Effectiveness of various methods for accomplishing mandatory annual review training

BACKGROUND: Diminishing healthcare dollars led our healthcare system to evaluate the effectiveness of providing multiple training methods for nine mandatory annual reviews (MAR), including infection control (IC) and bloodborne pathogens (BBP). Training options included lectures (L), self-paced posters with test (PWT), self-paced posters without tests (PWOT), and computer-based (Web). A study was conducted to determine which method led to better retention in each MAR by occupation. METHOD: Two anonymous questionnaires (1 month and 6 months post training) were sent to 100% of employees completing MAR in fiscal year 2003. Occupation groups included MDs, RN/LPNs, mental health (MH), dental, lab, pharmacy, research, non-RN/MD clinical, food service, facilities (housekeeping and engineering), and clerical. Questionnaires were codes by occupation and training method and consisted of three key questions from each MAR. Each MAR was scored based on the number of answers missed and converted to a % score (range: 0% = 3 questions missed, to 100% = 0 missed). RESULTS: Of the 3756 surveys sent, the overall response rate was 36.7%. Response rate at 1 month and 6 months was 39.88% and 33.55%, respectively. 1379 surveys met criteria for analysis. Analysis of variance (ANOVA) with post hoc Bonferroni correction revealed 53 significant differences in knowledge retention among method used and occupation based on mean MAR scores (p < 0.05). L was associated with lower retention than other methods in every category except two. For IC training, no method was significantly different except where Web showed better retention over PWOT (p = 0.0017) in the non-RN/MD clinical group. For BBP several differences were identified: Web showed better retention than PWT in dental (p = 0.012); PWT was better than Web for facilities (p = 0.046); PWOT was better than Web in MH (p = 0.017); PWOT, PWT, and Web were all better than L for non-RN/MD clinical (p = 0.041, 0.04, and 0.007 respectively); and Web was better than L in pharmacy (p = 0.01) and research (p = 0.03). CONCLUSIONS: Most disciplines had improved retention with self-paced methods of training, making the expensive and time-consuming lecture method less appealing. Retention scores varied among the self-paced methods by discipline. Clerical and facilities staff showed better retention with posters with test (PWT), while nurses, pharmacy, and non-RN/MD clinical, were more likely to retain information through Web training. This suggests the need to maintain several options for self-paced training.