transfer of training: the missing link in training and the quality of adult social care

Transfer of training: the missing link in training and the quality of adult

social care

Nicholas Clarke PhD

School of Management, University of Southampton, Southampton, UK

Accepted for publication 13 May 2012

CorrespondenceProfessor Nicholas ClarkeSchool of ManagementUniversity of SouthamptonHighfieldSouthampton SO17 1BJ, UKE-mail: [email protected]

What is known about this topic

d UK social policy documentationnow stresses the need to assess theimpact of training on outcomes onusers and carers to support work-force development.

d Findings from previous researchexamining training in social carehave offered inconclusive results.

d Evaluating training in social carehas been dominated by concerns ontake-up rather than impact.

What this paper adds

d Findings from reviewing 19 recentstudies show limited evidence forthe impact of training on changing

AbstractRecent UK social care reforms characterised by a policy of increasing

personalisation and choice in adult social care have been accompanied

by major reorganisation and investment in workforce training and devel-

opment. There is an assumed link between training and the quality of

care received. This assumption has a long pedigree in social care, but

rarely does it receive the scrutiny necessary for us to understand better

the nature of this relationship. This paper focuses on the potential for in-

service training to contribute to the transformation in social care asexpected by policy-makers. Reviewing recent findings from the evalua-

tion of training in social care shows that problems continue to persist in

demonstrating that training results in changes in practitioner behaviour

back on the job. Findings within the social care literature mirror those

found more widely in suggesting learner characteristics, intervention

design, and delivery and the workplace environment combine to influ-

ence whether training transfers to use on the job. The argument advanced

here is that without a focus on the transfer of training, the contributionof training to quality of care outcomes will remain illusory. A shift is

required in policy-makers’ mindsets away from training, to a focus on

training transfer in directing workforce development strategies. It might

then be possible to begin to identify how and in what configurations

training may be associated with quality of care outcomes.

Keywords: adult social care, literature review, training

practice.d Explanations for the limited transfer

of training include characteristics ofthe learners, training design andworkplace environment factors.

d Strategies to improve the transfer oftraining include changing the rolesof training staff, posttraining men-toring and the more flexible use ofpractice teachers.

Introduction

The notion of a robust relationship between training and quality of care has a

long pedigree in social care in the UK. The Seebohm (1968) report saw inter-

disciplinary in-service training as central to its aim of securing preventive,community-based social care. Further moves towards more community-ori-

ented social work outlined in the Barclay (1982) Report stressed the need for a

new balance of skills such that it was:

Vitally important that the continuing and widening provision of post-qualifying

training for social workers be given attention by local and national government. (Bar-

clay 1982, p. 154)

Increased community-based social care heralded by the community care

reforms again saw ongoing training as critical in underpinning change

(Department of Health 1989). Now, a pivotal role for training in achieving the

goals of social policy has again been mapped out in a combination of policy

documents outlining the personalisation agenda (Department for Education

and Skills ⁄Department of Health 2006, Care and Social Services InspectorateWales 2008, Gray & Horgan 2010).

ª 2012 Blackwell Publishing Ltd 1

Health and Social Care in the Community (2012) doi: 10.1111/j.1365-2524.2012.01082.x

While by far the most significant emphasis has beenon developing new qualifying education pathways

within social care, key roles for in-service training and

continuing development are also envisaged (Department

for Education and Skills ⁄ Department of Health 2006).

The White paper, Our Health, Our Care (Department of

Health 2006), outlines the chief areas that training is

expected to impact. Here, quality in adult social care is

articulated as combining (i) early intervention and pre-vention, (ii) choice and control, (iii) building social capital

and (iv) universal services. In recognising the consider-

able emphasis that is again placed on workforce devel-

opment as a means to secure changes in social care, this

paper explores the question of whether in-service train-

ing can deliver the gains in service transformation

expected. Although the link between training and better

care outcomes has often been taken for granted (Cohen& Austin 1994, Tryssenaar & Gray 2004), the PuttingPeople First adult social care workforce strategy has

explicitly recognised that evidence is needed. It states

that a long-term aim within adult social care is to:

…assess the impact of training and qualification on out-

comes for users and carers in order to highlight what

works and embed good practice across the workforce.

(Department of Health 2009, p. 32)

This is against a background where historically evalu-

ating training within social care has been accorded low

priority (Department of Health ⁄ Social Services Inspector-

ate 1997, p. 42). It is argued here that confidence in the

capacity for in-service training to deliver against these

ambitious social care goals is severely misplaced, unless

there is a significant shift by policy-makers in under-standing those processes that determine what makes

training effective. Furthermore, the aim of this paper is

to begin to map out a more theoretically informed frame-

work for understanding the training-quality of care link.

