TRAINING NEEDS ANALYSIS

Agnes R. Pampanga
RN, BSN,MA Guidance, Health, Ed.D.

Sultanate of Oman Ministry of Health Directorate of Continuing Education, DGET

Foreword This booklet is designed to bridge the gap between the theoretical
aspects of conducting training needs analysis and its practical delivery in Continuing Professional Education activities. This will also provide the trainers with a methodological toolbox necessary in analyzing training needs in their respective work place which will provide the basis for evaluation of CPE activities. Anwar Al Sketty, MMed Ed., RN. IPN cert.,ST.Dip., RNT Director Directorate of Continuing Education Directorate General of Education & Training

Prepared and Presented by:

Agnes R. Pampanga,

RN, BSN, MA Guidance, Health, Ed.D.

Specialist and Section Head, CME for Medical and Technical Staff Directorate of Continuing Education, DGET, Ministry of Health Sultanate of Oman

Presented during the DCE Regional Visits to all DGHS, DHS and Hospitals, January 21March 13, 2007-2008; Training of Trainers Workshop, Sohar Hospital, October 3-31, 2007 and Al Nahdha Hospital, Governorate of Muscat, Sultanate of Oman, February 6, 2008. Revised: April 2008

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Contents
Foreword TRAINING NEEDS ANALYSIS Introduction Step-wise Questions in Conducting Training Needs Analysis Common Indicators in Work Areas Sources of Information Methods in Conducting TNA Survey Method Questionnaire Interviews Focus Group Observation Analysis of Data Interpreting Data Analysis Putting the Problem in Order of Priority Communicate Findings Features of Effective Assessment General Principles in Assessment References Appendix A The Training Cycle Appendix B- Sample Questionnaire 1 2 4 4 6 6 11 12 13 14 15 16 18 19 19 20 21 22

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TRAINING NEEDS ANALYSIS

Introduction
Training Needs Analysis (TNA) is the key to reshaping the future of Continuing Professional Development (CPD) Programme in the hospital and educational institutes. It is the major component of training programmes. It is a crucial component of learning for ascertaining both the needs of the learners and the organization and as such it provides a fundamental link with relevant and effective teaching and learning process. It determines and identifies the existence of a gap between what is required of a person to perform their duties competently and what they actually know as a basis for initiating corrective measures and or remedial education. Training Needs Analysis can be an overwhelming process. It is a method that will bridge the gap between the required performance and the actual performance. It is also a method of determining whether a training need exists, and if it does, what training is required to fill the gap. The essence of TNA is to find out the general areas of work/ health care where an improvement is needed that would require CPD. It focuses on identifying needs of the target audience, developing a rationale for a training programme, identifying needed inputs, determining program content and setting program goals. To make Continuing Professional Education programmes more effective, TNA should be done before designing and conducting any training or workshops and to look into the needs of the organization, job performance and the staff.
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If training is the chosen solution to address those needs, it is important to first know the nature of the problem. Without that clarification, training can accomplish absolutely nothing except wasting time, efforts and resources. A training programme must be carefully planned and organized and based on needs analysis. When deciding whether to conduct TNA, the following basic questions should be asked, which eventually constitute the steps in conducting TNA:

Step-wise Questions to Ask in Conducting Training Needs Analysis

Step 6
Where will it be assessed?

Step 5
Who should be assessed & carry out the assessment?

Step 4
When should it be assessed?

Step 3
Why should it be assessed?

Step 2
How should it be assessed?

Step 1
What should be assessed?

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Appendix B Sample TNA Questionnaire

What should be assessed?

Existing work conditions based on the common indicators and other sources of information (page 4). Determine if there is a need/ problem in the work setting that has to be addressed.

How should it be assessed?

Decide on the methods and procedures in conducting TNA. Categorize identified needs/problems according to the needs of the organization, job performance and staff. Prioritize identified needs/problems. Decide on the corrective measures. Communicate findings.

Why should it be assessed?

Determine which areas need reinforcement, support, assistance, improvement and change.

When should it be assessed?

Decide on the date, time, duration of the conduct of TNA.

Who should be assessed and carryout the assessment?

Identify the target respondents, its categories and size and the staff who will carry out the TNA.

Where will it be assessed?

Decide on the location where to conduct TNA.

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Common Indicators:
Needs

Appendix A

of the Organization: organizational changes, changing workforce/ large staff turnover, inadequate recruiting process, new policies/ regulations, new development of services, treatment, procedures, new equipment/ systems, production or services, complaints from clients/patients, staff etc. Job Performance: poor quality of work, frequent errors,
performance dates not met, standards of the job, job description, perception of those in the job, supervisors and perception of others.

