Designing Training

Verify the performance gap and goal of training

Tips for Designing Training Work with those conducting the PNA to develop a clear understanding of the performance situation, the workers who will be attending training, and the working environment Collect and analyze existing training materials related to the performance situation Identify the guidelines for designing training that apply to the current situation Develop a list of the specific design and development steps and products (e.g., objectives, plan, syllabus, tests) along with approximate completion dates Use the guidelines to assess the overall quality of the training design

The first step in designing a training course is to verify that training really is required to improve worker performance. Information from the PNA, as well as any additional information obtained by the manager or trainer (see Managing Training) concerning the performance gap; the knowledge, skills, and attitudes needed to close the gap; the learner; and the job site will be shared with the design team.

Ask, “What do learners need to know and be able to do to perform essential tasks on the job?” Answering this question will produce a list of the specific knowledge, skills, and attitudes (KSAs) that will form the basis of the learning objectives and shape the content of the training course.

In your training designer role, you should:

• Use the results of the PNA for reference during the design process 
• Describe the performance gap that the training will address
• Clearly state the goal of the training course (i.e., describe, in broad terms, what the learner will be able to do after training)
• Link the goal of the training to the performance gap 

Gather background information about the learners and identify the knowledge, attitudes, and skills they need to acquire

Learn as much as possible about the type of healthcare worker for whom the course will be designed and the typical work setting for this type of worker (e.g., national-level supervisors at the ministry of health; family planning counselors at level 1 health posts). 

In your training designer role, you should:

• Gather information about learners, including:
  • Current level of knowledge, skills, and performance
  • Educational background, including reading and writing level and language(s) spoken
  • Job category and job description
  • Current or future location and type of facility where they work
  • Motivation/incentives for participating in training
  • Work relationships with supervisor and co-workers
  • Other characteristics that may be relevant to the knowledge and skills to be acquired and training methods to be selected (e.g., age, sex, culture, attitudes, local work practices)
• Gather information about:
  • Existing national policies and service delivery guidelines
  • Existing supervision system
  • Types of healthcare services offered at the work site
  • Size and condition of the work site (e.g., number and type of rooms, privacy, access to clean running water, supplies and equipment, and the like) when the learners are facility-based 
• Identify essential job tasks that the learners will be expected to perform on the job
• Identify knowledge, skills, and attitudes required of learners 

Identify content resources

The training course is based on the KSAs required of the learner on the job after training. For many courses, appropriate content resources (e.g., reference manuals, books, videos, learning exercises, anatomic models) may be available for use or adaptation. Identifying, reviewing, and adapting (if appropriate) existing content resources will help focus the content of the course and often reduces time and costs associated with design and development.

In your training designer role, you should:

• Identify and review relevant content resources
• Use existing content resources in the design of the training course

Write learning objectives

Learning objectives describe the specific KSAs the learner will know or be able to do after the training (i.e., they reflect the performance need). By meeting the course objectives, the learner will achieve the course goal. Thus, the objectives should connect the performance need to the training.

Learning objectives should be clear and measurable, and provide direction for the design, delivery, and evaluation of the course (i.e., the objectives may be knowledge-based, skill-based, or both). The objectives tell the learners what they will learn and how their knowledge and skill acquisition will be evaluated. The objective should clearly state what the learners are expected to know or do (the performance) and how well they must demonstrate mastery of the objective (the criteria). For example, “After completing this course, the learner will be able to counsel family planning clients according to the counseling checklist.”

In your training designer role, you should:

• Write learning objectives using a standard format
• Develop learning objectives based on essential KSAs required to perform job tasks 
• Use learning objectives as the basis for the training plan
• Ensure that learning objectives appear in the course materials for the trainer and learners

Develop the training plan

A well-developed training plan is the foundation for a successful training course. The three most common components of a training plan are the course syllabus, schedule, and outline or “map.” 

