Development of a tool to support managers in planning and evaluating staff training

AIM

To explore decision-making and evaluation strategies used by healthcare managers in relation to staff training and education, and to develop a tool to support managers with these tasks.

METHOD

Using snowball sampling, 30 healthcare managers in a variety of healthcare settings were recruited and interviewed using semi-structured interviews. Data were transcribed and analysed using thematic analysis.

FINDINGS

Four overarching themes were identified in relation to decision-making regarding staff training: the nature and characteristics of courses relevant to practice; the effect of practice requirements for education and training; staff motivation and interest; and the process of staff selection for training. Managers did not use formal, structured processes to make decisions about staff selection for training, nor to evaluate the outcomes of the training. Instead, they largely relied on their personal experience, knowledge and professional judgements. Based on these findings, the study team developed the Assessment, Planning and Evaluation of Training (APET) tool to support the planning and evaluation of training, and they invited feedback from healthcare managers. Positive feedback suggests that this tool could support managers' decision-making in relation to planning and evaluating staff training.

CONCLUSION

Healthcare managers' decision-making in relation to the planning and evaluation of staff training relied on judgements based on their personal experience and knowledge. The APET tool developed by the study team has the potential to ensure vital resources such as time and money are used optimally, which would improve outcomes for staff, patients and healthcare organisations.

'This wound has spoilt everything': emotional capital and the experience of surgical site infections

In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system.

Patients’ experiences of surgical site infection

The qualitative experience of having a surgical site infection (SSI) is often overlooked. The aim of this study was to present a description of how SSIs affect the lives of patients and their families. Seventeen former patients from three hospitals in England were interviewed to explore their experience of having an SSI. The interview data was transcribed and analysed into the following themes – horror stories, physical effects, psychological effects, effect on families, feelings of relief, not blaming the hospital, and lack of support after discharge. Numerous articles describe SSIs as being ‘distressing’ for patients. This study reveals the extent of the distress, with patients describing feeling ‘utter despair’ and ‘wanting to die’. These symptoms continued for months after patients had been discharged from hospital.