Aligning Strategy with Training and Finding Skill Gaps

UPI Study › Courses › Healthcare Organization and Management › Free lessons › Lesson 13.2 Free with a free account

Aligning Strategy with Training and Finding Skill Gaps

Healthcare Organization and Management · Chapter 13: Workforce Training and Development in HealthcareSection 13.2 · lesson 75 of 10511 min · free with a free account

← Training Strategies and the Learning OrganizationNext lesson: Types and Methods of Employee Training →

Earn 3 college credits for Healthcare Organization and ManagementRecommended for credit by NCCRS · Health 302 · self-paced · one payment, lifetime access
Enroll in Healthcare Organization and Management · $250 →Download the syllabus (PDF)

In this lesson

Turning strategic objectives into training plans and diagnosing real skill gaps.

  • Conduct a training needs assessment at the organizational, task, and person levels
  • Distinguish skill gaps from motivation and system problems using how a problem is spread
  • Rank capability gaps by risk and strategic weight
  • Write observable learning objectives and trace each plan item to a strategic objective

Free study notes

Get this lesson's notes by email

The key points and 4 practice questions with answers, in your inbox. One email, free.

One email. Unsubscribe in one click.

Transcript

Everything said in the video, section by section (1,465 words). Read along, or search it.

Opening Case

Forty Items and No Infusion Clinic

Priya Nair, Larkfield's chief nursing officer, is reading next year's training plan. It lists forty items, one request at a time, from every department. Larkfield's strategic plan says something else entirely. In fourteen months, the hospital opens an outpatient infusion clinic. Not one of the forty items mentions it. So how do you find out what training a strategy needs? And how do you tell when training isn't the answer at all?

Needs Assessment

Three Levels of Analysis

Marcus Bell, Larkfield's workforce analyst, says the missing step is a training needs assessment. It works out what capability the hospital needs, what it has now, and where the difference lies. It comes before any choice of method, including the choice not to train. William McGehee and Paul Thayer laid out its three levels in nineteen sixty-one. Organizational analysis asks what the hospital is trying to do. Task analysis asks what a role really requires. And person analysis asks who falls short, on what evidence. Most plans start at the bottom, with individual requests, so nobody knows whether the capability they're buying is the capability the hospital needs.

Organizational Analysis

From Strategic Objective to Capability Gap

Priya starts at the top, with Helen Wu, the chief executive. Take the objective: open the infusion clinic. What must Larkfield be able to do that it can't do now? Give chemotherapy and biologic infusions safely, manage reactions, and care for central lines and ports, for a full clinic every weekday. Who would need to do it? A team of about six nurses. Today, two Larkfield nurses have that experience. That gap is a workforce question before it's a training question. The answer could be recruiting, redesigning roles, reducing demand, or developing people. Priya chooses one hire and three nurses to develop.

Timing

Specific Objectives and Early Analysis

Two conditions make this work. The objective has to be specific enough to imply a capability. Improve quality implies nothing. Open an infusion clinic next fall implies a great deal. And the analysis has to come early. Capability that takes a year to build can't be assessed six weeks before opening day.

Task Analysis

Real Work Versus the Job Description

Next, task analysis. Abby Kowalski, an oncology nurse educator, spends two shifts watching Larkfield's two experienced infusion nurses work. Its central finding is almost always the same: the job description and the real work have drifted apart. The methods are plain. Watch the work. Ask people to describe a recent difficult case. Look at the points where things go wrong. Abby finds fewer of the listed technical tasks, and far more judgment, coordination with pharmacy, patient teaching, and navigating the system than any description admits. She writes each competency as an observable behavior, because a competency nobody can observe can't be assessed later.

Person Analysis

Triangulating Biased Evidence Sources

Then person analysis: which of the candidate nurses fall short, and on what evidence? Marcus warns that every source carries a bias. Performance data is objective, but covers only what's measured. A competency assessment is direct, but it measures performance while someone watches. Self-assessment is cheap, and it matches real skill poorly. A review of physician studies found the least skilled and most confident were the least accurate. Manager judgment adds context no instrument captures, and carries every rating bias. So triangulate. A gap that shows up in two independent sources is probably real. A gap in one source is a hypothesis.

Diagnosis

Can't-Do, Won't-Do, or System Problem

Before anything is prescribed, one question decides whether training is even the right tool. Is this a can't-do problem, or a won't-do problem? Or is it a system problem? Robert Mager and Peter Pipe put the first test bluntly. If the person's life depended on it, could they do it? If yes, training won't help. Then something else is stopping them. A system problem means the setting, workload, equipment or process makes the right action hard. A motivation problem means the action is possible and isn't happening, usually because of its consequences rather than character.

