Skilling with technology

A case study of Wadhwani Foundation partnering with Narayana Health to develop and deploy an innovative learning programme with the help of technology to skill their nursing employees by creating jobs-driven curriculum and vocational training


A case study of Wadhwani Foundation partnering with Narayana Health to develop and deploy an innovative learning programme with the help of technology to skill their nursing employees by creating jobs-driven curriculum and vocational training

India continues to face a growing gap in maintaining a skilled labour force in healthcare industry’s support and paramedical staff. Especially since these individuals are required to perform a skilled job without access to a job-competency-driven curriculum or having undergone limited formal training. India has only 24 nurses or nurse midwives per 100,000 people but needs to produce 1,200,000 additional nurses to meet internationally acceptable ratios. With appropriate training, ‘freshers’ who have passed secondary school, can be transformed into responsible healthcare support workers.

The challenges are manifold, including the creation of high quality coursework that builds job skills, scarcity of teachers (across regions and centres) who can deliver the training with consistent quality, and an inability to run these classes for in-service nursing workers who are busy with full shift schedules, etc.

To overcome these challenges, Wadhwani Foundations partnered with Narayana Health to develop and deploy an innovative learning programme. The programme leverages technology to skill their nursing employees by creating jobs-driven curriculum and vocational training. The courses will be implemented through a unique blend of online and in-class learner-centric strategies. By adopting this cutting edge ‘Flipped Classroom’ approach, nurses can participate in e-learning in their own time, anywhere. They can then come together for discussions, practicums, and evaluations in focused classroom sessions, thus reducing teacher/student coordination, while making high quality learning feasible.

The need

Narayana Health is projected to grow from 5,000 beds to 30,000 beds by 2020.

Narayana Health identified the following ‘pain points’ it faced, in relation to talent development, which are fairly symptomatic of the healthcare and general industry:

  • Highly dependent on expert trainers who are already in short supply
  • Inadequate training content and inconsistent training delivery
  • Shortage of job-ready applicants; skill and competency gap among new hires
  • The hours involved in training for instructors and employees viewed as ‘off-productive’ time; difficulty in planning training while staff juggles full-time shifts

Wadhwani Foundation’s formula is designed to address these types of issues, requiring buy-in and dedication from a variety of stakeholders.


The solution

Wadhwani Foundation funded the pilot/ proof of concept of the programme, while Narayana Health’s team provided required industry expertise and access to facilities. During the research and development phase, Wadhwani Foundation’s instructional design team for healthcare conducted weekly visits to meet with hospital leadership, senior nurses, and attended nursing staff training sessions and practicals. Prior to this project, Narayana Health’s induction and training challenges were emblematic of those faced in hospitals across India. Wadhwani Foundation’s solutions to these issues are: (Check table)


The Wadhwani Foundation method not only helps new staff orient themselves to a new environment more quickly, but also encourages camaraderie and healthy competition among cohorts. In order to meet the needs of staff members with long shifts and difficult schedules, these courses may be used for on-demand self-study. It is important to note that the healthcare modules begin with entry level jobs and are designed to progress to upper levels. General duty assistants (GDAs)/ nursing assistants (NAs) are encouraged to interface with patient families and perform basic medical procedures, such as patient feeding, patient movement, documentation and record keeping, etc. GDAs encounter a steep learning curve once they have joined a hospital and are often ill-equipped for their new role. The course outline was devised jointly in order to meet the National Occupational Standards (NOS) for job-specific skills, and provide GDAs/ NAs with the necessary soft skills. The resulting curriculum was also closely mapped to meet the training requirements of international and national accreditation boards such as JCI and NABH respectively.

The result

Reportedly, the six-month long effort resulted in development of content for the basic/ induction training programme which can be disseminated over five working days or 40 hours. Intermediate training consists of 40-hour modules that can be deployed over three months and the advanced training consists of 20-hour modules that can be implemented over six months.


The induction training programme was administered to 3000 nursing staff and has paved way for an innovative approach to learning across 40 subjects. 97 per cent of the students reported that they prefer the Wadhwani Foundation-Narayana Health approach, as opposed to their normal class or training sessions. They administered pre- and post-training tests to determine the cohort’s collective and individual knowledge. The post-training test results revealed that every single student achieved significant gains; on an average, students improved by more than 25 per cent. Some students’ scores jumped by 30 – 35 per cent.


We are helping skill nurses, nurses’ aides, sales clerk, etc, not because this was the easiest thing to do but because this is where the largest number of jobs is. And our mission over the next 5-7 years is to skill five million people and then place all or most of them into jobs. And if we do that then there would be some meaningful impact in the scale of India.
Dr Romesh Wadhwani, Founder & Chairman, Wadhwani Foundations

Wadhwani Foundation has done a great job in creating these teaching modules and I am sure in the years to come, these teaching tools will be available to every nurse of this country and the world.
Dr Devi Shetty, Founder & Chairman, Narayana Health

We had the subject matter expertise and Wadhwani Foundations could bring in technology into the space so that we could marry them together and come out with something really useful
Dr Rakesh Verma, Group Head – Training and Organizational Development, Narayana Health‘

I advise all my colleagues and practitioners to go through e-modules and it is really useful. I am now more confident in taking care of my patients
Saamya Salem, Staff nurse, Oman – Nurse from Oman undergoing training at Narayana Health

It will enable nursing education institutions to bring better trained and skilled population of nurses who are job ready.
Sonali Tarachand Jadhav, Principal, MS Ramaiah Institute for Nursing Education and Research

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