It does this through addressing two major questions: (i)

What evidence is there that in-service training can lead

to better outcomes in social care? and (ii) How can a bet-

ter understanding of the complex issue of training trans-fer inform workforce development strategies?

Key insights from previous reviews

In terms of the effectiveness of training in the social care

sector, one of the most critical questions to ask is, ‘Can

we actually tell the difference between the practice of aworker who has received in-service training and one

who has not?’ In the first review of the literature on the

impact of in-service training in social service agencies,

Clarke (2001) reported the results of twenty training eval-

uation studies published between 1974 and 1997. One of

the more salient findings was the extent to which evalua-

tions found either limited or no effects of the training onbehaviour. He cautioned that while it was common for

training to receive positive responses from trainees and

not infrequently produce gains in knowledge, there were

real problems in finding that new skills are then used on

the job. A major recommendation from that review was

the need for evaluations of training that undertake

longer term follow-up of training impact some time after

trainees have returned to their jobs.Since then, similar reviews of in-service training in

the care and health sectors have tended to confirm the

problematic nature of obtaining evidence for consistent

use of training on the job. Walters et al. (2005), for exam-

ple, undertook a systematic review of the impact of

workshop training in psychological treatment skills and

found poor evidence for the use of training by trainees.

Nolan et al. (2008) conducted an extensive review of theliterature on training in care homes. Although finding

both resident-focused outcomes and staff ⁄ organisation-

focused outcomes, they acknowledged that the outcomes

of training are often equivocal, while the benefits for resi-

dents are neither always found nor persistent. It seems

again timely to review the recent literature on the effec-

tiveness of in-service training in social care in relation to

training transfer, to determine whether such initiativesare likely to achieve the goals set by policy-makers. The

paper is now structured as follows: First, the findings

from a review of the literature on in-service training of

studies published between 1988 and 2010 are presented.

Next, these findings are critically discussed in light of

our understanding of wider developments in training

theory that identify (i) learner characteristics, (ii) inter-

vention design and delivery and (iii) work environmentinfluences as key factors influencing whether training

actually transfers to use on the job. Finally, a number of

strategies are put forward as essential to improve the

transfer of training to increase the likelihood that in-ser-

vice training will achieve the changes to practice in adult

social care suggested by policy-makers.

Method

The methodology for undertaking the review was

informed by two key sources. The first was the estab-

lished guidelines for undertaking systematic reviews

produced by the Centre for Reviews and Dissemination

at the University of York (Khan et al. 2001). The second

was the criteria used by Clarke (2001) contained in theprevious review of studies of in-service training in social

care published between 1974 and 1987. Electronic

searches were undertaken of seven bibliographic data-

bases (ABI Inform, Cumulative Index to Nursing and

Allied Health, Emerald, Medline, Psychinfo, Science

Citation Index and Social Science Citation Index). The

N. Clarke

2 ª 2012 Blackwell Publishing Ltd

search was conducted between November 2010 and Feb-ruary 2011 and aimed to locate articles or books contain-

ing details of a training evaluation study in either social

service, social work or social care settings that had been

published between 1998 and 2010. This search was

intended to gain an understanding of whether the

impact of training targeting the behaviour of social care

workers has changed since the earlier review. To facili-

tate the search for references, only those that containedthe term ‘training’ in their titles with either the terms

social care, social service or social welfare contained in

their abstracts were included in the first stage of the

search. This located a list of 8843 references. The

abstracts and titles contained in this list were then further

screened looking for references to either training evalua-

tion or training effectiveness. This resulted in a final list

of 1008 references. Articles were finally retained if theymet the following three criteria (Figure 1):

1. Studies should specifically focus on and provideresults from an empirical field evaluation of a train-ing programme and not merely describe training norsuggest possible evaluation strategies.

2. The training programmes evaluated must be specifi-cally for in-service training, defined as training anddevelopment provided for staff in-house by theiremployer organisation.

3. The agency providing the in-service training shouldbe located in the social care sector.

The vast majority of references (over 98%) related to

training evaluation studies that related to training for

social care users (such as managing treatment and

conditions or behavioural training), parent and children

training and educational programmes, or discussedinterventions that were not classified as in-service train-

ing. As a result, nineteen studies were finally retained

that met the criteria for inclusion in the review.

A standardised data extraction form was developed as

part of the review protocol that specified the information

to be collected and serve as the basis for further analysis.

The author was responsible for extracting data, while a

post-graduate researcher then checked the forms for accu-racy and to ensure that targeted data had been recorded.

The quality criteria for including studies recognised that

in relation to training interventions, quasi-experimental

research designs are often the norm, but organisational

circumstances often preclude using a comparison group.

