Training Needs Assessment Focus Group 2007
Summary of Findings
Introduction
The Virginia Department of Health (VDH) Emergency Preparedness and Response
(EP&R) Program conducted a survey about health department employee training needs at
the end of 2006. Regional focus groups were conducted May-June 2007 as a follow-up
to the training needs assessment survey.
Items of discussion were determined by looking at the data from the 2006 survey and
identifying priorities of respondents that needed further clarification. In addition, the
Office of Commissioner joined EP&R in the focus groups to gather information to
improve the VDH employee orientation. The employee orientation information gathered
will not be included for the purposes of this report. However, it is worthy of noting that
many participants stated that employee orientation should include EP&R information.
Purpose
The EP&R purpose of the focus groups was to gather additional information about the
emergency preparedness and response training needs of health department employees and
to gather information that will assist in a making TRAIN Virginia a user-friendly and
useful tool.
Methodology
Ten focus groups were conducted regionally. Sites were chosen based on the locations of
volunteers from the 2006 survey. Participants were invited via e-mail (Appendix A) and
were provided boxed lunches and an EP&R mug as an incentive to participate. Health
Directors were asked to help identify participants in a few areas when the initial
recruitment was not sufficient.
Betsy Marchant, Instructional Designer, and Mary Hagood, Orientation Project Manager,
conducted the focus groups following the discussion guide (Appendix B). Qualitative
data from the focus groups was analyzed using Atlas.ti.
Results
Focus group sizes ranged from 5 to 10 participants. In total, 75 health department
employees participated. Nurses were the most represented professional role (N=18),
followed by Environmental Health Specialists (N=13), Administrative Support Staff
(N=8), Health Educators (N=8), and Emergency Planners (N=8).
Site
Table 1: Participation in Focus Groups
Districts invited
Charlottesville/Albemarle
Health Department
Peninsula Health
Department
Virginia Beach Health
Department
Fairfax Health Department
Petersburg Health
Department
Montgomery County
Health Department
Southwest Virginia Higher
Education Center,
Abingdon
Fauquier County Health
Department
Madison Building,
Richmond
Polycom
Total:
Thomas Jefferson, Staunton, Winchester
Number of
participants
8
Peninsula, Portsmouth, Western Tidewater,
Three Rivers, Hampton
Chesapeake, Eastern Shore, Norfolk City,
Virginia Beach
Fairfax, Arlington
Crater, Chesterfield, Southside, Piedmont
10
New River, Roanoke City, West Piedmont
7
Cumberland Plateau, Lenowisco,
Washington
8
Loudoun, Prince William, Rappahannock,
Rappahannock/Rapidan, Alexandria
Central office, Henrico, Chickahominy
9
Central Virginia
5
75
10
5
5
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Table 2: Professional Roles of Participants
Professional role
Number of participants
Nurse
18
Environmental Health Specialist
13
Administrative Support Staff
8
Emergency Planner
8
Health Educator
8
Administrator/Director/Manager
5
Epidemiologist/Surveillance Staff
4
Nurse Practitioner
2
Nutritionist
2
Office Manager
2
Office Support Supervisor
2
Lab Professional
1
Dental Professional
1
Personnel Assistant
1
2
Emergency Preparedness and Response
Participants brainstormed specific areas of emergency preparedness and response on
which they or their coworkers need training. While 80% of participants reported that
they know what their role in an emergency would be in the handwritten survey, one of
the most discussed training needs in the focus groups was an individual’s specific role in
an emergency. Participants were concerned about how they would be contacted, where
they would need to report, who they would report to, and, specifically, what their
responsibilities would be.
The other most discussed training needs were the national incident management system
(NIMS) and incident command system (ICS). Many of the participants had taken NIMS
or ICS classes online. However, they felt that they needed practical discussions or
exercises in addition to the online course to help them understand how incident command
functions in public health. They wanted to know exactly who would fill roles and how
everyone’s role would fit together. They also felt that without application of the content,
they may need periodic refresher courses.
