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On-the-job training moves online

November 1, 2006
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Providers are turning to e-learning to train staff

The behavioral health industry has taken the charge of educating its workforce and improving workers' competency—within a budget—very seriously. As stated in a report from Michael A. Hoge and colleagues, "[C]ompetency has become an 'unavoidable' term in healthcare.... Policymakers laud it, educational programs are required to produce it, and consumers increasingly demand it."1 And as recommended in the Institute of Medicine's 2005 report on behavioral healthcare, "The health care workforce should have the education, training, and capacity to deliver high-quality care for mental and substance-use conditions."2

Yet providers know all too well that educational systems have not kept pace with healthcare's dramatic changes.1 Staff right out of school need significant on-the-job training to perform tasks at a level that produces solid outcomes. It has been challenging to train workers on needed skills to do their jobs. One way providers are meeting this challenge is by using e-learning, through use of online seminars, computerized/Web-based training materials, etc.

"Providers are leaders in creating flexible, innovative training and continuing education opportunities," says Linda Rosenberg, MSW, president and CEO of the National Council for Community Behavioral Healthcare, "and e-learning is integral to their efforts."

"E-learning gives employees the flexibility to take a course during downtime or when a client doesn't show for an appointment. It keeps employees doing their jobs and, therefore, maximizes billable services," says Lee Ann Slayton, a national consultant for the behavioral health industry and faculty coordinator for the National Council's Middle Management Academy.

"Another important aspect to e-learning is the efficiency of its self-paced, self-directed format," Slayton continues. "In an in-person workshop, everyone sits through the same material. Therefore, a seasoned employee may waste time reviewing material that he or she has mastered long ago, while the new employee might find the pace of the workshop too fast and may need more details to fully understand the topic. E-learning allows the employee to go at his or her own pace, and to delve as deeply into unfamiliar content as needed or to skip already mastered content."

E-learning also can help an organization manage and update content more easily, provide immediate feedback to trainees, make learning more fun and interesting, and track staff's performance and course completion.

Yet e-learning does not necessarily replace in-person training. Instead, it enhances traditional didactic learning experiences. This approach can help focus the in-person training event on changing paradigms and behaviors rather than spending a lot of time getting everyone up to speed on basic concepts.

One organization with e-learning experience is Health Resources of Arkansas, Inc. (HRA), which provides mental health and substance abuse services to a rural ten-county region in north-central Arkansas.

"E-learning is among the smartest moves we have made," says Sue Lamons, HRA's vice-president of promotional services. "We can more easily train on topics required by the state and accreditation organizations, and this system makes the content more interesting for participants. It is also a great time-saver, allowing staff to spend more clinical time serving clients." In fact, according to many studies, e-learning can provide a 35 to 40% time savings over traditional classroom instruction.

HRA's human resources department uses the e-learning system to keep track of staff credentialing progress and requirements, to provide up-to-date transcripts, and to make individual training records readily accessible to auditors (in a recent audit, CARF surveyors indicated they were pleased with HRA's use of e-learning).

HRA also created customized courses to complement those in the offered course library. E-learning saves some staff members a 240-mile round-trip to attend training sessions.

Many providers are sharing HRA's experience. "We have seen a 100% increase in our business in the past year, as e-learning technology is being creatively integrated with other training activities," says Sue Erskine, chief development officer at e-learning vendor Essential Learning.

E-learning clearly has an important role in providers' continuing education efforts. But Rosenberg reminds providers to view e-learning as part of a larger effort to improve the behavioral health workforce. "We also need to understand that more support is needed, from paying our workers a decent wage to upgrading our technology infrastructure," she says. "But e-learning is certainly an important component in addressing our workforce woes."

Kristin Battista-Frazee, MSW, is the National Council's Education Services Manager.

Lorraine Watson, PhD, is President of Essential Learning. The National Council and Essential Learning have partnered to offer e-learning to behavioral health providers.


  1. Hoge MA, Tondora J, Marrelli AF. The Fundamentals of Workforce Competency: Implications for Behavioral Health. 2003. Available at: http://www.annapoliscoalition.org/pdfs/Competency%20Fundamentals.pdf.
  2. Institute of Medicine. Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington D.C.:National Academies Press; 2005.