As a result, pragmatic considerations meant that studies

were included as long as (i) they had outcome measures

at the levels of either knowledge, behaviour ⁄ skills andperformance and (ii) the research design was deemed

appropriate to the stated research objectives.

Findings

The search located nineteen studies that documented the

impact of in-service training (Table 1). Six of the nineteen

studies only evaluated the impact of the training in terms

of knowledge or attitude change, which tells us littleabout actual changes to behaviours or job performance

(Rabin et al. 1998, Deakin & Littley 2001, Bryan et al.2002, Frenkel et al. 2002, Thulsius et al. 2002, Walker &

Harrington 2002). One study evaluated the impact of the

training 2 months following training, but only used self-

report measures of training needs (Sharples et al. 2003).

In contrast, Chang & Lin (2005) conducted an evaluation

of training designed to improve the feeding skills of careproviders that assessed performance through observa-

tion immediately before and after training. However,

they omitted any longer term follow-up of actual use of

training on the job. The remaining eleven studies evalu-

ated the impact of training to determine whether any

changes occurred in care practice on the job, and impor-

tantly after some time had elapsed after training.

Here, there were signs that problems continue to per-sist in terms of demonstrating the impact of in-service

training on the job. In echoing findings from the review

almost a decade earlier, eight of the eleven studies found

limited effects of the training to penetrate as far as use on

the job (Leung & Cheung 1998, Persessini & McDonald

1998, Buckley 2000, Bryan et al. 2002, Clarke 2002a,b,

2006, Dobson et al. 2002, Johnsson et al. 2002, Sharples

et al. 2003, Tsiantis et al. 2004, Gates et al. 2005, Bennettet al. 2007). Leung & Cheung (1998) presented data from

a longitudinal evaluation of a 3-month long, in-service

training programme relating to child protection services

(CPS) for 152 entry-level caseworkers in the United

Relevance criteria (1): Studiesmust focus on evaluating theeffectiveness of trainingprogrammes

All referencesidentified by search

n = 8843

Relevance criteria (2):1. Studies must report results froman empirical field evaluation2. Must be in-service training3. Agency in the social care sector

Meet initial relevancecriteria n = 1008

Exclude 7835

Meet final criterian = 25

Exclude 983

Quality assessment:1. Appropriate outcome measures2. Appropriate research design

Meet final criterian = 19

Exclude 6

Data extractionAnalysis: Focus on

training impact ANDeffectiveness

Figure 1 Flowchart showing review methods.

Transfer of training


Tab

le1

The

chara

cte

ristic

sof

in-s

erv

ice

train

ing

evalu

ation

stu

die

sconduct

ed

within

socia

lcare

agencie

s(1

998–2010)

Stu

dy

Conte

nt

targ

et

Researc

hdesig

n

Sam

ple

siz

e

Sta

tistical

tests

Evalu

ation

crite

ria

Behavio

ura

l

measure

Results

On-t

he-job

follo

wup

Leung

&C

heung

(1998)*

Child

pro

tection

Pre

⁄Post

test

Post

test⁄

Com

parison

gro

up

152

(skill

s)

Yes

Know

ledge

Att

itudes

Skill

s

Perf

orm

ance

Superv

isor

ratings

Self-r

eport

Positiv

e(1

,2)

Non-s

ignifi

cant

(3,

4)

24

month

s

Pers

essin

i&

McD

onald

(1998)*

Alc

oholis

mP

re⁄P

ost

test

Com

parison

gro

up

92

Yes

Att

itudes

Behavio

ur

Self-r

eport

Positiv

e(1

)

Non-s

ignifi

cant

(2)

3m

onth

s

Rabin

et

al.

(1998)

Socia

lw

ork

orienta

tion

Post

test

22

No

Reaction

XP

ositiv

eN

il

Fre

em

an

&M

orr

is(1

999)

Investigative

inte

rvie

win

gP

re⁄P

ost

test

12

Yes

Know

ledge

Skill

s⁄P

erf

orm

ance

Sim

ula

tions

Positiv

e(1

)

Non-s

ignifi

cant

(2)

Nil

Buckle

y(2

000)*

Child

pro

tection

Post

test

46

No

Reaction

Behavio

ur

XP

ositiv

e(1

)

Negative

(2)

6m

onth

s

Deakin

&Littley

(2001)

Dia

bete

scare

Pre

⁄Post

test

12

Yes

Know

ledge

XP

ositiv

e(1

)12

month

s

Bry

an

et

al.

