This study identified the needs of providing training to paramedical staff at Apollo

hospital. The results are expected to provide insight to policy makers, financers, and
health care organizations for guiding training planning and funding allocation
required for continuing professional education. This study uses available literature
regarding training needs that was designed as a questionnaire survey to investigate
the demographics, training needs and preferred approaches to improve the
performance of the target population. The study population included health care
professionals (paramedical staff) of major public health care facility Apollo. The
literature studied to identify training needs at Apollo used the Hennessy Hicks
Training Needs Analysis Questionnaire, which has been psychometrically tested for
validity and reliability. It is adopted by the World Health Organization as a training
assessment tool. The main part of the questionnaire comprises a core set of 30
items.
All 30 items refer to tasks that are central to the role of health care professionals and
are categorized into six super ordinate categories:, communication/teamwork, clinical
skills, administrative, managerial/supervisory and continuing professional education,
research/audit. . Respondents rate each item on a seven-point scale according to
two criteria: how critical the task is to the successful performance of the respondent’s
job and how well the respondent is currently performing the task. This instrument
allows for measuring training needs within broad categories as well as enables
comparisons between categories. Therefore, each category can be used
independently or in combination with other categories to obtain the required
information. Furthermore, the instrument has been extensively used by health care
professionals for various reasons. From the data available in the literature following
needs were found to be addressed with utmost priority.

ADDIE Model

The ADDIE Instructional Design Model:

A Structured Training Methodology
The ADDIE model is the generic process traditionally used by instructional designers
and training developers. The five phases—Analysis, Design, Development,
Implementation, and Evaluation—represent a dynamic, flexible guideline for building
effective training and performance support tools
It is an Instructional Systems Design (ISD) model. Most of the current instructional
design models are spin-offs or variations of the ADDIE model; other models include
the Dick & Carey and Kemp ISD models. One commonly accepted improvement to
this model is the use of rapid prototyping. This is the idea of receiving continual or
formative feedback while instructional materials are being created. This model
attempts to save time and money by catching problems while they are still easy to
fix.

Instructional theories also play an important role in the design of instructional

materials. Theories such as behaviorism, constructivism, social learning and
cognitivism help shape and define the outcome of instructional materials.
In the ADDIE model, each step has an outcome that feeds into the subsequent step.
1. ANALYSIS: The First Steps towards Quality Training

Let's take a look at the first phase in the ADDIE instructional design model—the
analysis phase. Great training programs don't come together by accident. They
require planning and analysis. You'll produce the best training if you first analyze
three important areas:

 The instruction goals you want to achieve

 The material that must be taught
 The learners' current capabilities

Instruction goals

1) Soft skills- Verbal & Non Verbal

Role of soft skills have become indispensable in the hospitality industry in the enhancement
of service delivery. Empathy is critical attribute for the effective handling of patients &
attendants as they are at higher stress level. In the Soft skill communication skills both verbal and
non-verbal are essential. However role of non -verbal skill is even more important as body
language, dress code help in forming impression even before any verbal communication is
started. This is important for all the cadre of paramedical staff at Apollo . A positive body language
(direct eye contact, warm smile, straight back, open arms, forward leaning posture) radiates
strength and security from the paramedic to the patient. A friendly, resonant voice with pitch
modulation, along with non-verbal gestures completes the picture of confidence. The Paramedic,
through his or her body language, should convey respect for the patient. Behaviour should neither
be arrogant, nor should it be deferential. Age-specific and gender-specific body language should
be used to convey a sense of professionalism, tempered with caring for the diabetic.

Expressive Empathy
Empathy is a feeling of concern, of feeling the same way as a patient does. It is a soft skill which
implies that one can treat the patient as oneself. Empathy is different from sympathy, which is
feeling of compassion, of pity, of looking down upon another person. To sympathize means
establishing an unequal relationship, while empathizing means a collaboration between equals.
Straightforward Simplicity
The simplest soft skill needed for effective counselling is straightforward simplicity. Whatever is
asked, stated or explained should be done in a simple, straightforward and short manner

2) Communication - The patient populations in Indian outpatient clinics are diverse and
there is a significant variation in their spoken language, cultural, educational and social
background. The doctor is therefore required to individualize the information for every
patient depending on the diverse backgrounds. We look at the different strategies that can
be used to effectively convey this to our patients.
3) Cultural awareness

Respecting the cultural issues of the patient can improve the confidence between the
patient and doctor. Appropriate training into understanding the varied cultural
requirements could help the doctor individualize the management of the patient. In India,
there is a big cultural variation and it is required that the medical physician should be well
aware of the majority of “do’s and don’ts” associated with the common cultural and ethnic
backgrounds of the patient. These should be included in the communication skills training
program and senior physicians must highlight the importance of such cultural sensitivities
during ward rounds.
Soft skills
Clinical skills
Administrative/ Supervisory/
Management
Computer skills
Personnel management
Time management
Public health promotion
Use of technical equipment
Disaster management/ Emergency
Stress management
Counseling

The Value of a Needs Analysis

The ADDIE analysis phase serves a major role in the quality assurance process. It
defines the project's needs and ways to measure its success. If you skip the ADDIE
analysis phase, you can easily introduce mistaken assumptions into the project.

 Wrong focus—the course content may not address the company's business
needs
  Too easy or too hard—the course could bore or frustrate the learners
 Incomplete, redundant, or inaccurate content—the course might not teach
the correct material

If you rush to development, you may not catch those errors until you launch the
course. At that point, it can be very costly to fix or redesign the course. In essence,
the training needs analysis is time well-spent.

