AN EVALUATION OF IN-SERVICE TRAINING AND DEVELOPMENT

OF PROFESSIONAL HEALTH WORKER

CHAPTER ONE

1.1 INTRODUCTION

Human Resources development has played a significant role in the economic development in

most developed countries such as United States of America, Britain and Japan among others. It

can, therefore be concluded that a developing country like Nigeria, with its rich natural resources

and the necessary financial support can also experience such economic success if the appropriate

attention is given to the development and training of her human resource. No wonder Nigeria

government is taking adequate steps to ensure that people acquire the necessary knowledge and

skills. The provision of secondary and technical schools, vocational training institutes and

colleges, professional and tertiary institutions, as well as the educational reforms currently taking

place in the country, are all geared towards the acquisition of skills and knowledge to ensure

effectiveness and efficiency in our workplaces. According to Ocquaye (2004) with these efforts

by the government, it has become necessary to provide long and systematic training and

development programs for employees. This is because every aspect and activity of an

organization involves people. For instance, a manager in an organization will not be successful

until he has subordinates beneath him who are well equipped with skills, talent and knowledge.

To manage an organization both large and small requires staffing them with competent

personnel. The formal educational system does not adequately teach specific job skills for a

position in a particular organization. Few employees have the requisite skills, knowledge,

abilities and competencies (SKAC) needed to work. As a result, many require extensive training

to acquire the necessary SKAC to be able to make substantive contribution towards the
organization’s growth, (Barron and Hagerty 2001). If employees are to experience flexibility and

effectiveness on the job, they need to acquire and develop knowledge and skills, and if they are

to believe that they are valued by the organization they work for, then they need to see visible

signs of management’s commitment to the their training and career needs. Training and

development are the processes of investing in people so that they are equipped to perform. These

processes are part of an overall human resource management approach that hopefully will result

in people being motivated to perform. (Barron and Hagerty 2001). It goes without saying

therefore that the training and development of employees is an issue that has to be faced by every

organization. However, the amount, quality and quantity of training carried out vary enormously

from organization to organization. According to Cole (2002:329), factors influencing the

quantity and quality of training and development activities include; the degree of change in the

external environment, the degree of internal change, the availability of suitable skills within the

existing work-force and the extent to which management see training as a motivating factor in

work.

In-service training within public service agencies is recognized as a key means through which

staff are provided with the necessary knowledge and skills to improve overall institutional

performance and achieve the objectives of the organization. Training is the process of acquiring

specific skills to perform a job better (Chiaburu & Tekleab, 2005, p. 608). It helps people to

become qualified and proficient in doing some jobs (Noe, 2009). Usually an organization

facilitates the employees' learning through training so that their modified behavior contributes to

the attainment of the organization's goals and objectives. Reports of training expenditure within

social services departments in the UK suggest increasing amounts of monies are invested in such

activity in order to meet the changing demands placed on social care and greater expectations for
higher standards in service delivery (Clarke, 2001). To make sure that the training program is

accomplishing its goals, an evaluation of the training can be valuable. Training should have, as

one of its critical components, a method of measuring the effectiveness of the training.

Evaluation will help employers determine the amount of learning achieved and whether an

employee’s performance has improved on the job.

One of the pivotal purposes of in-service training courses is to equip health workers with the

most relevant techniques that can be used in their daily health practices. In-service training (IST)

represents a significant proportion of investments made by Ministries of Health and development

partners in building the capacity of health workers to competently, safely and efficiently provide

quality health services. Scaling up health services requires significant in-service training

investments to build the capability of health workers to provide quality health services

competently, safely and efficiently. Despite this enormous investment, IST programs are rarely

evaluated, and there is growing demand for more effective, efficient and sustainable health

worker training. According to Health Workforce Advocacy Initiative (2010) the health

workforce plan should strengthen in-service training mechanisms so that health workers can be

adequately informed and skilled to provide high quality care, including mechanisms to ensure

training, especially on-site training, for health workers in rural areas (including possible use of

information technology). The in-service training should contribute to continuing professional

development. The ultimate aim of staff development is to improve the quality of health care

delivery for patient, both by improving the standard of health and quality of service delivery, and

by developing the community in which the health delivery takes place. The encouragement of

the professional growth of health should contribute both to their professional practice and their

part in the wider life of the society, as well to their career enhancement
However, human resource development in Africa, particularly, Nigeria is none of a mis-

fortune/match and the issue requires an urgent attention of all the economic stakeholders, both

the government, organizations and the concerned private and public outfit. In support of this,

Ake (1989), says the development of indigenous manpower to serve as the propelling force for

natural growth and development is no doubt a key to Nigeria’s socio-economic and political

development. He stressed further that this is a quite indispensable considering the argument of

the concept of transfer of technology as a propelling force for the development of the developing

countries of which Nigeria is one. It is important to state here that the lack of adequate emphasis

on human resources/ manpower development as tool of development in Nigeria particular at this

period of global financial and economic meltdown which the country is yet to device strategies

of overcoming on the part of government and private sector could not be far-fetch from the lack

of understanding both the concept and methods for manpower development in a post-colonial

Nigerian state in which the process of human resources development for natural growth was

distorted by colonialism with the attendant negative orientation that was injected into political

leadership (Ekpo 1989).

Many organizations meet their needs for training in an ad hoc and haphazard way. Training in

these organizations is more or less unplanned and unsystematic. Other organizations however set

about identifying their training needs, then design and implement training activities in a rational

manner, and finally assess results of training. It is worth noting that Nigeria has a huge public

sector inclusive, employing the highest number of human resources with varied skills. One such

organization in the public sector is the Lagos state university teaching hospital.
1.2 BRIEF BACKGROUND OF LAGOS STATE UNIVERSITY TEACHING

HOSPITAL (LASUTH)

Lagos State University Teaching Hospital Ikeja emerged from a modest beginning as a cottage

hospital which was established on June 20th 1959 by old western Region Government to provide

health care service for the people of Ikeja and its environs. The cottage hospital later

metamorphosed into a full-fledged Ikeja General Hospital which served as secondary level

hospital care facility. In 2001, it was transformed into a Teaching Hospital to provide world class

tertiary level medical care to the people of Lagos and training environment for medical students

of Lagos State University College of medicine and post graduate training for resident doctors.

The transformation of LASUTH continues through the implementation of quality management

system that will improve patient satisfaction by significantly reducing waiting time for

consultations, collection of prescribed drugs, laboratory tests and results to an acceptable

minimum. Facilities for advanced medical and surgical care are being rapidly expanded. The

continue surgical programme has been indigenized. Carchere catheterization in conjunction with

Reddington hospital has commenced and kidney transplant will commenced shortly. The hospital

is a major referred centre for Neurosurgery cases.

Lagos State University teaching Hospital at No 1-5 Oba Akinjobi street, Ikeja very close to

Nigeria Police College Lagos. Infrastructures are being renovated, new building put in place

constructed and processes are being re-engineered. Directional signage, client communication

notices, display of pertinent policies (in-patient, out-patient service quality and diagnostic

services) designated vehicular parking, numbered building and roads, appointment of fire
marshals and safety officers, designated muster points and training in quality services awareness

are in progress.

Lagos State University Teaching Hospital (LASUTH) is a 720 bedded teaching hospital with the

driving objectives to become a world class teaching hospital using cutting-edged technology and

highly developed human resources, to render medical care to the good people of Lagos.

Ultimately we aim to become an international recognized centre for medical tourism and a major

health resource for the Lagos mega city.

LASUTH VISION:

To be a centre of excellence in health care delivery

LASUTH MISSION:

To provide high quality health care service in a friendly environment where patient, satisfaction

is the ultimate.

1.3 STATEMENT OF THE PROBLEM

Lagos State University Teaching Hospital (LASUTH) is a government health facility in Lagos

State, and serves as educational hospital and referral point for the region population, and it serves

an estimated population of over 200,000. The hospital does recruitment year in and year out for

health workers and supporting staff. This facility encountered a challenge of in ability to deliver

a high quality services to the clients. This has been a very complicated problem which is not easy

to tackle. And it is difficult to identify the reason for the deterioration in the services provided,

given the low resources in the facility. That way, the facility had trouble identifying the causes

for this challenge. However, it is understood that this multifaceted challenge anchored mainly on
the health workers who need continuous development through training and in service education.

In LASUTH, the training unit was observed to be under staffed and not working efficiently. The

unit is officially existing in the structure, however, in practice has no role and not active in

training and educational activities. This to a large extent influenced the competencies, abilities

and skills of the health workers. Accordingly, the percentage of staff receiving internal training is

very low and in most cases it depends mainly on individual effort. Health workers are not

enthusiased for in service training and no improvement in their capabilities, which in turn lead to

the deterioration of the quality of health care delivery.

In the same vein, in-service training (IST) represents a significant proportion of investments

made by Ministries of Health and development partners in building the capacity of health

workers to competently safely and efficiently provide quality health services. Scaling up health

services requires significant in-service training investments to build the capability of health

workers to provide quality health services competently, safely and efficiently. Despite this

enormous investment, IST programs are rarely evaluated, and there is growing demand for more

effective, efficient and sustainable health worker training. In view of this, it is therefore

imperative to carry out an evaluation of in-service training and development of professional

health worker in LASUTH

1.4 Objectives of the Study

The objective of this study is to evaluate the in-service training and development of professional

health worker in LASUTH. Specifically the study wishes;

i. to ascertain the type of in-service training and development that need staff to improve

productivity in LASUTH
 ii. to determine the training and development policies, principles and practices in

LASUTH

iii. to examine how in-service training and development affect performance of health

workers in LASUTH.

iv. to ascertain the relevance and effectiveness of in-service training and development to

staff performance of LASUTH

v. to find out the relevance of the content of the training materials to the job of the

health workers in LASUTH.

vi. to examine the quality and presentation of resource personnel in your past in-service

training and development.

vii. to find out ways of evaluating health workers in-service training and development in

LASUTH

viii. to ascertain the benefits of evaluating in-service training and development of health

workers in LASUTH

1.5 Research Question

The following research questions were formulated to guide this study.

i. What type of in-service training and development do staff needs for improve productivity

in LASUTH?

ii. What are the training and development policies, principles and practices in LASUTH?

iii. How does in-service training and development affect staff performance of health workers

in LASUTH?

iv. What are the relevance and effectiveness of in-service training and development to the

staff of LASUTH?
 v. How relevant are the content of the training materials to the job of the health workers in

LASUTH?

vi. How would you rate the quality and presentation of resource personnel in your past in-

service training and development?

vii. What ways can we evaluate health workers in-service training and development in

LASUTH?

viii. What are the benefits of evaluating in-service training and development of health

workers in LASUTH?

1.6 Research Hypotheses

In order to achieve the objectives of this study the following hypotheses were adopted for

testing:

i. Ho: There is no significant relationship in the type of in-service training need by

health workers in LASUTH and staff productivity.

Hi: There is significant relationship in the type of in-service training need by health

workers in LASUTH and staff productivity.

ii. Ho: There is no significant relationship between in-service training and development

of staff and performance of health workers in LASUTH

Hi: There is significant relationship between evaluating in-service training and

development of staff and performance of health workers in LASUTH

iii. Ho: There is no significant relationship between the relevance of the content of the

training materials and the job of the health worker in LASUTH

Hi: There is significant relationship between the relevance of the content of the training

materials and the job of the health worker in LASUTH

1.7 Significance of the Study

The findings of this study will be useful to professional health workers in public and private

health sector, schools and researchers as it will provide practical solution and literature in this

respect. It will also help medical directors / administrators to map out strategy and introduce

modern schemes for training and development for their staff, to be able to meet the challenges of

change in the future. The importance of a healthy nation cannot be overemphasized as they say

health is wealth, therefore having well trained health personnel to deliver quality health service is

what the study is all about.

1.8 Scope and Limitation of the Study

The study focuses on an evaluation of in-service training and development of professional health

worker in LASUTH. The study will investigate: the type of in-service training and development

the staff needs to improve productivity in LASUTH, the training and development policy put in

place in LASUTH, how does in-service training and development affect staff performance of

health workers in LASUTH, the relevance and effectiveness of in-service training and

development to the staff of LASUTH, the content of the training materials to the job of the health

workers in LASUTH, rating the quality and presentation of resource personnel in your past in-

service training and development, ways we evaluate health workers in-service training and

development in LASUTH and the benefits of evaluating in-service training and development of

health workers in LASUTH. The researcher will use the senior and junior professional staff as

the population for the study as this will go a long to help us investigate an evaluation of in-
service training and development of the health professionals in Lagos state university teaching

hospital.

1.9 Limitation

Problems envisage are the unwillingness to respond to the interview question and questionnaire

which will leave the researcher seriously appealing to the respondents before they could respond.

Their show of indifference and uncomfortable disposition will not really help issues. The

absence or inaccessibility of reliable records and reports on LASUTH for the past ten years as

regard training and development activities will limit the research investigation. The

unwillingness of medical management to divulge strategic information in the name of

confidentiality will constitute limitation to the study. Another major limitation envisage is

finance and distance. Of course fund is needed to carry out a study of this nature. The distance

from home to the place of study will be stressful, combining family issues with a study of this

nature will be quite alarming.

1.10 Definition of Terms

Training

Training is improving an employee’s skill to the point where he or she can do the current job.

Training is the process by which members of organizations are thought to acquire knowledge,

skills and abilities they need to perform effectively the job at hand. Training is directed at the

present job. It is also the process of changing the skills, attitudes, and knowledge of employees

with the purpose of improving their level of competence. It is a planned process, usually

involving a series of stages where incremental improvements can be identified. It takes two main

forms. (i) On-the-job training whereby an employee receives instructions within the place of
work, usually through observing the tasks, being guided through them by experts, and then

practicing them. (ii) Off- the-job training whereby an employee is instructed away from the place

of work, either in a training on the premises (Edmund, 2001:372)

In-service training

In-service training is regarded as a form of practical training, short courses or longer formalized

programmes aimed at upgrading the skills and qualification, and sometimes salaries, of

unqualified or under qualified teachers. However, new policy directions tend to reconceptualised

INSET as an ongoing professional development of health practitioners (Mothatha, 2000:85) This

definition links up with the training that is done outside the classroom in a form of seminars and

workshops. Health workers are developed and capacitated during these workshops.

Development

Development on the other hand focuses on building the knowledge and skills of organizational

members so that they will be prepared to take on new responsibilities and challenges.