(2002)

Com

munic

ation

skill

sP

re⁄P

ost

com

parison

118

Yes

Know

ledge

Att

itudes

XP

ositiv

e(1

,2)

3m

onth

s

Cla

rke

(2002a,b

))R

isk

assessm

ent

Pre

⁄Post

test

14

Yes

Know

ledge

Skill

s

Case

vig

nett

e

Self-r

eport

Positiv

e(1

)

Lim

ited

Positiv

e(2

)

4m

onth

s

Dobson

et

al.

(2002)*

Com

munic

ation

skill

sP

re⁄P

ost

test

9Y

es

Know

ledge

Skill

s

Perf

orm

ance

Vid

eo

sim

ula

tions

Self-r

eport

Positiv

e(1

)

Non-s

ignifi

cant

(2,

3)

6m

onth

s

Fre

nkel

et

al.

(2002)

Ora

lhealth

care

education

Pre

⁄Post

166

Yes

Know

ledge

XP

ositiv

eand

Non-s

ignifi

cant

(1)

Nil

Johnsson

et

al.

(2002)

Patient

handlin

g&

movin

gskill

sP

re⁄P

ost

51

Yes

Skill

s

Perf

orm

ance

Vid

eo

skill

s

Self-a

ssessed

skill

s

Positiv

e(1

,2)

6m

onth

s

Thuls

ius

et

al.

(2002)

End

of

life

care

Pre

⁄Post

272

Yes

Att

itudes

XP

ositiv

e(1

)12

month

s

Walk

er

&H

arr

ingto

n(2

002)

Eld

erly

sexualit

yP

re⁄P

ost

109

Yes

Know

ledge

Att

itudes

XP

ositiv

e(1

,2)

Nil

Sharp

les

et

al.

(2003)*

Intr

oduction

tom

anagem

ent

Pre

⁄Post

test

com

parison

13

Yes

Skill

sS

elf-r

eport

train

ing

needs

line

manager

ratings

Subord

inate

ratings

Positiv

e(1

)

Non-s

ignifi

cant

2m

onth

s

Tsia

ntis

et

al.

(2004)*

Menta

lhealth

aw

are

ness

Pre

⁄Post

36

Yes

Know

ledge

Att

itudes

Perf

orm

ance

XP

ositiv

e(1

,2,

3)

2m

onth

s

qualit

ative

Chang

&Lin

(2005)

Feedin

gskill

sfo

rpeople

with

dem

entia

Pre

⁄Post

test

com

parison

31

Yes

Know

ledge

Att

itude

Behavio

ur

Perf

orm

ance

Observ

ation

Positiv

e(1

,2,

3,

4)

Nil

Eis

ses

et

al.

(2005)

Depre

ssio

ndete

ction

Pre

⁄Post

com

parison

173

Yes

Perf

orm

ance

Assessm

ent

Positiv

e(1

)N

il

Gate

set

al.

(2005)*

Vio

lence

pre

vention

Pre

⁄Post

com

parison

138

Yes

Know

ledge

Skill

s

Org

anis

ation

results

Vid

eo

sim

ula

tion

Positiv

e(1

,2)

Non-s

ignifi

cant

(3)

6m

onth

s

Cla

rke

(2006)*

Needs

assessm

ent

Pre

⁄Post

test

21

Yes

Skill

s

Perf

orm

ance

Case

vig

nett

e

Superv

isor

ratings

Positiv

e(1

)

Lim

ited

Positiv

e(2

)

3m

onth

s

Bennett

et

al.

(2007)*

Motivational

inte

rvie

win

gskill

sP

re⁄P

ost

test

contr

ol

44

Yes

Skill

s

Perf

orm

ance

Vid

eo

sim

ula

tion

Taped

inte

rvie

ws

Positiv

eand

non-s

ignifi

cant

(1)

Non-s

ignifi

cant

(2)

4m

onth

s

X,

Stu

dy

did

not

inclu

de

abehavio

ura

lm

easure

.

Key:

*Stu

die

sw

ith

no

or

very

limited

eff

ects

of

behavio

ur

change

on

the

job.

N. Clarke


States. Data on performance were obtained from stateperformance evaluation forms, which were used to com-

pare improvements in performance during three time

periods: (i) probation evaluation (6–9 months with CPS),

(ii) first annual evaluation (12 months with CPS) and (iii)

second annual evaluation (24 months with CPS). A fur-

ther measure of performance was obtained as a result of

trainees receiving an overall performance score from

their supervisors at the end of each evaluation period.The study found no significant differences between the

training group and a comparison group on these dimen-

sions. There was no clear evidence that the trained case-

workers performed any better than those untrained.

Similarly, Gysels et al. (2004) reviewed the results of six-

teen studies that had evaluated training programmes

aiming to improve the communication skills of profes-

sionals caring for people with cancer. They found thatwhereas participation in the training resulted in signifi-

cant improvements in the skills that were taught, there

was minimal effect of the training on actual practice or

skills used on the job.

