The science of training: a decade of progress

Influencing Physical Therapist's Self-efficacy for Musculoskeletal Ultrasound Through Blended Learning: A Mixed Methods Study

BACKGROUND AND PURPOSE

With the growing interest for physical therapists to incorporate musculoskeletal (MSK) ultrasound comes a need to understand how to organize training to promote the transfer of training to clinical practice. A common training strategy blends asynchronous learning through online modules and virtual simulations with synchronous practice on live simulated participants. However, few physical therapists who attend MSK ultrasound continuing education courses integrate ultrasound into clinical practice. Self-efficacy is a significant predictor of training transfer effectiveness. This study describes to what degree and how a blended learning strategy influenced participants' self-efficacy for MSK ultrasound and transfer of training to clinical practice.

SUBJECTS

Twenty-one outpatient physical therapists with no previous MSK ultrasound training.

METHODS

Twenty-one participants assessed their self-efficacy using a 26-item self-efficacy questionnaire at 3 intervals: before asynchronous, before synchronous training, and before returning to clinical practice. Participants were interviewed within 1 week of training using a semi-structured interview guide. Quantitative analysis included descriptive statistics and repeated-measures ANOVA. Thematic analysis was used to examine participants' experiences, and "following the thread" was used to integrate findings.

RESULTS

Self-efficacy questionnaire mean scores increased significantly across the 3- time points ( F [2, 40] = 172.7, P < .001, η 2 = 0.896). Thematic analysis indicated that asynchronous activities scaffolded participants' knowledge, enhanced their self-efficacy, and prepared them for synchronous learning; however, it did not replicate the challenges of MSK ultrasound. Synchronous activities further improved self-efficacy and helped participants better calibrate their self-judgments of their abilities and readiness to integrate MSK ultrasound training into clinical practice. Despite individual-level improvements in self-efficacy, interviewees recognized their limitations and a need for longitudinal training in a clinical environment.

DISCUSSION AND CONCLUSION

A blended learning approach positively affects participants' self-efficacy for MSK ultrasound; however, future training designs should provide learners with additional support during the transition phase.

The effect of gender on emotional reactions and perceptions when individuals meet themselves in immersive virtual reality

Immersive virtual reality-based training and research are becoming more and more popular and are in continuous development. For instance, it is now possible to be trained by one's virtual self (i.e., doppelganger), meaning that a trainee can participate in a training program in which the trainer resembles the trainee. While past research involving doppelgangers showed promising results, findings revealed gender effects such that doppelganger-based training seems to be beneficial only for male trainees. In the present research, we contribute to this literature by investigating the emotional reactions and perceptions that people have when they meet a virtual human in immersive virtual reality. Specifically, we assess the extent to which the appearance of the virtual human (doppelganger vs. unknown avatar) and an individual's gender influence these reactions and perceptions. We found that males felt more positive emotions toward their doppelganger than toward the unknown avatar and that females perceived their doppelganger as less competent and warm than the unknown avatar. Our findings have important practical implications in terms of virtual reality-based training and research design such that the use of a doppelganger (unknown avatar) might be recommended in a training program or research setting involving men (women).

Exploring objective measures for assessing team performance in healthcare: an interview study

Introduction

Effective teamwork plays a critical role in achieving high-performance outcomes in healthcare. Consequently, conducting a comprehensive assessment of team performance is essential for providing meaningful feedback during team trainings and enabling comparisons in scientific studies. However, traditional methods like self-reports or behavior observations have limitations such as susceptibility to bias or being resource consuming. To overcome these limitations and gain a more comprehensive understanding of team processes and performance, the assessment of objective measures, such as physiological parameters, can be valuable. These objective measures can complement traditional methods and provide a more holistic view of team performance. The aim of this study was to explore the potential of the use of objective measures for evaluating team performance for research and training purposes. For this, experts in the field of research and medical simulation training were interviewed to gather their opinions, ideas, and concerns regarding this novel approach.

Methods

A total of 34 medical and research experts participated in this exploratory qualitative study, engaging in semi-structured interviews. During the interview, experts were asked for (a) their opinion on measuring team performance with objective measures, (b) their ideas concerning potential objective measures suitable for measuring team performance of healthcare teams, and (c) their concerns regarding the use of objective measures for evaluating team performance. During data analysis responses were categorized per question.

Results

The findings from the 34 interviews revealed a predominantly positive reception of the idea of utilizing objective measures for evaluating team performance. However, the experts reported limited experience in actively incorporating objective measures into their training and research. Nevertheless, they identified various potential objective measures, including acoustical, visual, physiological, and endocrinological measures and a time layer. Concerns were raised regarding feasibility, complexity, cost, and privacy issues associated with the use of objective measures.

Discussion

The study highlights the opportunities and challenges associated with employing objective measures to assess healthcare team performance. It particularly emphasizes the concerns expressed by medical simulation experts and team researchers, providing valuable insights for developers, trainers, researchers, and healthcare professionals involved in the design, planning or utilization of objective measures in team training or research.

