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This series of self-study lessons on Central Service topics was developed by the International Association of Healthcare Central Service Materiel Management (IAHCSMM). The lessons are administered by Purdue University’s Continuing Education Division.

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Lesson Plan CRCST 99
On-Job Training for Central Service Employees
[Reprinted from Communiqué: March/April 2008]

Central Service managers rely on knowledgeable and trained Central Service technicians to provide required products and services. Well-planned training, delivered by skilled trainers, has always been of critical importance to the effective operation of the department. Increasingly sophisticated instrumentation, and the sterilization equipment and processes required to make these devices safe for re-use, elevates training to the highest level of priority.

Objective 1: Define the term, training, and explain its primary purposes.

Training is undertaken to provide new staff members with the short- and longer-term knowledge and skills required for them to be successful on the job. It is also required to update currently employed Central Service technicians about new or revised job responsibilities and work procedures.

Effective on-job training is performance-based; that is, it is planned and delivered in an organized way that focuses on tasks that are essential for on-job performance. What exactly must a competent Central Service employee know and be able to do to be successful? The answer to this question drives the planning and delivery of performance-based training experiences.

As the name implies, most on-job training occurs in the actual areas where Central Service technicians undertake their work responsibilities. It is also beneficial, however, to have a classroom or dedicated quiet or private space available, away from busy and often noisy work areas, to introduce new items and work processes. Many trainees will be anxious if, for example, they must learn to identify and remember new instruments in front of their peers. As an alternative, the trainer can identify new instruments, and the trainee can handle them, in the “quiet area.” The trainer can then review names and handling procedures as the trainee works with the instruments in the processing areas.

Objective 2: List the benefits of effective individualized on-job training programs.

There are several important benefits to on-job training when programs are effectively planned and delivered, including:

• On-job training incorporates basic adult learning principles – Individualized on-job training moves the focus to those being trained. It considers the trainee’s attention span and an approximate and reasonable amount of time necessary for the trainee to learn specific tasks. Trainees learn what they need to know at their own pace, with different training tactics, if appropriate. For example, one trainee may like to ask questions, another may want to practice one or more steps in a process before moving to the next step, and a third may be able to demonstrate proficiency immediately, without training for a specific task.
• On-job training provides maximum realism – Training must focus on real problems in the workplaces where the on-job training will occur.
• On-job training provides immediate feedback – Trainees can demonstrate (practice) what they have learned as soon as they have been taught. As the trainer observes the trainee’s knowledge and skills, the trainer can recognize proper performance—indicating that the training has been successful and attention can focus on additional work tasks—or provide additional training activities, if necessary On-job training can be used to train both new and experienced staff – On-job training can be used to teach new staff members all the tasks for which they will be responsible, and teach their more-experienced peers about revised work methods for tasks where they need to upgrade their skills.
• On-job training can be delivered by staff members who regularly perform the task – Trainees will not be intimidated by a higher-level manager, and the trainer can be a role model to encourage teamwork in a culture that emphasizes cooperation and mutual assistance.
• On-job training is well accepted by trainees– Use of the basic adult learning principles noted above focus on the best approach for each trainee. This individualized attention appeals to most trainees because it addresses their special concerns, rather than those of the group.

Objective 3: Describe the characteristics of effective on-job trainers.

Successful training requires much more than allowing a trainee to “tag along” with an experienced peer. Those who train must, first, have a desire to do so and, second, they must have the knowledge and skills required to perform the tasks that training will address. They must also know how to train; successful completion of a “Train the Trainer” program will be very beneficial. Along with a positive attitude and technical competence, this ability is very important.

Other characteristics of effective trainers include:

• appropriate communication skills
• patience
• humor
• time to train
• respect for trainees
• enthusiasm

Training activities are among the first on-job experiences in which many new Central Service employees will participate. Successful training experiences provide excellent initial positive reinforcement about their employment decisions. This emphasizes the need for careful selection and training of those who will provide training to new staff members.

Objective 4: Explain the need for and the use of training objectives in the training process.

Training objectives specify what trainees must know and should be able to do when training is successfully completed, and they drive performance-based training.

Objectives directly impact the content of training programs. Broad objectives define the requirements of the entire program, which must be designed to help trainees become competent in all job tasks. In contrast, more specific training objectives precede the development of content for specific training sessions that may focus on all, or only part of one job task.

Objectives also help trainers to evaluate training activities. For example, suppose that a training session objective requires that a trainee demonstrate how to safely operate a steam sterilizer. At the completion of the training, the trainer can determine its success by observing whether or not the trainee uses all the safety procedures taught during the session.

Objective 5: Review tactics in the four-step on-job training process.

There are four basic steps in effective an on-job training process, and numerous tactics are useful as each step evolves:

• Step 1: Prepare for Training – Current job descriptions are, hopefully, available to indicate the tasks that employees in a specific position are expected to perform. This important personnel management tool identifies the broad training program content for new employees. Task breakdowns can be developed to describe exactly how each task in the job description should be performed. Training plans can then be constructed to address the broad spectrum of content that emphasizes the job responsibilities, duties, and tasks for which Central Service technicians must be trained. Also, training lessons should be developed which identify the content and delivery methods for each task. Note: A well-developed job breakdown can serve as a training lesson. These basic training tools can then be used to train all new staff members hired for a specific position.
  