Development is used in relation to the process of helping managerial employees who perform

non-routine jobs to improve their managerial, administrative and decision-making abilities and

competence. Development is also the improvement of the skills and job performance of

employees through a set of planned learning activities in order for them to move to more

responsible positions within the organization. Development is a participatory, transforming

process leading to a greater dignity and self-reliance, greater vision and possibility, greater

community and interdependence (Welsh, 1990:310-311).

Staff development

Gerrard (2000:1) contends that staff development is intended to strengthen the capability of an

organization to perform its mission more effectively and more efficiently by encouraging and

providing for the growth of its human resources. Staff development affirms the ability of the

individual and the organization to grow and of each to contribute to the growth of the other. Staff

development makes the most of the present potential and prepares the individual and the

organization for the future.

Training & Development

In the field of human resource management, training and development is the field which is

concerned with organizational activity aimed at bettering the performance of individuals and

groups in organizational settings.

Health Workers

Health workers are people engaged in actions whose primary intent is to enhance health. These

include people who provide health services – such as doctors, nurses, midwives, pharmacists,

laboratory technicians – as well as management and support workers – such as hospital

managers, financial officers, cooks, drivers and cleaners (WHO, 2010).

 CHAPTER TWO

REVIEW OF RELATED LITERATURE

2.1 Overview of Training

One major function of the Human Resource Management is effective training and development.

Few people these days would argue against the importance of training as a major influence on

the success of an organization. Employees are a crucial, but expensive resource. In order to

sustain economic growth and effective performance, it is important to optimize the contribution

of employees to the aims and goals of the organizations. The importance of training as a central

role of management has long been recognized by leading writers. For instance according to

Drucker (1998), the one contribution a manager is uniquely expected to make is to give others

vision and ability to perform. The general movement towards downsizing, flexible structures of

organizations and the nature of management moving towards the devolution of power to the

workforce give increasing emphasis to an environment of coaching and support. Training is

necessary to ensure an adequate supply of staff that are technically and socially competent and

capable of career development into specialist departments or management positions. There is

therefore a continual need for the process of staff development, and training fulfils an important

part of this process. Training should be viewed therefore as an integral part of the process of total

quality Management.

Training and development remains a major component of human resource development. By

definition human resource is the manpower; employee or worker required by an organization, be

it public or private which enable it to achieve its predetermined objectives, the purpose for which

it is set up. It could mean the entire human resource (skilled, semi-skilled and unskilled)

available within the country. Human resource development or otherwise manpower development
is a continuous process of impacting new information, skills, attitude and ideas to employees

dictated by the requirement of job change. It is a means of overcoming employee obsolescence

through education and training. In other words, HR-development is a means by which

employees are kept current on their official duties, this means in effect that it is the process of

preparing the total quantitative and qualitative human asset in a nation or organization so that

they can move with the nation or organization as they develops, change and grow.

Workload shouldered by health workers could be contributing factors towards demoralizing

health workers to work efficiently. However, poor allocation of human resources to different

health system levels could create “artificial workload” in the health system. Planners should also

move beyond the assumption that existing health-care delivery systems are efficient. A study of

time use in Zanzibar, Tanzania, found that on average only 61% of providers' time was spent

productively; other studies find substantially lower productivity rates. The task mix itself—

generated by a de facto poor skills mix at different levels of the health system—generates

inefficiency. The use and targeting of payments, subsidies, and tax breaks, in combination with

greater attention to non-financing incentives and investment in supervision and capacity

building, can potentially help to increase worker productivity. To implement such strategies,

trends in provider productivity must be measured and managed. The substantial variations in

provider quality must also be addressed head-on to reduce the potential for inappropriate care

and ineffective use of resources.

As current trends indicate, in-service training may continue to form the mainstay of human

resources development assistance provided to facilities, and thus represents a timely opportunity

to take stock of existing practices and identify strategies by which in-service training can be

improved to ensure sustainability, effectiveness, and efficiency. With consensus across

stakeholder groups and regions, the improvement framework provides a global vision for

improvements in training that result in more competent health workers and better health care

Informal or on-the-job training is an important source of training and development and is used

widely across the civil service. However, it is treated as part of normal working hours and is not

recorded separately. The introduction of performance management is likely to lead to the formal

recognition of this type of training.

Given their importance to the organization, private sector companies devote considerable energy

to the training and development of top managers and their successors. However, the civil service

largely relies on networks, seminars and conferences for top management training and

development and lacks a specific programme in this area. A separate development programme

which takes account of the particular requirements and circumstances of top managers should be

developed, implemented and evaluated. The effectiveness of the training and development

function will typically depend on how well it is integrated into the strategy and business planning

process of a department and how well it is supported by top management.

2.2 Human Resource Management

For any enterprise to function effectively, it must have money, materials, supplies, equipment,

ideas about the services or products to offer those who might use its outputs and finally people,

which is the human resource, to run the enterprise. The effective management of people at work

is Human Resource Management, Armstrong (1996). Human Resource Management has

emerged as a major function in most organizations and is the focus for a wide-ranging debate

concerning the nature of the contemporary employment relationships. Managing human

resources is one of the key elements in the coordination and management of work organizations.

Several new technologies are used to ensure the creation and delivery of services and goods in
modern economies. Whatever means are used, the role of individuals and groups as employees

and the ability of management to effectively deploy such a resource is vital to the interest of both

the employee and organization.

Traditionally, Human Resource concerns itself with recruitment, selection, placement, training,

compensation and industrial relations among others, (Armstrong 1996). Beer et al (1984) define

Human Resource Management as the involvement of all management decisions and actions that

affect the nature of the relationship between the organization and its employees-the human

resources. According to Beer et al (1984), general management make important decisions daily

that affect this relationship, and this leads to a map of Human Resource Management territory,

the core of which they refer to as the four „Cs‟ and these are Competence of employees: High

competence creates a positive attitude towards learning and development. Commitment of

employees: High commitment means that employees will be motivated to hear, understand and

respond to management’s communication relating to the organization of work. Congruence

between the goals of employees and those of the organization: Higher congruence is a reflection

of policies and practices which bring about a higher coincidence of interest among management,

shareholders and workers alike. Cost effectiveness of

Human Resource Management practices: means that the organization’s human resource cost, that

is wages, benefits, training and indirect costs such as strikes, turnover and grievances, have been

kept equal to or less than those of competitors.

2.3 Human Resource Management and Training

Beardwell and Holden (1993) argue that the recognition of the importance of training in recent

years has been heavily influenced by the intensification of competition and the relative success
of organizations where investment in employee development is considerably emphasized. They

add that technological developments and organizational change have gradually led some

employers to the realization that success relies on the skills and abilities of their employees, and

this means considerable and continuous investment in training and development. It is the view of

Beardwell and Holden (1993) that Human Resource Management concepts such as commitment

to the company and the growth in the quality movement have led senior management teams to

realize the increased importance of training, employee development and long-term education.

Such concepts require not only careful planning but a greater emphasis on employee

development.

2.3.1 Training

According Cole (2002:330), in his book Personnel and Human Resource Management, training

is a learning activity directed towards the acquisition of specific knowledge and skills for the

purpose of an occupation or task. The focus of training is the job or task for example, the need to

have efficiency and safety in the operation of particular machines or equipment, or the need for

an effective sales force to mention but a few. Training is the planned and systematic modification

of behavior through learning events, activities and programs which results in the participants

achieving the levels of knowledge, skills, competencies and abilities to carry out their work

effectively (Gordon 1992:235). Pheesey (1971:130) defines training as the systematic process of

altering the behavior and or attitudes of employees in a direction to increase the achievement of

organizational goals. This means for any organization to succeed in achieving the objectives of

its training program, the design and implementation must be planned and systematic, tailored

towards enhancing performance and productivity.

The Manpower Services commission of the United Kingdom, which was set up by the 1973

Employment and Training Act defined training as a planned process to modify attitude,

knowledge or skill behavior through learning experience to achieve effective performance in an

activity or range of activities. According to them, the purpose of training in the work situation is

to develop the abilities of the individual and to satisfy the current and future of the organization.

Most organizations have long recognized the importance of training to its development. As new

technology progresses, making certain jobs and skills redundant, an increasing emphasis is being

placed on the need for a skilled and highly trained workforce. Many of the jobs being replaced

by machines have been of an unskilled and semi-skilled nature, and this emphasizes the need for

higher education and skills for those wishing to gain employment in the future.

According to Armstrong (1996:11), expressing an understanding of training emphasizes that

training should be developed and operated within an organization by appreciating learning

theories and approaches if the training is to be well understood. This was also affirmed by

Sherman et al (1996:13). They expressly indicated that the success of a training program depends

more on the organization‟s ability to identify training needs and the care with which it prepares

the program so that if the trainees do not learn what they are supposed to learn, the training has

not been successful. They further indicated that training experts believe that if trainees do not

learn, it is probably only because some important learning principle had been overlooked.

What they are saying is that the success or failure of a training program is frequently related to

the recognition and application of basic psychological principles of learning. This assertion is not

necessarily right. If the trainees do not learn anything then of what benefit will they be for the

organization. If trainees return empty, with nothing to contribute, it can also mean that even
though the organization might have done all that is necessary to ensure a successful training

program, the wrong candidate might have been selected for the training program. McGhee et al

(1996:54) wrote on the nature of learning and said learning is a term used to describe the process

by which behavioral changes results from experience. They also said the fact that learning has

occurred could only be inferred from a comparison of an individual’s behavior prior to the

experiences of specific kinds of task.

This is not to say that there has been no learning if there is no overt behavioral change. Since

training generally is intended to provide learning experiences that will help people perform more

effectively in their jobs, organizational training should follow the learning principle. Training

therefore can be explained as a planned and systematic effort by management aimed at altering

behavior of employees, in a direction that will achieve organizational goals. A formal training

program is an effort by the employer to provide opportunities for the employee to acquire job-

related skills, attitudes and knowledge, McGhee et al (1996:55)

2.3.2 Determination of training needs

The first step in managing training is to determine training needs and set objectives for these

needs. According to G.A Cole (2002:339) if an organization has to justify its training

expenditure, it must surely do so on the basis of organizational need. Organizations adopting a

systematic approach to training and development will usually set about defining their need for

training in accordance with a well organized procedure. Such a procedure will entail looking at

training needs from a number of different perspectives. These perspectives are; organizational,

departmental or functional, job and employee. Organizational need – the organizational analysis

happens in a situation where effectiveness of the organization and its success in meeting its goals

are analyzed to determine where deviation or differences exist. This makes it easy to know what
program to be implemented. According to Kaufman (1974:80), organization analysis looks at the

variances between their success and failure to ascertain which ones training could help remedy.

Functional need – at this level, training managers analyze the specific ability needs determined

by job descriptions and job specifications of the jobs in the work area or work unit.

The need can also be determined by observing the job performance of work groups and survey

job holders, supervisors, and training committees. Any lapses in their efficiency and

effectiveness help determine the training need. Individual need –Kaufman continues that

employees‟ training needs could be measured by the individual performances of the employees.

He stated that the effectiveness and efficiency is measured against the required standards through

interviews, observations, attitude surveys, or objective records of their performance. The

researcher thinks that these three levels – organizational, functional and individual gaps between

expected results and actual results can suggest training needs, for the researcher, active

solicitation of suggestions from employees, supervisors, managers and training committees can

also provide training needs ideas.

The particular perspective chosen will depend on the circumstances. For example, if changes in

the external environment of the organization are exerting pressures for change internally, then a

corporate or organizational perspective needs to be taken. If, however, the issue is one of

improving skills in a particular category of employees, then occupational or job group will

provide the focus of efforts.

Training need is any shortfall in employee performance, or potential performance which can be

remedied by appropriate training. There are many ways of overcoming deficiencies in human

performance at work, and training is only one of them. It is important to recognize this fact since
sometimes training staff are asked to meet needs which ought to be dealt with in some other way,

such as improving pay, replacing machinery or simplifying procedures. Armstrong (1996:17)

however, argues that training needs analysis should cover problems to be solved, as well as

future demands based on whether the organization must acquire new skills or knowledge or must

improve existing competencies.

Developmental needs can be determined via a study and understanding of individual executive

developmental needs, the development needs of the organization in terms of its projected goals

and aspirations, the quality and quantity of available manpower stock as well as the demands and

requirement of each executive position in the organizational hierarchy

Identifying skills needed by community health workers is important to achieving overall

program goals. Identified skills that can be addressed through training. For example, if the job

requires presentation skills, a training program should teach these skills. Review the job

description and job tasks for community health workers in a program, and identify needed skills,

attitudes, and knowledge.

2.3.3 Selecting Training Content

Most training programs for community health workers average 10 to 12 hours. A useful

guideline is to allow enough time for activities and avoid trying to cover too much in one

session. Ground rules, norms, and community guidelines all are part of establishing the learning

environment. They help participants determine and buy into individual and group behavior that is

acceptable and agreed upon for each training. A good strategy is to ask the group to offer

important ground rules for the training or to provide a list of prepared norms and invite the group

to add to the list (Frankel, 1984).

Facts about health issues can be presented in many ways. Community health workers can read

brochures, play games, listen to presentations, and watch videos. Participants can practice

interpersonal and communication skills through role-plays. Skits can exaggerate poor

communication skills. Participants can identify wrong communication techniques in the skit

and offer other more effective ways of communicating. These methods may be used to start a

discussion about which interpersonal and communication skills are most appropriate for a

given audience (Frankel, 1984).

One way to orient community health workers to the breast and cervical cancer early detection

program is to show a video about the program and ask participants to discuss what they saw on

the video. Another way is to conduct a skit showing the roles of program staff and service

providers (e.g., nurse, outreach worker, administrator). Participants wear a sign naming their

role. This helps to explain the program by connecting the different workers and describing their

duties

Trainers need certain traits to be effective with community health workers. They need to

understand the community, know the health content, be personable, relate comfortably to the

women in the community, reflect the diversity of the intended audience and the community

health workers, and have experience in actively involving participants in training (Frankel,

1984).

Experienced volunteers, lay health advisors, or community outreach workers can be effective

trainers. Providers can serve as resource persons to become familiar with participants, but

skilled trainers should conduct the training. Community outreach workers or members of

community health advisory groups can serve as trainers or help identify trainers who have the
background and cultural sensitivity to work well with community health workers. An orientation

for the trainers can address the unique training needs and strengths of community health

workers.