Imagine All the People: A Guided Internet-Based Imagery Training to Increase Assertiveness among University Students-Study Protocol for a Randomized Controlled Trial

The importance of communication skills for well-being and self-realization is widely accepted. Despite that, research on assertiveness and assertiveness training has declined significantly in recent decades. Consequently, traditional training does not consider the most recent novel technologies used to spread psychological interventions. This study proposes the development of ComunicaBene: a guided Internet-based imagery intervention to promote assertiveness. Moreover, it describes the study protocol for a randomized control trial to investigate the intervention's efficacy and acceptability. Participants will be randomly assigned to an experimental (ComunicaBene) or waitlist control condition. ComunicaBene consists of different online training modules corresponding to three phases: psychoeducation, imaginative exposure, and in vivo-exposure. Each module provides participants with theoretical and practical content about needs, emotions, communication style, and assertiveness. Moreover, during the program, every student is supervised by a Tutor. Participants in the control condition will be included in a waiting list. Primary and secondary outcomes will include changes in assertiveness, well-being, emotional awareness, worry, and rumination. Outcomes will be assessed at pre- and post-intervention, and via a 6-month follow-up. We expect that the results will support the efficacy of ComunicaBene as an innovative, scalable, affordable, and acceptable intervention to spread assertive training through the Internet and among a broad population.

Safety training in context: technical, cultural and political factors affecting its design, delivery and transfer

INTRODUCTION

Safety training is integral to modern safety management systems. However, what is trained in the classroom is not always adopted and applied in the workplace, creating the training transfer problem. Taking an alternative ontological stance, the aims of this study were to conceptualize this problem as one of 'fit' between what is trained and the contextual factors in the work environment of the adopting organization.

METHOD

Twelve semi-structured interviews were conducted with experienced health andsafety trainers having diverse backgrounds and experience. Data were thematically coded 'bottom-up' to capture reasons for safety training and where consideration of context occurs in the design and delivery of training. Then, the codes were thematically grouped against a pre-existing framework to categorize contextual factors that affect 'fit' into technical, cultural, and political factors each operating at different levels of analysis.

RESULTS

Safety training occurs to satisfy external stakeholder expectations and meet internal perceptions of need. Consideration of contextual factors can occur both in the design and delivery of training. A range of technical, cultural, and political factors were identified, which can operate at individual, organizational, or supra-organizational levels to influence safety training transfer.

CONCLUSIONS

The study draws particular attention to the influence of political factors and the impact of supra-organizational factors on the successful transfer of training, areas not consistently considered in safety training design and delivery.

PRACTICAL APPLICATION

The application of the framework adopted in this study provides a useful tool for discriminating between different contextual factors and the level at which they operate. This could enable more effective management of these factors to improve the potential for transfer of safety training from the classroom to the workplace.

A new approach for Training Needs Analysis: A case study using an Automated Vehicle

Considerable resources are invested each year into training to ensure trainees have the required competencies to safely and effectively perform their tasks/jobs. As such, it is important to develop effective training programmes which target those required competencies. One method that can be used at the start of the training lifecycle to establish the tasks and competencies that are required for a task/job and is considered an important activity to perform when developing a training programme is a Training Needs Analysis (TNA). This article presents a new TNA approach and uses an Automated Vehicle (AV) case study to demonstrate this new approach for a specific AV scenario within the current UK road system. A Hierarchical Task Analysis (HTA) was performed in order to identify the overall goal and tasks that drivers need to perform to operate the AV system safely on the road. This HTA identified 7 main tasks which were decomposed into 26 sub-tasks and 2428 operations. Then, six AV driver training themes from the literature were combined with the Knowledge, Skills and Attitudes (KSA) taxonomy to identify the KSAs that drivers need to perform the tasks, sub-tasks and operations that were identified in the HTA (training needs). This resulted in the identification of over 100 different training needs. This new approach helped to identify more tasks, operations and training needs than previous TNAs which applied the KSA taxonomy alone. As such, a more comprehensive TNA for drivers of the AV system was produced. This can be more easily translated into the development and evaluation of future training programmes for drivers of AV systems.

Identifying challenges to critical incident decision-making through a macro-, meso-, and micro- lens: A systematic synthesis and holistic narrative analysis

It is predicted that emergency responses to critical incidents will increase over the next few decades, as society faces unique and dynamic challenges (e.g., pandemics, migrant crises, and terrorism). As such, it is necessary to breakdown, identify, and evaluate the unique barriers associated with decision-making in the context of critical incident responses. The aim of the current study was to synthesize the bibliographic characteristics of the research on decision making and present a holistic narrative analysis of the multi-layered factors. Additionally, the systematic synthesis of evidence facilitated a critical appraisal of the quality and distribution of evidence across macro-, meso-, and micro- levels. Results suggested that research was moderately heterogeneous, as evidence captured diverse narrative factors. However, micro-centric characteristics (e.g., cognitive-related factors) were not well represented. Instead, research primarily focused toward intermediate meso-level characteristics, capturing factors such as "interoperability" and "organization policy and procedure" as critical challenges to decision-making. Six key narratives were also identified and discussed. Both the quality appraisal and narrative findings suggested that research should seek opportunities to experimentally assess, evaluate and validate decision-making. Whilst this has previously appeared ethically and practically problematic, advances in technology, research and analysis have allowed high-fidelity simulation experimentation to recreate critical incidents.

