Ashley Hughes, Stephanie Zajac, Jacqueline Spencer, and Eduardo Salas wrote a recent research note for the International Journal of Training and Development. The research note is build around an evidence-based checklist of actionable insights for practitioners that will help to enhance the effectiveness of training interventions. These actionable insights would help to prevent ‘transfer problem’, meaning that trained skills are not being used on the job.
For the full details and scientific evidence behind each suggested action, I suggest you access the research note. Nevertheless, here’s my summary of their main advice on improving training transfer before, during, and after training implementation:
Conduct a training needs analysis to align the training’s content and participants with the organizational objectives
Involved stakeholders should be aware of training, understand its importance, and — obviously — be prepared for the training program. The scholars provide seven specific actions here, including the setting of personal training goals, and aligning resources and rewards with the training.
Training attendance should be framed as an opportunity, and the training’s anticipated benefits could be emphasized (e.g. improvement of work processes or on-the-job performance).
A climate which encourages learning should be created, with dedicated time (and opportunities) for post‐training learning and a sense of accountability for using trained knowledge, skills, and abilities.
Piloting the training with a single department or subset of trainees is highly encouraged. This is one way that greatly helps to assess whether the training design is appropriate in terms of content and delivery.
Error‐encouragement framing can influence a trainee’s learning orientation and thus errors made during training should be framed as growth opportunities.
Use of the trained skills should be supported and planned. For instance, participants could be given a small workload reduction to provide opportunities to apply the learned knowledge and skills once they return to their position.
Management and training participants should be held accountable for their use of skills on the job.
Think about using just‐in‐time or refresher training and coaching, if needed.
Assess training effectiveness criteria including training transfer using metrics and analytics. Specifically, the scholars propose that the criteria measured in the training evaluation should correspond to the training needs identified through the training needs analysis that was conducted before the training.
Training evaluation criteria should consider the scope and timeframe of the training. Take into account that distal outcomes such as ROI may take longer to realize.
However, three years later now, a STAT investigation has found that the supercomputer isn’t living up to the lofty expectations IBM created for it. IBM claims that, through Artificial Intelligence, Watson for Oncology can generate new insights and identify “new approaches” to cancer care. However, the STAT investigation (video below) concludes that the system doesn’t create new knowledge and is artificially intelligent only in the most rudimentary sense of the term. Similarly, cancer specialists using the product argue Watson is still in its “toddler stage” when it comes to oncology.
Let’s start with the positive side. For specific treatments, Watson can scan academic literature, immediately providing the “best data” about a treatment — survival rates, for example — thereby relieving doctors of tedious literature searches. Due to this transparency, Watson may level the hierarchy commonly found in hospital settings, by holding (senior) doctors accountable to the data and empowering junior physicians to back up their arguments. Furthermore, Watson’s information may empower patients as they can be offered a comprehensive packet of treatment options, including potential treatment plans along with relevant scientific articles. Patients can do their own research about these treatments, and maybe even disagree with the doctor about the right course of action.
Although study results demonstrate that Watson saves doctors time and can have a high concordance rate with their treatment recommendations, much more research is needed. The studies were all conference abstracts, which haven’t been published in peer-reviewed journals — and all but one was either conducted by a paying customer or included IBM staff on the author list, or both. More importantly, IBM has failed to exposed Watson for Oncology to critical review by outside scientists nor have they conducted clinical trials to assess its effectiveness. It would be very interesting to examine whether Watson’s implementation is actually saving lives or making healthcare more efficient/effective.
Such validation is especially necessary because several issues are identified. First, the actual capabilities of Watson for Oncology are not well-understood by the public, and even by some of the hospitals that use it. It’s taken nearly six years of painstaking work by data engineers and doctors to train Watson in just seven types of cancer, and keep the system updated with the latest knowledge. Moreover, because of the complexity of the underlying machine learning algorithms, the recommendations Watson puts out are a black box, and Watson can not provide the specific reasons for picking treatment A over treatment B.
Second, the system is essentially Memorial Sloan Kettering in a portable box. IBM celebrates Memorial Sloan Kettering’s role as the only trainer of Watson. After all, who better to educate the system than doctors at one of the world’s most renowned cancer hospitals? However, doctors claim that Memorial Sloan Kettering’s training has caused bias in the system, because the treatment recommendations it puts into Watson don’t always comport with the practices of doctors elsewhere in the world. When users ask Watson for advice, the system also searches published literature — some of which is curated by Memorial Sloan Kettering — to provide relevant studies and background information to support its recommendation. But the recommendation itself is derived from the training provided by the hospital’s doctors, not the outside literature.
Doctors at Memorial Sloan Kettering acknowledged their influence on Watson. “We are not at all hesitant about inserting our bias, because I think our bias is based on the next best thing to prospective randomized trials, which is having a vast amount of experience,” said Dr. Andrew Seidman, one of the hospital’s lead trainers of Watson. “So it’s a very unapologetic bias.”
However, this bias causes serious problems when Watson for Oncology is implemented in other countries/hospitals. The generally affluent population treated at Memorial Sloan Kettering doesn’t reflect the diversity of people around the world. According to Martijn van Oijen, an epidemiologist and associate professor at Academic Medical Center in the Netherlands, Watson has not been implemented in because of country level differences in treatment approaches. Similarly, oncologists at one hospital in Denmark said they have dropped implementation altogether after finding that local doctors agreed with Watson in only about 33 percent of cases. Different problems occurred in South Korea, where researchers reported that the treatment Watson most often recommended for breast cancer patients simply wasn’t covered by their national insurance system.
Kris, the lead trainer at Memorial Sloan Kettering, says nobody wants to hear the problems. “All they want to hear is that Watson is the answer. And it always has the right answer, and you get it right away, and it will be cheaper. But like anything else, it’s kind of human.”