Accredited training programs are useful for training community health workers. Community

health workers can complete 15 to 20 credit hours of coursework through some colleges and

receive certification upon completing the course. A 17-credit-hour program at San Francisco

State University’s Community Health Training and Development Program Center awards 13

credit hours for core competencies for community health workers. For the remaining 4 credit

hours, community health workers may choose electives such as women’s health, domestic

violence, HIV/AIDS, or alcohol and drug abuse.

2.3.4 Training Policy

Kenney et al (1992:3) makes a point that companies should have different policies for training

depending on the class or level of employment or level of employees to be trained. They pointed

out that training policies are necessary for the following reasons:

1) To provide guidelines for those responsible for planning and implementing

training;

2) To ensure that a company’s training resources are allocated to pre-determined

requirements;

3) To provide for equality of opportunity for training throughout the company; and

4) To inform employees of training and development opportunities As much as these

policies seem to be accurate, they are silent on the elements of budgetary

provision and top management support for training.

According to Michael Armstrong in his book A Handbook for Personnel Management Practice

(1996:55), training policies are expressions of the training philosophy of the organization. He

also affirms the assertion of Kenny et al (1992), but even further stated that training policy shows

the proportion of turnover that should be allocated to training. He again advocated that a training

philosophy is imperative to indicate the degree of importance the organization attaches to

training. This will if not eliminate entirely, reduce the laissez-faire approach to training.

Notwithstanding the essence and the benefits of training, policies can prove to be a difficult task

for Directors especially if they are doing so for the first time, and if they do not have the advice

of a training officer with previous experience at the level.

What this means for the workplace is that training and assessment becomes part of everyday

practice. Training resources are created to align with the organizational infrastructure and

policies and procedures, so that training is directly relevant to both employers and employees.

Career force Workplace Advisors (CWAs) work with employers to support implementation of

documentation and to advice on training supports and workplace assessment, in a way that works

for each workplace. The embedded model of training helps to create a culture of learning within

organizations by assisting workplaces to put in place systems that make learning central to their

everyday practice (Ryan, 2002).

2.3.4 Determining training objectives and training plan

After these analyses have been done, it is easier for the training objectives to be established and

also to know what the learners must be able to do after the training program. According to

McKenna and Beech (2002:110) in their book “Human Resource Management-A Concise

Analysis”, it is stated that “It is important that a sound basis is established for other associated

elements of Human Resource

Management practice such as performance management (appraisal), reward management

(motivation) combined with training and development”. What this means is that training and

development itself cannot help in total employee development without the complement of

employee appraisal and motivation. One of the things to consider in designing a training

program is what the program is to accomplish, that is the objectives. In other words a training

program cannot be designed until what that program is to accomplish is known. It is imperative

for organizations to realize that in designing a training program it is equally important to

consider what the trainees should know or be able to do after the training is complete. Training

objectives should however be attainable and measurable. A training program is successful if the

objectives are achieved.

Zaccarelli (1997) outlines the process of planning training as;

i) Develop a training plan

Once attainable and measurable training objectives have been considered, a training plan can be

developed. This planning tool provides a step-by-step written document for others to follow. A

training plan can be either a complete training program or just one task. The training plan details

the course content, resources required, method of training, who should do the training and who

should be trained.

ii) Design a training lesson

Once a training plan outlining general program requirements has been developed, the

organization will need to concentrate on specific segments of that plan. This is done with the use

of a training lesson. Generally, there is one training lesson for each training session. This means
if ten sessions are planned, ten training lessons must be developed. A training lesson serves the

following purpose;

a) It provides a content outline for the lesson

b) It suggests activities/specific instructions which will help to make training easier

c) It defines suggested time to be spent on each segment within the segment

iii) Select the trainer(s)

Who is going to train? Who is a good communicator and has the necessary knowledge/skill to

train? What should the trainer do to get the trainees ready for the training? These are the

questions to be addressed when selecting a trainer.

iv) Prepare the trainer (s) Training is one of the most important things any organization does. As

a result, the personnel responsible for training must be given adequate training themselves, as

well as equip them with the necessary logistics. Remotely linked to this, trainees must also be

concerned and prepared for the learning experience

2.3.5 Presenting the Training

a) Kinds of Training

There are various types of training that an organization may adopt depending on the main

objectives of training and these are outlined below;

i. Refresher Training

Here the employees are made to attend refresher courses at specific training institutions such as

Ghana Institute of Management and Public Administration (GIMPA), Institute of Management

Studies, Polytechnics and the like, sponsored by the employer. This exposes the employee to

modern trends in his field of business. That is, it involves updating skills to meet the job

requirement of employees.

ii. Orientation Training

This is mainly concerned with acquainting new employees with the organization. This

training is aimed at getting all new entrants familiarize with the organization‟s goals,

structure, culture, work standard and other conditions of employment.

iii. Career or Development Training

This type of training aims at preparing employees for the future. This enables

employees to take up higher responsibilities.

iv. Job Training

This involves teaching the employee now to perform the job for which he or she was hired or

employed for. This is to help employees to acquire the necessary skills and experience for

specific jobs.

b) Methods of Training

The selection of method for training need to be based on identified training needs, training

objectives, an understanding on the part of the trainees, the resources available and an awareness

of learning principles. DeCauza et al (1996:70) explained that the most popular training and

development method used by organizations can be classified as either on-the-job or off-the-job.

Looking at the sophistication of the equipment in LASUTH, the on-the-job training would be
very ideal. According to DeCauza et al, there are a variety of training approaches that managers

can use and these include:

i. On-the-job Training

This is the most widely used training method, as in comparison, on-the-job method of training is

simple and less costly to operate. Observing this method critically, the training places the

employee in actual work situations and makes them appear to be immediately productive. Here,

there is a close collaboration between trainer and learner. There are three common methods that

are used in on-the-job training and these are; learning by doing, mentoring and shadowing and

job rotation.

Learning by doing: this is a very popular method of teaching new skills and methods to

employees. Here the now employee observes a senior experienced worker and learns what to do.

The advantage here is that this method is tried and tested and fit the requirements of the

organization. The disadvantages are that the senior worker is not usually trained in the skills and

methods of training therefore it can be a process that may be time consuming as a new comer

struggles to cope with the senior worker’s explanations. Far more successful is to use a senior or

experienced worker who has been trained in instruction or training method and whose teaching

skills are coordinated with a developed program linked to off-the-job courses.

Mentoring: this is another version of the system whereby a senior or experienced employee takes

charge of the training and development of a new employee. This suggests a much closer

association than master/apprentice and elements of a father/son relationship can exist whereby

the mentor acts as an advisor and protector to the trainee.

Shadowing and job rotation: this usually aims to give trainee managers a feel for the organization

by giving them the experience of working in different departments. Trainees must be encouraged

to feel it is not time wasting and people in the various departments in which they are temporarily

working must feel a commitment and involvement in the training if it is to work. Unfortunately,

trainees are not usually welcomed and are seen by supervisors and workers in the department as

obstacles to the daily routines. If well structured and planned with the cooperation of all

departmental supervisors, this method can be a worthwhile learning experience.

Job rotation is another version of training that became popular in the 1970s to help relieve

boredom and thereby raise the productivity of shop floor workers. It is a management technique

used to rotate incumbents from job to job or from department to department or from one plant to

another in different geographical areas. The rotation is done on co-ordinate basis with a view to

exposing the executives and trainees to new challenges and problems. It is also aimed at giving

executives broad outlook and diversified skills. If appropriately implemented this can be an

excellent learning experience for workers and suitably fits with Human Resource Management

concepts of team-work and empowerment whereby people are encouraged to greater

responsibility for their work and that of the team. On the negative side, there have been

criticisms that not enough structured training is given to enable workers to do these jobs well.

However, the researcher believes that on-the-job method of training has a setback. A critical

review of the method reveals that, although employees learn doing the job, their productivity

tends to be low because they do not have the skills and knowledge needed to be effective and

efficient. In an on-the-job training method, the emphasis is more on the acquisition of specific,

local knowledge in a real situation. Unlike on- the-job method, off-the-job method emphasizes
developing an understanding of general principles providing background knowledge and

generating an awareness of comparative ideas and practices.

ii. Vestibule Training

This method of training is where the worker is trained to use machine or perform a task similar to

the ones in the real work situation. Under this method of training, the training program is

conducted out of the job in an area separate from thework place under the supervision of a

skilled instructor. After going through the vestibule training for a specified time period, the

trainees are expected to apply their newly acquired skills when they are assigned to their real job.

iii. Behavior Modeling

Here, some of the methods used in the assessment centers include business games, in-basket,

simulation, problem-centered cases, and many others, to enable the trainee learn the behaviors

appropriate for the job through role-playing. The use of behavior modeling is based on social

theory, and it is in particular an effective method for interpersonal or social skills training. This

method of training incorporates the use of videos to clearly demonstrate the way things ought to

be done, what behaviors are to be avoided.

Behavior modeling is often based on the demonstration of the right and effective way to behave

and as a result, trainees are provided with facilities to practice this. Bryn (1990:17) puts it this

way, that behavior modeling is where target behaviors are selected and videos on each of the

behaviors produced, showing competent persons achieving success by following specific

guidelines. Key points are displayed on screen and are backed by trainer-led discussions.

Learning here is trainer enforced through role play.

 iv. Understudy Training

An understudy is a person who is training to assume a position at a future date, the duties and

responsibilities of the position currently occupied by the person he or she in understudying. An

individual or group is assigned to assist a superior officer in the performance of his duties related

to the position and at times left to grapple with the day-to-day problems which confront the

superior in the performance of duty. They are allowed to solve them with or without the help of

the superior. When the understudy shows promise of talent, he takes over when the superior is

transferred, retired or is promoted to a higher position, Decauza et al (1996:70).

v. Case Study

Here, trainees are given case studies of real or imagined events in an organization to study,

analyze and give an opinion. After analyzing several cases under the guidance of instructors, the

trainees are exposed to certain concepts, problems, techniques and experiences, which they will

later face on the job. The object of this method is to help the trainees think logically and develop

the ability to analyze alternative courses of action systematically and objectively.

vi. Business Exercise

In this type of training exercise, the work situation is stimulated and the trainees are presented

with reports, correspondence and memoranda, as in a real work situation, to handle. Business

exercise training helps employees to develop decision-making, time management, planning and

communication skills. It also helps them to develop a “feel” for the work situation before they

apart the real job.

vii. Group Training

Group training method includes group discussions, seminar and sensitivity training. Here,

trainees having different or similar backgrounds and experiences meet to share ideas on specific

topics decided by the trainer. If organized properly, it offers trainees from different backgrounds

an opportunity to share valuable information and learn from each other‟s experience. An

example is the T-group which is an approach to human relations; the original emphasis is that it

is a form of group therapy. The seminars have the benefit of encouraging participants whiles

providing opportunities for trainees to learn from each other. The T-group is however, leaderless,

unstructured groups designed to encourage learning room experience and group dynamics, and

also provide a forum for the giving and receiving of personal feedback.

2.3.6 Training, Performance and Productivity

The quality of employees and their development through training are major factors in

determining long-term profitability and optimum performance of organizations. To hire and keep

quality employees, it is good policy to invest in the development of their skills, knowledge and

abilities so that individual and ultimately organizational productivity can increase. Traditionally,

training is given to new employees only. This is a mistake as ongoing training for existing

employees helps them adjust rapidly to changing job requirements. Organizations that are

committed to quality invest in training and development of its employees (Evans and Lindsay

1999). According to Evans and Lindsay (1999), Xerox Business Products and Systems invest

over $125 million in quality training. Motorola & Texas Instruments provide at least 40 hours of

training to every employee quarterly. Training and development have become an essential

responsibility of HRM departments in organizations particularly as employees require new skills,

knowledge and abilities, which should not be cost-justified as most public sector organizations

engage in. Neo et al. (2000) bemoaned the lack of training and development by employers in the
United States when they stated that statistics suggests that only 16% of United States employees

have never received any training from their employers. In the same way Neo et al. (2000) noted

that now organizations are beginning to realize the important role that training and development

play in enhancing performance and increasing productivity, and ultimately stay in competition.

They reiterated that as a result of this realization, General Electric, Texas Instruments and

Federal Express have all made substantial investments in training. They now invest between 3%

and 5% of their payroll in training. In a study in America on the impact of human capital

investments such as employer-provided training and development, Black and Lynch (1996)

citing Bishop (1994) indicated that employer-provided training and development raises

subjective productivity and performance measure by almost 16%. Again Black and Lynch (1996)

citing Bartel (1989) stated that returns on training and development investments increase

productivity by 16%.

According to Onah (1993) Training is like sharpening an existing skill in order to reflect the

trends in technology and other social –cultural environmental changes of an organization.

Productivity is the goal of today’s competitive business world and training can be a spring board

to enhance productivity. The aim is to enable them contribute their full measure to the welfare,

health and development of the organization. He emphasized Manpower training and

development must be based on a need analysis derived from a comparison of “actual

performance’’ and behavior with “required performance’’ and behavior. Manpower training and

development is one of the major ways organization invests in the workforce for greater return

today and even in the foreseeable future. The 2003 World Health Report (WHO, 2004a)

identified the performance of health systems organization and management as a major influence

on the achievement of better health objectives. Achievement of the overall objective of the health
sector and social welfare which is the provision of quality health and social welfare services to

the public depends, to a large extent on availability of skilled personnel; sufficient in numbers

and skills mix and appropriately deployed at all levels of care”( Chief Medical Officer –

MOSHW,2008).

Organizational effectiveness rests on the efficient and effective performance of workforce that

makeup the organization. The efficient and effective performance of the workforce inturn, rest

on the richness of the knowledge, skills and abilities possessed by the workforce. Manpower

training and development in most organizations is a continuous act/exercise. The inexorable

march of time and the ceaseless glamour for social change combine to make adaptability and

continuing preparation of the workforce as inevitable as the initial acquisition of knowledge and

skills. This cannot happen if employees training and development do not occur in an enterprise.

In other to maximize the productivity and efficiency of the organization, every executive,

manager or supervisor in a public or private organization has the responsibility and indeed the

bounding duty to ensure the development of their employees who have requisite knowledge and

expertise.