Cognitive aids in the management of clinical emergencies: a systematic review

Clinical emergencies can be defined as unpredictable events that necessitate immediate intervention. Safety critical industries have acknowledged the difficulties of responding to such crises. Strategies to improve human performance and mitigate its limitations include the provision and use of cognitive aids, a family of tools that includes algorithms, checklists and decision aids. This systematic review evaluates the usefulness of cognitive aids in clinical emergencies. Following a systematic search of the electronic databases, we included 13 randomised controlled trials, reported in 16 publications. Each compared cognitive aids with usual care in the context of an anaesthetic, medical, surgical or trauma emergency involving adults. Most trials used only clinicians in the development and testing of the cognitive aids, and only some trials provided familiarisation with the cognitive aids before they were deployed. The primary outcome was the completeness of care delivered to the patient. Cognitive aids were associated with a reduction in the incidence of missed care steps from 43.3% to 11% (RR (95%CI) 0.29 (0.15-0.16); p < 0.001), and the quality of evidence was rated as moderate. The use of cognitive aids was related to decreases in the incidence of errors, increases in the rate of correctly performed steps and improvement in the clinical teamwork skills scores, non-technical skills scores, subjective conflict resolution scores and the global assessment of team performance. Cognitive aids had an inconsistent influence on the time to first intervention and time to complete care of the patient's condition. It is possible that this was a reflection of how common or rare the crisis in question was as well as the experience and expertise of the clinicians and team. Sufficient thought should be applied to the development of the content and design of cognitive aids, with consideration of the pre-existing guideline ecosystem. Cognitive aids should be tested before their deployment with adequate clinician and team training.

A prospective randomized study to compare standard versus intensive training strategies on long-term improvement in critical care ultrasonography proficiency

BACKGROUND

Critical care ultrasonography (CCUS) has become a daily diagnostic tool for intensivists. While the effective training measures for ultrasound novices are discussed widely, the best curriculum for the novices to retain a long-term proficiency is yet to be determined.

METHODS

Critical care medicine fellows who underwent an introductory CCUS workshop were randomly allocated into the standard training (ST) or the intensive training (IT) group. The IT group received an 8-h training besides the standardized fellowship education that the ST group received. Participant improvement in CCUS proficiency tests (maximum score, 200) after a 6-month training intervention was compared between the groups. CCUS examinations performed in patient care were observed over 2 years.

RESULTS

Twenty-one fellows were allocated into the ST (n = 10) or the IT (n = 11) group. No statistically significant difference was observed in the median (interquartile range [IQR]) improvement in CCUS proficiency tests between the ST group and the IT group: 18 (3.8-38) versus 31 (21-46) (P = .09). Median (IQR) test scores were significantly higher in postintervention than preintervention for both groups: ST, 103 (87-116) versus 124 (111-143) (P = .02), and IT, 100 (87-113) versus 143 (121-149) (P < .01). Participating fellows performed 226 examinations over the 2 years of observation.

CONCLUSIONS

Fellows improved their CCUS proficiency significantly after 6-month training intervention. However, an additional 8-h training did not provide further benefits.

“Power of words”: impact, concerns and applications of nonviolent communication training

Purpose

The purpose of this study is to evaluate the effectiveness of a training program on nonviolent communication (NVC) and assess its impact, concerns and applicability to the context of work. This study also focuses on the factors that influence the retention and application of the skills acquired during the training after three months of completion of the program.

Design/methodology/approach

This study uses a qualitative approach. Purposive sampling was used, and 14 semi-structured interviews were conducted to study the impact of an NVC training program titled “Power of words”. Thematic analysis based on Kirkpatrick’s model of training evaluation was used to arrive at the findings.

Findings

NVC training was found to have created a sustainable shift in perspective and behaviour of the participants; however, the learning and application of the NVC skills were found to be dependent on individual and contextual factors. The role of the facilitator was found to be crucial in creating safe spaces that were essential for open sharing and effective practice. NVC was found to be easier to apply to contexts of personal relationships; however, in a work context, it holds immense scope to create both organisational- and employee-level outcomes.

Research limitations/implications

This study has implications for developing theory on NVC and its consequences to humanistic management and employee thriving.

Practical implications

This study has implications for developing theory on NVC and its consequences for humanistic management and employee thriving. This study has practical implications for humanising communication at work and also has implications for leaders, managers, coaches, counsellors, HR professionals and OD professionals, to improve employee or client experiences. This study also has implications for the potential community development.

Social implications

This study also has implications for the potential community development as a consequence of NVC training.

Originality/value

The research on the application of NVC training to context of work is very limited, and also, there is very limited research on both the effectiveness of online training and the retention and application of the learning after three months of completion of the program. This study fills these gaps.

Training satisfaction relative to turnover intention: the mediating role of employee loyalty

Purpose

The purpose of this study is to focus on Turnover intention (TI) which is gaining significance in the Jordanian government sector as well as in many other international institutions. Organizations tend to seek valuable benefits from the human resource capital they have to achieve their competitive advantages. However, TI becomes a global issue as well as in Jordanian public context. The research framework of this study is based on the satisfaction and social psychological literature.

Design/methodology/approach

By applying the convenience sampling method, data were collected through an online questionnaire; 354 respondents from the governmental sector participated in this study. Data were analyzed using the statistical software Smart PLS.

Findings

Results revealed that mind wandering (MW) has a negative impact on training satisfaction (TS) while trainer efficacy (TE) has a positive impact on TS. Meanwhile, work–life conflict (WLC) was not significantly related to TS. TS has a negative impact on TI and a positive impact on employee loyalty (EL). However, EL has a negative impact on TI, and, at the same time, it mediates the relationship between TS and TI. Moreover, the study demonstrates sequential mediation for TI.

Originality/value

The research adds to the body of knowledge by testing a new framework. Moreover, it introduces sequential mediation for TI.