Persessini & McDonald (1998) collected self-report

data to determine the impact of training on the job. They

presented the results of an evaluation of a 2-day training

programme for 92 social care practitioners that wasdesigned to improve practitioners’ attitudes, knowledge

and competencies concerning the use and ⁄ or abuse of

alcohol among elderly people. In a 3-month follow-up,

only 27.5% of trainees reported that their agencies

encouraged the application of the knowledge and skills

they acquired through training, while 53.6% reported

that their agencies had ‘no reaction’ to their learning

experiences. A few practitioners even stated that theiragencies actually opposed their application of new

knowledge and skills. Tsiantis et al. (2004) evaluated the

impact of two 2-day training programmes designed to

improve the awareness of 36 care home staff on dual

diagnosis (mental health and learning disability). Posi-

tive changes in knowledge and attitudes improved

immediately following training. However, a 2-month fol-

low-up of staff indicated that minimal changes to prac-tice had occurred. Staff reasons for failing to implement

the training included work overload and that other col-

leagues at work used a different assessment approach.

These findings suggest that over the past two

decades, there has been little progress in designing

evaluations that are able to track training effects within

social care beyond the immediate confines of the trainees

themselves (Reid et al. 1989). The omission to includesuitable comparison groups as part of the evaluation

design in eleven of the studies reviewed also suggests a

lack of rigour undermining confidence in the findings

obtained more generally. Also of concern are that these

findings are also illustrative that beyond issues of train-

ing design, factors outside participation in the trainingoften determine the use of training on the job (Buckley

2000, Clarke 2001, Horwath 2001). Buckley (2000), for

example, reported an evaluation of an inter-agency train-

ing programme for staff in child protection, which,

although only relied on trainee feedback 6 month follow-

ing training, suggested that the training had variable

impact on practice despite trainees having identified

strategies for implementing training goals.Previously, the failure to demonstrate training effects

led Lindsey et al. (1987) to raise questions regarding the

expectation of short-term, in-service training pro-

grammes to sufficiently provide participants with the

skill mastery and feedback required to have any signifi-

cant impact on care practice. More recently, Godfrey

(2000), in a study examining the preferences of care

home residents for the staff who worked there, foundthat training was not a significant predictor of resident

preference after controlling for time in post. Confidence

in any expected training–quality of care link is instead

further undermined by studies showing that reliability,

continuity of care, kindness, cheerfulness and compe-

tence in undertaking tasks are identified as the qualities

most desired from staff in care homes (Henwood 2001).

Arguably, many of these aspects are more likely to fol-low from better job design and work organisation strate-

gies than from investments in training (Juillerat 2010).

Clearly, findings such as these do not augur well for the

recent policy goals of adult social care, if so much is

being placed on the transforming capacity of training by

policy-makers or managers. The extent to which in-ser-

vice training should be expected to deliver improve-

ments in quality of care as envisaged is clearly of someconcern.

Positive impacts of training on performance?

As a counterpoise to these findings, recent evidence from

the wider training literature suggests that a positive link

can be found between training and quality of work out-comes. In a meta-analysis of 67 studies examining the

impact of training on organisational-level outcomes,

positive and significant effects were found on a number

of indicators including human resources (HR) outcomes

and organisational performance outcomes (Tharenou

et al. 2007). Nineteen studies included in this review

reported significant relationships between training and

HR outcomes. Thirteen of these studies looked at rela-tionships between training and attitudes and of these,

the results of twelve studies were positive and signifi-

cant. Seven of the eleven studies examining relationships

between training and behaviour (mostly turnover or

retention) were also significant. Two of the four studies

examining human capital aggregated to the organisation-



al level found that training was associated with higheroperator skills (Wright et al. 1999) and staff competency

(Zheng et al. 2006). Particularly significant from a social

care perspective, nearly 75% (11 out of 15) of studies

examining relationships between training and work

quality (such as customer responses) found positive and

significant results. These latter results in particular sug-

gest that positive relationships between training and the

quality of care received by users should at least be apossibility.

