When the acquisition of knowledge and skills is identified as the solution to a performance problem or gap at a work site, training or other learning interventions will be used to improve the performance of health care workers. The key individuals involved in this process include:

Supervisors: responsible for monitoring and maintaining the quality of services and ensuring health care workers are properly supported in the work place. In this guide, "supervisor" refers to a learner's "in-charge" at the health care facility.

Trainers: responsible for helping health care workers acquire the necessary knowledge and skills to perform well on the job.

Health care workers: responsible for the delivery of quality services (e.g., clinicians, counselors, administrators, cleaners). In this guide, "learners" is used throughout to refer to health care workers participating in learning interventions.

Co-workers: responsible for supporting learners while they are engaged in training and as they apply new knowledge and skills at the work site.

As the case story shows, supervisors, trainers, learners and co-workers all have responsibilities before, during and after a training intervention if practices at a facility are to improve. By working as partners, these individuals can help sustain the knowledge and skills gained during training. Many interventions can be used to enhance the performance of health care workers and the quality of clinical services (e.g., focusing on improved management practices and supervisory approaches, adequate equipment and supplies, clear job expectations, performance feedback). As described in the case story, many of the possible interventions overlap and require coordinated implementation.

Learning interventions are the most common means of helping health care workers obtain the necessary knowledge and skills to perform well on the job. The most common types include:

Classroom-based, group training courses.

Distance-learning programs in which interactions with the trainer and other learners are facilitated using technology, whether high-tech (e.g., computer applications used over the Internet, interactive videoconferences) or low-tech (e.g., print-based materials sent via the postal service).

Structured on-the-job training (OJT) courses that are facilitated by a trainer or supervisor at the job site (e.g., whole site training).

Independent self-study programs delivered using various media including print, audio/video tapes, CD-ROM, the Internet.

Programs that involve a combination of the above interventions.

These various learning interventions can be very effective in enabling health care workers to develop essential knowledge and skills. Nevertheless, they are only part of the transfer of learning process that helps to ensure that such interventions result in improved job performance.

What is transfer of learning?

Transfer of learning is defined as ensuring the knowledge and skills acquired during a learning intervention are applied on the job. The goal is for learners to transfer 100% of their new knowledge and skills to their jobs, resulting in a higher level of performance and an improvement in the quality of services at their facilities.