Practical Aspects of Research into Staff Training

1. Practical Aspects of Research into Staff Training 18th November 2005 Dr Martin Campbell School of Psychology University of St Andrews Dr Andrew Jahoda Dept. of Psychological Medicine University of Glasgow

2. Practical Aspects of Research into Staff Training • There is a gap between academic research and traditional professional practices and between academic research the needs of people with learning disabilities. There is a need to: • Demonstrate that research proven interventions are effective in everyday service settings • Translate the findings of controlled research into practice • Make research findings more “digestible” for staff

3. Workshop 2:Practical Aspects of Research into Staff Training • Task • To produce: • three current opportunities for getting (training) research into practice and • three barriers which prevent (training) research getting into practice

4. Workshop 2 - Timings • 5 minutes – introductions • 10 minute presentation on opportunities for getting research into practice (AJ) • 10 minute presentation on barriers to getting research into practice (MC) • 20 minutes on identifying three current opportunities and three barriers (groups) • 10 minutes for groups to present summary of discussion to each other • 5 minutes round up

5. Staff Training – Research into Practice Some of the barriers • Staff training by itself is not effective in improving staff performance • Other influences, including leadership, legislation, subculture*, resources and public expectations of practice and training. • Measuring the effectiveness of staff training is complex, using different outcome measures

6. Barriers on people with learning disabilities acquiring or using self-care skills Cullen, Burton and Thomas 1989

7. “It is generally assumed that in-service training leads to improved staff performance and, finally more effective service programmes. Workshops are frequently used to deliver this training and generally consist of prepared talks, audio-visual aids, case presentations and live demonstrations, discussion groups, handbooks and texts, specially prepared instructional materials and questionnaires allowing participants to evaluate the workshop. Available research does not bear out the optimistic assumptions made about the value of in-service training. In objectively rating the services provided by six institutions for the retarded it has been found that the least effective of the six had the strongest in-service training programme and that, overall, there was simply no relationship between institutional effectiveness and in-service training” (Quillitch, 1975)

8. Case Study: Research into the effectiveness of Staff Training Staff training alone is not an adequate solution to deficits in staff performance Ziarnik JP, Bernstein GS (1982) There is currently insufficient evidence to unequivocally establish the effectiveness of staff training alone in improving staff practice in managing challenging behaviour.Health Evidence Bulletin (1999) Staff training alone by itself will not improve staff performance Cullen (2000)

9. Staff Training – Research into Practice Some of the Barriers • Subculture • “But we’ve always done it that way….” • What/where is the evidence? • Do we have enough evidence to justify changing training practices? • Perceived quality, relevance andapplicability of the training itself

10. Some of the Barriers (continued) • Researchers assuming that producing and disseminating research is sufficient • Researchers producing research in inflexible formats • Research that is not driven by “end user” needs (staff or service users) • Cost of subscription to databases • How training effectiveness is measured

11. Various outcome measures to evaluate effectiveness of training Subjective outcome- what staff report about the usefulness of the training Cognitive outcome - knowledge gain by staff Behavioural outcome - impact of training on staff behaviour Client centred outcome - the impact of the training on clients Organisational outcome - the impact on the work organisation

12. Case studies Subjective and Cognitive outcomes: Study evaluated a care staff trainingprogramme aiming at improving awareness on issuesof dual diagnosis in a group of 36 care stafffrom residential and community centres in Greece. The overwhelming majority of staff were very satisfiedwith training. Changes occurred mostlyin their knowledge and attitudes rather than practice. J. Tsiantiset al (2004)

13. Behavioural, Cognitive, Client-centred outcomes: “Staff training was found to influence healthy eating practices of clients. Similarly, the increase in the activity levels of people with learning disabilities that resulted from staff training on a model of active support has positive effects on health. Appropriate training has also been shown to have a positive impact on staff knowledge and confidence in supporting people with challenging behaviour.” NHS Learning Disabilities Health Needs Assessment (2004)

14. Behavioural outcomes: A case controlled cross sectional study of 102 adults with a profound intellectual disability. The evidence supports the use of a combined staff training and supervision format in communication intervention Increased levels and quality of staff-client communications. Granlund M, Terneby J, Olsson C. (1992)

15. Is Training or Management required? Training – changing staff behaviours through describing and demonstrating particular techniques Management – modification of the working environment so as to change behaviour through cues or feedback Research suggests that to effectively improve staff performance a combination is required; together with positive monitoring, effective staff supervision and appraisal systems