Training and development needs assessment

The first step in achieving full capability for staff is a comprehensive training and development
needs assessment. Too often, staff development programmes are offered simply because
someone has requested them or because they have been done in the past to address a situation
that may not still exist. Considering the demands placed on staff already, it is imperative to
target staff development carefully where it is most needed. Systematic assessment of development
needs based on organisational goals can be used as a basis for developing specific
content and appropriate methods.
The ultimate purpose of staff development is to change practices and behaviours in clinical
settings. Practices and behaviours that are appropriate for staff development are ones
that:

• can be made more effective and efficient (e .g. a different way of managing patient appointments,
  a revised clinical procedure] ;
• need maintenance usually because they are not done very often in the normal course of
  work but are essential to be done well when called upon to do so [e.g. health and safety
  updates, cardiopulmonary resuscitation, hazardous materials and infection control];
  • new employees need to learn (e.g. department-specific practices and standards] ;
• employees who are new to a role need to learn (e .g. a staff member who transfers to an outpatient
  setting after working in the acute setting];
  • are needed as a result of new knowledge or new technology (e .g. a new piece of equipment];
  • have been identified as a result of information gathered from complaints, near misses, clinical
  incidents, audits and patient surveys.
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  CHAPTER 8 MOTIVATING AND DEVELOPING OTHERS
  Development planning
  After needs have been determined, the next step is to plan staff development programmes.
  Development planning entails identifying learner objectives and matching them with educational
  methods. Learner objectives should be specific, measurable statements about desired
  behaviours, skills or knowledge to be acquired within a specific time frame. The strategy used
  to affect the desired outcome should be based on learning needs, the employee and available
  resources.
  Department managers and team leaders have a variety of options for meeting the development
  needs of their staff. As mentioned above, the staff development department within the
  organisation will typically offer induction programmes and mandated training and often more.
  Progressive staff development departments are increasingly using a variety of techniques for
  staff development, such as computer-based learning and self-paced learning packages as well
  as traditional lectures, demonstrations and workshops.
  Work-based learning is also an option. Many departments tap into the expertise within and
  outside the organisation by inviting staff to present topics for discussion during staff meetings
  or team meetings. Some clinics have regular educational times where clinic appointments are
  not scheduled and formal training occurs.
  Three main questions should be considered in assessing learning needs and planning for
  staff development: Can the learner do what is required? What is the best method to facilitate
  learning? What can be done to ensure that what is learned will be transferred into practice? As
  well as underpinning the design of staff development with learning theories, theories of motivation
  can be applied to build the individual’s desire to learn and to apply skills and concepts
  learned. Three learning theories help guide what we know about staff development: social
  learning theory, relapse prevention and adult education theory.
  Learning theories
  Social learning theory
  Bandura described social learning theory in 19??. It is a behavioural theory based on reinforcement.
  Bandura believed that people learn new skills and behaviours through direct
  experience or by watching other people. The observer learns that some behaviours are
  rewarded and therefore should be retained, while other behaviours are punished or go unnoticed
  or unrewarded and should therefore be abandoned.
  According to social learning theory, the anticipation of reward influences what the person
  does or does not observe. This response suggests that observational learning is more effective
  when the observer has a good reason to pay attention rather than simply being rewarded for
  imitating what is seen. For example, a student may be asked to observe a qualified member of
  staff conducting an initial assessment. Owing to the student being most interested in developing
  her capability in the role, she is likely to focus mainly on the staff member’s actions. The student
  may not pay as much attention to the patient, therefore missing vital cues. If the qualified staff
  member had asked the student to focus on the patient, looking for hesitation and noting the questions
  the patient asked, she would have learned something very different from the experience.
  Figure 8.4 illustrates this theory.
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  Anticipated
  reinforcement
  Choosing and
  observing a
  model
  Figure 8.4 Social learning theory
  Relapse prevention
  LEARNING THEORIES
  Attitude change
  if behaviour is
  consistently
  effective
  Relapse prevention emphasises learning a set of self-control and coping strategies to
  increase retention of newly learned behaviours. This type of strategy is often used to prevent
  relapse into harmful personal habits, such as overeating, smoking or other addictive
  behaviour. However, it can also be useful in changing work-related behaviours, such as
  coming to work late or losing your temper with a colleague. The premise behind this model is
  that learners are:
• taught to anticipate high-risk situations;
• taught coping strategies for avoiding high-risk situations;
• taught that slight slips or relapses are predictable and need not become failures.
  As a result, the learner’s effectiveness increases because the learner anticipates potential
  problems and is confident in using coping strategies. In addition, this model minimises the possibility
  of small relapses turning into absolute failure. Based on this model, learners should be
  encouraged to identify possible failure situations and ways to cope with them, and practise
  such situations using new skills in the neutral environment of education. Training for response
  to fire or clinical emergency incorporates this idea. If a fire were to break out in a building, fear
  would cause most people to react instinctively, putting themselves and others in danger. Fire
  training is designed to help people to anticipate this high-risk situation [potential for panic]
  and to respond in a predictable, patterned way that minimises danger.
  Adult learning theory
  Knowles [ 19 50] proposed the adult learning theory, which described differences in the
  learning styles of adults and children. Prior to Knowles’ work, it was assumed that the same
  teaching principles could be used for both children and adults. Knowles suggests four basic
  conceptual differences between adult and child education: self-concept, experience, readiness
  to learn and time perspective. These characteristics are described in Table 8.1.
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  Table 8.1 Characteristics of adult learners and educational implication
  Adult learner
  characteristics Implications for adult learning