The course syllabus contains basic information about the course (e.g., description, goal, learning objectives, learner selection criteria, evaluation criteria, suggestions for supporting the learner before, during, and after training). 

The course schedule indicates the number of training days and is a day-by-day description of the general course activities (e.g., presentations, exercises, clinical practice, knowledge and skill evaluations). 

The course outline or map describes how the trainer should conduct each session in the course schedule (including activities and exercises to support the learner during and after training). If the same course is to be given in different sites and/or by different trainers, the course outline will help ensure that the training is delivered in a standard way each time.

In your training designer role, you should:

• Develop a training plan that is within the budget established for the training and includes components such as a course syllabus, schedule, and outline. Consider the learning objectives and ask: 
  • How many days will the course require? 
  • How many learners will attend the course? 
  • Will the course have both classroom and clinical components?
  • What learning methods are appropriate for the course (e.g., interactive presentations, case studies, role plays, simulations with anatomic models, problem-solving exercises, computer exercises, guided clinical practice with clients)? 
  • Should knowledge and skill evaluations be administered?

Develop or adapt training materials

The training materials, or training package, should include all of the materials required by the trainer and learner to implement the training plan. A subject matter expert will be needed if new materials must be developed or existing materials adapted. Sometimes it is possible to find existing materials designed to meet the same performance need. In this case, it will not be necessary to develop new or adapt existing materials. Before delivery of the first training course, the materials should be developed or adapted and then tested. Training materials typically include:

• A reference manual, containing content essential to the KSAs being taught—this manual is the basis for the delivery of the course, as well as a resource the learners will use on the job
• Supporting reference materials (e.g., national or international standards or guidelines)
• Audiovisuals (e.g., transparencies, computer presentations) drawn from content in the reference manual
• A learner’s guide, which includes the course syllabus, schedule, exercises, case studies, role plays, skill development checklists, and an action plan form (to help the learner apply newly learned KSAs on the job) 
• A trainer’s guide, which includes the same information as in the learner’s guide, as well as the course outline, answers to exercises, knowledge and skill assessments, and suggestions for helping the learner apply newly learned KSAs at the job site

In your training designer role, you should: 

• Develop or adapt reference materials (if you are not proficient in the KSAs that are the basis of the course, you must identify a subject matter expert to develop or adapt the reference materials)
• Develop audiovisuals
• Develop a learner’s guide
• Develop a trainer’s guide 

Develop or adapt evaluation instruments

Evaluation of KSAs learned during a training course determines if learners have met the learning objectives and helps the trainer know whether training met its learning goal. Examples of ways to evaluate learners’ knowledge are multiple-choice tests, oral interviews, essay tests, and written reports. Knowledge evaluations administered before and after the course are referred to as pre- and post-tests. Examples of skill evaluation approaches include using checklists for direct observation of performance during simulations (e.g., counseling role plays, procedures with anatomic models) and during procedures with clients. Attitudes are assessed during skill evaluation. 

KSA evaluation instruments must be valid. To be valid, an instrument must be based on the learning objectives (i.e., it must measure what it says it is going to measure). Evaluation instruments must be objective, meaning that the personal opinions of the trainer do not affect the scoring process. Evaluation instruments must also be reliable. To be reliable, an instrument must measure the achievement of the learning objectives consistently each time it is used.

In addition to instruments for evaluating the learners, a learner satisfaction form for the course should be developed or adapted. Learners complete this form at the end of the course to provide feedback about the training (e.g., satisfaction with the course content, trainer’s training skills, course logistics).

If existing training materials—including evaluation instruments and the learner satisfaction form—are being adapted, it is essential that the instruments and form be revised to ensure that they are consistent with the goal and learning objectives of the course being designed.

In your training designer role you should:

• Make sure that knowledge, skill, and attitude evaluation instruments are valid, objective, and reliable
• Develop appropriate knowledge evaluation instruments
• Develop appropriate skill evaluation instruments
• Develop a learner satisfaction form