2.3.7 Effectiveness and relevance of In-service training and development

Enhanced in-service health worker case-management training sessions were conducted in

February 2009 and August 2009. Cadres of health staff involved in the training included: nurses,

laboratory technicians, public health officers, clinical officers and doctors. The training sessions

took place over three days in the form of workshops sited outside of the health workers’ working

stations. It consisted of several units including: the epidemiology of malaria in Kenya, diagnosis-

treatment-counseling-drug dispensing for uncomplicated malaria, diagnosis and treatment of

severe malaria, prevention and management of malaria in pregnancy, basic techniques related to
stock management, principles of monitoring and evaluation and practical sessions on diagnostic

procedures using blood slides and rapid diagnostic tests [RDTs]. One day of the training was

devoted to the management of uncomplicated malaria. No follow up of the training was provided

2.3.8 Content of training and development materials

The training curriculum, facilitators’ manual on the diagnosis, treatment and prevention of

malaria and job aids were developed by PSI/Kenya in collaboration with the Ministry of Public

Health and Sanitation’s, Division of Malaria Control (DOMC), case management working group

partners and educational specialists. The training materials covered all of the training topics

including those where deficiencies in practices were detected in the past and those which were

the focus of the ‘haraka upesi’ intervention - prompt AL treatment for febrile children and health

workers’ adherence to recommended case management. The manuals included objectives,

content and modalities of delivery for each training unit. Alongside the training, the job aids

were piloted to assess health workers understanding of the job aids messages. The key

recommendation from the pilot, that was included in the final intervention package, was that for

ease-of-use health workers requested a booklet encompassing miniature wall charts. Therefore,

of relevance for the evaluation of the management of febrile children below 5 years of age, the

following training materials were distributed to each health worker who attended the training: 1)

revised national guidelines for the diagnosis, treatment and prevention of malaria for health

workers; 2) participant’s training manual based on revised national guidelines; and 3) five job

aids promoting presumptive AL treatment of febrile children and dispensing and counseling

tasks for patients with AL prescribed. Of five job aids disseminated, three were in wall chart or

poster format, one was a booklet with miniature versions of the wall charts and one was the

folder for the training materials with the ‘haraka upesi’ banner. The target of the training was
universal coverage of all front-line health workers providing outpatient services. By the end of

August 2009 an estimated 962 health workers had received the enhanced in-service training in 25

separate sessions at different locations across twelve districts within Nyanza province.

Concerning the material resources provided for the workshop, some of the senior staff were of

the opinion that the resources provided for the training were inadequate. This is because training

materials such as handouts, softcopies, CDs and slide presentations were not adequate, which is

also consistent with the findings of Piyali, et al. (2011). In this study, 47.7% of participants

opinioned the resources were inadequate. Additionally, water and food provided for the training

were insufficient. This is in line with 45% of the respondents of Piyali, et al. study who felt that

the handout and other resources were not sufficient. However, 52.3% of the respondents of the

current study were of the view that the resources provided for the training were sufficient. A

greater percentage of the senior staff rated the quality of resource persons provided for the

workshop high.

2.3.9 Training Personnel Presentation

The training was facilitated by the national DOMC trainers of trainers (TOTs) who are

specialists in the different training units and have previously undertaken case-management

training of health workers. The training format and teaching modalities included lectures, group

discussions, case scenarios, role plays and question and answers quizzes. Between October and

November 2008, a two-day pilot of the training with health workers and national trainers was

undertaken in Kisumu East and Kisumu West districts in Nyanza province to establish the

duration and feasibility of the intervention training. The feedback given by the health workers

from this pilot was that overall duration of the training required more than two days to cover

successfully all training units. Following this feedback the DOMC and PSI concluded that three-
day training would provide adequate time to cover all training programme according to the

curriculum. Furthermore, considering that peripheral health facilities often have only one health

worker any training duration beyond three days was deemed unacceptable since it would have

resulted in substantial disruption of the service delivery.

According to Nawal Mansour (2011) recounting his experience I put down the action plan for

my department and evaluated resources present and those needed and the plan was put in

action. I asked equipment for the activities as computer, printer, photocopying machine, papers

and stationery. The first actual step in preparing the training plan was a questionnaire

distributed to all categories of personnel working in the hospital, surveying their expectation

and types of training courses needed from this department. Waiting for the feedback from the

personnel, I prepared a booklet including an introduction to the vision and mission of the new

department in addition to the strategy of work that will be followed. This was distributed to the

heads of all departments. The feedback was analyzed and the training courses were prepared. I

contacted staff members at the faculty of Nursing and Faculty of medicine in addition to

specialists in health management in the ministry of health to be the trainers in the different

workshops. The place was organized in order to fit for the courses with audiovisual facilities.

The announcement of each training course was sent to all departments including the topics and

the participants who are involved in every workshop. I struggled a lot so that the attendee would

receive certificates of attending the workshops or training courses including contents and

amount of hours , and succeeded in doing this and certificates were accredited from the ministry

of health. A post workshop questionnaire was prepared to evaluate the satisfaction of the

attendees to improve our work in the following workshops. Every workshop conducted at the

department needed a lot of work till the day of the course. Even the preparation of the tea and
coffee breaks was my responsibility. The department is working with the same regulations and

every year we update the workshops and courses according to the need assessment performed

according to different department’s feedback.

2.4 Ways of evaluating training and development

Evaluation is a process to determine the relevance, effectiveness, and impact of activities in light

of their objectives. In evaluating an extension training programme, one needs to consider that

most training activities exist in a larger context of projects, programmes, and plans. Thus Raab et

al. (1987, p. 5) define training evaluation as "a systematic process of collecting information for

and about a training activity which can then be used for guiding decision making and for

assessing the relevance and effectiveness of various training components."

Kirkpatrick (1976) suggested four criteria to evaluate training programmes: (1) reaction, (2)

learning, (3) behavior, and (4) results. Each criterion is used to measure the different aspects of a

training programme. Reaction measures how the trainees liked the programme in terms of

content, methods, duration, trainers, facilities, and management. Learning measures the trainees'

skills and knowledge which they were able to absorb at the time of training. Behavior is

concerned with the extent to which the trainees were able to apply their knowledge to real field

situations. Results are concerned with the tangible impact of the training programme on

individuals, their job environment, or the organization as a whole.

The UK civil service has introduced an accreditation system, the Investment in People

Programme (IIP), to assess independently the quality of training provided in each department.

Accreditation is mandatory and is linked to the performance appraisal system. Achieving

accreditation is used as a performance indicator for senior managers. It involves an assessor from
an independent agency evaluating the systems in place for training, including senior management

commitment, good policies, plans linked to the department’s business objectives and competency

requirements, etc. Assessors also check training operations and levels of staff satisfaction at

ground level. The accreditation process has resulted in informal training being recorded, formally

recognized and included in the annual training report. By causing people to give recognition to

and capture all forms of training and development, IIP has helped to show the routes to

development other than formal training, for example, programmes for mentoring and coaching,

and has underpinned the move towards continuous professional development.

Upon checking the effectiveness of training, Kenney et al (1992:11) stated that the training

program is reviewed during and after its completion by the training officer, the line manager, and

if necessary, by the trainees themselves. Evaluation differs from validation in that it attempts to

measure the overall cost benefit of the training program and not just the achievement of its laid

down objectives. Hamlin (1974) advocated that until control measures are taken to correct any

deficiencies after the training, evaluation has not been completed and thereby ineffective.

Evaluation is an integral feature of training, but it could be difficult because it is often hard to set

measurable objectives.

There are several methods for evaluating training. Beardwell and Holden (1993) have cited some

of these methods as follows;

1. Questionnaires (feedback forms): this is a common way of eliciting trainee

responses to courses and programs.

2. Tests or examinations: these are common on formal courses, especially those that

result in certification for instance a diploma in word processing skills. End-of-

 course tests can also be employed after non-certificate short courses to check the

progress of trainees.

3. Projects are initially seen as learning methods but they can also provide valuable

information to instructor about the participants‟ understanding of subject matter.

4. Structured exercises and case studies also provide opportunities to apply learned

skills and techniques under the observation of tutors and evaluators.

5. Interviews of trainees after the course or instruction period are another technique

for gathering information directly from the learners. These can be formal or

informal, individual or group, face-to-face or by telephone.

2.5 Benefits of Training and development

The purpose of training is mainly to improve knowledge and skills, and to change attitudes or

behavior. It is one of the most important potential motivators which can lead to many possible

benefits for both individuals and the organization. Changing technology requires that employees

possess the knowledge, skills and abilities needed to cope with new processes and production

techniques. According to Cole (2002) training can achieve:

1) High morale - employees who receive training have increased confidence

and motivation;

2) Lower cost of production- training eliminates risks because trained

personnel are able to make better and economic use of material and

equipment thereby reducing and avoiding waste;

 3) Lower turnover– training brings a sense of security at the workplace

which reduces labor turnover and absenteeism is avoided;

4) Change management- training helps to manage change by increasing the

understanding and involvement of employees in the change process and

also provides the skills and abilities needed to adjust to new situations;

5) Provide recognition, enhanced responsibility and the possibility of

increased pay and promotion;

6) Give a feeling of personal satisfaction and achievement, and broaden

opportunities for career progression; and

7) Help to improve the availability and quality of staff. Derrick et al

(2000:55) looked at the training environment and the structure of

organizations, and emphasized on the effects of internal political and

cultural factors on training and development. Sherman et al (1996:16)

argues that many new employees can be equipped with most of the

knowledge, skills and attitudes needed to start work, but others may

require extensive training to ensure their effective contribution to the

organization. A majority however, will require some type of training at

one time or another to maintain an effective level of job performance.

According to Krietner (1995:8) in his book The Good Manager‟s Guide, no matter how carefully

job applicants are screened, typically a gap remains between what the employee does know and

what they should know. An organization which desires to gain the competitive edge in its

respective industry, needs among other things, extensive and effective training of its human
resources. Training is therefore a key element for improved organizational performance; it

increases the level of individual and organizational competences. It helps to reconcile the gap

between what should happen and what is happening – between desired targets or standards and

actual levels of work performance. Although many employers continue to have reservations

about the cost and extent of tangible business returns from training, the development of skills has

been identified as a key factor in sharpening competitiveness. Casio (1989: 256) puts it this way

“The economic and technological trends, the pace of innovation, change and development are

growing faster year-by-year and as a result, provide clear signals that training and development

are so relevant that both organizations and individual stakeholders must give a serious attention

to.

Tessin (1978) discussed extensively how benefits accrues to organization, individual and inter-

group relations through training and development whereas, Dickey (1982) submission bothers on

individual benefit; bearing in mind that the workers are in the organization While the

organizations are in the workers. Discussing the benefits separately under subheading as done by

tessin(1978) and dickey(1982) will amount to jamboree in simplicity. Therefore, let them be

merged under one heading.

 Training and development leads to improved profitability.

 Training and development leads to improved job knowledge and skills at all levels of

organization.

 Training and development improve workers morale and job satisfaction.

 Training and development improves workers commitment to the organization.

 Training and development help to nourish better corporate image.

 Training and development improve job involvement of the workforce.

  Training and development improve the relationship between boss and subordinate and

general inter group relationship

 Training and development enhance organizational development.

 Training and development assist in preparing guidelines for works.

 Training and development assist in understanding and implementing organizational

policies.

 Training and development provide information for future needs in various facets of the

organization.

 Training and development assist workers to adjust to changes.

 Training and development assist in conflict management.

 Training and development improve labour-management relationship.

2.5 Theoretical model of the study

For the purpose of this study two theoretical model will be adopted namely Nadler’s critical

events model and Singer’s four-phase model

2.5.1 Nadler’s critical events model

This model unlike the previous models is more comprehensive and brings the issue of job

performance into the training process. Training should not be done but rather it should be

conducted to correct a particular performance deficiency. It is therefore meaningful for the

trainer take into consideration the current employee’s performance and what best training option

is to be taken.

According to Nadler (1995, p.12), this model recognizes the importance of identifying

organizational needs and is seen as critical to the entire process. The critical events model

comprises the following critical stages in a training process: identification of the needs of an
organization; specifying job performance; identifying learners’ needs; determining objectives;

building a curriculum; selecting instructional strategies; obtaining instructional resources;

conducting training and the evaluation of training (refer to figure 3.5).

Organizational needs assessment

Nadler (1995, p.12) states that it is important for the organization to determine its training needs

before anything else in the training process. The first step in the training process is coming up

with proper organizational needs analysis will assist the trainer in designing and developing a

relevant and effective training and development initiative that will go a long way in addressing

organizational performance problems.

Identify the needs of the

organization

Conducting Specify job

training performance
 Obtain Evaluation Identify
instructional and learner’s
resources feedback needs

Select
Determine
instructional
objective
strategies

Build curriculum

Figure 3.5: Nadler’s Critical Event Model

Source: Nadler (1995, p.12).

Specify job performance

The second step is to specify employee’s job performance. Employees have to understand what

their jobs entail for them to be developed in their area of speciality.

Nadler (1985, p.13) argues that often employee’s jobs are not specified and as a result it becomes

difficult for the trainer to tell whether the employee performance problem is skill, knowledge or

behavior related. Without specifying employee job performance it becomes impossible for the

trainer to plan, design, deliver, and evaluate the necessary training initiative aimed at improving

the individual’s performance. Having specified job performance, the trainer can now identify the

learner’s needs in relation the organizational needs.

Identify learner’s training needs

Nadler (1985, p.13) believes that the identification of learners needs must be in line with the

overall organizational needs. There should be a correlation between the individual’s needs and
those of the organization. The primary purpose of training in any case is to improve performance

and therefore, the link between individual training and organizational performance improvement

must be borne in mind. Individual training should impact directly or indirectly on the overall

performance of the organization and therefore, addressing the learner’s needs will automatically

have a bearing on the type of training required. Having identified the learner’s training needs, the

next stage is to determine training objectives.

Determine objectives

Nadler (1985, p.14) states that training objectives identify what training and development

initiatives must deliver to address a performance deficiency. It is therefore important, for the

training objectives to be clear so that the trainer may know what to expect from training. The

next stage after determining objectives is to build the curriculum.

Build the curriculum

The next stage according to the Nadler’s critical event model is building the curriculum.

According to Nadler (1985, p.14), having determined training objectives, the next stage is for the

trainer to develop the curriculum in line with the learner’s needs. The curriculum should focus on

addressing performance issues, an ultimate aim of the training initiative. The next stage involves

the selection of the strategy.

