Training is an important part of efforts to reduce workplace injury, illness, and death. In the United States, the total cost of workplace training is over $100 billion per year.¹ In light of the costs and time involved with safety and health training, businesses want to know whether training can meet the goals of decreasing workplace injuries and illness, and whether the cost of training programs can be justified.

To better understand if occupational health and safety training and education programs have a beneficial effect on workers and businesses, the National Institute for Occupational Safety and Health (NIOSH) in collaboration with the Institute for Work and Health (IWH), Ontario, Canada, conducted a review of some of the recent research in this area. Earlier this month NIOSH and IWH released "A Systematic Review of the Effectiveness of Training & Education for the Protection of Workers."

This report shows that investment in training results in positive changes in worker knowledge and skills, attitudes, and behavior. These results are encouraging given that a primary purpose for workplace training is to impart new skills/behaviors that are transferred into the workplace. However, this research revealed that training as a lone intervention has not been demonstrated to have an impact on reducing injuries or symptoms. The fact that the study did not show an effect of training on health outcomes was, in part, an indication that training alone is not sufficient to result in reduced morbidity, mortality, or injury. For training to be effective in preventing occupational injuries and illness, it also requires management commitment and investment and worker involvement in a comprehensive hazard identification and risk management program. Additionally, the nature of the available research, (we studied only randomized, controlled trials) prohibited us from linking training to health outcomes. Randomized, controlled trials are considered by many, but certainly not all, to be the gold standard in research designs, but they are often expensive, difficult to conduct, and sometimes impractical for workplaces. As a result, many training studies are only quasi-experimental or completely correlational. This makes it quite a bit harder if not impossible to draw generalizable conclusions about the effectiveness of the training studied.

The research also examined the impact of one characteristic of training programs—the degree to which they "engage" the learner in training activities. Low engagement is defined as training that uses oral, written, or multimedia presentations of information by an expert source, but requires little or no active participation by the learner other than attentiveness. High engagement involves hands-on practice in a realistic setting. The review of randomized, control trials published in the last ten years found that a single session of high engagement training has a greater effect on behavior than a single session of low/medium engagement training. However, we shouldn't consider these results conclusive because there were so few quality studies available and the differences between high and low engagement were small.

In many cases, it was difficult or impossible to draw firm conclusions about the areas we examined due to the lack of quality research. There is a critical need for high quality, controlled studies of workplace health and safety training. That said, given that workplace education and training programs have a positive impact on health and safety behaviors, as we noted earlier in our discussion, and that training and education is a fundamental component of workplace safety and health protections, we recommend that workplaces continue to conduct education and training programs.

Researchers, training providers, labor, and management should continue to work together to advance the knowledge of effective practices in education and training. We encourage these parties to incorporate an evaluation component of training wherever possible and to utilize comparison or control groups. Additional research may reveal that improving training quality and effectiveness may require not only changes in the current parameters of the training programs, but also changes such as additional resources and an expansion of the audience for training to include supervisors, foremen and owners. We would appreciate your input on occupational health and safety training, particularly the feasibility of adding additional rigor to research designs through use of randomized controlled trials or other methodologies utilizing comparison groups, novel methods for evaluating "transfer of training" into the workplace, and methods that facilitate the measurement of "return on investment" of training to organizations.

We offer the following suggestions as areas for future research:

• Studies investigating factors associated with optimal intervals for refresher training
• Studies exploring and better defining the concept of training "engagement"
• Studies broadening our understanding of the effects of pre-training factors on training success
• Studies that discriminate between various elements related to training methods, delivery, and media
• Additional investigations clarifying what is known about factors affecting transfer of training
• Further exploration of the role of national culture in training effectiveness, particularly as it relates to beliefs about acceptable risk²
• Broad efforts to validate comprehensive models such as that proposed by Alvarez et al.³

—Carol Merry Stephenson, Ph.D.

Dr. Stephenson is Chief of the Training Research and Evaluation Branch in the NIOSH Education and Information Division.

References

1. Rivera RJ, Paradise A. State of the industry report. Alexandria (VA): American Society for Training and Development; 2006.
2. Burke MJ, Chan-Serafin S, Salvador R, Smith A, Sarpy S. The role of national culture and organizational climate in safety training effectiveness. European Journal of Work and Organizational Psychology. 2008; 17:133-154.
3. Alvarez K, Salas E, Garofano CM. An integrated model of training evaluation and effectiveness. Human Resource Development Review. 2004; 3(4): 385-416.

Posted 1/29/2010 at 12:17 pm