A. Introduction—What the CTS Adopted as its Approach to Training Delivery

In 1992, the Center for Substance Abuse Prevention (CSAP) inaugurated a radical new approach to training and learning. The approach was to have a solid research base in the emerging prevention theory, cognitive sciences, cultural diversity, technology transfer, and the diffusion of innovation, communications, and social marketing. Undergirding all this is systems and complexity theory.

Beginning with themselves and their contractors, CSAP began to transform theory into practice. Contractors were expected to collaborate with each other, even though they had previously been
competitors. A learning community was established that attempted to facilitate this internal cooperation and collaboration within the CTS. What was learned was then to be applied to the
contractors' work with their constituencies: nurses, physicians, dentists, community partnerships,
State substance abuse prevention agencies, and others.

This new approach was a substantial departure from the current practice for some contractors and
CSAP staff, whereas for others it represented “business as usual.” As stand-up, event-based, instructor-led training was replaced with more continuous, activity-based, individual-centered
learning, much was learned by CSAP staff, contractors, consultants, and constituents.

The focus of this paper is on what happened during this 4-year period as the CTS moved from a focus on delivering training to a focus on facilitating learning. The paper describes what worked well, what didn't, and what the CTS needs to do in the future.

B.     What Worked and What Didn't

1)     Most Useful Aspects of the CTS Approach to Training

Preparation for Training

Having facilitators work with participants in advance of training delivery (whether onsite, by telephone, or through mailed prework packages) lays the groundwork for the training and helps break down barriers and fosters team building. Working with a representative of the organization hosting the training is useful, and it is especially helpful to assign specific roles to that representative, for instance, logistics tasks. Thorough planning of logistics before delivery is crucial.
 

Learner-Centered Training

Allowing participants to define their own needs, using language appropriate for the audience, and
tailoring training for specific audiences by using relevant examples and well-matched trainers are
key elements of learner-centered training. Flexibility, sensitivity, and thorough preparation on the part of those delivering training are necessary to accommodate the needs and learning styles of individual participants. Having participants establish norms for the training is time well spent.
 

“Team Time”

At training for community representatives, giving participants "team time" helps them to learn from one another and establish contacts to work with when they return to their communities. Representatives of diverse community agencies rarely have the opportunity to communicate, so time given for team building during training is seen as very valuable.
 

Ongoing Process of Learning and Practice

In the CTS philosophy, training is regarded as an ongoing process, rather than a once-and-done event. Training presents a series of limited opportunities for learning, each building on previous learning and practice. In the CTS, continuous learning is facilitated by equipping the learners with the necessary mind set and tools to pursue their learning objectives.
 

New Training Technologies

CTS began to explore new delivery technologies (e.g., distance learning, CD-ROM) that help offset increasing constraints on the time and funds available for training. This exploration should continue. Human contact and electronic contact must complement one another.
 

2)     Less Successful Aspects of CTS Approach to Training Delivery

Attendees Not Always the "Right People"

Some programs did not get the "right" people to training. The CTS was intended to involve decisionmakers in various communities and professional groups. Sometimes, people are sent to
training because they have the time, need continuing education units (CEUs), need a new employee
orientation, or are substitutes for decisionmakers who had agreed to attend, but could not.
 

Less than Adequate Training Reinforcement

After delivery, training reinforcement is crucial for helping participants to apply their learning. More training reinforcement should be provided than was done in the CTS, and the reinforcement should be automatic, rather than contingent upon a request from the participant. Reinforcement should take place earlier, for example, 2 months rather than 6 months after training. To reduce costs associated with onsite training reinforcement, participants should make specific plans at the training, identify what support they will need, and set a schedule for telephone technical assistance. Facilitators can then discuss those plans with participants' organizations/supervisors.
 

Facilitators Too Prominent

In keeping with the notion of empowering participants, facilitators should gradually move out of
perceived leadership roles as the ongoing learning progresses, and should arrange for participants
to take on the facilitation role. CTS should develop guidelines for sharing the responsibility for training between the organization and the participant, and explore ways to increase the value of CTS training by making improved job performance an outcome expected of individual training participants.
 

Better Context for Training

A better idea is to deliver training within systems (e.g., academic programs, hospitals, managed care organizations) as a way of building prevention into the organizational structure. CTS training was often delivered as a free-standing event or as part of a professional conference.
 

Faulty Integration of Learning Community Concepts

Learning community concepts should be integrated more thoroughly into planning, delivery, and follow-up reinforcement of training. The CTS espoused this approach, but often implemented it only in a perfunctory fashion.
 

More Attention to Application of Training

Training programs must take into account the environment in which participants work and how it will affect their ability to implement learning. Planners and facilitators should work with managers in the sponsoring organizations to understand what is expected from participation in the training and to gain commitment from the organization for participants to implement and practice what they learned. This process empowers training participants. To facilitate implementation of learning, the training should be planned to include elements that can be readily applied in participants' organizations or communities.
 

C.     What Should Be Done Differently in Future Deliveries of CTS Training

Recommendations for the processes of assessing audiences and their needs, recruiting participants, and integrating activities in support of transfer of training are as follows:

More Situational Analysis

• Do a situational analysis for each training delivery and make appropriate modifications. The better the analysis, the better the training from curriculum design to evaluation.

Better Recruitment of Participants

• Recruit participants carefully. Do research early to learn how and why groups select participants for training and make appropriate changes. Make sure audiences see the need before they come to training. Not all CTS audiences saw the need for this training. We tried to prematurely enter into markets not yet open to us.

• Gain leverage with organizations to prevent last-minute substitutions of participants. One technique was getting an accreditation organization to adopt guidelines developed by a CTS project. Because the organization needed to learn about the guidelines in CTS training to get accreditation, high-level members of the organization attended training themselves rather than sending substitutes.

Ensure Transfer of Training

• In order achieve transfer of training, work with participants early and throughout the planning and design process. The curriculum developers need to have an in-depth understanding of the target groups, as well as the content areas. Reach agreement with training and technical assistance recipients on goals, strategies for achieving goals, and implementation steps. All involved (managers, curriculum developers, trainers, facilitators, participants), should agree on and maintain a commitment to the learning outcomes during all phases of the process of designing, developing, disseminating, and evaluating training.

More Planning

• Planning is especially important when the goals of training involve building systemic support for people to use what they have learned. Allow adequate time and energy for planning. It usually takes a minimum of 6 months from initial contact to day of event to set up an event on a national level. Planning needs to start earlier; a scheduler should be used to define roles and responsibilities. A collaborative system for training/technology transfer takes much longer to develop than planners expect.

Share Responsibility with Audiences

• Be mindful that the responsibility for training/technology transfer rests with all involved (including the target population), from the initial conceptualization of ideas, through planning, implementation, and follow-through.

• Help host organizations to create systems that will support trainees as they apply what they have learned. Application of training is highly dependent on being within a system that will itself apply the knowledge/technology and will support individual learners in applying it.

Values May Need Explanation

• Recognize ways in which values inherent in the training may not coincide with the audience's values. For example, emphasis on cultural diversity is often considered to be irrelevant to managed care systems and other health care systems because staff and clients are (or perceive themselves to be) monocultural. Further, community prevention theory and the practices of health care systems do not always mesh well at present. Medical systems seek scientific data to support change and will implement strategies only if their success is documented. Finally, health professionals may not need or want to do the same thing (or in the same way) as a community based group.