Select of instructional strategy

According to Nadler (1985, p.15), the selection of instructional strategy is about how training

will be delivered. Trainers must ensure that the selected instructional strategy is suitable for all

trainees for them to benefit from the programme. Nadler (1985, p.15) reiterates that even if when

curriculum is well built, it is important that the method used enhances the learner’s skill,

knowledge, attitude and behaviour. It is imperative that the strategy be understood by all for it to
be effective. For training initiatives to take place, resources must be made available. The next

stage is obtaining instructional resources.

Obtain instructional resources

Nadler (1985, p.16) states that for any training to take place managers should show their

commitment by providing the training department with instructional resources and other training

related assistance for that matter. After obtaining the resources training can be conducted.

Conduct training

The next stage after acquiring the instructional resources is for the trainer to conduct training.

The trainer should be mindful of the rates at which learners learn and he or she must make the

necessary provision to cater for the various learning needs of learners. The final stage in the

Nadler’s critical event model is evaluating the training and development initiative.

Evaluate training

This is the most crucial stage in a training process. Evaluating training provides important

information to all stakeholders about the training programme. Nadler (1985, p.18) recommends

that organisations must have qualified training evaluators in order to carry out the evaluation

process. He argues that more often than not, trainers are given the responsibility of evaluating

training and development initiatives without the necessary training. Nadler(1985, p.18) further

observes that information on a given programme will assist both the trainees, trainers, training

departments, directors and management in determining the value of training and the information

may be used for further training programmes.

It can be concluded that the Nadler’s critical events model provides important organizational

issues to be taken into consideration for training to be effective. These include the assessment of
learner’s needs and those of the organization, provision of instructional resources, and selection

of instructional strategy

2.5.2 Singer’s four-phase model

One of the reasons why the researcher chose the Singer’s four phase model is because the model

clearly indicates when and how training should be evaluated, the stage that forms the basis of

this research.

Phillips (1991, p.174) states that this model is similar to the Goldstein model but he makes use of

four clearly defined phases: viz, assessing training needs, designing the training programme,

choosing the training method; and evaluating training results

A brief description of the model is provided below.

Assessing training needs

Singer (1990, p.174) explains that the analysis process should be an ongoing process and should

interface with other organizational areas using organization, task and person analysis.

Design training programme

During this phase the trainer must determine the most appropriate formats as well as select the

trainees and decide on the methods to be used for the final programme evaluation. It is important

for the trainer to be knowledgeable on learning principles to assists him to effectively design the

training programme.

Choose Training Methods

The trainers should decide on the most appropriate location for the training to be conducted i.e.

whether the trainees are taught relevant knowledge, skills and abilities in their actual workplace

(on-the-job), or at a location other than the real job site (off-the-job). The trainer should take

cognizance of both the advantages and disadvantages of each approach (Singer 1990, p.179).
Evaluate training results

Singer (1990, p.193) argues that understanding the learning principles and designing appropriate

training programmes is only of value when trainees acquire knowledge, skills and abilities which

they can pass on to their actual jobs. Singer further states that after the training has been

conducted, trainers should expend a significant effort determining how effectively the training

goals were met. He argues that those programmes which fail to reach their goals should be

eliminated and those which are a success should be retained.

Singer (1990, p.193) recommends that to simplify the evaluation process, the evaluation

programme should be divided into to four logical steps:

 Reaction-establishing the degree to which the trainees enjoyed the

programme through the use of reaction forms;

 Learning-establishing whether the training material which has been taught, has been learned.

Appropriate measures should be developed to measure the amount of learning that has taken

place during training; Behaviour-establishing whether what has been learnt in the training

process has been transferred into practice. Before and after measure should be used to evaluate

behavior; and

 Results-establishing the overall impact that training has had on the organisation.

Singer (1990, p.195) is of the belief that organisations which conduct reasonably comprehensive

training evaluation rarely progress beyond the learning stage. He further argues that failure to

evaluate behaviour and results may leave significant doubt as to whether the training programme

achieved its intended goals of facilitating transfer of the training to the work situation, with a

positive contribution to the functioning of the organisation.

It is clear that Singer views the evaluation the same way as training practitioners, that being to

establish through the evaluation process the training programme’s effectiveness.

Figure 3.6: Singer’s Four Phase Model

Source: Phillips (1991, p.174)
 CHAPTER THREE

METHODOLOGY

3.1 Research Design

The study is a survey in the form of cross sectional study in which data was collected once across

a population through sampling. Nine categories of staff shall be used based on the relative

number of Lagos state university teaching hospital. One hundred and sixty employees were

selected using convenience sampling technique, to which questionnaires will be administer. The

questionnaires will be administered personally by the researcher to the respondents.

An interview schedule to gather information on the subject from the Management of Lagos state

university teaching hospital (LASUTH) was also used to ascertain Management’s view on how

LASUTH has traditionally dealt with issues of training and development. The Facilitator

responsible in training and the group Human Resource Manager provided the information

needed. Documents on training from LASUTH were also reviewed. This was to help the

researcher ascertain whether LASUTH has a training policy in place, whether LASUTH has

career progressions projection for each employee, and also to check whether the processes of

training were being duly followed.

3.2 Target Population

All employees of Lagos state university teaching hospital comprising doctors, nurses, hospital

facilitators, administrative staff, caterer, laundry, accounts, contract cleaners and hospital

ordelies of LASUTH constituted the target population, spread over the Lagos state university
teaching hospital (LASUTH). The total population of all the staff employed into the Lagos state

university teaching hospital under the state recruitment policy is 1290.

The population distribution is shown in Table 3.1

Category No Sample Percentage

Doctors 300 30 10% of 300

Nurses 650 65 10% of 650

Hospital facilitators 25 10 no %

Administrative staff 50 10 20% of 50

Accounts 30 10 no %

Caterer 20 5 no %

Laundry 15 5 no %

Hospital orderlies 150 15 10% of 150

Contract cleaners 50 10 20% of 50

Total 1290 160 100

Sampling Size and Sampling Technique

The sample size was 160, made up of 30 doctors, 65 nurses, 10 administrative staff, 5 caterers, 5

laundry, 15 hospital orderlies and 10 contract cleaners. However, the researcher consider the

sample size of 160 small for the kind of study intended but time and financial resource

constraints made it imperative to restrict the sample to that size.

Sampling procedure employed was:

i. All the staff of the Lagos state university teaching hospital was included in the study

to allow for adequate representation of the various views expressed.

ii. Convenience sampling selection method was used. In all 160 employees will be

administer questionnaire.

3.4 Source of Data Collection

The data for this research work was obtained essentially from primary and secondary sources.

The researcher traces the history of LASUTH and its role of training and development over the

last ten years from secondary sources. The purpose of the questionnaires was to investigate the

awareness of training program and the role LASUTH plays in the training and development of its

employees. It was also to investigate why employees self-sponsored themselves to acquire new

skills, knowledge and abilities, and how this affected employee performance.

Primary data was also sourced from semi-structured personal interviews conducted. Here an

extensive discussion will be arranged with medical management, training manager and the

Human Resource Manager. These interviews will be intended to provide general perception on

how LASUTH has traditionally dealt with issues of training and development. A copy of the

questionnaire is attached as Appendix 1, and an interview schedule attached as appendix 2

The secondary data, which constitutes the source of data, was gathered from the LASUTH

corporate plan, its Human Resource Management policy, Hospital magazines, bulletins, in-house

newsletters, annual reports on training, books and journals on Human Resource Management,

training and development.

3.5 Research Instrument

Comprehensive research instruments will be developed and tested before the real investigation

starts. A questionnaire for this research will be administered to 160 employees; this questionnaire

title an evaluation of in-service training and development of professional health worker was

developed after consulting literatures and discussions with the supervisor. The items were

subsequently edited and vigilantly selected bearing in mind the research questions. The

questionnaire was in one part only, constituting the main items, which directly addressed the

research questions. Items 1-3 was expected to provide an answer to the number of years

employees had worked with the organization, their gender as well as educational background.

Items 8-12 of the questionnaire were to elicit information on training programs available at

LASUTH, their benefits to employees in the various departments. Items 13-15 sought

information on employees‟ development and the role of management in assisting them. Items 16

and 17 were to provide insight into the perception of employees as to whether employees were

aware of any career progressions that management had outlined for them. The remaining items

were basically to throw more light on LASUTH training policies, the importance they attach to it

and employees awareness of any such policies. The questionnaire greatly helped the researcher

in her data analysis. Other minor tools used were personal interviews, occasional conversations

and direct observation.

The Medical directors, Training Manager and Human Resource Manager will be interview to

ascertain whether Lagos state university teaching hospital has been involved in training and

development for employees over the last 10 years (2000-2010), whether there is a documented

training policy in place, and whether there are career progression projections for all employees
3.6 Administration of the Instrument

In the first technique, the Medical directors and the training manager as well as the Human

Resource Manager were interviewed personally to ascertain the training policies and programs

available for staff, that is, non graduate employees of LASUTH. The same procedure was used to

determine the importance attached to employee training and development, and their associated

obstacles, and how training programs are evaluated.

To support the data collected through these interviews, questionnaires will be administered to the

various groups of employees of LASUTH. A total of 160 questionnaires constituting 28 items,

specially designed were administered personally to employees in the various departments at

convenience. Employees were given a couple of days to carefully fill out the questionnaires.

3.7 Analysis of Data

In order to ensure logical completeness and consistency of responses, data editing will be carried

out each day by the researcher. Identified mistakes and data gaps will be rectified as soon as

possible. Once editing was done with, data will be analyzed qualitatively and quantitatively. The

qualitative data from interviews and secondary documents will be analyzed using content

analysis and logical analysis techniques. The technique for quantitative data analysis will be the

frequency distribution and percentages, which will be use to determine the proportion of

respondents choosing the various responses and chi square statistical technique will be use to test

the hypotheses at 0.05 level of significant. This was done for each group of items relating to the

research questions. The proportions will show the diverse views of employees on the various

sub-issues Tables were also used to ensure easy understanding of the analyses.
 CHAPTER FOUR

INTRODUCTION

In line with the first research question and hypothesis, the researcher wanted to ascertain whether

LASUTH has been involved in the evaluation of in-service training and development of

professional health worker for the past 10 years. An interview with 10 high rank officer and

management staff indicated LASUTH has been involved in the evaluation of in-service training

and development of professional health worker for the past 10 years. From the interviews

training was part of the early beginnings of LASUTH and has continued since it was clear to the

management that training could be used to induct and for orientate new employees and improve

performance of existing employees.

This was confirmed by the information contained in other related documents on training and

development, that most employees have had some form of training or the other.

However, at of a total of 160 questionnaires that was distributed only 92 representing 57.5% was

retrieved while 28 representing 17.5% were not attended to and 40 representing 25% were not

found. The break down is shown in the table below.

Table 4.1 Table Showing Questionnaire Distribution

Item No Percentage

Retrieved 92 57.5

Not attended to 28 17.5

Not found 40 25.0

 Total 160 100

This chapter will be divided into the following sub-heading

Section A: Biographical data

Section B: Research questions analysis

Section C: Testing the hypotheses

Section D: Discussion of findings

4.1 Biographical data of Respondents

4.2 Gender Distribution of Presentation

Gender No Percentage

Male 34 36.96

Female 58 63.04

Total 92 100.00

Table 4.2 shows that 34 (36.96%) of the respondents are males while 58 (63.04%) are females. It

is therefore obvious that there are more females in Lagos State University Teaching Hospital

then males. This may not be unconnected from the fact that nursing profession is more embrace

by the females than the males since the number of respondents that indicated their position as

nurse are more.

4.3 Qualification Distribution of Respondents

 Qualification No Percentages

SSSC 1 1.09

Ordinary Level - -

Advance Level 2 2.17

HND 24 26.09

First Degree 41 44.57

Masters 22 23.91

PHD 2 2.17

Others - -

Total 92 100.00

Table 4.3 indicates the educational qualification of the respondents. It shows that 1 (1.09%) of

the respondents possess SSCE/GCE, 2 (2.17%) had advance level qualification, 24 (26.09%) had

a polytechnic HND qualification, 41 (44.57%) had a university degree, 22 (23.91%) had master

degree and 2 (2.17%) specified that they have doctorate degree. It is revealed from the study that

a majority of them possess a university degree, follow by those that have HND qualification and

those that possess master degree. This goes a long way to show that health workers are

professionals who are skilled in their chosen career.

4.4 Position Distribution of Respondents

Position No Percentage
 Doctor 28 30.44

Pharmacist 4 4.35

Nurse 42 45.65

Admin staff 6 6.52

Lab scientist 9 9.78

Medical records 3 3.26

Total 92 100

Table 4.4 shows the position of the respondents. It was revealed in the study that 28 (30.44%) of

the respondents are doctors, while 4 (4.35%) are pharmacist, 42 (45.65%) are nurses, 6 (6.52%)

are administrative staff, 9 (9.78%) are laboratory scientist and 3 (3.26%) are in medical records.

The above analysis shows that there are more nurses’ follow by doctors in Lagos state university

teaching hospital as compare to any other position. One will definitely expect this because it is a

hospital which requires professionals that render specialize services.

4.5 Work Experience Distribution of Respondents

Work Experience No Percentages

1 – 10yrs 59 64.13

11- 20yrs 27 29.35

 21 – 30yrs 5 5.45

31 – 40yrs 1 1.09

Total 92 100

Table 4.5 above indicates respondents working experience. The study shows that 59 (64.13%) of

the respondents have working experience between 1-10 years, 27 (29.35%) have working

experience between 11-20 years, 5 (5.45%) have working experience between 21-30 years and 1

(1.09%) have working experience between 31-40 years. From the analysis it is shown that there

is considerable number of staff with working experience in Lagos state university teaching

hospital. With this number of years in service one would expect that majority of them would

have benefited from one form of training or the other.

4.2 Research Question Analysis

This section presents the research question analysis using simple percentage technique.

Research Question One

What type of in-service training and development do staff needs for improve productivity in

LASUTH? The analysis of data is shown in table 4.6, 4.7 & 4.8.