  Useful tactics in preparing for training also include developing the required time schedule. The training plan should indicate how long the training activity will require and where, in the overall training plan sequence, that training for a specific task should occur. For example, assume that experience suggests training for a specific task can be taught at any time after the trainee has learned about workplace safety and equipment operation. Then the trainer will have flexibility in determining when the training for the task should occur. The best time to schedule training when there is sufficient time to adequately conduct the training. This is likely to be when production volume is low, when staff normally in the area are working elsewhere or on a break, and when the trainer has adequate time to facilitate the training activities.
  
  It is also important to assure that all necessary equipment, tools, and materials are available. An appropriate training location must be identified (and noted in the training plan) and arranged. The training work station should be prepared, and it should be relatively free of any unnecessary equipment, supplies, or other items that could detract from the training experience.
  
  Another important part of training preparation involves the trainee him- or herself. It is important that the trainee be comfortable, and the trainer should discuss what the trainee already knows. Effective trainers explain what the trainee will learn during the session, tell why the training is needed, and preview the training. As they do so, they tell how it will relate directly to the trainee’s work, and they can stress that the training session will be enjoyable and worthwhile. Trainees will want to know how they will be evaluated, and this is an important topic that should also be discussed before the training actually begins.
  
  Trainers should determine what the trainee already knows. This is easy to accomplish when on-job training is used. For example, if a specific item of equipment must be operated as part of a task, the trainer can request that the trainee demonstrate its proper operation. If this is done successfully, that aspect of the training will not be necessary. If the trainee cannot properly operate the equipment, however, training should focus on equipment operation at the appropriate point in the training lesson. The trainer can then devote the most available training time to those steps where training is most needed.
  
  
• Step 2: Present the Training – This step will be much easier when it is preceded by thorough preparation. The trainer will then have access to a solid foundation of training tools: training objectives (indicating the purpose of training), job descriptions (listing tasks in a specific position), training lessons (providing the “what” and “how” of the training content), and task breakdowns (specifying exactly how a task should be done). Trainers should emphasize and demonstrate the correct way to do a task. Repetition may be necessary to assure that the trainee understands how each task should be performed.
  
  Trainers should be patient and proceed through the training session at an appropriate pace. Trainees should be encouraged to ask questions, and trainers should ask open-ended questions (those requiring an explanation as part of the response) to help determine what the trainee does (and does not) understand about the task.
  
  The training should follow an orderly sequence, which should be addressed in the training lesson the trainer is following. For example, when possible, simple tasks are taught before complex tasks, and tasks are taught in the order (sequence) in which they are normally performed.
  
  Effective trainers make the session interesting by using humor (in good taste and where appropriate), by telling the trainee how he or she will benefit from the training, by clarifying how the training relates to other tasks, and by explaining how it will benefit the patients.
  
  
• Step 3: Practice – After the training has been presented (Step 2), the trainee should be asked to demonstrate and then practice the task. Repetition also helps the trainee to learn and to begin building the speed that will be required on the job.
  
  Trainees should be asked to explain the “how” and “why” of a job task, and additional questions should be posed to help assure that the trainee understands the “why” behind the “how” of the training. Trainers should correct errors noted during the training, and they should recognize that, especially when the tasks or steps being taught are difficult, initial progress may be slow. The trainee will then require more extensive repetition to build speed and to perform the task more consistently and correctly. Trainers should also realize that some trainees learn faster than others. This principle is especially easy to incorporate into training when the on-job training approach is used. Within reason, training can be presented at the pace judged to be best for the individual trainee. Also, the time allowed for trainee demonstration can be varied.
  
  Trainees should be praised for their proper performance. It is probably not possible to say too many good things to a trainee! Everyone likes to be thanked for a job well done, to be told how important and special they are, and to receive immediate input about how they are viewed by others.
  
  
• Step 4: Follow-Up – One goal of the training should be that the trainee can work without constant supervision. The trainer should, however, continue to observe the trainee on, at least, a routine but random basis to assure that no problems arise. Coaching can emphasize the proper way to do the work. Any actions taken to correct deviations from expected performance are a very important part of the follow-up process.
  
  Trainers should continue to emphasize the importance of asking questions, and they should encourage the trainees to ask for assistance at any time. Trainees want to know how their supervisor or trainer views their work, and this feedback is important. On-going reinforcement helps to build the trainee’s positive attitude.
  
  Trainers can use objective tests, observation of after-training performance, rating scales (which allow trainees to evaluate the training from their own perspectives), interviews and surveys, third-party opinions, analysis of operating data, and exit interviews to assess the worth of training. Evaluation should address training effectiveness (determining if training goals were accomplished), trainer improvement possibilities, if any, and ways to improve the content and delivery during subsequent training programs.
  
  When trainees are able to perform the work to necessary quantity and quality standards, they should be asked for suggestions about better ways to do the required work, and they should be encouraged to improve upon existing standards. They should also be told about the importance of performing each task in the way that they were trained unless the supervisor agrees that another procedure can be used.
  
  Experienced Central Service employees have many responsibilities and, sometimes, a less-than-ideal amount of time available to complete them. Some job assignments may, at least temporarily, need to be delegated to other staff members to provide the time required for trainers to plan and deliver training. Effective trainers are those who consistently use the most appropriate strategies to assure that training benefits can be realized with the minimal expenditures of time, effort, and financial resources. Better trainers yield better employees who, in turn, are better able to meet the goals of the Central Service department.

Reference

For more information about training, see the eight part series on the topic beginning in the March – April, 2006, issue of Communiqué.

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