Next, participants discussed their need to know where to look for emergency
preparedness and response resources, including policies and procedures, contacts, and
updated information. The VDH Emergency Preparedness and Response Web site was
mentioned a few times, but some participants were not aware of it. Participants also
suggested that a manual be produced with this information so that they would be able to
refer to it quickly without having to download or read online.
Another highly discussed topic was the need to practice responding to emergencies.
Participants acknowledged that it is difficult to have everyone participant in an exercise
at once. However, they suggested that it be required that all employees participant in
exercises and/or for central office to develop exercise templates that can be used locally
periodically, especially if all employees could not participate at once. They also felt that
exercises need to extend across districts because in an emergency it may be that one
district steps in to assist another. In addition, they appreciated interacting with other
partners during exercises.
Participants often expressed interest in first aid and CPR being offered to all health
department employees. In addition, participants suggested providing more training to
prepare themselves and their families for emergencies. For example, employees
suggested training on developing plans for child or elder care if they are called upon for
an emergency during off duty hours. On a related note, several participants also
expressed interest in Community Emergency Response Teams (CERT) training.
Participants were apprehensive about using communication equipment such as portable
radios, walkie talkies, and satellite phones during an emergency. They felt they needed
training on how to use the equipment and the jargon that should be used. They were also
concerned about how they would be contacted and stay updated in an emergency,
especially if electricity and phone lines are not working.
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Several of the focus groups discussed the fact that risk communication training is only
provided to a few people, when in fact, all levels of staff are going to come in contact
with the public during an emergency. In addition, several participants mentioned that
their managers attend EP&R trainings, but do not bring the information back to their
employees. They were also concerned that they never hear any lessons learned from
exercises or real events.
Several participants felt that training is not consistent across districts. They felt that all
districts should be provided the same trainings so that in an emergency, they would be
able to work across districts if needed. They suggested that a centralized training plan be
developed and fine-tuned for individual districts.
Communication Skills
Participants were asked to identify types of communication skills training needed. The
most discussed topic was communication with the public or media. Participants felt that
only upper level staff is receiving trainings in this area. They were concerned that these
where not necessarily the folks that are on the front line talking to the public. They said
that those who answer the telephones and come in direct contact with the public need
skills to know who they can talk to and what to tell them. Several suggested providing
training on talking points and types of calls that should be escalated to those employees
who answer the telephones.
The next most common topic discussed was training in Spanish. Participants
acknowledged that a growing number of clients are Hispanic and that they were having
more and more language barriers. Even though translation services are available,
participants felt that they needed basic skills to, at a minimum, tell patients that a
translator is on the way. They also felt that employees need training in cultural
sensitivity so that culturally appropriate care can be provided.
Another highly discussed topic was interpersonal communication skills, used both
internally with other employees and externally with clients. Participants felt that
employees need skills to be able to listen and clearly understand what someone is trying
to say. In addition, they felt it was important to hear what a person is not saying by
interpreting body language. They also said that employees need skills to speak clearly
and concisely in plain language, especially avoiding acronyms and jargon. On a related
note, many participants discussed the need for training on how to deal with confrontation.
They acknowledged that they have many upset or panicked patients to deal with, in
addition to dealing with coworker confrontations.
Participants suggested developing a common protocol for communication, for example,
how to answer the telephone and write emails. They felt that many phone calls are not
answered appropriately and that it would help to have training on telephone etiquette and
to also provide employees with a contact list so that they can properly redirect phone
calls if needed. They also recognized that some employees lack skills in using email and
thought that this hindered some communication.
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TRAIN Virginia
The majority of the participants were aware of TRAIN, however, many reported only
visiting the site when they were required to use it to register for a course. Most of the
discussion about TRAIN was that it is not user friendly. Even those who considered
themselves computer savvy reported having difficulty with the navigation. Participants
also reported having problems searching for classes, both when they know the title of the
course and when they do not. A few also expressed frustration in receiving
announcements for courses via e-mail before it was been posted to TRAIN, therefore,
when they searched for the course it was not there.