4.6 What kind of training did you participate in, please specify

Responses No Percentage

Basic life supports programme such as obstetrics 37 40.22

 accident emergency, Breast Cancer, HIV/AIDS,

Mental health e.t.c

Health management and environment 2 2.17

programme

Mandatory continuous programme 2 2.17

Management/admin programme 10 10.87

E- health programme 7 7.61

Seminars and workshops 26 28.26

Post graduate programme 8 8.70

Total 92 100.00

Table 4.6 indicates the kind of training and development that staff has gone through based on

need. A total of 37 (40.22%) specified that they have gone through basic life supports

programme such as obstetrics accident emergency, Breast Cancer, HIV/AIDS, Mental health

e.t.c to improve productivity. While 26 (28.26%) of the respondents specified that participating

in seminars and workshops is another kind of training and development they needed in order to

improve productivity. Also 10 (10.87%) of them specified that the kind of training and

development they have participated on is Management/administrative programme in order to

improve productivity. And 7 (7.61%) of them specified that they participated in E-health

programme as a way of boosting their productivity.

From the above analysis it is obvious that the type of in-service training and development staff

needs for improve productivity are as followed; basic life supports programme, seminars and

workshops, Management/administrative programme and E-health programme

4.7 What were the objectives of the training?

Responses No Percentage

To help improve performance 38 41.30

To acquire skills and knowledge in the professional field 30 32.61

Others specified Residency training programme 2 2.17

To be acquit with the use of ICT for e-health 4 4.34

No Response 18 19.57

Total 92 100.00

Table 4.7 indicates the objectives of the training and development LASUTH staff participated in.

A total of 38 (41.30%) showed that one of the major objectives of the training and development

is to improve performance. While 30 (32.61%) of the respondents indicated that another

objective of the training and development is to acquire skills and knowledge in the professional

field. In the same vein 4 (4.34%) of them revealed that the objective of the training they

participated on is to be acquitted with use of ICT for health otherwise known as E-health. And

18 (19.57%) of them did not responded to this item.

From the above analysis it is obvious that the objectives of in-service training and development

staff needs for improve productivity are as followed; to improve performance, to acquire skills

and knowledge in the professional field and to be acquitted with use of ICT for health otherwise

known as E-health.

4.8 What methods were used for the facilitation?

Responses No Percentage

Seminar & Workshops 32 34.78

On the Job training 20 21.74

Understudy training 6 6.52

Formal lectures 20 21.74

No Responses 14 15.22

Total 92 100.00

Table 4.8 indicates the methods used for facilitation of training and development that staff

participated on. A total of 32 (34.78%) specified that one of the method that facilitate training

and development is seminars and workshops. While 20 (21.74%) of the respondents specified

that on the job training and formal lecture are other methods use for facilitation during training

and development respectively. In the same vein 6 (6.52%) of them specified that understudy

training is also a method use for facilitation. However, 14 (15.22%) of them did not respond to

the item
From the above analysis it is obvious that the following are used for the facilitation of training

and development in LASUTH; seminars and workshops, on the job training, formal lecture and

understudy training

Research Question Two

What are the training and development policies, principles and practices in LASUTH?

The analysis of data is shown in table 4.9-4.16

4.9 Are you aware of any training programs in LASUTH?

Response No Percentage

Yes 70 76.09

No 14 15.22

Undecided 8 8.70

Total 92 100.00

Table 4.9 indicates whether the respondents are aware of any training programme in LASUTH.

A majority of them responded positively that they are aware of one form of training programme

or the other that take place in LASUTH with 70 (76.09%) affirming this. This shows that there is

indeed training and development policies, principles and procedures that guide management on

the kind of training and development programme to expose staff to. However, 14 (15.22%) of

them disagreed to have been aware of any training programme in LASUTH and 8 (8.70%) of the
respondents were undecided. Finding shows that staff are aware of training and development

programme in LASUTH which invariably mean that there is a training policy that stipulated this.

4.10 Have you had any form of training since you joined LASUTH?

Response No Percentage

Yes 69 75

No 22 23.91

Undecided 1 1.09

Total 92 100

Table 4.10 revealed whether the respondents have had any form of training since they joined

LASUTH. A total of 69 (75.00%) of the respondents responded positively that they have had one

form of training since they joined LASUTH. While 22 (23.91%) said they have not had any form

of training since they joined LASUTH and only 1 (1.09%) was undecided. It is therefore

concluded that majority of them have partook in one form of training or the other

4.11 If your answer is yes to question six (4.10), how long?

Response No Percentage

1 – 6 months 29 42.03

7–12 months 11 15.94

1 – 3yrs 19 27.54
 Over 4yrs 10 14.49

Undecided - -

Total 69 100.00

Table 4.11 shows how long the training lasted for those that responded positively to have had

one form of training since they joined LASUTH. A total of 29 (42.03%) indicated that the

duration of their training was between 1-6 months, 19 (27.54%) also indicated that theirs

spanned a period of 1-3 years, 11 (15.94%) showed that their training spanned a period of 7-12

months and 10 (14.49%) revealed that theirs lasted for over 4 years. In a nutshell it can be

concluded that majority of the staff spend the following duration in training in this order; 1-6

months, 1-3 years, 7-12 months and over 4 years. From the analysis it is clear that the training

and development policy of LASUTH made provision for this.

4.12 How were you selected, please specify.

Responses No Percentage

Compulsory course 2 2.17

Written & oral interview 8 8.70

Based on Merit 15 16.30

Selection by H.O.D or Board of 30 32.61

 Directors

Voluntary & self-sponsored course 13 14.13

By chance 1 1.09

No response 23 25.00

Total 92 100.00

Table 4.12 revealed how staff that have participated in training was selected. A total of 30

(32.61%) of the respondents stated that they were selected by their head of departments and

board of directors for the training, 15 (16.30%) indicated that they were selected based on merit,

13 (14.13%) showed that their training was voluntary and self-sponsored, 8 (8.70%) of them

revealed that their selection was based on written and oral interview and 2 (2.17%) specified that

their selection for the training was due to compulsory course

4.13 Have you ever be sponsored for further studies or personal development program?

Response No Percentage

Yes 33 35.87

No 51 55.44

No response 7 7.61

Total 92 100.00
Table 4.13 indicates whether respondents have been sponsored for further studies and personal

development programme. A total of 33 (35.87%) of the respondents agreed that they have been

sponsored for further studies and personal development programme, 51 (55.44%) of them

disagreed that to have been sponsored for further studies and personal development programme

and 7 (7.61%) of them did not respond to this item. From the analysis it is clear that majority of

the staff are not sponsored for further studies and personal development.

4.14 Are you aware of any career development projection for you?

Response No Percentage

Yes 39 42.39

No 43 46.74

No response 10 10.87

Total 92 100.00

Table 4.14 revealed whether the respondents are aware of any career development projection. A

total of 39 (42.39%) of the respondents showed that they are aware of career projection for them,

while 43 (46.74%) said they are not aware of any career projection for them and 10 (10.87%) of

them did not respond to this item.

4.15 Are you aware of any training and development projection for you?

Response No Percentage
 Yes 40 43.48

No 41 44.57

No response 11 11.96

Total 92 100.00

Table 4.15 revealed whether the respondents are aware of any training and development

projection. A total of 40 (43.48%) of the respondents showed that they are aware of training and

development projection for them, while 41 (44.57%) said they are not aware of any training and

development projection for them and 11 (11.96%) of them did not respond to this item.

4.16 Have you ever self-sponsored yourself for further studies to acquire new skills,

knowledge and abilities?

Response No Percentage

Yes 72 78.26

No 14 15.22

No response 6 6.52

Total 92 100.00

Table 4.16 indicated if respondents have ever self-sponsored themselves for further studies to

acquire new skills, knowledge and abilities. A total of 72 (78.26%) of the respondents showed
that they have self-sponsored themselves for further studies to acquire new skills, knowledge and

abilities, while 14 (15.22%) said they have never self-sponsored themselves for further studies to

acquire new skills, knowledge and abilities and 6 (6.52%) of them did not respond to this item.

From the analysis it is obvious that majority of the respondents self-sponsored themselves for

further studies to acquire new skills, knowledge and abilities in LASUTH.

4.17 In your opinion, do you think training at LASUTH is planned and systematic?

Responses No Percentage

Yes 44 47.83

No 18 19.57

Not sure 30 32.61

Total 92 100.00

Table 4.17 shows the opinion of respondent if they think training at LASUTH is planned and

systematic. A total of 44 (47.83) of the respondents indicated that training in LASUTH is

planned and systematic, 18 (19.57%) of the respondents indicated that training in LASUTH is

neither planned nor systematic and 30 (32.61%) said they are not sure. Less than half of the

respondents stated that training is planned and systematic, while more than half of the

respondents do not think that training is planned and systematic in LASUTH.

Research Question Three

How does in-service training and development affect staff performance of health workers in

LASUTH? The analysis of data is shown in table 4.18

4.18 In your opinion, do you think training has helped improve your performance since
you joined LASUTH?

Response No Percentage

Yes 69 75

No 8 8.70

No response 15 16.30

Total 92 100.00

Table 4.18 reveals the opinion of respondent if they think training has helped improve their

performance since they joined LASUTH. A total of 69 (75.00%) of the respondents indicated

that training has helped improve their performance since they joined LASUTH, 8 (8.70%) of the

respondents indicated that training has not helped to improve their performance since they joined

LASUTH and 15 (16.30%) did not responded to this item. Finding shows that training and

development in LUSUTH helped to improve staff performance. This is corroborated by the

response gotten from the interview when the interviewee indicated that the purpose of the

training is to improve the skills and performance of staff

Research Question Four

What are the relevance and effectiveness of in-service training and development to the staff of

LASUTH? The analysis of data is shown in table 4.19

4.19 How relevant and effective is the in-service training to staff performance

Response No Percentage

Very important 58 63.04

Important 20 21.74

Not sure 14 15.22

Total 92 100.00

Table 4.19 show how relevant and effective is in-service training. A total of 58 (63.04%) stated

that the relevance and effectiveness of in-service training is very important to staff performance,

20 (21.74%) of the respondents indicated that the relevance and effectiveness of in-service

training to staff performance is important and 14 (15.22%) indicated that they are not sure of the

relevance and effectiveness of in-service training. Finding indicated that the relevance and

effectiveness of in-service is very important and important respectively to the performance of

staff in LASUTH.

Research Question Five

How relevant are the content of the training materials to the job of the health workers in

LASUTH? The analysis of data is shown in table 4.20

4.20 How relevant is the content of the training materials to the Job.

Response No Percentage

Very relevant 45 48.91

relevant 31 33.70

Not relevant

Can’t say 16 17.39

Total 92 100.00

Table 4.20 indicates the relevant of the content of the training materials to the Job. A total of 45

(48.91%) stated that the content of the training materials to the job is very relevant, 31 (33.70%)

of the respondents indicated that the content of the training materials to the job is relevant and 16

(17.39%) indicated that they can’t speak of the relevance of the content of the training materials

to the job. From the analysis it clear that the content of the training materials is very relevant to

the job as a majority attest to this.

Research Question Six

How would you rate the quality and presentation of resource personnel in your past in-service

training and development? The analysis of data is shown in table 4.21

4.21 How would you rate the skills and manner of persecution of the resource personnel?

Response No Percentage
 Very high 24 26.09

high 46 50.00

Low 4 4.35

No response 18 19.57

Total 92 100.00

Table 4.21 revealed how respondents rate the skills and quality of presentation of resource

personnel in their past training and development programme. A total of 24 (26.09%) stated that

the skills and quality of presentation of the resource personnel was very high, 46 (50.00%) of the

respondents indicated that the skills and quality of presentation of the resource personnel was

high, 4 (4.35%) of them showed that the skills and quality of presentation of the resource

personnel was low and 18 (19.57%) of the respondents did not respond to this item. From the

analysis it clear that the skills and quality of presentation of the resource personnel is high as a

majority attests to this.

Research Question Seven

What ways can we evaluate health workers in-service training and development in LASUTH?

The analysis of data is shown in table 4.22 & 4.23

4.22 How was the training evaluated? Please specify

Responses No Percentage

Through skill organization and staff performance 16 17.39

 Through examination 24 26.09

Through the filling of questionnaire 6 6.52

Not evaluated 5 5.44

No response 41 44.57

Total 92 100.00

Table 4.22 reveals how training is evaluated in LASUTH. A total of 16 (17.39%) specified that

training in Lagos state university teaching hospital is evaluated through skill organization and

staff performance, 24 (26.09%) of the respondents specified that training in Lagos state

university teaching hospital is evaluated through examination, 6 (6.52%) of them specified that

training in Lagos state university teaching hospital is evaluated through the filling of

questionnaire. However, 5 (5.44%) of the respondents indicated that training in LASUTH is not

evaluated and 41 (44.57) of them did not respond to this item. The analysis show that half of the

respondent in total specified that training is evaluated in LASUTH, while half do not think that

training is evaluated in LASUTH.

4.23 Was there follow up of the training

Response No Percentage

Yes 39 42.40

No 34 36.96

No response 19 20.65
 Total 92 100.00

Table 4.23 reveals if there was follow up of the training. A total of 39 (42.40%) of the

respondents indicated that there was follow up of the training in LASUTH, 34 (36.96%) of the

respondents indicated that there was no follow up of the training in LASUTH and 19 (20.65%)

did not responded to this item. From the analysis it is clear that not many of them agreed that

there was follow up of the training in LASUTH.

Research Question Eight

What are the benefits of evaluating in-service training and development of health workers in

LASUTH? The analysis of data is shown in table 4.22 & 4.23

4.24 Are you motivated by and satisfied with the training programme of LUSUTH

Response No Percentage

Yes 56 60.87

No 18 19.57

No response 18 19.57

Total 92 100.00

Table 4.24 reveals the opinion of respondent as regards motivation and satisfaction with the

training programme in LASUTH. A total of 56 (60.87%) of the respondents indicated that they
were motivated by and satisfied with the training programme in LASUTH, 18 (19.57%) of the

respondents indicated that they are not motivated by and satisfied with the training programme in

LASUTH , 18 (19.57%) did not responded to this item. From the analysis it is clear that one of

the benefits of in-service training is staff motivation and satisfaction.

4.25 In your opinion, do you think training has helped improve your performance since
you joined LASUTH?

Response No Percentage

Yes 69 75.00

No 8 8.70

No response 15 16.30

Total 92 100.00

Table 4.25 reveals the opinion of respondent if they think training has helped improve their

performance since they joined LASUTH. A total of 69 (75.00%) of the respondents indicated

that training has helped improve their performance since they joined LASUTH, 8 (8.70%) of the

respondents indicated that training has not helped to improve their performance since they joined

LASUTH and 15 (16.30%) did not responded to this item. From the analysis it is clear that one

of the benefits of in-service training is to help improve staff performance.