The Impact of Mobile Technology-Delivered Interventions on Youth Well-being: Systematic Review and 3-Level Meta-analysis

BACKGROUND

Rates of mental health problems among youth are high and rising, whereas treatment seeking in this population remains low. Technology-delivered interventions (TDIs) appear to be promising avenues for broadening the reach of evidence-based interventions for youth well-being. However, to date, meta-analytic reviews on youth samples have primarily been limited to computer and internet interventions, whereas meta-analytic evidence on mobile TDIs (mTDIs), largely comprising mobile apps for smartphones and tablets, have primarily focused on adult samples.

OBJECTIVE

This study aimed to evaluate the effectiveness of mTDIs for a broad range of well-being outcomes in unselected, at-risk, and clinical samples of youth.

METHODS

The systematic review used 5 major search strategies to identify 80 studies evaluating 83 wellness- and mental health-focused mTDIs for 19,748 youth (mean age 2.93-26.25 years). We conducted a 3-level meta-analysis on the full sample and a subsample of the 38 highest-quality studies.

RESULTS

Analyses demonstrated significant benefits of mTDIs for youth both at posttest (g=0.27) and follow-up (range 1.21-43.14 weeks; g=0.26) for a variety of psychosocial outcomes, including general well-being and distress, symptoms of diverse psychological disorders, psychosocial strategies and skills, and health-related symptoms and behaviors. Effects were significantly moderated by the type of comparison group (strongest for no intervention, followed by inert placebo or information-only, and only marginal for clinical comparison) but only among the higher-quality studies. With respect to youth characteristics, neither gender nor pre-existing mental health risk level (not selected for risk, at-risk, or clinical) moderated effect sizes; however, effects increased with the age of youth in the higher-quality studies. In terms of intervention features, mTDIs in these research studies were effective regardless of whether they included various technological features (eg, tailoring, social elements, or gamification) or support features (eg, orientation, reminders, or coaching), although the use of mTDIs in a research context likely differs in important ways from their use when taken up through self-motivation, parent direction, peer suggestion, or clinician referral. Only mTDIs with a clear prescription for frequent use (ie, at least once per week) showed significant effects, although this effect was evident only in the higher-quality subsample. Moderation analyses did not detect statistically significant differences in effect sizes based on the prescribed duration of mTDI use (weeks or sessions), and reporting issues in primary studies limited the analysis of completed duration, thereby calling for improved methodology, assessment, and reporting to clarify true effects.

CONCLUSIONS

Overall, this study's findings demonstrate that youth can experience broad and durable benefits of mTDIs, delivered in a variety of ways, and suggest directions for future research and development of mTDIs for youth, particularly in more naturalistic and ecologically valid settings.

Investigating acceptability of a training programme in precision medicine for frontline healthcare professionals: a mixed methods study

BACKGROUND

Precision Medicine offers tailored prevention, diagnosis, treatment and management to patients that considers genomics, lifestyle and environmental factors. If implementation of Precision Medicine is to advance, effective, focused upskilling of frontline healthcare professionals through quality continuing professional development is needed. This study reports on an evidence-based approach to needs assessment to investigate the current level of knowledge of Precision Medicine, acceptable content for training, the perceived potential of a more precision approach to patient care and motivation to participate in a training programme among pharmacists, advanced practice nurses and general practitioners. Investigating perceived needs can avoid a top-down approach and support a design that is fit for purpose to targeted professions.

METHODS

This study reports on 2 focus groups (n = 12) delivered in French and German with equal professional participation of the targeted professions. The research objectives were investigated in two phases. During the first phase, a literature review and expert consultations were conducted to develop a definition of PM, patient cases and content for training. In a second phase, these investigations were further explored using focus groups to investigate acceptable learning objectives, the potential of PM to relevant professions and motivation of participants. Quantitative investigations using rating scales and visual analogues were incorporated. The focus groups were audio recorded, transcribed by intelligent verbatim and translated to English. NVivo was used for data analysis and interpretation following a hybrid approach using the Framework Method and thematic analysis. The analytical framework, Implementation Science, was applied to organise and present research data.

RESULTS

Precision Medicine is considered a new topic area, largely unfamiliar to frontline healthcare professionals.. There was acceptance of a more precision approach to care among all participants with perceived positive implications for patients. Valuable insight was gathered on acceptable content and form for training. All participants expressed concerns on readiness within their professions which included an insufficient system infrastructure, a lack of time to attend needed training, a lack of clarity for use in practice and the time needed to build a support network.

CONCLUSIONS

A precision approach to patient care is on the horizon for health care professionals not only in hospital settings but also at the community level. Our results conclude that an adaptable and flexible training programme in PM is timely, contextually relevant and conducive to the needs of targeted health professions for successful implementation. A training programme in PM will require support across sectors and stakeholders, supporting insurance models, educated patients and integrated care supported by innovative technology. Implementation Science outcomes are a useful strategy towards design of an effective training programme that can have measurable impact in practice.

Evaluation of the Dangerous Decibels Brazil Program in Workers Exposed to Noise

Introduction

Noise-induced hearing loss can be avoided by taking preventive measures.

Objective

To assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan.

Method

Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups-the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student's t-test for paired data (<0.05).

Results

After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training.

Conclusion

The Brazilian version of the Dangerous Decibels® program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated.

