Designing and Implementing Training Programs. (MDS-3: Managing Access to Medicines and Health Technologies, Chapter 52)
(2012; 20 pages)


Training is any planned activity to transfer or modify knowledge, skills, and attitudes through learning experiences. Personnel may require training for a variety of reasons, including the need to maintain levels of competence and respond to the demands of changing circumstances and new approaches and technologies. Training by itself cannot solve structural, organizational, or policy problems within an organization, although supportive supervision and the use of motivational strategies can help sustain performance improvement derived from training. The first step in the design of training involves an assessment of training needs. The assessment comprises -

  • Observing workers performing normal duties
  • Interviewing workers and others
  • Studying routine reports or performance reviews, along with job descriptions
  • Identifying performance problems

The second step involves defining the training program’s learning objectives. The learning objectives, which are derived from the needs assessment, specify the observable, measurable actions that each learner will be able to demonstrate as a result of participating in the training activities.

The third step is the creation and implementation of a training program to improve performance, taking into account the experience and educational levels of the personnel and the time and resources available for training.

Options range from short courses to long-term placements in academic institutions in the country, in the region, or overseas, and non–classroom-based interventions, such as on-the-job training, coaching, and mentoring.

All options must be weighed against the immediate operational needs of the program or institution, because facilities may not have enough personnel to operate when staff members go for training.

The learning outcomes that must be achieved, along with the training environment, audience characteristics, and the experience of the trainer, all determine the mix of learning methods and media that will achieve maximum effectiveness. Methods and media may include lecture, discussion, case study, role-playing, group exercise, simulation games, brainstorming, and demonstration. If no published training materials-including audiovisual aids-are available, the trainer must develop them. Development of the training program also includes design of the training evaluation, which is carried out during the course as well as at its conclusion. During the course, trainers monitor learner progress and satisfaction to identify where they may need to make adjustments to the training program. At the end of the course, trainers should collect data on how well the learners achieved the course objectives and how satisfied they were with the training experience. Whenever possible, the trainer should follow up with participants after they return to their work situations to assess the impact of training on performance. Data collected during follow-up can help identify the need for additional training or reinforcement of newly acquired skills, as well as inform review and revision of the training materials.

In some countries, availability of basic training and continuous professional development programs is limited; therefore, many health workers lack access to formal training opportunities and new ideas and approaches that can improve their work performance. Well-designed in-service training programs can help fill this need. Training should be put into a context of continuous performance improvement. Changing and improving practices require an environment conducive to work, the appropriate learning resources, and the continuous use of motivational strategies. Training should be based on competencies: the abilities required to do work to the standards expected. Therefore, training should result in changes in work behavior that lead to an improved, efficiently functioning pharmaceutical management system. At the same time, training alone is unlikely to change overall supply system performance unless the environment and supervisory systems support change (see Chapter 37) and unless individuals are encouraged to maintain changes (see Chapter 51).

Learning requires active involvement. People prefer to learn in different ways-through visual stimuli, verbal interactions, and learning by doing. Therefore, offering a variety of training opportunities and training techniques is usually more effective than using only one approach. Training can be formal or informal, academic or applied, guided or self-directed, or provided in public agencies or private institutions.

Training alone is often not sufficient to change behavior or improve performance. Improved performance, changed attitudes, and new skills acquired during training may need to be complemented by and maintained through continuing education, supportive supervision, and adequate motivational incentives. In many cases, structural changes, such as workspace improvements and increased access to supplies and equipment may be needed to support improved performance.

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