That in-service training sometimes does achieve posi-

tive changes to performance on-the-job for social care

workers is attested to by results from two training evalu-

ation studies included in this recent review. Eisses et al.(2005) investigated the impact of a training programme

designed to improve the skills of staff from ten residen-

tial care homes in detecting depression in elderly resi-dents. The training consisted of two 2-hour sessions,

where they were trained in using a standardised screen-

ing instrument and recognition of psychopathology. One

hundred and seventy-three staff participated in training

and 155 staff acted as a control group. Data collected at

6 months post-training showed that staff had improved

their skills in recognition of depression and this improve-

ment had been maintained. Johnsson et al. (2002) evalu-ated the impact of four, 4-day traditional training

programmes in moving and handling over 4 weeks,

compared with eight, half-day quality circles that met

over 2 months. Fifty-one participants drawn from both

hospital and home-based care settings participated in the

research. Postintervention follow-up 6 months later

found significant improvements in lifting techniques as

judged through video-ratings as well as a decrease inparticipants’ physical exertion. The important question

remains, however, as to why some training is effective in

some circumstance, while not in others. Without a better

understanding of the complex processes associated with

training effectiveness, any contextual factors surround-

ing the training and quality of care link will remain elu-

sive. For Kozlowski et al. (2000), one of the primary

leverage points through which training at the individuallevel can impact organisational-level outcomes such as

quality, is through training transfer. It is a focus on trans-

fer, and not merely training that policy-makers and man-

agers must look to, to determine how training can

impact on the quality of care.

Discussion

The concept of transfer in relation to training is one

which combines both the notion of generalisation of the

material learnt on the training programme to the job,

and the subsequent maintenance of this knowledge or

skill gain over time (Baldwin & Ford 1988, Arthur et al.

2003). The most recent estimate of the precise extent ofthe problem based on survey data suggests that the

transfer of training to use on the job or changes in job

performance fails to occur in about 40% of trainees

immediately following training, and that ultimately only

50% of training effort results in any real individual

improvement (Saks 2002). The problem should be recog-

nised as an acute one, which organisations and agencies

in the social care sector need to address, if the ongoinginvestment in training is to lead to the transformation in

care anywhere near like that envisaged. A recent review

of the literature on training transfer has listed the chief

factors involved in influencing training transfer as falling

within three major categories: (i) learner characteristics,

(ii) intervention design & delivery and (iii) work environ-

ment influences (Burke & Hutchins 2007). All three sets

of factors influence the amount of learning that takesplace on training, while also determining whether any

learning gained is then subsequently generalised to use

on the job. A similar framework can be applied to catego-

rise data relating to the effectiveness of in-service train-

ing in social care that has been gathered from a number

of studies that have appeared in the literature to date

(e.g. see Clarke 2001, 2002a,b, 2006, Figure 2).

Learner characteristics

We know very little about how learner characteristics spe-

cifically influence the outcomes of social care-related

training. Clarke (2002b) suggested that a contributory fac-tor in the failure of training in risk assessment to transfer

to practice was the extent to which trainees viewed the

training as for their own ‘personal development’. This

seemed to have implications in two major ways. The first

concerned minimal expectations that anything learned

was expected by the agency or their managers to be used

on the job. The second aspect related to job autonomy.

Elsewhere, job autonomy is widely recognised as a good

Findings from studiesin social care

Learning andretention

Use on the job(performance) Transfer

Learner characteristicsTrainee expectations

Perceived utility

Intervention design &delivery

Identical elementsBehaviour modelling

Work environmentSupervisor support

Peer supportOrganisational policies

Heavy caseloadsNo time for reflection

Figure 2 Factors influencing the transfer of social care training

based on findings from studies in social care.

N. Clarke


indicator of informal learning (Fuller & Unwin 2004).However, in this instance, a sense of professional auton-

omy interacted with the absence of clear standards of

practice expected by the agency in risk assessment. This

resulted in these care workers free to decide if and how

they integrated any new learning in their practice.

A further learner factor was identified by Clarke

(2006) in his evaluation of needs assessment training in a

study involving 21 care managers. Here, the extent towhich trainees believed that the training was relevant to

their practice influenced both their learning on the train-

ing course itself, and their subsequent use of the training

on the job. This insight supports findings from the wider

training literature that has identified individual

trainee beliefs regarding the value of training as

significantly influencing training outcomes (Lim & Mor-

ris 2006, Shankar 2006).

Intervention design & delivery

The best mix of activity, type of instruction and optimum

duration of a training programme continue to remainimportant questions for in-service training; however, our

knowledge here too is fairly scant. Previous research has

found that providing positive reinforcement of skills

through a series of successive experiences sequentially

leading to more difficult interactions, combined with

classroom rehearsal of the skills being taught are all inte-

gral components of training transfer (Arthur et al. 2003).

Specifically in relation to in-service training for socialcare staff, Tolson (1988) has advocated the use of the ‘sys-

tematic skill training model’ as a means to train staff in

new skills emphasising drill and repetition of specifically

defined skills, followed by feedback and trainee reflec-

tion on practice. An analysis of the particular training

delivery techniques referred to in a number of social care

training evaluation studies finds the consistent use of

experiential and behaviour modelling methods. Wright& Fraser (1987), for example, stated that the development

of their workshop on functional family therapy was

‘based upon research on androgyny and learning theory’

and incorporated lecture, video and audio-taped mate-

rial, role-play exercises, case studies and discussion

groups. Similar methods have been identified in other

studies (e.g. Rodway 1992).

