Professor Fiona Patterson Director of the Organisational Psychology Research Team

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Professor Fiona PattersonDirector of the
Organisational Psychology Research Team

• Training and skill acquisition in the context of
  EWTD

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Training Skill Acquisition in the Context of
EWTD

• Prof Fiona Patterson
• City University, London
• Work Psychology Group

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Overview

• Review research on training effectiveness
  complex skill acquisition for occupational groups
  in general
• Present a theoretical framework to explain the
  individual/organisational factors that influence
  training effectiveness
• What how to evaluate training?
• Implications for training effectiveness in
  medicine
• Suggest key areas for intervention to optimise
  training effectiveness in the context of EWTD

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Issues surrounding EWTD

• Positive outcomes for trainees eg. reduced
  fatigue
• EWTD perceived as reducing continuity of care
• Limited knowledge of results in the training
  cycle?
• Reduced time available for craft speciality
  training in particular
• ASiT continues to believe that the restrictions
  imposed by the EWTD will detrimentally affect the
  quality of training of junior surgeons and
  therefore the quality of surgical service
  provision in the future
• A need to identify specific training activities
• Conflict between service training is a
  fundamental issue

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Key themes from the research

• Organisational Culture / Climate
• Transfer of training - how best to maximise the
  application of skills learned during training to
  job performance
• Shift working how best to design the shifts to
  minimise negative effects on employee job
  performance
• The influence of work design on learning
  development
• Training methods approaches specific examples
  of training methods approaches of relevance to
  medicine
• Training content growing recognition that
  social/analytical skills are increasingly needed
  for effective performance. Relevance of team
  working skills to enhance learning.
• Affect/attitude - training directly influences
  job performance through the transfer of
  knowledge/skills indirectly through influencing
  trainee attitudes
• Evaluation of training - need for appropriate
  evaluation of training methods

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Millers Pyramid
Acad Med 1990 65 S63-7
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Evaluation of Training (Kirkpatrick, 1968)
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Flexible working
PMETB
Tomorrows Doctors
Selection for training
MMC
Assessment
EWTD
Consultant contract
Academic medicine
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PERSON
A Theoretical Framework of the Factors
Influencing Training Effectiveness (Patterson,
2009)
Cognitive Ability
Conscientiousness
Pre-training Self-efficacy
Achievement Motivation
LEARNING OUTCOMES
Fear of Failure
Declarative Knowledge
Valence
Job Performance
Skill Acquisition
Age
Motivation to learn
Transfer
Post Training Self-efficacy
JOB/CAREER VARIABLES
SITUATIONAL VARIABLES
Job Involvement
Locus of control
Culture/climate
Career Commitment
Affect
Trainer Support
Career Exploration
Peer Support
Attitude
Career Planning
Work Design
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Implications Organisational?

• Work design, multi-disciplinary team working,
  service reconfiguration, increased focus on
  training in rota design
• Support for prioritisation of training
• Structured training with objectives clearly
  aligned with achievement of competencies as set
  out in MMC guidance from Royal Colleges
• Alignment between Deanery, SHA Trusts
• Optimisation of existing underused resources
• Organisational cultural change is required
• Identify address barriers to training transfer

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Implications Resources for trainees trainers?

• Greater utilisation of on the job training
  opportunities contact time with
  consultants/trainers
• Coaching, mentoring supervision. Peer mentoring
  is underused
• Trainer empowerment. Training the trainer/tools
  to improve effectiveness
• Complex technical skills acquisition needs
  special consideration
• Opportunities in handover simulation e-learning
  technology to support training
• Innovative structures for feedback assessment
  required
• Designing effective training evaluation
  diagnostics
• Benchmarking best practice

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Summary

• Availability of a range of potential learning
  models including traditional classroom based
  methods is essential
• In practice, intended link between assessment
  learning may not be being capitalised on as
  effectively as desired
• Self efficacy and confidence are critical to
  successful training interventions this is
  linked to organisational culture
• Learning in the multi faceted, complex
  environment of medicine is multi-dimensional -
  this must be recognised when planning
  evaluating training
• Evaluation must account for contemporary
  theoretical models of training effectiveness to
  more accurately identify scope for intervention

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Thank you

• f.patterson_at_city.ac.uk
• s.marshall_at_workpsychologygroup.com

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Any Questions?
03.02.09
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