‑ 7. Manuscript preparation 5. Clinical laboratory safety lance 8. Basic computer skills 6. Evidence‑based laboratory 6. Supervision and delegation medicine 7. Management of resources 7. Evaluation and selection of ana‑ and supplies lytical methods and equipment 8. Monitoring and evaluation 8. Specimen management 9. Team building 9. Equipment maintenance 10. Strategic planning 10. Customer care 11. Career prospects 11. Competence assessment 12. Case studies in cytology and his‑ 12. Ethics and professionalism tology 13. Data management, report writ‑ 13. Molecular and immunodiagnos‑ ing, and presentation skills tic techniques 14. Case studies in clinical microbiol‑ 14. Semen analysis ogy 15. Research proposal development 15. Case studies in clinical chemistry and operational research 16. Case studies in hematology 16. Grant proposal writing 17. Case studies in medical parasi‑ 17. Use of statistical and program‑ tology ming tools 18. Case studies in blood transfusion science 19. Case studies in immunology Essuman et al. Human Resources for Health (2023) 21:74 Page 8 of 11 laboratory professionals’ current place of work, years better care for patients as staff develops themselves pro- in service, the reason for attending CPD activities, the fessionally [20]. period for attending the last CPD, supervisory role and The study identified (i) quality management systems; number of staff being supervised (Table  4). Laboratory (ii) pathophysiology, data interpretation, and research; professionals who work in private hospitals and labora- (iii) technical competence; and (iv) laboratory manage- tories (OR = 4.38, 95% CI = 1.41–13.58) are more likely ment, leadership, and coaching as the priority areas for to prefer topics in quality management systems. Labora- training by laboratory professionals in that order. Similar tory professionals who are working with Ghana Health domains have earlier been identified as priority areas for Service (OR = 2.82, 95% CI = 1.12–7.09), teaching hos- personnel in Botswana [3]. The study also reported qual- pitals (OR = 4.64, 95% CI = 1.63–13.25), and private ity management systems as the highest prioritized among hospitals/laboratories (OR = 4.47, 95% CI = 1.50–13.32) their medical laboratory professionals. This similarity would likely prefer topics on technical competence than reflects the increased demand for total quality manage- colleagues working with teaching and research institu- ment within medical laboratories across Africa [21–23]. tions. Laboratory professionals with 1–5 years of experi- Contrary to the findings of the present study, healthcare ence (OR = 3.42, 95% CI = 1.01–11.60) were more likely professionals in Uganda cited research and audit as the to prefer topics on laboratory management, leadership, domain with the largest training need [24] while health and coaching (LMLC) than those with 15 years of expe- workers in the United Kingdom preferred topics that rience. Laboratory professionals who attend CPDs for addressed anxiety and lack of confidence [25]. The train- license renewal (OR = 0.54, 95% CI = 0.34–0.87) are less ing needs of health workers may vary by location. There likely to prioritize topics in LMLC. Laboratory profes- has been an increased demand for quality management sionals who had not attended CPDs for more than 3 years systems in the Ghanaian health sector as many medi- (OR = 5.67, 95% CI = 1.39–23.14) and at Teaching Hos- cal laboratories strive for international accreditation. It pitals (OR = 3.12, 95% CI = 1.05–9.34) are more likely was therefore not surprising that techniques to identify to prioritize topics in pathophysiology, data interpre- and control sources of errors in laboratory procedures tation, and research (PDR). People in supervisory role (88.9%), ethics and professionalism (88.3%), and imple- (OR = 0.27, 95% CI = 0.11–0.65), and supervising 1–5 menting a quality management system (87.7%) emerged (OR = 0.39, 95% CI = 0.16–0.95) or 6–10 (OR = 0.39, 95% as the topmost ranked topics. Knowledge in these areas