Problem Spread

Fourteen Nurses Leave the Same Section Blank

Ellen Murphy, the charge nurse on 4 South, has a request for the plan: training on the new discharge form. All fourteen of her nurses leave the same section blank. The strongest evidence is how a problem is spread. A problem in everyone who does a task is almost never a skill gap. Fourteen people didn't each fail to learn one section. A problem in one person out of fifteen, all trained the same way, is a person-level issue, though skill or motivation still needs sorting out. And a problem clustered in one time, one place, or after one change points at conditions, not people. Ellen's request goes to the form's designers instead.

Overuse

Why Training Is Overprescribed

Why is training prescribed so often for problems it can't solve? The reasons are institutional, not ignorance. It's visible and documentable. It's cheaper and faster than changing a process or adding staff. It places the problem in individuals, so no senior decision is needed. And after an incident, it's defensible. The cost goes beyond wasted budget. The problem stays, while a record says it was dealt with, which makes the next occurrence harder to investigate honestly. And staff learn that raising a difficulty gets them sent on a course, so they raise fewer.

Quick Check

Skin Checks Skipped on Weekends

Quick check. On 4 North, a skin check is done reliably on weekdays. On weekends, the very same nurses skip it most of the time. Skill gap, motivation problem, or system problem? Pause, and decide. A system problem. The same people succeed on weekdays, so capability isn't what changes. Something about weekends does, like thinner staffing or fewer supplies. Motivation is the tempting answer. But it's the same nurses, with the same consequences, on both kinds of day. Look at what the weekend changes first.

Gap Sources

Data That Already Reveals Gaps

Gaps announce themselves in data a hospital already holds. Incident and near-miss reports show where practice breaks down. Quality indicators, audits, turnover and exit data, and complaints each show another kind of shortfall. Only one source looks forward: planned service changes, like the infusion clinic. Every other source describes a gap that has already done harm.

Prioritizing

Ranking by Risk and Strategic Weight

There will be more gaps than money, so Priya ranks them on two scales. Risk is the harm if the gap persists. Strategic weight is how much the strategy depends on it. High on both is unarguable. High risk and low strategic weight still gets done, because risk isn't optional. The trap is high strategic weight with low risk. It's nobody's emergency, so it's deferred year after year, until the day the capability is needed. The infusion clinic sits right there. Priya moves it to the top.

Learning Objectives

Observable Behavior, Conditions, and Standard

Abby turns each gap into a learning objective: what the nurse will be able to do afterward, as an observable behavior, under stated conditions, to a stated standard. Understand the reaction policy isn't one. Understanding can't be observed, so it can't be assessed. Given a simulated patient showing an infusion reaction, stop the infusion and start the clinic's reaction protocol in the correct order. That is one. The discipline pays three times. It forces clarity about the gap. It decides the method. And it supplies the assessment, because the objective and its test are the same statement.

Quick Check

A Usable Sepsis Screen Objective

Quick check. The emergency department is writing objectives for a new sepsis screen. Which of these is a usable learning objective? Pause, and decide. The third. It names a behavior you can watch, the conditions of a mock triage, and a standard of four minutes, so it doubles as the test. Appreciate why detection matters sounds more caring, which makes it tempting. But appreciation can't be observed, so nobody could ever say it was met.

Training Plan

Tracing Each Item to an Objective

Finally, the plan itself. For each item it states the gap, the evidence, the objective, the method, the full cost with released time, and the measure. The last column names the organizational objective the item serves. It's the one usually left blank, and its absence makes training budgets easy to cut. Marcus applies one test. Could someone outside nursing trace the chain from objective, to capability, to training item, without taking a step on trust? Mandatory items have their own justification. They just get labeled as mandatory, not dressed up as strategic.

Case Resolved

A Plan That Opens With the Clinic

Back to Priya's forty items. The new plan opens with the infusion clinic, traced from Helen's objective to named competencies, one hire, and three nurses in development. Ellen's discharge form goes to redesign, not a classroom. And a dozen items are honestly labeled mandatory. A strategy tells you what training it needs, when someone walks the chain down from the objective. And the distribution of a problem tells you when training isn't the answer.

Key Takeaways

Needs Assessment Essentials

To recap. Assess needs before choosing any method, including the option not to train. Three levels: organization, task, and person, each with evidence. Ask whether it's a can't-do, won't-do, or system problem, and read how it's spread. Rank gaps by risk and by strategic weight. Objectives must be observable, and every plan item should trace to a strategic objective.

About Healthcare Organization and Management at UPI Study

Healthcare Organization and Management (Health 302) is a self-paced online course of 105 video lessons in 18 chapters, from health systems and the law to ethics, leadership, teams, strategy, informatics, finance, quality, human resources, marketing and evidence-based practice. It carries a NCCRS credit recommendation for 3 semester credits.

