Educating AND training for safety

Time after time, I visit with long-term care professionals about their safety and security program, and inevitably, the topic turns to training. In these conversations, it always amazes me how frequently we use the terms “education” and “training” in the same breath, and treat them as if they mean the same thing. In reality, they don’t.

First and foremost, we all agree that learning is important in every facet of our jobs, and your safety and security program is a perfect example of how critical learning is. Properly educated and trained staff will be well prepared to save lives and protect residents, visitors and each other.

For the purposes of this discussion, let’s agree that we define learning as an observable change in behavior. And in order for that behavior change to occur and to be retained, we have to both educate our employees AND train them.

In providing training in the safety and security arena, we can rely on Bloom’s Taxonomy of Learning:

• Cognitive domain (knowledge)
• Psychomotor domain (skills)
• Affective domain (attitude)

Each domain represents a progressive elevation within the learning continuum, and each must be recognized before moving on to the next.

The Cognitive Domain

The cognitive domain represents knowledge. As I said earlier, education and training are similar, but much different. We educate the mind; we train the hands.

In the cognitive domain, we educate the employee’s minds on the facets of safety and security. Let’s use fire extinguisher training as an example. It would be very easy to teach every employee how to use a fire extinguisher and just leave it at that. A child can be trained to regurgitate the P-A-S-S acronym.

In the cognitive domain, we introduce the student to the classes of fire we might encounter, the parts of the fire extinguisher, how to properly and safety carry the extinguisher from point A to point B, operating techniques and more. Before they ever pull the pin, aim at the base of the fire, squeeze the trigger and sweep the base of the fire, they have and understanding of the basics of fire behavior, and how the extinguisher works. We have educated their minds.

The Psychomotor Domain

The next level, the psychomotor domain, involves practical skills development—in other words, it is competency-based. Our employees, with a cognitive understanding of the fire extinguisher, are now ready to have their hands trained in the proper use of the extinguisher. And this training is repetitious on purpose: Repetition builds competency, and you want the right skills to become habits.

Before long, the proper use of the safety device will become second nature. Think about driving your car. When you come to a stop sign, you don’t consciously think, “now I must take my foot off the accelerator, bring it over to the brake pedal, and gently depress the brake pedal until my car comes to a complete stop.” Welcome to your subconscious mind.

The Affective Domain

While the cognitive domain deals with knowledge and the psychomotor domain deals with skills, the affective domain deals with attitude. Although attitude has many definitions, most seem to involve measuring people, issues, objects, etc. along a dimension ranging from positive to negative. 

Four main methods are used for changing attitudes in performance interventions:

1. Exposure Effect: This technique uses simple experiences to start the attitude formation by exposing a person to a concept, object or person a number of times.
2. Reinforcement: This technique rewards a behavior that has a positive and desirable result.
    
3. Persuasive Communication: This technique is based upon three main characteristics: source, message and audience.

• the source—how believable and likable you are to an audience
• the message—content and style
• and audience—educational level, other attitudes

For example, when performing live fire extinguisher training, after a successful evolution in which the employee properly uses the extinguisher to extinguish a flammable liquids fire, the employee walks away with a sense of accomplishment and confidence in him/herself and the equipment being used.

4. Changing Viewpoints: While discussions primarily work through the cognitive side, everything we do is based on attitude, knowledge and emotion. After completing our training, a simple question like “how do you feel now that you have been through the training compared to before you took the training” may produce some interesting dialogue, and show a change in attitude and values.

Many times, when I visit LTC facilities and ask about their safety training program, I am told that “the employees have to watch X number of safety videos each year,” or “we use the ABC online learning module and each employee has to take the online training refreshers each year.” Yippy skippy. What I am really hearing is, “we are doing the minimum amount to get by.”

Granted, online training and video-based training are both very acceptable methods of providing education. Video and online training programs are training the mind in an informative, instructional way, but we are missing the other critical component: training their hands. We must give employees the skills necessary to perform the tasks. We must provide training in the Psychomotor domain.

Hands-on training saves lives. Just ask the heroes at St. John Regional Medical Center in Joplin, Mo., where 183 patients were evacuated in just 90 minutes after a tornado devastated the facility. Prior to the tornado, the employees regularly trained on evacuation and developed the skills to perform emergency evacuations in the worst of conditions. Without this training, they would not have been nearly as successful. If their approach had been limited to video and online training, the results may have been even more devastating.

I encourage all of you to look at your training program, and decide for yourself: Am I just educating their minds, or am I properly training their hands?

Stay safe and stay in touch!

Steve Wilder

Steve Wilder, CHSP, STS, is president and chief operating officer of Sorensen, Wilder & Associates (SWA), a healthcare safety and security consulting group based in Bourbonnais, Ill. SWA performs workplace safety compliance audits and security vulnerability assessments in all types of healthcare facilities. Wilder can be reached at (800) 568-2931 or swilder@swa4safety.com.