The use of case studies to facilitate the transfer oftraining incorporates the principle of ‘identical elements’

into training design, whereby attempts are made to

include identical problems or situations found in the

work environment within the actual training programme

itself (Ford & Weissbein 1997). Lindsey et al. (1987)

described how each skills module taught followed a for-

mat in which participants gained knowledge about the

skill, observed a model of the skill, had the opportunity

to practise the skill, and received feedback on their per-formance. In particular, participants engaged in exercises

that enabled them to integrate their use of several skills,

which were individually taught.

A problem remains, however, that to date, there has

been little systematic research investigating the efficacy or

power of social care training under different design con-

figurations. A study on training task-centred casework by

Shapiro et al. (1980) compared the impact of two condi-tions of training design, and found that modelling and

role-playing as learning methods achieved greater gains

in skill learning scores by trainees, than those trainees

who had received role-play alone. Weinbach & Kuehner

(1986) evaluated the outcomes of a 6-day training course

of ‘Integrated Casework Skills’ for financial assistance

workers. These trainees received additional peer rein-

forcement of the learning gained in training through a ser-ies of weekly meetings with a peer who observed and

provided feedback on performance. Compared with the

control group, which had received no peer reinforcement,

the experimental group scored significantly higher on

written tests and effective use of skills.

More recently, Thulsius et al. (2002) presented the

results of a learning intervention that targeted 200 care

home staff in Sweden, with the aim of improving carepractice in end-of-life care. Although the evaluation did

not focus on skills or changing behaviours, the study is

novel, in that it abandoned traditional training methods

in favour of more learner-centred approaches. Small

group work was combined with some lecture input, and

discussion. Individuals were placed in one of five small

groups (or quality circles) to work together on develop-

ing care home policy in areas including ethics, symptomcontrol and last days care. The intervention lasted

12 months and individuals spent between 26 and 100

working hours on their projects. Measures of both atti-

tude and well-being demonstrated significant improve-

ments for the intervention group compared with a

control. However, Burke & Hutchins (2007) note that

there remains a paucity of evidence to support many of

the learning methods used on training programmes andthat have become fashionable over recent years.

Work environment influences

Mirroring wider findings in the training literature(Tracey et al. 1995), the work environment within social

care agencies and organisations (incorporating elements

such as organisational climate, structure and agency poli-

cies) has been found to influence the effectiveness of

training. In particular, the role of the supervisor has been

identified as occupying a significant role in maximising

the transfer of training as well as the alignment of train-

ing with organisational procedures and policies (Clarke



2002b). Gebhardt-Taylor (1982) suggested that factorssuch as negative attitudes towards the training by super-

visors and administrators, the fact that training was man-

datory, and the characteristics of the social and political

milieu of the agency where training had taken place,

were significant impediments to learning on the training

programme. Gregoire (1994) described a number of bar-

riers cited by course participants as impeding them from

implementing practice goals they set following training.Significantly, a lack of time and resources, the daily

demands of child welfare practice, and the refusal by

supervisors to endorse proposed practice changes.

The wide ranging set of factors influencing training

transfer gives an indication of the scale and complexity

of the problem that may be facing adult social care. Just

over 25 years ago, it was a recognition of the failure of

child welfare agencies to deal with the transfer challengethat led Cohen & Austin (1994) to comment that:

Public child welfare bureaucracies, for the most part, sim-

ply have not built the internal or external structures for

promoting continuous learning and improvement. Yet, this

is precisely what is required if major transformations are to

occur in the delivery of services. (p. 2)

Since then, continuing findings indicating the limited

impact of training to penetrate as far as behaviour

change on the job suggest that very little progress has

been made. This can no longer be ignored, and arguablyposes one of the most significant challenges to the suc-

cess of the transformational agenda in UK social care. It

requires a sea change in thinking about in-service train-

ing as no longer occurring primarily as a result of train-

ing participation, and instead a major shift in focus to

posttraining support. In particular, workload pressures

appear to actively prevent trainees applying any new

knowledge gained from training into their care practice.Without time to reflect on what has been learnt and try

out new skills, training has little effect (Secker & Hill

2002). This requires an additional investment beyond the

provision of training itself. Reducing caseloads for work-

ers, where necessary, has to be a clear aim. Setting clear

and specific goals by supervisors for trainees to improve

aspects of their performance increases the likelihood of

transfer. This can also be supported by trainers workingwith trainees to set goals at the end of training

programmes. Studies show that this has previously met

with some success in social care training (Wright &

Fraser 1987, Tracey & Pecora 1988). There is some evi-

dence that follow-up training events or booster sessions

some time after participants attended training encourage

ongoing transfer of training and inoculate against skill

decay (Gaudine & Saks 2004). Behavioural managementstrategies, where trainees are encouraged to anticipate

and plan to respond to difficulties they may encounter in

implementing the training, have also been found to assistwith transfer (Marx 1982).

