Perspective Paper 1

Addressing Workforce Training Gaps in Aged Care: Implications for Nursing Education in Resource-Limited Settings

By Ms Nellie Y. Semer 

Abstract

Background:
The aged care sector globally faces workforce shortages and increasing complexity of care needs, raising concerns about workforce preparedness and quality of care [1,3].

Methods:
This paper presents a narrative review and critical analysis of existing literature and policy reports on workforce training and nursing education in aged care, with a focus on both high-income and resource-limited settings [2,6].

Results:
Key gaps were identified in aged care curriculum emphasis, clinical placement quality, simulation-based training, and transition-to-practice support [7,9,12]. These gaps contribute to reduced clinical competency and workforce retention challenges [10,17].

Conclusion:
Strengthening nursing education through competency-based curricula, simulation-enhanced learning, and structured transition programs is essential to improving workforce readiness and care quality [5,12].

Keywords:
Aged care; nursing education; workforce; clinical competency; simulation; training

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1. Background

Population ageing represents one of the most significant demographic shifts of the 21st century. The projects that the number of people aged 60 years and older will reach approximately 2.1 billion by 2050 [1]. This demographic transition has profound implications for healthcare systems, particularly in the provision of aged care services.

In Australia, the aged care sector has undergone extensive scrutiny following the , which identified systemic issues including workforce shortages, inadequate training, and inconsistent care quality [3]. Recent national workforce reports further highlight critical shortages and increasing demand for skilled nursing staff [17,18,19].

A critical determinant of aged care quality is the preparedness and competency of the nursing workforce. Evidence suggests that current nursing education systems are not adequately equipping graduates with the skills required to manage complex geriatric care [7]. These challenges are amplified in resource-limited settings such as Papua New Guinea, where infrastructure and training opportunities remain constrained [2].

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2. Methods

This study adopts a narrative review and critical discussion approach, drawing on peer-reviewed literature, global health reports, and policy documents related to aged care workforce development and nursing education [2,6]. Sources were selected based on relevance to workforce training, clinical competency, and education systems in both high-income and resource-limited settings.

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3. Results

3.1 Workforce challenges in aged care

The aged care workforce is characterized by persistent shortages, high turnover rates, and increasing workload demands [17,19,20]. In Australia, workforce supply has not kept pace with population ageing, leading to increased pressure on existing staff and concerns about care quality [18].

Newly graduated nurses often report feeling underprepared for aged care practice, particularly in managing dementia, multimorbidity, and end-of-life care [7]. This contributes to transition shock, which is associated with stress, reduced confidence, and early career attrition [4,10].

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3.2 Gaps in nursing education

Limited emphasis on aged care in curriculum

Nursing curricula frequently prioritize acute care settings, resulting in limited exposure to gerontological nursing and reduced student preparedness [8].

Variability in clinical placement quality

Clinical placements in aged care settings are often inconsistent, with inadequate supervision and limited learning opportunities impacting skill development [9].

Underutilization of simulation-based learning

Simulation-based education has been shown to improve clinical competence and decision-making [12]. However, its application in aged care education remains limited, particularly in low-resource environments [16].

Inadequate transition-to-practice support

Structured transition programs are not consistently implemented, despite evidence demonstrating their effectiveness in improving retention and job satisfaction among new graduates [10].

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3.3 Limitations in training systems

Training systems in both high-income and resource-limited settings face challenges including insufficient educator capacity, limited access to continuing professional development, and weak alignment between education and workforce needs [6,14].

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4. Discussion

Addressing workforce training gaps in aged care requires a coordinated approach involving educational institutions, healthcare organizations, and policymakers. Recent Australian workforce strategies emphasize the need for improved training pathways and workforce sustainability [18].

Competency-based education provides a framework for aligning educational outcomes with workforce requirements, ensuring that graduates possess the skills necessary for aged care practice [5]. Simulation-enhanced learning offers additional opportunities to develop clinical competence in a safe and controlled environment [12,16].

In resource-limited settings such as PNG, innovative and contextually appropriate strategies are required. These include low-cost simulation models, strengthened partnerships between educational institutions and healthcare providers, and peer-based learning approaches [6].

Importantly, workforce reforms must also address retention challenges. Evidence indicates that supportive work environments, professional development opportunities, and structured transition programs are critical to improving workforce stability [10,17].

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5. Implications for Practice and Policy

• Integration of aged care competencies into nursing curricula
• Expansion of simulation-based education and training programs
• Implementation of structured transition-to-practice programs
• Strengthening national workforce strategies and policy alignment [14,18]
• Investment in continuing professional development, particularly in rural and resource-limited settings

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6. Conclusion

Workforce training gaps in aged care represent a significant barrier to the delivery of high-quality healthcare services. Strengthening nursing education through competency-based curricula, simulation-enhanced learning, and structured transition programs is essential to improving workforce readiness and patient outcomes [5,12].

Future research should focus on evaluating the effectiveness of these interventions and their applicability across diverse healthcare contexts, particularly in resource-limited settings.

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