What do job insecure people do? Examining employee behaviors and their implications for well-being at a weekly basis

The current study investigated employees' weekly responses to experienced job insecurity. Based on appraisal theory, it was postulated that employees may adopt three coping strategies in response to job insecurity (i.e., remaining silent, adapting, or being proactive) in order to maintain or improve their weekly well-being. We introduced a multilevel moderated mediation model, explaining how weekly job insecurity would be related to well-being in the following weeks through these three behaviors. We also expected that subordinate emotional regulation and supervisor prosocial motivation (both defined as trait variables) would function as contextual factors moderating the relationships of job insecurity with employee behavior and well-being. A 5-week diary study of 149 subordinates partially supported the model. The results showed longitudinal conditional indirect effects of job insecurity on subordinate well-being depending on subordinate emotional regulation style and supervisor prosocial motivation. In doing so, the study offers two main contributions to the job insecurity literature. First, employees are not passive responders to perceived job insecurity, but active shapers through coping depending on the context. Subordinates' emotional regulation strategy and supervisors' prosocial motivation, as trait variables, impact on how subordinates respond to perceived job insecurity over weeks. From a practical point of view, the dynamic nature of perceived job insecurity suggests implications for interventions to maintain subordinates' well-being.

NoiBene, a Group Intervention for Promoting Mental Health Among University Students: A Study Protocol for a Randomized Controlled Trial

University students’ mental health has become a public health issue since increasingly students report high levels of psychological distress. Mental health difficulties influence students’ lives, such as academic performance, relationships satisfaction, and quality of life. Moreover, different kinds of obstacles often hinder help-seeking behavior. Such evidence strongly suggests the need to implement prevention and promotion strategies to increase health and well-being in educational contexts. This article presents a study protocol for implementing and evaluating NoiBene, an evidence-based group intervention that aims to promote mental health and well-being, improve a series of transversal competencies (e.g., emotional awareness, commitment to values, assertiveness, goal setting), and decrease dysfunctional transdiagnostic mechanisms (i.e., perfectionism, repetitive thinking, experiential avoidance). A randomized controlled trial will be conducted to evaluate the protocol’s efficacy. Participants will be assigned to one of the three conditions: the NoiBene Group condition (NB-G), the NoiBene guided web-based condition (NB-WB), or the waiting list condition (WLC). The NB-G intervention consists of six face-to-face group meetings, each dedicated to specific issues related to well-being or vulnerabilities. Every meeting includes an explanation of the theoretical contents, individual and group exercises, and role-plays. The NB-WB intervention covers the same topic addressed in the NB-G intervention. In this case, participants carry out a series of online modules, including theoretical explanations, practical exercises, useful activities, and self-monitoring tools. Students will individually meet the Tutor once every 2 weeks. The primary outcome will include an increase in mental health and well-being. Secondary outcomes will include changes in emotional awareness, assertiveness, perfectionism, rumination, worry, self-criticism, experiential avoidance, and academic performance and satisfaction. We expect that participants in both NoiBene conditions will show these outcomes. However, we hypothesized that the NB-G conditions will be more effective than the NB-WB in improving assertiveness. Besides treatment efficacy, we expect that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. Outcomes will be assessed at pre-, post-intervention and 6-months follow-up. In conclusion, we believe that NoiBene is a promising tool that can improve students’ well-being, and it could have positive implications for preventing mental health disorders among students.

Benefits of business conference participation for Australian SME managers: a case study of a belt and road initiative conference

Purpose

This study aims to explore the benefits of participation in a topic-relevant business conference as a learning and professional development apparatus for senior managers of small- and medium-sized enterprises (SMEs). It analyzes the experiences of 12 Australian SME senior managers who participated in a Belt and Road Initiative (BRI) business conference in Hong Kong.

Design/methodology/approach

Data were collected through pre- and post-conference attendance interviews. Kirkpatrick and Kirkpatrick’s (2005) four levels framework was used to analyze the effectiveness of business conferences on the participants at four different levels of the framework: reaction, learning, behavior and results.

Findings

This study finds that the business conference has shown effectiveness for the participants at the reaction (Level 1), learning (Level 2) and behavior (Level 3), indicating that participation in a topic-relevant business conference is useful for the learning and professional development of SME managers. However, only a moderate level of results (Level 4) was identified from attending the BRI conference, which implies that the content and quality of the business conference may influence the achievement of expected results.

Originality/value

This paper contributes a new understanding of the benefits of topic-relevant business conference participation as a learning and professional development apparatus for SME senior managers.

Improving Training Motivation and Transfer in Hospitals: Extension of a Conceptual Model

Health-care professionals undergo numerous training programs each year in order to fulfill licensure requirements and organizational obligations. However, evidence suggests that a substantial amount of what is taught during training is never learned or transferred back to routine work. A major contributor to this issue is low training motivation. Prior conceptual models on training transfer in the organizational sciences literature consider this deficit, yet do not account for the unique conditions of the hospital setting. This chapter seeks to close this gap by adapting conceptual models of training transfer to this setting that are grounded in organizational science. Based on theory and supplemented by semistructured key informant interviews (i.e., organizational leaders and program directors), we introduce an applied model of training motivation to facilitate training transfer in the hospital setting. In this model, training needs analysis is positioned as a key antecedent to ensure support for training, relevant content, and perceived utility of training. We posit that these factors, along with training design and logistics, enhance training motivation in hospital environments. Further, we suggest that training motivation subsequently impacts learning and transfer, with elements of the work environment also serving as moderators of the learning-transfer relationship. Factors such as external support for training content (e.g., from accrediting bodies) and allocation of time for training are emphasized as facilitators. The proposed model suggests there are factors unique to the hospital work setting that impact training motivation and transfer that should be considered when developing and implementing training initiatives in this setting.