Generally, participants did not know that it could be used to track their training or that a
non-TRAIN course could be added to a transcript. Several reported that they do not use
the system because required continuing education courses for their profession are not
offered on the site. Others responded that they did not know what types of classes, other
than those required, might be available on TRAIN. Participants were also concerned that
using TRAIN is a duplication of effort with Department of Human Resources
Management (DHRM) reports and databases used by individual districts.
Other barriers that were mentioned to using TRAIN included having the time, being able
to remember passwords, having limited computer access, knowing how to access TRAIN,
and being computer literate.
Participants were asked what one thing they would change about TRAIN to make it
easier to use. The suggestion offered by participants most often was to make it easier to
search for courses. They claimed that they were not able to find courses even when using
the specific title. Next, participants suggested more marketing to let them know the types
of courses available, including those from other states. They felt the more TRAIN is
publicized as a tool that can be incorporated into every day activities, not just EP&R
activities, the more likely people will become comfortable with using it. To improve
overall usability, participants suggested making it easier to register for the site and
reducing the layers within the site.
Other suggestions to make TRAIN easier to use were making log in names and
passwords the same as the ones that they use for other applications, putting a link to
TRAIN on the VDH home page, providing tutorials on how to use it, making it easier to
move a completed course to your transcript, and making it easier to print certificates.
Focus Group Questionnaire
In an effort to get as much information as possible, while being efficient with time,
participants were given a one-page questionnaire to complete before or after the focus
group. In this survey, the majority of participants said that the find out about trainings
via e-mail. All of the participants said that they have access to a computer with
connection to the Internet. Only 8% of participants did not have speakers with their
computer. Fifty-five percent of the participants reported that they could spend 60
minutes or more in one sitting to complete a computer-based course. Only 11% of
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participants said that they could spare only 15 minutes or less in one sitting on a
computer-based course.
Chart 1: Time available for one sitting of computer-based training
20
15
Number of
participants
10
5
0
<15
15
30
45
60
>60
Minutes
The most requested computer trainings were statistical programs (i.e., SAS, EpiInfo),
Microsoft Access, Geographic Information System (GIS), and Microsoft Excel,
respectively. A significant number of respondents were also interested in obtaining
training in Microsoft PowerPoint, web design, and epidemiological programs (i.e.,
Essense, Biosense, NEDSS).
Chart 2: Requested computer training
35
25
20
15
10
Program
Other
Epi Programs
Statistical
Web design
WebVision
Excel
Access
PowerPoint
0
GIS
5
Word
Number of requests
30
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Limitations
There are some limitations to the data collected through the needs assessment. First,
every health district was not represented. Second, 75 participants is only a fraction of
health department employees. And lastly, participants were either self selected or
nominated by their health director. One must keep in mind that the purpose of the survey
is not to measure data, but to gain insight into employee’s thoughts on the issues that
were discussed.
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Appendix A: E-mail Invitation
The Virginia Department of Health (VDH) Commissioner’s Office and Emergency
Preparedness and Response Program are conducting focus groups regionally with health
department employees. The purpose of the groups is to identify specific training needs
regarding VDH new employee orientation and emergency preparedness and response.
You are being contacted because you indicated in a recent survey your willingness to
participate in a focus group to provide more specific information about training needs at
VDH. We would like to invite you to participate in a regional focus group on May ___,
2007 from 11:00 am – 1:00 pm at the _______ Health Department. In consideration for
your time, you will receive a boxed lunch and an Emergency Preparedness and Response
coffee mug.
If you are still willing to participate in a focus group, please reply directly to this e-mail
or call _______. We will only be able to accept the first 15 people who respond.
Your identity will be held confidential.
Thank you in advance for your cooperation.
Sincerely,
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Appendix B: Focus Group Discussion Guide
Welcome and background (5 minutes)
Thank you for taking the time to join our discussion today. My name is {insert name}
and I’ll be moderating our discussion today. As you are aware, the Emergency
Preparedness and Response Program conducted a survey about your training needs at the
end of 2006. Most of you are here today because you indicated that you would
participate in a focus group on the subject.
Before we begin, I want to let you know that the goal of this discussion is to gather
additional information about the emergency preparedness and response training needs of
your district. In addition, we’ve teamed up with the Office of the Commissioner to also
gather information about how VDH’s employee orientation can be improved.
