A Call for Less Training in Healthcare

I was walking through a sea of learning professionals at a my local ATD chapter’s annual awards banquet when I overheard a woman saying, “Like we always say, it’s not life and death . . . it’s just training.” The comment almost stopped me in my tracks. While I understand the sentiment of the woman’s statement, those of us in healthcare know that training can indeed mean life or death.

Healthcare isn’t unique in this. Parallels are often drawn between the airline industry and the healthcare industry. Both industries are highly regulated. Precision in standardized practices is essential for safety in, and errors can result in disaster. Both industries focus on delivering an excellent service experience, and in both training can mean life and death. These parallels are laid out in John Nance’s award-winning book Why Hospitals Should Fly: The Ultimate Flight Plan to Patient Safety and Quality Care.

However, there are key differences too. For example, the customer is not watching the airline mechanic work, and the pilot is safely hidden behind a locked door with a book of checklists. Meanwhile, the nurse, doctor, or therapist is applying their craft in full view of the patient, their family, and colleagues. Additionally, in equipment and service delivery models, there is a higher degree of standardization, redundancies, safeguards, and automation in the aviation industry (Kapur et al., 2015).

So, why the call for less training in healthcare? I’m not making a strong opening argument, am I? After 25 years in healthcare and more than a decade in healthcare learning and development, I’ve come to believe that we are spinning our wheels trying to keep up with all the training needs. Rather than spending most of our time creating training courses and programs, we should be spending our time and energy creating an empowered culture of learning.

Learning in the Healthcare Industry

Healthcare does not enjoy the luxury of closing. In our unique environment, many factors necessitate a shift from creating formal learning courses and events to empowering learning through systems and processes.

• Shift workers are not tied to computers nor easily scheduled in classrooms.

• The pace of change in healthcare is fast.

• The content is complex with a heavy reliance on critical or contextual thinking.

• There is a prevalence of high-risk, low-volume skills and competencies.

• Mergers, acquisitions, new ways of working, and other external factors are stretching leader and corporate professionals’ capabilities.

Adding additional challenges to healthcare learning and development is a growing complexity-experience gap among nurses, who are the core of our workforce. The Advisory Board Company’s research in 2019 showed that while we’ve largely addressed the looming registered nurse shortage, the retirement of the baby boomer generation is still creating an experience gap at a time when healthcare delivery is becoming increasingly complex. If unaddressed, the experience-complexity gap will widen and could put clinical quality and safety at risk.

Toward a New Mindset

Healthcare learning professionals have a choice. We can continue trying to keep up with increasing complexities and pace-of-change, or we can shift our energy to creating an empowered learning culture.

Our efforts focus in four areas:

1. Use Modern Delivery Methods

A silver lining to the pandemic has been the acceleration of the shift to mobile, on-demand learning where device-agnostic video and learning objects dominate. Virtual simulations, AR, and VR technologies are becoming more accessible to an industry already familiar with simulations.

2. Make Learning Invisible

Innovation and integration advancements have made it easier than ever to integrate LMS objects across systems and platforms. In addition, user adoption platforms or electronic performance support systems make it easy to create in-the-flow-of-work learning in web-based applications.

3. Communicate and Promote “Pull” Resources

Learning and development teams don’t have a monopoly on behavior change. Our marketing friends have their own toolkits for driving consumer behavior. If we want to create empowered learners, we need to improve at selling and promoting self-help learning resources.

4. Knowledge Sharing and Social Learning

As our organizations also become more complex, learning and development teams should be leading in creating systems, processes, and opportunities for cross-departmental and cross-functional knowledge sharing. While technology can help here too, simple tactics such as inserting a “personal learning moment” into a clinical unit’s interdisciplinary morning huddle has shown to be effective.

I argue that we need less training in healthcare because, instead of content creators and facilitators, we should be enablers and trusted advisors. Our focus should be less on creating training and more on creating learners. We are still in the midst of a global pandemic that has put extraordinary demands on us as a profession. It’s been a tiring year! My fear is that if we don’t change how we think about our role as learning professionals, that fatigue will stay with us as we scramble to keep up; or worse yet, we will become obsolete. It’s not just training . . . it’s a matter of life and death.