Who Guides the Needs Analysis?

During the needs analysis phase, the training specialist may speak with many people
to learn about the project and its overall goals. Here are just a few examples of
individuals who can provide information:

Project sponsors (executives or senior leadership)—who can discuss the

business goals and objectives
 Subject matter experts—who can describe undocumented knowledge
 Representative members of the target audience—who can demonstrate
their current skills and behaviors

It is often critical to work with anyone who will be impacted by or have influence on
the final training product.

Questions that Drive the Analysis

When you start your project with a training needs analysis, you collect critical
information about organisation’s needs, learners' capabilities, and course content.
Here are some of the questions that a training specialist may ask during the ADDIE
analysis phase:

 What are the organisations’ needs driving this training project?

 What are the goals and objectives for this training project?
 How will you define success for both the learner and the project?
 How will you measure that success?
 Who is the intended training audience?
 What do the members of the learning audience already know?
 What do they need to learn?
 What resources are already available?

The training specialist uses the answers to these, and any possible combination of
other questions, to write the course's performance objectives.
2. The Role of Instructional Design

Once a training specialist has written the course's learning objectives and confirmed
them with the client, it's time to begin the instructional design phase. During the
design phase, the training specialist plans what the course should look like when it's
complete.

At the end of the instructional design phase, the training specialist produces an
instructional design document for the course. In many ways, this document is similar
to an architect's blueprints or a software engineer's design document. The
instructional design document describes the course's content, but it doesn't contain
the course content—just like a blueprint isn't a house and a software design
document isn't the actual software.

Creating an Instructional Strategy

At the start of the instructional design phase, the training specialist should have a
pretty good idea of what the learners will already know when they start the course
(also called the entry profile by carrying a learner analysis).

During the instructional design phase, the training specialist reviews the course's
learning objectives and considers the following questions:

 How should content be organized?

 How should ideas be presented to learners?
 What type of training methodologies be used?
 How should the course evaluate learners' accomplishments?

The answers to these questions help the training specialist produce the instructional
design document. This document describes the course structure and its instructional
strategies.

During the instructional design phase, the training specialist does not create course
content. The actual course content and training materials will be created during the
training development phase.
3. A Successful Training Development

A successful development phase draws upon the information collected in the needs
analysis phase and the decisions made in the instructional design phase.

If the team has done solid work during the first two phases of the ADDIE
methodology, then the training development phase should proceed smoothly and
quickly. The training specialists and client have agreed on the course's purpose,
structure, and content. Now it's easy to focus on writing the materials.

Steps in Training Development

The following steps are the most commonly taken while developing training projects:

 Create a prototype: A training prototype provides a preview. It shows what

the final course will look like when it is complete.
 Develop the course materials
 Conduct a tabletop review:
During the tabletop review, the training specialist and client check the
content's accuracy and completeness. They walk through the course
materials as experts looking for errors rather than as learners interacting with
the course.
 Run a pilot session: The pilot test of the course takes place before the
official course implementation. It provides the training specialists and the
clients a final chance to review the course prior to its official launch
4. Launching the Course: the Implementation Phase

The ADDIE model provides a systematic methodology to plan, develop, and test the
course before it launches. If you follow the ADDIE model, you'll have a high degree
of confidence about the course when it's ready to launch:

 The course meets important organisations goals

 The course covers content that learners need to know
 The course reflects the learners existing capabilities

It's possible for someone to write and launch a course without following the ADDIE
instructional design methodology, but there's a much higher degree of risk. The
course could have the wrong focus, confuse or frustrate the learners, or even lack
critical content. So, if the course has been developed without planning or testing,
then all you can do is hope that the course will go well.
5. Evaluating the Course

Evaluation Questions

When a course launches, it's not the end of the process. The ADDIE evaluation
phase provides a final review checkpoint for the project. During the evaluation
phase, the training specialist measures how well the project achieved its goals. Here
are just some of the questions that might be explored during the evaluation phase

 Do learners like the course?

 Do learners achieve the learning objectives at the end of the course?
 Do the learners change their behaviors in the workplace?
 Does the course help the company achieve its business goals?

For some questions, it's fairly easy to collect information. You can find out learners'
opinions of the course through a short survey immediately after the course. A pre-
test and post-test can measure how well learners achieved the learning objectives.

However, it takes more time and effort to measure changes in workplace behaviors
and improvement towards business goals. In both cases, you can't measure these
results immediately. You want to measure the long-term improvements rather than
the immediate results. The evaluation phase can extend for months.

Effective training helps learners make lasting changes to their workplace behaviors.
The changes shouldn't just last for a few days or a few weeks, but they should
remain with the learner months after the training course. A training specialist might
follow-up with a sample group of learners several months after the course to see
what the learners currently do. While the training specialist might identify people who
need refresher training, the study's purpose is to measure the course's long-term
effectiveness. If many of the learners quickly fall back into their old habits, then that's
a course-level issue that needs the training specialist's attention.

Similarly, the course should produce measurable business results. During the needs
analysis phase, the training specialist asked the organisation’s leadership to identify
business metrics that they want to improve through the training. Some courses may
have an immediate effect on a metric that's measured daily or weekly, but many
courses affect metrics that take longer to measure and detect a change. Sometimes
the company has to wait an entire quarter or longer before it can measure the
course's impact on its business results.

Adapted from Intulogy training material