Toward Optimized Effectiveness of Employee Training Programs

Abstract. Although organizations invest heavily on employee training, the effectiveness of employee training programs has not been well-established. In the current study, we examine the training delivery features of employee training programs to derive a better understanding of features that may be of best benefit in the improvement of employee affective outcomes. Specifically, and via the use of meta-analysis ( k = 79 studies totaling 107 independent effect sizes), we focus on two broad classes of affective employee training outcomes including attitudinal and motivational outcomes. Results evidence support for the effectiveness of employee workplace training interventions and indicate that employee training programs associated with attitudinal versus motivational outcomes require different features while being delivered to reach optimal effectiveness.

Determinants of Social Entrepreneurs in Southeast Europe: GEM Data Analysis

With this paper, we aim to examine the relationship between cognitive, social, and demographical factors, as well as national culture and its relationship with social entrepreneurial activity in Southeast Europe (SEE). The empirical research employs a binary logistic regression model, utilizing data obtained from the Global Entrepreneurship Monitor. For the purpose of the empirical research, we selected a sample of early-stage entrepreneurs who founded their businesses in Hungary, Romania, Slovenia, Croatia, or North Macedonia. The research sample in these five countries includes 10,012 examinees, of which 615 are social entrepreneurs. A statistically significant relationship was identified between observed phenomena in terms of entrepreneurial networking, risk aversion, individualism, entrepreneurial social image, media impact, gender, work status, and education. The results can be explained by the specific entrepreneurial context of the SEE region. We also point out recommendations for future research.

Evaluating the Longitudinal Efficacy of SafeTALK Suicide Prevention Gatekeeper Training in a General Community Sample

OBJECTIVE

The majority of individuals experiencing depression or in crisis do not seek assistance through formal support pathways. Thus, the presence of informal "gatekeepers" in the community is vital to identifying and supporting these individuals through crisis. The objective of this study was to evaluate the longitudinal effectiveness of "SafeTALK" suicide prevention gatekeeper training in a general community sample.

METHOD

Two hundred and sixty-two community members participated in half-day (4-h) gatekeeper training sessions. Surveys were taken pre- and post-training and at 6-month follow-up to evaluate participants' knowledge, preparedness, and efficacy, as well as reluctance to intervene as a suicide prevention gatekeeper.

RESULTS

Longitudinal effects were revealed for three of four evaluated appraisals. Scores for knowledge, preparedness, and efficacy were significantly higher (improved) 6 months after training, compared to pre-test. While participants showed even greater immediate effects (i.e., pre-test to post-test), follow-up scores indicate that the positive effects of training were sustained over 6 months.

CONCLUSIONS

This study is the first to evaluate SafeTALK in a community population. SafeTALK was shown to be effective at improving knowledge, preparedness, and efficacy with effects declining over time but remaining significant from pre-test. Community suicide prevention programs can benefit from the inclusion of gatekeeper training programs.

The Kirkpatrick model for training evaluation: bibliometric analysis after 60 years (1959–2020)

Purpose

A number of studies on Kirkpatrick’s four-level training evaluation model have been published, since its inception in 1959, either investigating it or applying it to evaluate the training process. The purpose of this bibliometric analysis is to reconsider the model, its utility and its effectiveness in meeting the need to evaluate training activities and to explain why the model is still worth using even though other later models are available.

Design/methodology/approach

This study adopts a “5Ws+1H” model (why, when, who, where, what and how); however, “when” and “how” are merged in the methodology. A total of 416 articles related to Kirkpatrick’s model published between 1959 and July 2020 were retrieved using Scopus.

Findings

The Kirkpatrick model continues to be useful, appropriate and applicable in a variety of contexts. It is adaptable to many training environments and achieves high performance in evaluating training. The overview of publications on the Kirkpatrick model shows that research using the model is an active and growing area. The model is used primarily in the evaluation of medical training, followed by computer science, business and social sciences.

Originality/value

This paper presents a comprehensive bibliometric analysis to reconsider the model, its utility, its effectiveness in meeting the need to evaluate training activities, its importance in the field measured by the growth in studies on the model and its applications in various settings and contexts.

Why trainees evaluate the same trainer differently? Examining a dual-process model of training effectiveness

Purpose

It is commonly observed in trainings that all trainees do not get satisfied with the performance of the trainer. The usual way to increase the satisfaction of trainees is a stress on improving task communication of the trainer. It is based on the assumption that effective task communication essentially fosters training effectiveness. This study aims to provide preliminary evidence that effective task communication can also obstruct training effectiveness besides promoting it. To achieve this objective, the authors hypothesized a dual-process model of training effectiveness based on uncertainty reduction theory.

Design/methodology/approach

This was a field study in which the authors collected time-lagged data from seven trainings. The trainings were designed to impart technical knowledge of multilevel analyses to professional social science researchers. Confirmatory factor analysis for ordinal indicators was used to test the measurement properties of the model and scales. Structural equation modeling for ordinal indicators was used to test hypotheses.

Findings

This study provided evidence of an overall positive effect of the trainer’s task communication on the trainee’s communication satisfaction. A complex mediation analysis also revealed the existence of two opposite psychological processes. While the first process transmitted the positive effect of task communication to communication satisfaction, the other process diminished this positive effect. Implications for the theory and practice of training are discussed.

Originality/value

Training scholars and practitioners universally believe that an effective task communication of trainers essentially promotes training effectiveness. This study has provided empirical evidence that this assumption is an incomplete picture of a complex reality that requires further investigation.