is CI = 0.15–0.97) staff are less likely to prioritize topics in necessary for meeting international laboratory standards PDR. such as the International Organization for Standardiza- tion (ISO 15189), Clinical and Laboratory Standards Discussion Institute (CLSI), and Good Clinical Laboratory Practices This study sought to identify and prioritize the training (GCLP). Human resource is the organization’s most cru- needs of Ghanaian medical laboratory professionals and cial resource whose behaviors, talents, and aspirations highlight the challenges faced in accessing CPD pro- affect: the other resources that the organization uses, the grams. It is hoped that the findings of this study would organizational efficiency, and its effectiveness [26]; hence help provide focused CPD that meets the needs of practi- prompt policies and intervention in CPD programs tioners as well as the changing trends in medical labora- should target addressing their training needs to help in tory practice. Laboratory professionals reported financial promoting quality health care delivery in the country. cost implications (67.7%) and workload/time constraints The most preferred modes of CPD delivery reported in (51.8%) as the main reasons impeding their participation the present study are face-to-face presentations, training in CPD activities. Financial and workload constraints workshops, and hands-on workshops. Our findings are have been cited as major issues impeding CPD attend- quite similar to those earlier reported by medical labo- ance by laboratory staff in Nigeria [19]. CPD attendance ratory professionals in Botswana [3] and among other is hampered by a lack of relief coverage, inability to take health workers [27, 28]. These studies reported that train- paid or unpaid study leaves, the use of personal time for ing workshops, hands-on workshops, and internet-based required training, inadequate staffing, and issues with learning were the most preferred mode of CPD training leadership [20]. Given the changing financial situation in among medical laboratory professionals in Botswana. In the country and around the world, CPD planners should other studies, the online mode was preferred by health target developing cost-effective events which could eas- workers and managers for CPD delivery [18, 29]. Con- ily be assessed. Again, employers and supervisors should trarily, just a few medical laboratory professionals (24%) support the training of staff by providing clear policies to in our study population preferred internet-based learn- support staff CPD. CPD should be seen as a shared pro- ing. The possible reason for these modes of preferences fessional responsibility where organizations gain from may be due to familiarity with these methods ─ the E ssuman et al. Human Resources for Health (2023) 21:74 Page 9 of 11 Table 4 Factors that influence the choice of training needs of medical laboratory professionals in Ghana based on logistic regression analysis Independent variable Outcome variable Quality management Technical competence Laboratory management, Pathophysiology, data systems leadership, and coaching interpretation, and research OR (95% CI) P-value OR (95% CI) P-value OR (95% CI) P-value OR (95% CI) P-value Age group 20–30 0.52 (0.06–4.43) 0.547 0.28 (0.04–2.01) 0.207 0.22 (0.03–1.55) 0.129 0.16 (0.01–2.14) 0.167 31–40 0.42 (0.06–3.25) 0.407 0.26 (0.04–1.62) 0.148 0.29 (0.05–1.84) 0.191 0.16 (0.01–1.94) 0.150 41–50 0.53 (0.08–3.72) 0.522 0.69 (0.12–3.97) 0.680 0.67 (0.12–3.83) 0.653 0.13 (0.01–1.46) 0.099 > 50 1 1 1 1 Gender Female 0.91 (0.53–1.57) 0.729 0.89 (0.54–1.49) 0.669 1.08 (0.64–1.83) 0.781 1.26 (0.73–2.15) 0.406 Male 1 1 1 1 Cadre type Others 1.35 (0.13–14.43) 0.802 0.55 (0.05–5.99) 0.622 0.22 (0.02–2.01) 0.180 0.79 (0.07–8.44) 0.846 Lab Manager 1.82 (0.42–7.87) 0.423 0.69 (0.15–3.19) 0.634 0.58 (0.13–2.55) 0.470 0.54 (0.11–2.73) 0.457 Medical Lab Scientist 2.72 (0.76–9.71) 0.124 1.25 (0.32–4.930 0.750 0.95 (0.25–3.63) 0.936 1.26 (0.30–5.26) 0.755 Medical Lab Technician 2.18 (0.60–7.96) 