THE TRAINING CYCLE

TRAINING NEEDS ANALYSIS (TNA) (Identify the needs of the organization, job performance & staff)

Specify

Needs

of the Staff: value of the job performed, job satisfaction, knowledge, skills, attitude, conflicts among staff etc.
F E E D B A C K CURRICULUM DESIGNING (Determine objectives, content, instructional methodologies/ resources)

THINK

Can you identify and list down at least 5 needs/ problems in your respective area of work?

MONITORING and EVALUATION

Sources of Information: A. Health Workers

Critical Incident Studies (Clinical Audit)

> an incident where a health worker feels he/she did not do the task well or with unsatisfactory outcome.
Focus Group Discussions Interviews Observation
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TRAINING IMPLEMENTATION (Presentation & Facilitation Skills)

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REFERENCES

Questionnaires Test of skills (Checklists)

Boud, D. (1995). Enhancing Learning through Self-Assessment Dent, J & Harden R. (2001). Teachers A Practical Guide for Medical

B. Health System Managers

supervision reports appraisal reports discussions questionnaires health mgt. information system -reports errors in treatment quality assurance

Guide to Managing Continuing Education in the Ministry of Health, Sultanate of Oman Nadler, L & Nadler Z (1994) Designing Training Programs The Critical Events Model Reece, I. & Walker, S. (1997). ingA Practical Guide Teaching, Training and Learn-

Suvedi, M., Heinze,K. & Ruonavaara, D. (1999) How to Conduct Evaluation of Extension Programs. University of Dundee: Trends in Medical EducationDistance Learning Course for Masters Degree in Medical Education.

C. Documents
that describe changes in health policy, in priorities for health

care or in resources. D. Epidemiological data/ Management Information System:

What diseases/conditions lead to too many preventable deaths

or too much disability/suffering?

In what way is the health service unsatisfactory?

E. Public
complaints, articles in newspapers, TV/ radio programmes patient satisfaction survey

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Methods in Conducting TNA: Survey Method-questionnaires, checklists etc Informal/Formal Interviews Observation Performance Tests Reports from Superiors anecdotal, incident reports Examination of Records, Performance Appraisal, Result of Patient Satisfaction Survey, Quality Assurance Management Requests Formal Research SURVEY METHOD QUESTIONNAIRE Before you begin . . . Make a list of what you want to know and how the information will be used. Check to make sure the information is not already available somewhere else. As you write questions try to view them through the eyes of the respondents.

Features of Effective Assessment

H Valid Assessment if it actually measures what is intended to measure.

i.e. The task is to advise mothers on the preparation of weaning foods. The assessment should be based on observing the staff do the task.
H Reliable Assessment if it provides a consistent and accurate judgment

for what it is intended to measure.

General Principles in Assessment

It is important to clearly spell out what it is you are assessing. Define the intended learning outcomes before you think about choosing the assessment tool. The assessment technique which you use should be an effective measure of whatever it is you wish to assess. The wider the range of assessment you use, the more confident you can be in your final judgment. Use assessment instruments with discernment. Use the results of your assessment constructively.

The aim of a questionnaires design is to solicit quality participation. Response quality depends on the trust the respondents feel for the survey, the topic, the interviewer, and the manner in which the questions are worded and arranged. Consider whether the questionnaire is going to be mailed, given directly to respondents,, used in a telephone survey or used in personal interviews. Before you begin, it is essential to know what kind of evidence you need for the TNA and how the information will be used.

Note: Assessment should not only be focused on the organization, trainees but also on the organizers/ trainers themselves on their self-assessment. Self assessment is the key to professional growth. It refers to the persons own assessment of knowledge, skills, attitudes and judgment level relevant to maintain a competent practice.

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Communicate Findings
Provide stakeholders and other audiences with the results of the TNA. Needs analysis results should be utilized as basis for designing training curriculum and planning future programmes. Reporting Tips
Reports that are short, concise and to the point are the ones that get attention. Craft the style and content of the TNA report to fit the intended audience. Avoid technical terms that your audience/readers may not know. Use a conversational tone Use a combination of long and short sentences. Read report aloud to check for confusing ideas and sentences. Write in an active voice. Use a logical structure for your documents. Allow sufficient time for getting feedback.

Writing the questionnaire

1. The title of the questionnaire should be appealing to the respondents. 2. The type used should be large and easy to read. 3. The questionnaire should appear professional and easy to answer. 4. The introduction should identify the audience and the purpose of the survey and give directions on how to complete the questionnaire. 5. Questions should not appear crowded. 6. Each question should be numbered and sub-parts of a question should be lettered. 7. Questions should be arranged in a logical order with general questions preceding more specific ones. Easy-to-answer questions come first, followed by increasingly complex, thought provoking, or sensitive questions. Personal or potentially threatening questions should be placed at the end. 8. Be explicit about what is required to answer each question. 9. Sufficient spaces should be left for answering open-ended questions. 10. Clearly indicate where branching occurs and where general questions resume.