A Realist Evaluation of Team Interventions in Acute Hospital Contexts-Use of Two Case Studies to Test Initial Programme Theories

BACKGROUND

Designing and implementing team interventions to improve quality and safety of care in acute hospital contexts is challenging. There is little emphasis in the literature on how contextual conditions impact interventions or how specific active ingredients of interventions impact on team members' reasoning and enact change. This realist evaluation helps to deepen the understanding of the enablers and barriers for effective team interventions in these contexts.

METHODS

Five previously developed initial programme theories were tested using case studies from two diverse hospital contexts. Data were collected from theory driven interviews (n = 19) in an Irish context and from previously conducted evaluative interviews (n = 16) in a US context. Data were explored to unpack the underlying social and psychological drivers that drove both intended and unintended outcomes. Patterns of regularity were identified and synthesised to develop middle-range theories (MRTs).

RESULTS

Eleven MRTs demonstrate how and why intervention resources introduced in specific contextual conditions enact reasoning mechanisms and generate intended and unintended outcomes for patients, team members, the team and organisational leaders. The triggered mechanisms relate to shared mental models; openness, inclusivity and connectedness; leadership and engagement; social identity and intrinsic motivational factors.

CONCLUSIONS

The findings provide valuable information for architects and facilitators of team interventions in acute hospital contexts, as well as help identify avenues for future research. Dataset: The data presented in this study are available on request from the corresponding author. The data are not publicly available due to their sensitive nature and potential identification of participants.

Towards an analysis of the transfer of training: empirical evidence from schools in Spain

Purpose

The transfer of training has been identified with the effectiveness of training. The purpose of this work is to analyse the impact of training stages (training needs analysis, application and evaluation) as they relate to training transfer.

Design/methodology/approach

The study participants correspond to a sample of 116 teachers with managerial responsibilities (management teams and department heads) from 17 secondary schools in Spain. This work hypothesises five significant relationships: needs analysis and application of training, application and transfer of training, evaluation and analysis of training needs, evaluation and application of training and evaluation and transfer of training. The hypotheses were tested using structural equations, namely, the partial least squares–structural equation modelling technique and SmartPLS version 3.2.9.

Findings

The relationships between application and transfer of training, between evaluation of training and needs analysis, application and transfer of training are positively contrasted. The relationship between the analysis and application of training is not contrasted.

Originality/value

This work analyses the relationship between the training process’s different phases (analysis, application and evaluation) in the training output (training transfer) and emphasises the role of evaluation in the training process.

Personality Predicts the Efficacy of a Physician Leadership Development Program

It is imperative for health care organizations to foster leadership skills in their workforce. Leadership development programs offer a potential mechanism to achieve this goal. These development programs are likely not equally effective for all participants. This study evaluates the efficacy of one such program and determines personality predictors of its efficacy. Before and after a 12-month leadership development program, 28 physicians from various disciplines completed self-reported measures of leadership knowledge across 3 domains. At baseline, participants also provided personality data across the Big-5 factors of personality as well as 2 narrow facets (learning-goal orientation and preference for collaboration). Results suggest that leadership development programs can increase knowledge across leadership domains. Extraversion and conscientiousness predict changes in knowledge. Learning-goal-orientation and preference for collaboration personality facets provide incremental predictive power. Leadership development programs can improve self-rated knowledge across a range of leadership domains and is differentially effective for people based on their personalities.

Doppelganger-based training: Imitating our virtual self to accelerate interpersonal skills learning

Interpersonal skills require mastering a wide range of competencies such as communication and adaptation to different situations. Effective training includes the use of videos in which role models perform the desired behaviours such that trainees can learn through behavioural mimicry. However, new technologies allow new ways of designing training. In the present study, given that virtual reality is emerging as a valuable training setting, we compare two different demonstration conditions within virtual reality by investigating the extent to which the use of doppelgangers as role models can boost trainees' interpersonal skills development as compared to a role model that does not resemble the trainees. We also assess trainees' level of self-efficacy and gender as potential moderators in this relationship. Participants delivered a speech in front of a virtual audience twice. Before delivering their second speech, they watched a role model giving a speech in front of the same audience. The role model was either their doppelganger or an avatar of the same gender depending on the condition they were randomly assigned to. Results showed that the doppelganger-based training was the most beneficial for male trainees low in self-efficacy. These findings have important implications for training design, suggesting that doppelganger-based training might be effective only for a specific subset of trainees.

The Science of Workplace Instruction: Learning and Development Applied to Work

Learning is the engagement in mental processes resulting in the acquisition and retention of knowledge, skills, and/or affect over time and applied when needed. Building on this definition, we integrate the science of training and the science of learning to propose a new science of workplace instruction, linking the design of instructional events to instructional outcomes such as transfer and job performance through the mediating effects of learner events and learning outcomes. We propose three foundational elements: the learner, instructional principles, and training delivery (methods and media). Understanding and applying instructional principles are the primary methods for enhancing training effectiveness; thus, we detail 15 empirically supported principles. We then discuss the erroneous pursuit of aptitude-by-treatment interactions under the guise of learner styles and age-specific instruction. Finally, we offer suggestions for future research that draw on the foundation of instructional principles to optimize self-directed learning and learning in synthetic learning environments.

