Training is any planned activity to transfer or modify knowledge, skills, and attitudes through learning experi- ences. Personnel may require training for a variety of rea- sons, including the need to maintain levels of competence and respond to the demands of changing circumstances and new approaches and technologies. Training by itself cannot solve structural, organizational, or policy prob- lems within an organization, although supportive super- vision and the use of motivational strategies can help sustain performance improvement derived from training. e rst step in the design of training involves an assess- Observing workers performing normal duties Interviewing worker sand others Studyingroutinereportsorperformancereviews, along with job descriptions
Identifyingperformanceproblems e second step involves de ning the training program’s learning objectives. e learning objectives, which are derived from the needs assessment, specify the observable, measurable actions that each learner will be able to demon- strate as a result of participating in the training activities. e third step is the creation and implementation of a training program to improve performance, taking into account the experience and educational levels of the per- sonnel and the time and resources available for training. Options range from short courses to long-term place- ments in academic institutions in the country, in the region, or overseas, and non–classroom-based interven- tions, such as on-the-job training, coaching, and mentor- ing. All options must be weighed against the immediate operational needs of the program or institution, because facilities may not have enough personnel to operate when sta members go for training. learning outcomes that must be achieved, along with the training environment, audience characteristics, and the experience of the trainer, all determine the mix of learning methods and media that will achieve maximum e ectiveness.
Methods and media may include lecture, discussion, case study, role-playing, group exercise, simulation games, brainstorming, and demonstration. If no published training materials—including audiovisual aids—are available, the trainer must develop them. Development of the training program also includes design of the training evaluation, which is carried out during the course as well as at its conclusion. During the course, trainers monitor learner progress and satisfaction to identify where they may need to make adjustments to the training program.
At the end of the course, trainers should collect data on how well the learners achieved the course objectives and how satis ed they were with the training experience. Whenever possible, the trainer should follow up with participants a er they return to their work situations to assess the impact of training on performance. Data collected during follow-up can help identify the need for additional training or reinforcement of newly acquired skills, as well as inform review and revision of the training materials. In some countries, availability of basic training and con- tinuous professional development programs is limited; therefore, many health workers lack access to formal training opportunities and new ideas and approaches that can improve their work performance.
Well-designed in-service training programs can help ll this need. Training should be put into a context of continuous performance improvement. Changing and improving practices require an environment conducive to work, the appropriate learning resources, and the continuous use of motivational strategies. Training should be based on competencies: the abilities required to do work to the standards expected. erefore, training should result in changes in work behavior that lead to an improved, e ciently functioning pharmaceutical management system. At the same time, training alone is unlikely to change overall supply system performance unless the environment and supervisory systems support change (see Chapter 37) and unless individuals are encouraged to maintain changes (see Chapter
51). Learning requires active involvement. People prefer to learn in di erent ways—through visual stimuli, verbal interactions, and learning by doing. erefore, o ering a variety of training opportunities and training techniques is usually more e ective than using only one approach. Training can be formal or informal, academic or applied, guided or self-directed, or provided in public agencies or private institutions. Training alone is o en not su cient to change behav- ior or improve performance. Improved performance, changed attitudes, and new skills acquired during train- ing may need to be complemented by and maintained through continuing education, supportive supervision, and adequate motivational incentives.
In many cases, structural changes, such as workspace improvements and increased access to supplies and equipment may be needed to support improved performance. A country’s national pharmaceutical program alone is not in a position to handle comprehensive training for policy makers and midlevel managers; many of their learn- ing objectives are best handled through general manage- ment training. However, it is still possible and necessary to reorient this group on pharmaceutical policies and issues through information exchange, reports, and seminars. Training for operations-level personnel is critical because they o en lack the basic knowledge and skills necessary to be e ective at their jobs. Finally, training alone will not result in signi cantly improved performance unless it is linked to an enabling institutional environment.
is illustrated by Figure 52-1, which is a conceptual framework for building in-country capacity for pharmaceutical management services. It illus- trates the concept that health structures, systems, and roles, sta and infrastructure, skills, and tools must all be addressed to strengthen a country’s ability to e ectively pro- vide pharmaceutical services. training program is composed of a schedule of activi- ties with training goals, learning objectives, subject areas, methods, trainers, trainees, methods of assessment, and locations. A good training program is designed to address performance problems, such as long delays in getting medicines from suppliers to the main stores, delays in distributing medicines from midlevel stores to end-user units.