Reports should include:

- a brief description of the TNA, purpose, scope, respondents, setting, methodology/ procedures used, a summary and analysis of findings, conclusions and recommendations.

11. Key words should be bold face or capitalized to avoid the possibility that they are misread. 12. Request for demographic information should be included near the end of the questionnaire. 13. For mail surveys, remind respondents to return the questionnaire and provide an addressed, postage-paid envelope. 14. The questionnaire should end with a Thank you.

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( Sample TNA questionnaire- Appendix B)

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Mailed Questionnaires
The appearance of a mailed questionnaire is of utmost importance. It must sell itself to the respondent to be returned. Therefore, considerable care should be taken in designing the format of the questionnaire. A simple booklet can be constructed by folding an 8 1/2 by 11-inch paper in half. Make questions fit the page so that the respondent does not need to turn the page to answer a question. Provide easy-to-follow directions on how to answer the questions. Arrange questions and answers in a vertical flow. Put answer choices under rather than beside the questions so that respondents move down the page rather than from side to side.

Identified Problems

S (1-3)

U (1-3)

G (1-3)

Total Rating

Rank

THINK

Prioritize and rank the identified problem in the previous activity according to the 3 factors, seriousness, urgency and gravity using the above table. (page 4)

On the basis of the identified and ranked priority problem, a Training Needs Analysis Plan in order of priority should be prepared. Training Needs Analysis Plan in Order of Priority
Rank Problem/Needs Target Group Corrective Measures

Designing a Questionnaire Cover Letter

1st paragraph: Explains the purpose of the study Describes who will be answering the questionnaire. Assures confidentiality of responses 2nd paragraph: Assures the respondent the TNA is useful. Let the respondent know that he/she is important to the success of the TNA

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Putting the Problem in Order of Priority

There are three factors to consider in prioritizing the problem: Seriousness of the Problem - the degree with which the impact, consequence or effect of the problem hinder the operations of the organization and its subsystem. Urgency of the Problem - the length of time available for the problem to be solved in order not to aggravate the existing situation. Gravity of the Problem - the extent to which the problem, if left unattended, will give rise to other problems. Each problem can be given a rating of priority on a scale of 1-3 for each of the three factors mentioned above. The 3 ratings can be added to get the total rating of each problem, then and only then the problems could be ranked accordingly.
3rd paragraph: Provides directions on how and when to return the questionnaires. Explains the questionnaire identification number for facilitating follow-up. 4th paragraph: Reemphasizes the studys organizational and social usefulness. Promises a copy of survey results if desired. Indicates willingness to answer any question. Includes a statement of thanks, a closing and the senders name and title.

Writing Questions
The questions used in a questionnaire are the basic components that determine the effectiveness of your survey. Consider what information to include, how to structure the questions and whether people can answer the questions accurately. Good survey questions are focused, clear, and to the point. Every question should focus on a single, specific issue or topic.

Rating Scale of the 3 Factors Seriousness Very serious - 1 Serious -2 Urgent Very urgent - 1 Urgent -2 Gravity Great extent - 1

Poor: Which type of training do you like best? Better: Which type of these trainings are you most likely to attend? The objective of these questions is to measure the participants preference. The first question lacks focus, participants may like a particular training, but may not attend because of high registration fees. The meaning of the question must be completely clear to all respondents. Clarity ensures that everyone interprets the question the same. Poor: When was the last time you went to the doctor for physical examination on your own or because you had to?
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Less serious - 3

Less urgent - 3

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Better: How many months ago was your last physical examination? The first question could be interpreted in weeks, months, years, or by date. Keep questions as short as possible. Short questions are easier to answer and less subject to error by interviewers and respondents. Long questions are more likely to lack focus and clarity. Poor: Can you tell me how many children you have, whether theyre boys or girls, and how old are they? Better: What is the age and sex of your children? A respondent may answer the first question ambiguously. It is not possible to determine the ages of each child from this response. Questions should be written to avoid bias. Poor: Is it true that our cleaners work long hours? Better: On average how many hours do cleaners work in their jobs?

Interpreting Data Analysis

Analysis of data focuses on organizing and reducing information and making logical or statistical inferences; interpretation on the other hand, attaches meaning to organized information and draws conclusions. All interpretations, to some extent, are personal and idiosyncratic. Therefore, not only interpretations but also the reasons behind should be made explicit. The following are useful interpretation methods: 1. 2. 3. 4. 5. Determining whether objectives were met. Determining whether assessed needs have been reduced. Determining the value of accomplishments. Interpreting results in the light of assessment procedures that generated them. Asking external assessors/ stakeholders/ or other groups to review the data and to provide their judgments of strengths and weaknesses, successes and failures.