1. The need to Adults need to know why they need to learn something before they will engage with
   know learning. The first task of the teacher or facilitator of learning is to help the learners become
   aware of the ‘need to know’. At the very least, facilitators can make an intellectual case for
   the value of the learning in improving the effectiveness of the learners’ performance or the
   quality of their lives. Even more potent tools for raising the level of awareness of the need
   to know are real or simulated experiences in which the learners discover for themselves
   the gaps between where they are now and where they want to be. Exposure to new or
   unusual experiences, working with a mentor, undertaking clinical supervision and staff
   review are all processes that can bring the need for the learning to awareness.
2. The learners’ Adults see themselves as responsible for their own decisions, for their own lives. Once
   self-concept they have arrived at that self-concept, they develop a deep psychological need to be seen
   by others and treated by others as being capable of self-direction. They resent and resist
   situations in which they feel others are imposing their wills on them. This presents a
   serious problem in adult education: the minute some adults walk into an activity labelled
   ‘education’, ‘training’ or anything synonymous, they tend to revert to the conditioning
   provided by their experience of school, and sit passively waiting for the teacher to teach.
3. The role of Adults come into an educational activity with both a vast quantity and varying quality
   the learners’ of life and work experiences. The emphasis in adult education is on experiential
   experiences techniques- techniques that tap into the experience of the learners, such as group
   discussion, simulation exercises, problem-solving activities, case studies and handson
   practice. Adult learners also benefit from learning from peers and using their
   experience to benefit others.
4. Readiness to Adults become ready to learn those things they need to know and be able to do in order
   learn to cope effectively with their real-life situations. An especially rich source of ‘readiness
   to learn’ are the developmental tasks associated with moving from one developmental
   stage to the next. The critical implication of this assumption is the importance of timing
   learning experiences to coincide with those developmental tasks.
5. Orientation There are ways to induce readiness through exposure to models of superior
   to learning performance, career counselling, simulation exercises and other techniques.
   In contrast to children’s and youths’ subject-centred orientation to learning [at
   least in school]. adults are life-centred [or task-centred or problem-centred] in their
   orientation to learning. Adults are motivated to learn to the extent that they perceive
   that learning will help them perform tasks or deal with problems that they confront in
   their life situations. Furthermore, they gain new knowledge, understandings, skills,
   values and attitudes most effectively when they are presented in the context of
   application to real-life situations.
6. Motivation Whilst adults are responsive to some external motivators [better jobs, promotions,
   higher salaries and the like). the most potent motivators are internal [the desire for
   increased job satisfaction, self-esteem, quality of life and the like). Motivation is often
   eroded by factors such as not wanting to admit that they have something to learn,
   lack of opportunity for development, time constraints, competing commitments and
   experience of poorly designed programmes that fail to consider the unique needs of
   the adult learner, being afraid that, if they have been out of ‘formal’ education for a
   long period, they may have lost that skill and, thereby, show themselves up

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