The effectiveness of the ICD-11 training program among clinical coders in Malaysia

Background: The World Health Organization endorsed the International Classification of Diseases 11th revision (ICD-11) in 2019 for ICD morbidity and mortality data reports. In Malaysia, the Ministry of Health (MOH) started to use it in 2024 after the long history of ICD-10 used since the 1990s. Objective: The present study aimed to evaluate the effectiveness of the ICD-11 training program conducted by the MOH. Method: A prospective single-arm study was conducted among 45 clinical coders at the MOH, where an online self-administered questionnaire included the (i) reaction level and (ii) learning level. Descriptive statistics were applied to the learning and reaction level input for data analysis. A paired t-test statistical analysis was used to analyse the difference in learning level scores in pre- and post-training programs. Results: Participants' overall satisfaction with the training courses was 93%, with most choosing somewhat agree and strongly agree in the reaction-level questionnaire. For the learning level, the average mean score for post-training (5.47) was higher when compared to pre-training scores (3.62), with a paired-sample test showing a significant difference (p < 0.05) between the mean scores. Conclusion: The increased efficacy in ICD-11 diagnosis coding among participant clinical coders post-training was statistically significant, and we recommend that MOH continue to host such training programs to enhance the knowledge and expertise of clinical coders. Implications for health information management practice: These findings emphasise the effectiveness of ICD-11 training programs, and add to the growing evidence about the need for standardised ICD training programs and resources to educate and train clinical coders in preparation for ICD-11 international rollout.