4.26 Has training offered you the opportunity to identify any potential you have for
further development.
 Response Number Percentage

Yes 69 75.00

No 5 5.44

No response 18 19.57

Total 92 100.00

Table 4.26 reveals whether training has offered the respondents opportunity to identify any

potential for further development in LASUTH. A total of 69 (75.00%) of the respondents

indicated that training has offered them opportunity to identify potential for further development,

5 (5.44%) of the respondents disagreed with this and 18 (19.57%) did not responded to this item.

From the analysis it is clear that another benefit of in-service training is that it offered the staff

opportunity to identify potential for further development.

4.3 Testing the hypotheses

This section is concern with the chi-square analysis of the three null and alternate hypotheses

formulated in this study. The formulated hypotheses in chapter one of this study was tested

respectively as follow. The hypotheses were tested at 0.05 level of significance.

Table 4.27: Summary of chi-square analysis showing type of in-service training need by

health workers in LASUTH and staff productivity

Items Response Dr Pharm Nurse Admin Lab Sci Med Rec Total

What kind of . Basic life supports 8 1 21 - 6 1 37

training did you programme
participate in, . Health management and

please specify environment programme

2 - - - 2
. Mandatory continuous

programme 1 - 1 - 2

. Management/admin

programme
2 - 4 3 - 1 10
. E- health programme
3 1 1 2 7
. Seminars and workshops

8 1 14 2 1 26
. Post graduate programme

4 1 1 1 - 1 8
Total

28 4 42 6 9 3 92

Degree of freedom (DF) = (R-1) (C-1) = 6-1) (7-1)

= (5) (6)

= 30

Level of significance = 0.05

Degree of Freedom (DF) = 30

X2 – critical = 18.31

X2 – calculated = 19.42

Decision = Rejected

The null hypothesis of no significant relationship was rejected, in other words the alternate

hypothesis is accepted. This is because the x2-calculated (19.42) is greater than the x2-critical

(18.31). This implies that there is significant relationship in the type of in-service training need
 by health workers in LASUTH and staff productivity. In a nutshell, it can be concluded that the

type of training given to health workers align with their job needs.

Table 4.28: Summary of chi-square analysis showing how in-service training and

development affect staff performance of health workers in LASUTH

Items Response Dr Phar Nurse Admin Lab Med Rec Total

m Sci

In your opinion, do you Yes 21 3 33 4 6 2 69

think training has helped
improve your No - - 6 1 1 - 8
performance since you
joined LASUTH? No Response 7 1 3 1 2 1 15

Total 28 4 42 6 9 3 92

Degree of freedom (DF) = (R-1) (C-1) = 6-1) (3-1)

= (5) (2)

= 10

Level of significance = 0.05

Degree of Freedom (DF) = 10

X2 – critical = 18.31

X2 – calculated = 20.12

Decision = Rejected

The null hypothesis of no significant relationship was rejected, in other words the alternate

hypothesis is accepted. This is because the x2-calculated (20.12) is greater than the x2-critical
 (18.31). This implies that there is significant relationship between evaluating in-service training

and development of staff and performance of health workers in LASUTH. In a nutshell, it is

show that evaluation of training and development is one way of ascertaining whether the training

staff undergoes is equal and directly proportional to their performance.

Table 4.16: Summary of chi-square analysis showing how relevant the content of the

training materials is to the job of the health workers in LASUTH

Items Response Dr Phar Nurse Admin Lab Med Rec Total

m Sci

In your opinion, do you Very relevant 13 2 21 3 4 2 45

think training has helped
improve your Relevant 11 1 15 2 2 - 31
performance since you
joined LASUTH? Not relevant - - - - - - -

Can’t say 4 1 6 1 3 1 16

Total 28 4 42 6 9 3 92

Degree of freedom (DF) = (R-1) (C-1) = 6-1) (4-1)

= (5) (3)

= 15

Level of significance = 0.05

Degree of Freedom (DF) = 15

X2 – critical = 18.31
X2 – calculated = 18.98

Decision = Rejected

The null hypothesis of no significant relationship was rejected, in other words the alternate

hypothesis is accepted. This is because the x2-calculated (18.98) is greater than the x2-critical

(18.31). This implies that there is significant relationship between the relevance of the content of

the training materials and the job of the health worker in LASUTH. In a nutshell, finding shows

that the content of the training materials is relevant to the job of the staff. It indicates that this

will boost the skills and performance of the staff on the job.

4.4 Discussion of findings

In this section, the finding of the study was discussed alongside with the literature review to

either confirm or oppose existing research. The findings of this study revealed that the type of in-

service training and development staff needs for improve productivity are as followed; basic life

supports programme, seminars and workshops, Management/administrative programme and E-

health programme. According to the study, the objectives of these training and development are

as follows; to improve performance, to acquire skills and knowledge in the professional field and

to be acquitted with use of ICT for health otherwise known as E-health. The following methods

are said to be used in LASUTH training and development programme; seminars and workshops,

on the job training, formal lecture and understudy training. The study also shown that there is

significant relationship in the type of in-service training need by health workers in LASUTH and

staff productivity. This findings is supported by Cole (2002:330) who stated that training is a

learning activity directed towards the acquisition of specific knowledge and skills for the purpose

of an occupation or task. He emphasized that the focus of training is the job or task for example,
the need to have efficiency and safety in the operation of particular machines or equipment, or

the need for an effective sales force to mention but a few. This finding was also supported by

Armstrong (1996:17) who noted that training needs analysis should cover problems to be solved,

as well as future demands based on whether the organization must acquire new skills or

knowledge or must improve existing competencies. DeCauza et al (1996) also corroborated this

finding by noting that there are varieties of training approaches that managers can use and these

include: on-the-job training, mentoring, vestibule training, behavior modeling, understudy

training etc.

In the same vein, this findings revealed that staff are aware of training and development

programme in LASUTH which invariably mean that there is a training policy that stipulates this,

study also show that majority of them have partook in one form of training or the other, in the

same vein majority of them show that their inclusion was selection by head of departments and

board of directors, others were based on merit, voluntary and self-sponsored. It is also stated that

a majority of them were not sponsored by the hospital management rather they sponsored

themselves. Finding also shows that less than half of the respondents stated that training is

planned and systematic, while more than half of the respondents do not think that training is

planned and systematic in LASUTH. This finding is supported by Frankel (1984) who noted that

a good strategy is to ask the group to offer important ground rules for the training or to provide a

list of prepared norms and invite the group to add to the list. Kenney et al (1992:3) also

collaborate this by stating that companies should have different policies for training depending

on the class or level of employment or level of employees to be trained.

However, finding shows that training and development in LASUTH helped to improve staff

performance. This was corroborated by the response gotten from the interview when the
interviewee indicated that the purpose of the training is to improve the skills and performance of

staff. The study also shown that there is significant relationship between evaluating in-service

training and development of staff and performance of health workers in LASUTH. This findings

is corroborated by Neo et al. (2000), who contended that now organizations are beginning to

realize the important role that training and development play in enhancing performance and

increasing productivity, and ultimately stay in competition. In support of this finding WHO

(2004a) identified the performance of health systems organization and management as a major

influence on the achievement of better health objectives.

Furthermore, findings also revealed that the relevance and effectiveness of in-service is very

important and important respectively to the performance of staff in LASUTH. This is to say that

training and development programme is very important to the quality of service staff renders to

client. This findings was supported by Piyali, et al. (2011) who noted that the training materials

covered all of the training topics including those where deficiencies in practices were detected in

the past and those which were the focus of the ‘haraka upesi’ intervention – prompt treatment for

febrile children and health workers’ adherence to recommended case management.

However, findings also revealed that the content of the training materials is very relevant to the

job as a majority attest to this. Study also shows that there is significant relationship between the

relevance of the content of the training materials and the job of the health worker in LASUTH.

This findings is supported by Piyali, et al. (2011) who noted that the training materials covered

all of the training topics including those where deficiencies in practices were detected in the past

and those which were the focus of the ‘haraka upesi’ intervention prompt treatment for febrile

children and health workers’ adherence to recommended case management. He emphasized that
the manuals included objectives, content and modalities of delivery for each training unit and the

job aids were piloted to assess health workers understanding of the job aids messages

Furthermore, finding shows that the skills and quality of presentation of the resource personnel is

very high and high respectively as a majority attests to this. This findings is supported by Nawal

Mansour (2011) who noted that the training was facilitated by the national DOMC trainers of

trainers (TOTs) who are specialists in the different training units and have previously undertaken

case-management training of health workers.

The study also revealed that half of the respondent in total specified that training is evaluated in

LASUTH, through skill organization and staff performance, through examination and through

the filling of questionnaire. While half of them do not think that training is evaluated in

LASUTH. Finding also shows that there was no follow up of the training in LASUTH. This

findings is supported by Beardwell and Holden (1993) who cited some methods to evaluate

training to include; Questionnaires, Tests or examinations, Structured exercises and case studies

etc. Chief Medical Officer (MOSHW) (2008) who noted that one day of the training was devoted to

the management of uncomplicated malaria and no follow up of the training was provided

Finally, findings indicated that one of the benefits of in-service training is staff motivation and

satisfaction. And also to help improve staff performance and in-service training offers the staff

opportunity to identify potential for further development. This findings is supported by Cole

(2002) who that employees who receive training have increased confidence and motivation; give

a feeling of personal satisfaction and achievement, and broaden opportunities for career

progression; and help to improve the availability and quality of staff. This finding is also in

consonance with Tessin(1978) and Dickey(1982) who both noted that training and development
leads to improved profitability, training and development leads to improved job knowledge and

skills at all levels of organization and training and development improve workers morale and job

satisfaction. Neo et al. (2000) also corroborated this finding by noting that now organizations are

beginning to realize the important role that training and development play in enhancing

performance and increasing productivity, and ultimately stay in competition.

RESPONSE FROM INTERVIEW OF TEN MANAGEMENT STAFF OF LASUTH

a. All the respondents’ interview admitted that LASUTH have been involved in training

and development for the past 10years.

b. They also admitted that the purpose of training and the key internal and external

impact of the training is

 To give quality and effective medical care

 To improve the skills and performance of staff

 To motivate staff and increase their productivity

 To be able to meet international standard.

c. All the respondents indicated that LASUTH have a training policy and briefly

describe the policy and procedure to include.

 Identification of training needs either long or short term

 Notification of release and sponsorship

 Selection of qualify staff.

d. They all admitted that all the ranked and file of LASUTH are aware of the training

policy and also agree to make available the training policy and all other document

relating to training and development.

e. Eight at of ten of the respondents shows that training practice develop in LASUTH

 Through unit and department continuing education staff

 Through clinical reviews

 Through programmes organization by management such as workshops, seminars

and lectures while two of stated respectively that training practice develop in

LASUTH right from inception of the teaching hospital, and when LASUTH

change from general hospital.

f. A majority of the respondents indicated that in service training, on the Job training,

off the Job training, training the trainer, orientation are the principles of training apply

at the workplace.

g. Majority of the respondents agreed that individual and organization needs are

determined; through individual assessment and evaluation, through clinical meetings

where skill and knowledge of staff are displayed.

h. While only two shows that individual and organization needs are determined by the

board of the hospital, and through screen and select.

i. All the respondents indicated that staff are selected for training by

 By selection from department

 Nomination by department base on merit

 Personal interest

j. All the respondents also admitted that training objectives are determined
  Through assessment and evaluation

 Through assessment and reports

 Monthly and yearly assessment, and systematic approach

 Immediate learning need, task and duties

 By the need of the hospital / staff

 Through committee in charge

k. Majority of the respondents also indicated that the training plan is developed through

 The use of quality personnel

 Resource personnel

l. while few noted that training plan is developed by

 Head of department

 Committee in charge

 Management

m. Most of the interviewee noted the following as the kind of training used.

 In-service training

 Orientation

 On-the-job and off-the-job training

 Internal and external training

 Training the trainer

n. All the respondents also noted that following are the methods of training used

 Seminal & workshops

 Clinical lecture
  Personal contact

 Facilitation

o. All the respondents interview indicated that training is evaluated in the following

ways

 Through the output i.e. increase in the number of client that access the facility

 Assessment of participant after training through post training test

 Through the service rendered and performance

 Through questionnaire

p. All the interviewee indicated the following as the monitoring mechanism used to

monitor training policy

 Supervision

 Monthly & annual evaluation

 Quality assurance

 Through Annual Performance Evaluation Report (APER) form

q. All the respondents noted that in their assessment training has impacted on staff

motivation and performance

 By increasing individual productivity

 Through the show of interest in training by personnel

 Through improvement in performance

r. Most of the respondent agreed to keep personal profile of each employee and also

records of past training with date which was shown to me.

s. They also agreed that there is career, training and development progression projection

for each employee.

 t. According to majority of the interviewed staff, the least number of employees trained

each year is within the range of 250-280.

The study shows that response to the interview was in line with response from the questionnaire

as majority of them noted that there have been training and development for the past ten years

and its objective is to improve staff performance and skills on the job. Both categories of

respondents noted that the kind of in-service training and development used are in-service, on-

the-job, lectures seminal and workshops. Though majority of the interviewee stated that they

evaluate training and development by staff performance, APER, and questionnaire which is in

line with the few that responded to this in the questionnaire. However, majority of them that

responded through the questionnaire said that in-service training and development is not

evaluated in LASUTH and there is no follow up of training.

CHAPTER FIVE
 SUMMARY, CONCLUSION AND RECOMMENDATION

5.1 Introduction

This chapter focuses on the summary of the study, conclusion based on the findings of this study,

recommendation and suggestion for further study. This study evaluate the in-service training and

development of professional health worker in LASUTH

5.2 Summary

This study employed descriptive survey to execute the in-service training and development of

professional health worker in LASUTH in Lagos state. A total of eight research questions were

raised and three null hypotheses were formulated and tested. The instrument used for data

collection was the questionnaire. Simple percentage and chi-square of significant relationship

were employed in the analysis of data. A total of 92 at of 160 respondents used as sample were

actually used as sample.

From the data analysis the following findings were obtained.