Types of Information Questions can be formulated to elicit four types of information: knowledge/skills; beliefs, attitudes and opinions; behavior and attributes.

Knowledge/skills questions include what people know, how well they

understand something and how they perform certain skills.

Involving and using stakeholders to the interpretation task is one of the methods that could bring multiple perspectives, cooperation and ownership of the endeavour. Stakeholders can be supplied in advance with results of the needs analysis before calling them for a meeting. At the meeting, findings are systematically reviewed in their entirety. Questions such as: What does this finding mean?, What are its implications? What should be done? etc. maybe asked during the process of analyzing and interpreting the results.

Beliefs, attitudes and opinions include peoples perceptions, their

thoughts, feelings, judgments or their ways of thinking. Behavioral questions ask people about what they have done in the past, what they do now or what they plan to do in the future.
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Analysis of Data
1. Quantitative Data - looks at the incidence and quantity of events - It is numerical and maybe analyzed by calculating averages, ranges, percentages and proportions. - Simply account for what is happening in numerical terms.

Attributes are a persons personal characteristics, such as age, education, occupation or income. Attribute questions ask respondents who they are, not what they do.

Types of Questions: 1. Closed-Ended questions have pre determined categories of responses from which the respondent can choose. When asking this type of question, make sure that all alternative response categories have been included. i.e. To what extent do you agree or disagree with the accreditation system? 1. strongly disagree 2. disagree 3. agree 4. strongly agree

- It can be presented either by graph, bar/pie charts, tables

2. Qualitative Data

- Information that is primarily expressed in terms of themes, ideas, events, personalities, histories etc. -Provides information to the people involved in the CPE programme/activities. - Standard of usefulness is important in this analysis.

2. Open-ended questions allow respondents to answer in their own words rather than select predetermined answers. i.e. What new knowledge, skill or training would you suggest to further improve your current performance?

When Doing qualitative analysis consider:

The words used by the participants and the meaning of those words. The context. Interpret the comments in the light of the context. The internal consistencies and inconsistencies. Determine the cause of

INTERVIEWS Guidelines for conducting Interviews: Conduct the interview without an audience to avoid distraction. Respondents of the interview should be made to understand that their responses are confidential and that the interview is voluntary. The interview should be conducted in the most convenient time for the respondents.

the inconsistencies. The frequency of the extensiveness of comments. The intensity of comments. The specificity of response. Dominant themes

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Establish rapport by expressing appreciation of the respondents responses and willingness to participate. Questions be read ss they appear in the questionnaire and record answers accurately. Interviewers opinion should not be expressed. To get a clearer response, the interviewer should probe the question, if an answer to an open-ended question is incomplete. The interviewer should not insist if the respondent refuses to answer the question. It may jeopardize the whole interview.

How to begin a Focus Group Discussion The first few hours in a focus group discussion is critical. Initially, the moderator must create a thoughtful, permissive atmosphere, provide the ground rule and set the tone of the discussion. In group discussions, the recommended pattern is to start with the welcome of participants followed by the presentation of the objectives, an overview and the main topic, the ground rules and the first question. How to ask questions in a focus group 1. Open-ended questions be used to stimulate discussion. e.g. What did you think of the CPE programme?

FOCUS GROUP

2. 3.

Dichotomous questions-those that can be answered with a yes or no be avoided. Why questions are rarely asked. - It can make learners defensive and feel the need to provide an answer and make them respond with attributes or influences.

It is typically 8-12 small group of people who are relatively homogeneous, which is selected to discuss a particular topic in a non-threatening atmosphere. It is usually moderated and recorded by a skilled interviewer. It usually measures needs and issues, attitudes, perceptions and opinions on specific topics and impacts of a particular CPE programme on individuals and the group. Focus group is easy to set up, fast and relatively inexpensive, stimulates dialogue and can generate ideas for evaluation questions to be included in other survey methods. On the other hand, focus group could easily be misused that will require special moderator skills. Avoiding bias and capturing major issues that emerge can be difficult. Likewise, data interpretation is tedious.

4. 5. 6.

Think back questions maybe used that may remind learners of an experience rather than to speculate on the future. Focus questions should be carefully prepared. Asking focus questions should be sequenced, starting from general to specific questions.

OBSERVATION This method provides gathering of information about behavioural actions and reactions through direct observation, interviews with key informants and participation in the activities being assessed. It is useful in determining conflicts or misunderstandings, assessing work needs and problems.

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