Abstract
BackgroundThe transfer of training to the workplace is the aim of training interventions. Three primary factors influence transfer: trainee characteristics, training design and work environment influences. Within medical education, the work environment factors influencing transfer of training remain underexplored. Burke and Hutchins’ review of training transfer outlined five work environment influences: opportunity to perform, supervisor/peer support, strategic link, transfer climate and accountability. This study aimed to explore the ways in which work environment factors influence the transfer of training for medical trainees.MethodsInternal Medicine Training in Scotland includes a three-day boot camp involving simulation-based mastery learning of procedural skills, immersive simulation scenarios and communication workshops. Following ethical approval, trainees were invited to take part in interviews at least three months after following their boot camp. Interviews were semi-structured, anonymised, transcribed verbatim and analysed using template analysis. Member checking interviews were performed to verify findings.ResultsA total of 26 trainees took part in interviews between January 2020 and January 2021. Trainees reported a lack of opportunities to perform procedures in the workplace and challenges relating to the transfer climate, including a lack of appropriate equipment and resistance to change in the workplace. Trainees described a strong sense of personal responsibility to transfer and they felt empowered to change practice in response to the challenges faced.ConclusionsThis study highlights barriers to transfer of training within the clinical workplace including procedural opportunities, a transfer climate with challenging equipment availability and, at times, an unsupportive workplace culture. Trainees are driven by their own sense of personal responsibility; medical educators and healthcare leaders must harness this enthusiasm and take heed of the barriers to assist in the development of strategies to overcome them.
Highlights
IntroductionThree primary factors influence transfer: trainee characteristics, training design and work environment influences
The transfer of training to the workplace is the aim of training interventions
A series of studies in various specialties have found that skills training can be retained well up until around three months [16, 17] and thereafter this can decline with opportunities to perform, booster sessions and simulation-based mastery learning as factors that can improve skill retention [18,19,20,21,22]
Summary
Three primary factors influence transfer: trainee characteristics, training design and work environment influences. The work environment factors influencing transfer of training remain underexplored. This study aimed to explore the ways in which work environment factors influence the transfer of training for medical trainees. The three primary factors influencing transfer, first outlined by Baldwin and Ford, are: trainee characteristics, training design and work environment influences [2]. A series of studies in various specialties have found that skills training can be retained well up until around three months [16, 17] and thereafter this can decline with opportunities to perform, booster sessions and simulation-based mastery learning as factors that can improve skill retention [18,19,20,21,22]. Skill retention is a related concept, training transfer is distinct by virtue of its focus on addressing the ability to transfer skills and training to a different setting or problem
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