1. Majority of the respondents revealed that the type of in-service training and development

staff needs for improve productivity are as followed; basic life supports programme,

seminars and workshops, Management/administrative programme and E-health

programme. They also show that the objectives of the training and development are as

follows; to improve performance, to acquire skills and knowledge in the professional

field and to be acquitted with use of ICT for health otherwise known as E-health. In their

respond the following method was used for the training; seminars and workshops, on the

job training, formal lecture and understudy training. The study also shown that there is
 significant relationship in the type of in-service training need by health workers in

LASUTH and staff productivity.

2. Majority of respondents revealed that they are aware of training and development

programme in LASUTH. They also indicated that majority of them have partook in one

form of training or the other, in the same vein majority of them show that their inclusion

was selection by head of departments and board of directors, others were based on merit,

voluntary and self-sponsored. It is also stated that a majority of them were not sponsored

by the hospital management rather they sponsored themselves. Finding also shows that

less than half of the respondents stated that training is planned and systematic, while

more than half of the respondents do not think that training is planned and systematic in

LASUTH.

3. Majority of the respondents revealed that training and development in LASUTH helped

to improve staff performance. This was corroborated by the response gotten from the

interview when the interviewee indicated that the purpose of the training is to improve the

skills and performance of staff. The study also shown that there is significant relationship

between evaluating in-service training and development of staff and performance of

health workers in LASUTH.

4. Majority of respondents revealed that the relevance and effectiveness of in-service is very

important and important respectively to the performance of staff in LASUTH. This is to

say that training and development programme is very important to the quality of service

staff renders to client.

 5. Majority of the respondents indicate that the content of the training materials is very

relevant to the job. Study shows that there is significant relationship between the

relevance of the content of the training materials and the job of the health worker in

LASUTH

6. Majority of the respondents revealed that the skills and quality of presentation of the

resource personnel is very high and high respectively.

7. Findings also revealed that half of the respondent in total specified that training is

evaluated in LASUTH, through skill organization and staff performance, through

examination and through the filling of questionnaire. While half of them do not think that

training is evaluated in LASUTH. Finding also shows that there was no follow up of the

training in LASUTH.

8. Findings also revealed that majority of the respondents indicated that the following are

the benefits of in-service training and development; staff motivation and satisfaction,

improve staff performance and offers staff opportunity to identify potential for further

development.

5.3 Conclusion

Based on the findings of the study it is therefore concluded that the type of in-service training

and development staff needs for improve productivity are as followed; basic life supports

programme, seminars and workshops, Management/administrative programme and E-health

programme. This is to improve performance, to acquire skills and knowledge in the professional

field and to be acquitted with use of ICT for health otherwise known as E-health. The methods
used for the training are as follows; seminars and workshops, on the job training, formal lecture

and understudy training.

In the same vein, it can be concluded that staff are aware of training and development

programme in LASUTH and have also partook in one form of training or the other. Study shows

that majority of them were selected by head of departments and board of directors, others were

based on merit, voluntary and self-sponsored. Finding also stated that a majority of them were

not sponsored by the hospital management rather they sponsored themselves. Finding also shows

that less than half of the respondents stated that training is planned and systematic, while more

than half of the respondents do not think that training is planned and systematic in LASUTH.

However, majority of the respondents revealed that training and development in LASUTH

helped to improve staff performance. This was corroborated by the response gotten from the

interview when the interviewee indicated that the purpose of the training is to improve the skills

and performance of staff. The study also shown that there is significant relationship between

evaluating in-service training and development of staff and performance of health workers in

LASUTH.

In a similar manner, a majority of respondents revealed that the relevance and effectiveness of

in-service is very important and important respectively to the performance of staff in LASUTH.

This is to say that training and development programme is very important to the quality of

service staff renders to client.

Furthermore, a majority of the respondents indicate that the content of the training materials is

very relevant to the job. Study shows that there is significant relationship between the relevance

of the content of the training materials and the job of the health worker in LASUTH. It can be
concluded that the skills and quality of presentation of the resource personnel is high as indicated

by a majority of the respondents.

Finally, half of the respondent in total specified that training is evaluated in LASUTH, through

skill organization and staff performance, through examination and through the filling of

questionnaire. While half of them do not think that training is evaluated in LASUTH. Finding

also shows that there was no follow up of the training in LASUTH. Finding shows that the

following are the benefits of in-service training and development; staff motivation and

satisfaction, improve staff performance and offers staff opportunity to identify potential for

further development.

5.4 Recommendations

The following recommendations are set forth in the light of these findings:

1. There should be systematic and proper planning of training and development policy as it

allow the scope and objective of LASUTH to be well defined.

2. Training and development programme should be redefined and properly evaluated in

LASUTH so as to ascertain the relevance and effectiveness of the each training on staff

performance and overall productivity.

3. There is also the need for follow up to see if the staff sent for training are measuring up

with the skill and knowledge acquire during the training

4. Lagos state university teaching hospital should motivate their staff by sponsoring most of

the training and development programme as finding shows that majority of the staff sponsored

themselves.
5. There should be fairness and transparency in the selection of staff for training and

development programme.

6. Identification of training needs should be done more professionally in conjunction with

the medical director as well as the individuals involved together with the HR personnel.

5.5 Suggestion for Further Research

From the result obtained from this study the following suggestions for further studies are made.

1. An investigation should be conducted on the impact of training and development policy

and procedure of Lagos state university teaching hospital.

2. A comparative on the evaluation of in-service training and development in public and

private health sectors in Nigeria

3. A study should be conducted on the impact of in-service training and development on

staff motivation and productivity

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 APPENDIX 1
Department of Business Administration,

Faculty of Social Science,

University of Benin,

Edo State.

July, 19th 2011.

Dear Respondents,

AN EVALUATION OF IN-SERVICE TRAINING AND DEVELOPMENT

OF PROFESSIONAL HEALTH WORKER

This study is primarily designed to assess an evaluation of in-service training and

development of professional health worker in Lagos state university teaching

hospital, Lagos, Nigeria as a case study. The questionnaire is for the purpose of collecting data
about evaluation of in-service training and development.
You are kindly requested to contribute to the success of this study by giving candid answers to
the questions contained in the attached questionnaire. Be rest assured that any information
supplied will be treated with strict confidence. We do not seek to know your identity as this is
purely an academic exercise. Please feel free to tick the appropriate boxes and endeavor to write
out your answers where necessary.

Thank you.

Yours faithfully,
 QUESTIONNAIRE

This questionnaire has been designed to solicit information for purely academic purposes. This is
to enable the researcher complete her thesis on the topic; AN EVALUATION OF IN-SERVICE
TRAINING AND DEVELOPMENT OF PROFESSIONAL HEALTH WORKER: A CASE
STUDY OF LAGOS STATE UNIVERSITY TEACHING HOSPITAL, in pursuance of Master
degree.

NB. All information given would be treated with utmost confidentiality. Thank you.

SECTION A

BASIC DEMOGRAPHIC DATA (PLEASE TICK WHERE APPROPRIATE)

1. Gender;

a) Male ( )

b) Female ( )

2. Educational Background;

a) Senior Secondary School Cert ()

b) Ordinary Level ()

c) Advance Level ()

d) Higher National Diploma ()

e) First Degree ()

f) Master’s Degree ()

g) Other (please specify) ()

SECTION B

INFORMATION ON TRAINING AND WORKER PERFORMANCE

4. What is your position in LASUTH?

a) Doctor ()

b) Nurse ()

c) Admin staff ()

d) Hospital facilitator ( )

e) Hospital orderlies ()

f) Accountant ()

g) Caterer ()

h) Laundry ()

i) cleaner ()

5. How long have you been working with LASUTH?

a) 1 – 10 years ( )

b) 11 – 20 years ( )

c) 21 – 30 years ( )

d) 31 – 40 years ( )

6. Are you aware of any training programme in LASUTH?

a) Yes

b) No

7. Have you had any form of training since you joined LASUTH?

a) Yes ( )

b) No ( )
8. If you answered yes to question 6, how long ago?

a) 1 – 6 months ( )

b) 7 – 12 months ( )

c) 1- 3 years ( )

d) Over 4 years ( )

e) Not applicable ( )

9. If you have been with LASUTH for at least two years, how many times have you had any
form of training?

a) Only once ( )

b) Twice ( )

c) Several times ( )

d) Never ( )

10. How were you selected? Please specify.

...................................................................................................................................

...................................................................................................................................

...................................................................................................................................

11. What were the objectives of the training?

a) To help improve performance ( )

b) To acquire more skills ( )

c) Other please specify ( )

12. What kind of training did you participate in? Please specify

……………………………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

13. What methods were used for the facilitation?

a) Seminar ( )

b) On-the-job training ( )

c) Understudy training ( )

d) Formal Lectures ( )

14. How was the training evaluated? Please specify.

…………………………………………………………………………………………

…………………………………………………………………………………………

………………………………………………………………………………………….

15. In your opinion, do you think training at LASUTH is planned and systematic?

a) Yes ( )

b) No ( )

c) Not sure ( )

16. Are you motivated by and satisfied with the training program of LASUTH?

a) Yes ( )
b) No ( )

17. In your opinion, do you think training has helped improve your performance since you
joined LASUTH?

a) Yes ( )

b) No ( )

18. Has training offered you the opportunity to identify any potential you have for further
development?

a) Yes ( )

b) No ( )

19. Have you ever been sponsored for further studies or personal development program?
What kind of sponsorship please specify

a) Yes ( )

b) No ( )

20. Are you aware of any career development projections for you?

a) Yes ( )

b) No ( )

21. Are you aware of any training and development projections for you?

a) Yes ( )

b) No ( )
22. Have you ever self sponsored yourself for further studies to acquire new skills, knowledge
and abilities?

a) Yes ( )

b) No ( )

23. How relevance and effective is the in-service training

A) Very Important ()

b) Important ()

c) Not sure ()

24. Was there follow up of the training

a) Yes ()

b) No ()

25. If your response to item 23 is not sure, please indicate why

a) I already have the knowledge & skills ()

b) The timing is wrong ()

c) Training is not relevant to job requirement ()

26. How relevant is the content of the training materials to the job?
a) Very relevant ()

b) Relevant ()

c) Not relevant ()

d) Can’t say ()

27. If your response to item 26 is positive did it meet your job requirement?
a) Yes ()
b) No ()

28. How would you rate the skills and manner of presentation of the resource personnel?
a) Very high ()

b) High ()

c) Low ()
 Appendix 2

Interview Schedule for Management of LASUTH

SCHEDULED INTERVIEW QUESTIONS FOR

MANAGEMENT OF LAGOS STATE UNIVERSITY TEACHING HOSPITAL

Please indicate your rank and Fill in the blank spaces.

Rank

………………………………………

Department ……………………………….

2. Has LASUTH been involved in training and development for employees over the past 10
years (2000 – 2010)?

…………………………………………………………………..

…………………………………………………………………..

…………………………………………………………………..

…………………………………………………………………..

2. How long has LASUTH been involved in training and development?

………..………………………………………….

............................

..…………………………………………………………………….
……………………………………………………………………...

3. What are the major purposes of training and what key internal and external influences impact on
training?

………………………………………………………………....

........

………………………………………………………………………

………………………………………………………………………

………………………………………………………………………

………………………………………………………………………

1. Does LASUTH have a training policy in place? Is the policy documented?

………………………………………………………………………

………………………………………………………………………

………………………………………………………………………

2. Briefly describe the training policy and procedures in LASUTH.

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………
…………………………………………………………………………..

3. Are the rank and file of LASUTH aware of the training policy?

…...............................

..............................................................................

………………………………………………………………………….

………………………………………………………………………….

4. Would you please make available to me documents on training policy and all other
documents related to training and development?

…………………………………………………………………………

………………………………………………………………………...

………………………………………………………………………..

5. How did training practice develop in LASUTH?

………………………………………………………………………

..

………………………………………………………………………

..

………………………………………………………………………

..

………………………………………………………………………
...

…………………………………………………………………………

6. What principles of training apply at the workplace?

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

………………………………………………………………………...

………………………………………………………………………..

10. The training process.

a) How are individual and organizational needs determined?

………………………………………………………………………….

………………………………………………………………………….

………………………………………………………………………….

………………………………………………………………………….
…………………………………………………………......

...................

b) How are staff selected for training?

…..........................................................................................

...................

………………………………………………………………………….

………………………………………………………………………….

…………………………………………………………………………

c) How are training objectives determined?

…………………………………………………………………………

…………………………………………………………………………

……………………………………………………………

...................

…………………………………………………………………………

…………………………………………………………………………

d) How is the training plan developed?

………………………………………………………………………….
………………………………………………………………………….

………………………………………………………………………….

………………………………………………………………………….

………………………………………………………...

..........................

11. In presenting the training;

a) What are the kinds of training used?

………………………………………………………..

...........................

…………………………………………………………………………..

…………………………………………………………………………..

…………………………………………………………………………..

b) What methods of training are used and why?

……………………………………………………...

...............................

…………………………………………………………………………

……………………………………………………………………………
……………………………………………………………………………

……………………………………………………………………………

c) How is training evaluated?

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

7. Is the implementation of the training policy monitored to ensure that it is practiced as

prescribed? What is the monitoring mechanism used?

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….
 8. In your assessment, has Training impacted on staff motivation and performance? Could
you please specify in terms of contribution to;

a. Increased individual productivity.

………………………………………………………… …………..

………………………………………………………………………

………………………………………………………………………

………………………………………………………………………

b. Training in terms of numbers.

………………………………………………………………………

………………………………………………………………………

………………………………………………………………………

9. Does training have an effect on worker performance and productivity? How do

you measure training effect on worker performance and productivity?

…………………………………………………………………………………..

…...........................................................................................................................

…………………………………………………………………………………..

…………………………………………………………………………………...
…...........................................................................................................................

10. Do you keep personal profile of each employee?

……………………………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

11. Do you have records on past training with dates on each worker?

……………………………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

12. Do you have career progression projections for each employee?

……………………………………………………………………………………

……………………………………………………………………………………
…………………………………………………………………………………

....

……………………………………………………………………………………

13. Do you have training and development projections for each employee?

………………………………………………………………………………………..

………………………………………………………………………………………..

…………………………………………...................................................

...................

14. Please provide data on employees sponsored in the past 10 years in terms of;

a)

Number sponsored each year for the past 10 years

b)

Type of sponsorship offered

c)