0.237 0.70 (0.17–2.79) 0.609 0.78 (0.20–3.07) 0.724 0.92 (0.21–3.94) 0.905 Medical Lab Assistant 1 1 1 1 Years in service 1–5 0.50 (0.13–1.90) 0.307 2.15 (0.62–7.46) 0.228 3.42 (1.01–11.60) 0.049 1.56 (0.44–5.52) 0.492 6–10 1.04 (0.29–3.76) 0.958 2.24 (0.70–7.20) 0.176 2.72 (0.88–8.44) 0.084 1.72 (0.55–5.41) 0.353 11–15 1.11 (0.34–3.66) 0.866 1.89 (0.64–5.61) 0.250 2.25 (0.76–6.62) 0.142 1.02 (0.36–2.94) 0.965 > 15 1 1 1 1 Current place of work Ghana Health Service 2.36 (0.90–6.14) 0.080 2.82 (1.12–7.09) 0.028 1.21 (0.48–3.06) 0.687 0.76 (0.31–1.85) 0.541 Mission Hospital 1.39 (0.50–3.80) 0.528 2.08 (0.78–5.59) 0.145 0.71 (0.27–1.91) 0.500 0.71 (0.27–1.83) 0.474 Teaching Hospital 2.82 (0.95–8.39) 0.062 4.64 (1.63–13.25) 0.004 2.48 (0.87–7.08) 0.089 3.12 (1.05–9.34) 0.042 Private Hospital/Laboratory 4.38 (1.41–13.58) 0.011 4.47 (1.50–13.32) 0.007 1.83 (0.63–5.32) 0.269 1.60 (0.55–4.68) 0.390 Teaching/Research Institution 1.00 1 1 1 Being in a supervisory role No 0.52 (0.22–1.22) 0.133 0.74 (0.32–1.71) 0.481 0.56 (0.26–1.20) 0.133 0.27 (0.11–0.65) 0.003 Yes 1 1 1 1 No. of staff supervised 0 1 1 1 1 1–5 0.60 (0.25–1.43) 0.252 0.96 (0.41–2.23) 0.923 1.02 (0.47–2.22) 0.960 0.39 (0.16–0.95) 0.039 6–10 0.42 (0.17–1.05) 0.064 0.49 (0.21–1.19) 0.115 0.65 (0.29–1.49) 0.311 0.39 (0.15–0.97) 0.044 > 10 1 1 1 1 Period for last CPD Not specified 1.97 (0.51–6.22) 0.999 3.34 (1.12–9.87) 0.999 4.81 (0.36–63.90) 0.234 0.20 (0.01–3.82) 0.281 > 3 1.95 (0.60–6.32) 0.266 2.80 (0.83–9.47) 0.097 3.62 (1.19–11.00) 0.023 5.67 (1.39–23.14) 0.016 1–3 1.05 (0.53–2.09) 0.890 0.87 (0.47–1.63) 0.668 0.98 (0.51–1.86) 0.944 1.17 (0.61–2.26) 0.639 < 1 1 1 1 1 Reason for attending CPD Facilitation of license renewal 0.69 (0.42–1.12) 0.133 0.67 (0.42–1.07) 0.096 0.54 (0.34–0.87) 0.010 1.10 (0.67–1.82) 0.696 Exchange of expertise with col‑ 0.55 (0.18–1.68) 0.297 0.77 (0.26–2.33) 0.647 0.72 (0.25–2.08) 0.539 0.38 (0.12–1.18) 0.095 leagues Improvement in knowledge 1 1 1 1 and skills OR odds ratio; 95% CI 95 percent confidence interval Essuman et al. Human Resources for Health (2023) 21:74 Page 10 of 11 traditional way of organizing training workshops has workload/time constraints as the main reasons imped- always been the case where medical laboratory profes- ing their participation in CPD activities. We recom- sionals are required to travel and converge at designated mend that stakeholders including the Allied Health centers. Aside from the training, it has always been an Professions Council, Ghana Association of Medical opportunity to reunite with colleagues, make new rela- Laboratory Scientists, accredited academic institutions, tions and explore other opportunities; this in our view, and organizers of CPD activities should incorporate might be a key factor influencing the choices selected these training needs into future programs and address by the respondents. Due to advancements in wireless challenges highlighted in this study. This would help in and smartphone technology, eLearning has switched to having a more focused and targeted continuing profes- mobile learning, which is seeing a significant increase in sional development that meets the needs of practition- use due to the COVID-19 pandemic [30]. However, the ers and clients as a whole. lack of stable internet services and insufficient skills in the use of information technologies could be reasons why most participants would rather not opt for internet-based AbbreviationsCPD C ontinuing professional development platforms for CPD delivery. OR O dds ratio CI Confidence interval Strengths and limitations of the study Acknowledgements This study is the first survey of Ghanaian health profes- We would like to acknowledge all medical laboratory professionals who sionals, as far as we know, that aimed to identify and participated in the study. This study is dedicated to medical laboratory profes‑sionals across the length and breadth of Ghana for their relentless services to prioritize what professionals report as their training and the country’s healthcare despite