Bystander-Based Sexual Violence Prevention With College Athletes: A Pilot Randomized Trial

The prevention of sexual violence on college campuses is a pressing public health issue. Given recent U.S. federal and state requirements for campus responses to sexual assault, many campuses may plan to implement brief, bystander-based programs to create a violence-free environment. This pilot study evaluates one such program for male undergraduate athletes, Wingman 101. The primary purpose of this study was to determine the feasibility and acceptability of participation in Wingman 101, as well as barriers to program implementation. Data for this project were collected from 80 undergraduate male athletes (M age = 19.99) on three contact sport teams in spring 2012. Participants were randomly assigned to program or a no-program control condition. Implementation data were collected at the end of each session from program participants and facilitators. Outcome data were collected over three waves (pretest, posttest, 2-month follow-up) and assessed bystander attitudes, beliefs, and behaviors. Analysis of implementation data indicated that the program was well received and implemented with high fidelity, with facilitator relatability emerging as a particularly important aspect of implementation. However, participants also listed numerous barriers to potential bystander intervention following the program. The presence of these barriers supports quantitative reductions in positive attitudes about intervention at posttest. Implications of findings for policy and practice on postsecondary campuses are discussed.

Improving the Strategic Benchmarking of Intellectual Capital Management in Logistics Service Providers

This research developed a new integrated method for addressing the deficiencies and gaps generally found in past studies on benchmarking and for benchmarking intellectual capital (IC) in the underdeveloped domain of logistics. To resolve the lack of consideration of relationships among past benchmarking concepts and the impacts of their managerial factors, as well as to examine the wide range of elements and indicators of IC influencing the sustainable development of organizations, the proposed approach integrated the analytic network process and the concept of thinking and non-thinking assets with the generic benchmarking procedure. This new hybrid method was implemented in four commercial companies in courier service. The proposed method prioritized and identified the magnitudes of the factors focused upon, including the IC elements, and their performance measures by considering the fundamental characteristics of intangible assets. The obtained results highlight that management focuses on the IC of the best performer and other companies. This benchmarked outcome showed gaps and improvement as well as sustainable development opportunities for inferior logistics companies. The improved framework provides more systematic and specific benchmarking processes to consider, obtain, and compare the in-depth details of IC management. Moreover, ours is the first research on benchmarking that specifically focused on IC management in logistics service providers.

Effect of mental rehearsal on team performance and non-technical skills in surgical teams: systematic review

BACKGROUND

Simulation-based training in medical education has become a common method to develop both technical and non-technical skills in teams. Mental rehearsal (MR) is the cognitive act of simulating a task in our heads to pre-experience tasks imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare, and offers potential for more efficient training in time-pressured surgical and medical team contexts. This study aimed to review the available literature to determine the impact of MR on team performance and non-technical skills in healthcare.

METHODS

MEDLINE, Embase, British Educational Index, CINAHL, Web of Science, PsycInfo and Cochrane databases were searched for the period 1994-2018. The primary outcome measure was improvement in team performance and non-technical skills. Study quality of RCTs was assessed using the Medical Education Research Quality Instrument. The reported impacts of MR in all included studies were mapped on to the Kirkpatrick framework for evaluation of educational interventions.

RESULTS

Eight studies with 268 participants were identified that met the inclusion criteria, of which there were six randomized trials, one prospective pragmatic trial and one qualitative study. Three studies found MR to be effective in improving team non-technical skills. MR practices were varied and often poorly defined. MR benefited team non-technical skills when it was specifically designed to do so, but was not an automatic consequence of technical MR alone. The majority of studies demonstrated benefits of MR for technical performance, but only three showed positive impacts on teamwork. Overall the studies were of low quality and lacked sufficient discriminatory focus to examine impacts on teamwork dynamics.

CONCLUSION

MR can improve technical performance, but the benefits on non-technical skills are less clear. Future research should look at longitudinal mixed-method evaluation designs and focus on real clinical teams.

Educational needs of employees in work-related stress management

BACKGROUND

Dynamic and intense socio-economic, scientific and technological development has both positive and negative effects on the business world. Due to increasing problems of work-related stress, the issue of stress management has arisen. Primary stress management and proactive interventions in work-related stress prevention are specifically activated. In this regard, the issue of educational needs of employees for the prevention of work-related stress is of particular importance.

OBJECTIVE

The basic concern that has drawn our attention is whether employees generally show the desire and need to adopt the knowledge in the field of work-related stress prevention and relief and whether they are supported by the management of their business organization.

METHODS

We used several methods to conduct this research: survey, scaling and comparative method. The comparative method was used for the analysis of legal documents in the field of occupational safety and health in six Balkan countries with the aim of determining the legal obligations of employers in managing workplace stress. The research population consisted of employees in small and medium-sized enterprises in the city of Kraljevo (the Republic of Serbia), while the research sample was determined by a random sampling method and included 450 respondents.

RESULTS

Despite the recommendations of international organizations, the employers in most countries are not legally bound to deal with work-related stress management. The results have shown that there is a correlation between work-related risks/stressors and educational needs of employees for learning or acquiring knowledge in the field of work-related stress prevention. Employees express the desire to become acquainted with the possibilities of overcoming work-related stress.

CONCLUSION

Employees' education and training have an invaluable role and considerable importance in primary, work-related stress management. The knowledge about the causes and mechanisms of work-related stress development is an important step towards its prevention. The research has shown that employees express the need for acquiring knowledge to prevent stress at work. In this regard, it is necessary to provide legally binding support of the manager in order to undertake the activities of work-related stress management. Interventions should target work-related stress at its source with a focus on prevention rather than an individual approach whose long-term benefits are uncertain.