1. Phd Study The transfer of training from the ‘classroom to the mental health practice setting
Ian McGonagle

2. Context and shaping an interest
NHS spends £4.3. billion on all forms of education and training.
The vast majority of training programmes receive only superficial evaluation
The estimated ROI on training is between 10 and 20%.

3. Multiple Case Study Design
Pose the research question
Identify the underpinning theories
Determine the case – It’s context and the phenomena of interest
Determine the specific case study approach
Identify the data collection methods most suitable to answer the research question
Select analysis strategies appropriate to each of these data collection strategies
Determine conclusions and develop a ‘case description’
What is the role of personal factors (motivation etc) in the ability to transfer training in the learning system?
What role do the training team play in the design and delivery of a training programme to deliver planned outcomes?
What is the role or organisational /practice factors in the transfer system?
Motivation
Self Efficacy
Individual and Team Identity
Multiple Case Study Design
Questionnaires
Participant interview
Focus group
Statistical analysis
Content analysis
Thematic analysis
Primary care providers who are beginning to integrate mental health
services into their workforce.
Secondary mental health care providers with a long history of
providing secondary mental health services, but not in primary care
Independent providers working in primary care

4. Defining the Terms
Learning – not located solely in the individual it may take place in the system and be seen as a form of ‘transformation’. Not from position a – b but one that expands a learners potential range of options
Transfer – the ability to extend what has been learned in one context into a new one
Classroom – a space designed for creativity, social interaction and testing of ideas and skills.
Practice Setting – not a steady state, subject to fluctuations, full of disparate components and may reflect complex arenas but with an inherent order.
Spend time reflecting on the nature of practice settings
We think in terms of hierarchy, pecking order etc this may a do a disservice to the complexity in organisations and teams

5. Kirkpatrick model for educational evaluation
Level
Outcome
Method of measurement to review impact of training 1
Reaction
A measure of how the learners reacted to the training by asking learners to numerically rate sections of the course, and asking for written feedback and suggestions on how the course could be improved 2a
Modification of values and attitudes
Measured through a ‘before’ and ‘after’ measure of attitudes 2b
Acquisition of knowledge and skills
Measured through changes in self-reported levels of knowledge of the subjects covered in the course and confidence before and after attending the training 3
Change in behaviour
Measured through changes in learners’ specific behaviours before and after the training 4a
Change in Organisational Practice
Measured using agreed organisational outputs 4b
Benefits to people who use services
Could be measured through eliciting service user views a suitable length of time after the training

6. Holton et al (2000) Model of factors which influence the transfer of learning
Motivation to Learn
Reaction
Learning
Ability
Motivation to Transfer
Transfer Climate
Individual Performance
Transfer Design
Expected Utility/
Return on Investment
External Events
Organisational
Results
Link to Organisational
Goals
Personality
Characteristics
Intervention
Readiness
Job
Attitudes
fulfilment

7. IAPT HI Training Course Employment
Sept 09
Sept 10
Jul 11
IAPT HI Training Course
Employment
Prim care
2nd Care
Priv/indep
T1. T3 T2
HI Training
Course
Design
features
and
application
Motivation
Job satisfaction
Knowledge of CBT
Self Efficacy
Burnout
TARS
Barriers to Change
Case Study x 3-5
Transfer of learning from
the ‘classroom’ to the
practice setting

8. Holton et al (2000) Model of factors which influence the transfer of learning
Motivation to Learn
Reaction
Learning
Ability
Motivation to Transfer
Transfer Climate
Individual Performance
Transfer Design
Expected Utility/
Return on Investment
External Events
Organisational
Results
Link to Organisational
Goals
Personality
Characteristics
Intervention
Readiness
Job
Attitudes
fulfilment
Questionnaires
Case Studies

9. Training programme Leads
Instructional Design Competencies
Structured Interview
Training Acceptability Rating Scale (TARS)
Academic Motivation Scale
Knowledge quiz
Burnout inventory
Job satisfaction scale
Self Efficacy Scale
Participants
Clinical/practice Teams
Team Climate Inventory interview
Barriers to Change Questionnaire
Self rating of the generalisability of training

10. Questionnaire Analysis
t-test or non parametric equivalent by Wilcoxon signed ranks test.
Repeated measures ANOVA might be useful and more efficient.
Factor analysis for another perspective ?

11. Case Studies
Transfer is not merely learning new knowledge and social interaction. The focus is on specific structures and processes (and patterns)
Processes
Structures
Patterns
see Pslek P.E. (2001) Redesigning health care with insights from the science of complex
adaptive systems. In: Crossing the Quality Chasm: A New Health System for
the 21st Century. Washington: National Academy Press.
Note: Argyris: Double loop learning

12. Identity Patient outcomes System capacity
Systemic
Socialisation
professional values
accountability
education
Organisational
structure
philosophy/culture
resources
communication
sustainability
supervision
protocols
Moderating factors
Attributes
to be
measured
Purpose. Interdependency
Of service Accountability responsibility Relationships Work relationships
Trust reciprocity
Communication supervisory relationships
Respect hierarchy
Values base to practice
Outcomes
Identity Patient outcomes System capacity