Every lesson transcript is free on pages like this one, and the videos are free with a free UPI Study account. Enrolling adds a practice quiz after each lesson, the graded work and final exam that earn the credit, lifetime access, and an official transcript on completion. UPI Study has helped over 130,000 students with college credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Enroll now → Course details Download the syllabus All Health courses Every course with PRO →

Why take it here

Why students take Healthcare Organization and Management with UPI Study

How hospitals and clinics are runHealthcare Organization and Management covers how care organizations are led and run: health law and ethics, leadership and teams, strategic planning, health informatics, budgets, quality improvement, staffing and marketing. It is a core course in healthcare administration and health management degrees.
Credit at a fraction of the priceThe same 3 credits can cost $750 or more at a US college. Here it is one payment, self-paced, with lifetime access.
Finish your degree soonerTransfer credits reduce the courses you still owe, so you can graduate earlier or lighten a heavy semester.
Strengthen an applicationA completed college-level course on an official transcript shows admissions and scholarship committees you can do the work.
Study on your own scheduleNo start dates, no deadlines. Watch the lessons, practice, and take the final when you are ready.
130,000+students helped with college creditsACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Where the credit goes

Universities that work with NCCRS

Healthcare Organization and Management carries a NCCRS credit recommendation. These universities work with NCCRS; some are UPI Study's signed partners. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Thomas Edison State UniversityThomas Edison State UniversitySigned partnerUniversity of the PeopleUniversity of the PeopleSigned partnerCharter Oak State CollegeCharter Oak State CollegeSigned partnerStrayer UniversityStrayer UniversitySigned partnerColumbia Southern UniversityColumbia Southern UniversitySigned partnerIndiana TechIndiana TechSigned partnerPenn StatePenn StateWorks with NCCRSSouthern New Hampshire UniversitySouthern New Hampshire UniversityWorks with NCCRSSUNYSUNYWorks with NCCRS +many more cooperating universitiesFind my college →

Find my college → Not listed? Ask Athena in the corner of this page, or book a 15-minute call.

FAQ

Questions students ask us

About Aligning Strategy with Training and Finding Skill Gaps

What is a training needs assessment and what are its three levels?
A training needs assessment works out what capability an organization needs, what it has now, and where the gap lies, before any training method is chosen. William McGehee and Paul Thayer described three levels in 1961: organizational analysis of what the organization is trying to do, task analysis of what a role really requires, and person analysis of who falls short and on what evidence.
How can you tell whether a performance problem needs training or something else?
Ask whether it is a can't-do, won't-do, or system problem. Robert Mager and Peter Pipe's test asks whether the person could do it if their life depended on it; if so, training will not help. How the problem is spread also helps: a gap shared by everyone doing a task usually points to the system, and one clustered in a time or place points to conditions.
How should training gaps be prioritized when the budget is limited?
Rank each gap on two scales: risk, the harm if the gap persists, and strategic weight, how much the strategy depends on it. Gaps high on both come first, and high-risk gaps get done even with low strategic weight. The common trap is a gap with high strategic weight but low current risk, which gets deferred year after year until the capability is suddenly needed.
How do you write a measurable learning objective for healthcare staff training?
State what the learner will be able to do as an observable behavior, under stated conditions, to a stated standard. Understand the reaction policy is not usable, because understanding cannot be observed. Given a simulated patient showing an infusion reaction, stop the infusion and start the reaction protocol in the correct order is usable, and it doubles as the assessment.

About the Healthcare Organization and Management course

How many college credits is Healthcare Organization and Management?
Healthcare Organization and Management (Health 302) carries a NCCRS credit recommendation for 3 semester credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
How much does Healthcare Organization and Management cost and what is included?
$250, paid once, with lifetime access: all 105 video lessons, a practice quiz after each, the graded work and final exam, and an official transcript when you finish. Students who want several courses choose UPI Study PRO instead.
Which universities accept UPI Study credits?
UPI Study has signed partner agreements with universities such as Thomas Edison State University, University of the People and Charter Oak State College, and works with universities such as Penn State, SNHU and SUNY. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities. Use "Find my college" on this page to check yours.
How long does Healthcare Organization and Management take?
It is self-paced with no deadlines. The 105 lessons total about 17 hours of video; most students add reading and practice time and finish in a few weeks to a few months, on their own schedule.
How are the exams done?
Quizzes and assignments are online in the course. The final exam is taken online with proctoring; a person on the UPI Study team checks assignments, usually within two days.
How do my credits reach my college?
When the course shows 100% complete, request the official transcript from your dashboard. It is sent to the college you name, and you can send it to more than one. Check your college first with "Find my college" on this page, or ask Athena.

Ready for the full course? Earn 3 credits in Healthcare Organization and Management.

105 video lessons, a quiz after each one, and the graded work that earns the credit. Recommended for credit by NCCRS.

Enroll in Healthcare Organization and Management →Download the syllabusEvery course with PRO →
Healthcare Organization and Management
3 credits · NCCRSEnroll →