More recently, the seriousness of the transfer issue

has spurned other alternatives to support transfer. Curry

et al. (2005), for example, describe a range of strategies

that have been employed in US state child welfare agen-

cies. In California and Oklahoma, they have engaged

staff to act as mentors in a structured 5-week programme

to promote training transfer for new workers. The stateof Ohio has focused on widening the remit and function

of training staff to ensure that they focus on training

transfer. Now they provide posttraining mentoring and

coaching for workers and supervisors. At the same time,

a new code of ethics for training staff was produced that

incorporated a specific standard requiring transfer activi-

ties to be planned and implemented alongside training.

Within the UK, recent research has highlighted the extentto which those holding positions as practice teachers in

social care agencies feel their skills are underused (Kear-

ney 2003). Alongside similar changes to the roles of train-

ing staff in social care agencies to support transfer,

clearly, a wider role for practice teachers can also be

envisaged in areas such as coaching and mentoring.

The above concerns and challenges lead us to doubt

whether the transformation expected to occur throughtraining will materialise unless there is significant mod-

ernisation of the entire HR infrastructure within the

social care field. As a start, changes must occur in train-

ing practice. Over more than a decade ago, authors

bemoaned the poor state of training evaluation typically

found in UK organisations in both the private and public

sectors (Sims 1993). Tome (2008) has argued that change

to training practice in the public sector has been far lessdiscernible due to differing expectations of what consti-

tutes evaluation. He distinguishes between the human

resource development (HRD) expert approach to train-

ing evaluation often found in private sector organisa-

tions, compared with the public administrator approach,

more typically found in areas of the public sector. The

HRD approach views evaluation as a concern with

understanding the impact of training on learning andperformance. In contrast, the programme administrator

sees training evaluation as concerned with collecting

activity data associated with the execution of training

and the appropriateness of its planning. Although argu-

ably both perspectives offer valuable information for

determining the potential impact of training, only the

HRD approach has the capacity to offer concrete answers

regarding the training–quality of care link.We also need to acknowledge that although this

paper focuses on how to improve training transfer in

adult social care, training as a developmental interven-

tion continues to receive considerable criticism. Often, it

is limited in targeting narrow skill-based learning, and

N. Clarke


removed from the realities of the skill utilisation in theactual workplace. Elsewhere, alternative on-the-job

learning and development interventions including action

learning, coaching and project-based learning have been

found to be often far more effective in securing

skill maintenance and generalisation (Skinner & Whyte

2004).

Finally, as in all reviews, there are a number of limita-

tions. The first is the decision not to include non-Englishdatabases or studies due to the financial costs. This may

well have excluded new insights into aspects of training

effectiveness that have been shaped by a predominantly

US-based industrial organisation literature. Resource lim-

itations also meant that results from theses were not

included in the search. The main problem being that a far

greater amount of data from more recent studies could

have been included. Finally, it is recommended that tworesearchers take part in the data extraction process for

reviews to minimise bias. Although subsequent checking

of data extraction forms was undertaken by a second

researcher here, this was primarily to ensure accuracy

and completeness. As a result, initial biases relating to

which studies met the review criteria may have occurred.

Conclusions

The training literature has for some time urged the need

for organisations and trainers to direct their efforts to

training transfer. There does now appear to be a wider

recognition within social care for the need to undertake

outcome-focused evaluations of training, suggesting

moves towards an HRD approach to workforce develop-ment. But this alone may only confirm what we already

know about the limited impact of training. Instead, there

needs to be a re-orientation by policy-makers to widen

their focus from training to incorporate training transfer.

Here, research is needed that identifies what posttraining

interventions work best in social care agencies to improve

the likelihood of skill utilisation as a result of training.

Studies are needed that identify the ways in which train-ing and other forms of workforce development contribute

to care outcomes, testing a range of differing models. The

transformation of adult social care towards greater

personalisation is argued to be dependent upon moderni-

sation of the workforce. The scale envisaged is unlikely

without considerable modernisation of traditional

approaches, processes and methods that continue to

dominate workforce development in social care.

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transfer of training: the missing link in training and the quality of adult social care

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