the many challenges. development needs. Responses were received from all representative regions of the country, and medical labo- Author contributionsConceived and designed the study: RKDE, NAA, and MAE; data collection: ratory scientists in all cadres with varying years of experi- RKDE, MAE, IED, FAB, PA, LAA, SA, and FBKS. Data management and statistical ence. The findings of this study should be considered in analysis: MAE and JA. Wrote the first draft of the manuscript: MAE, RKDE, LAA, light of some limitations; first, the lack of an accessible and SEB. All authors read and approved the final manuscript. and comprehensive national registry of medical labora- Funding tory professionals in the country may have hampered The authors received no financial support for the research, authorship, and/or the recruitment of participants. However, respondents’ publication of this article. different ages, varying years of experience, cadre, and places of work justify the representativeness and general- Declarations izability of the study. Although the online survey method Ethics approval and consent to participate of data collection employed limits potential interviewer This study received approval from the Allied Health Professions Council bias and social desirability bias, participants may have (AHPC) and the Ghana Association of Medical Laboratory Scientists (GAMLS). Messages sent to participants included statements that indicated that their misread or misunderstood certain items in the survey participation was voluntary and are free to redraw from the study at any instrument. Lastly, as this study was conducted using a point. Respondents were informed of the purpose of the study and given all cross-sectional design, the results could not imply any details including what the outcome of the study will be used for, their right to either give or withdraw their consent, data protection, and issues regarding cause–effect relationship as reverse causality remains a confidentiality. possibility. Consent for publication Not applicable. Conclusion This study has identified what laboratory profession- Competing interests The authors declare that they have no competing interests. als in Ghana perceive as important training needs, the preferred mode of delivery, and challenges impeding Availability of data and materials their participation in CPD programs. Topics address- All data generated and analyzed during this study are included in this pub‑ lished article and its supplementary information files (Additional file 1). ing quality management systems were identified as the most preferred by participants. The identified needs Author details 1 shall help in developing CPD programs that address Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, what medical laboratory professionals perceive as edu- Ghana. 2 Institute of Leadership and Management in Education (InLaME), cational and professional training needs and meets the Accra, Ghana. 3 Department of Medical Laboratory Technology, Accra Technical changing medical trends. Ghanaian medical laboratory University, Accra, Ghana. 4 School of Public Health, University of Ghana, Legon, Ghana. 5 Laboratory Department, University Health Services, University of Cape professionals cited face-to-face presentations, training Coast, Cape Coast, Ghana. 6 National Tuberculosis Control Programme, Korle workshops, and hands-on workshops as their preferred Bu, Accra, Ghana. mode of CPD delivery, and financial implications and E ssuman et al. Human Resources for Health (2023) 21:74 Page 11 of 11 Received: 17 May 2022 Accepted: 4 September 2023 23. Tenkorang EY. Health provider characteristics and choice of health care facility among Ghanaian health seekers. Health Syst Reform. 2016;2:160–70. 24. Byamugisha J, Munabi IG, Mubuuke AG, Mwaka AD, Kagawa M, Okullo I, Niyonzima N, Lusiba P, Ainembabazi P, Kankunda C. A health care profes‑ References sionals training needs assessment for oncology in Uganda. Hum Resour 1. 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