In talking about your training needs, please be aware that we should identify any training
that you feel is needed; however, some of it may be out of the EP&R or orientation
purview. We will pass along that information to the right folks.
There are no right or wrong answers. I want this to be a discussion, so please listen and
respond to each other as well as me. I expect we will be talking for an hour and a half to
two hours. Please feel free to get up and go to the restroom, or to leave if you need to.
We’re tape recording and taking notes during the session today so we won’t miss any of
your insights or opinions. Please speak up – only one person at a time. If several people
are talking at the same time the tape will sound garbled. We will be on a first name basis
today but no names will be attached to any reports that result from this discussion.
Do you have any questions before we get started?
Introductions (5 minutes)
We have name cards on the table in front of you to help me remember your names.
Before we start talking, let’s go around the room and have each person introduce
themselves. Tell us your name and what you do. For example, my name is __________,
and I am the _____________ for VDH.
In-Depth Discussion (1 hour 15 minutes)
1. Let’s start today’s discussion by talking about new employee orientation.
Tell me how long you’ve worked for VDH and a little about what your new employee
orientation involved? (Facilitator note: Go around the table and let each person
describe)
-(Probe) What topics did it cover?
-(Probe) Who conducted it?
-(Probe) Were your expectations met?
What topics/activities did you expect to be covered during orientation that weren't?
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2. Aside from orientation topics, what information or skills do you think everyone who
works in public health should know or be able to do? (Facilitator note: Ask to the
group)
3. Let’s get a little more specific now. In the needs assessment survey conducted last
year, many of you listed emergency preparedness and response as a gap you see in
yourselves and in coworkers. However, this topic is very broad. Let’s take a few
minutes to brainstorm the specific things within this topic that you think your group
could use training on.
You have sheets of paper and markers in front of you. With those, I would like
you to list the top two emergency preparedness and response information or skills
you think you and/or your coworkers could enhance with additional training?
Please use one sheet per idea. (Facilitator note: When participants are done, go
around the table and let each person talk about their first thought, then around the
table again to talk about their second thought, and so forth)
4. In the needs assessment survey conducted last year, many of you also listed
communication skills as a gap you see in yourselves and in coworkers. This is also a
very broad topic. Let’s take a few minutes to brainstorm the specific things within
this topic that you think your group could use training on.
Again, with your sheets of papers and markers, please list the top two types of
communication skills you think you and/or your coworkers could enhance with
additional training? (Facilitator note: When participants are done, go around the
table and let each person talk about their first thought, then around the table again
to talk about their second thought, and so forth)
5. Okay, let’s spend our last few minutes talking about how you keep track of your
training. The state EP&R office hosts a learning management system called TRAIN
Virginia. TRAIN allows you to search and register for courses that may be offered
around the state and web-based courses on a variety of tops. It also can help you keep
a record of the courses you have taken.
Are you aware of TRAIN?
What are your barriers to using TRAIN?
If there was one thing that we could do to make TRAIN easier to use, what would
it be?
Closure (5 minutes)
Before we close, is there anything else you want to add to our discussion?
Thanks again for coming. I really appreciate your taking the time to share your comments
and give us some feedback.
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Appendix C: Focus Group Questionnaire
Focus Group Questionnaire
1. How do you find out about trainings that are offered?
2. What kind of materials would be useful to accompany a course?
`
3. Do you have access to a computer?
 Yes
 No
If yes, does the computer have: Speakers?
 Yes
 No
Internet access?
 Yes
 No
4. How long, in one sitting, can you spend to take a web/computer-based course?
 Less than 15 minutes
 15 minutes
 30 minutes
 45 minutes
 60 minutes
 More than 60 minutes
5. What type of computer training, if any, do you need?
 Word
 PowerPoint
 Excel
 Access
 Web VISION
 Web design
 Statistical analysis program (e.g., SAS, Epi Info)
 Epidemiology data systems (e.g., Essense, Biosense, NEDSS)
 GIS
 Other, please specify:____________________
 None
6. Do you know what your role is in an emergency event?
 Yes
 No
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