The LTC Training Dilemma: Finding the Right Training Company

Every day, a typical long-term care (LTC) organization experiences many training-related challenges. Worker skill and performance gaps and an increasingly diverse workforce point to the need for careful, culturally attuned training program planning. Frequent changes in accreditation requirements for training and budget cuts resulting from the economic downturn add to the complexity of developing effective training curricula.

If your organization uses outside vendors for onsite training, today’s training industry offers many valid options and presentation styles. A systematic approach to evaluating what training companies offer can help make the selection process easier—and less time-consuming!

As is true when hiring an administrator, nursing supervisor, or program director, it is important to ensure that a training vendor can meet the unique needs of your organization. Understanding how the training provider operates and specifically how its staff will work with you and other decision makers can help you assess the company’s fit as a training solutions partner for your organization. To begin this process, exploring relevant aspects of the training task and the vendor’s experiences will help you gain deeper insight into its potential to train your employees effectively.

Industry wisdom

While individual LTC organizations often have many unique characteristics and challenges, there are numerous concerns that are common throughout the industry. These issues include:

  • Nursing professionals who are highly educated in clinical topics and patient communication, but who lack knowledge in key areas, including (1) effective techniques for communicating with technical and nonclinical personnel whom they are supervising. RNs who are exceptional professionals may still lack skills in communication of performance expectations, employee conflict resolution, leadership, and team-building techniques; and (2) resident safety, OSHA compliance for medical personnel, and other relevant supervisory topics for the long-term care environment.

  • Licensed practical nurses (LPNs) who have strong technical knowledge, but little training in geriatrics or communication with geriatric patients and family members.

  • Nursing assistants and aides who need to absorb a great deal of information very quickly to perform their jobs. In addition to patient care knowledge and skills, unskilled workers need rapid, effective training to ensure their own safety and prevent workplace injuries, communicate with geriatric patients, and manage their time and tasks effectively. Effective training of these employees can impact not only their performance, but also their job satisfaction—a critical consideration given the challenge of retaining workers in this category.

Given these commonalities, a training vendor with extensive healthcare industry experience and, in particular, LTC experience, can be a good choice. A strong industry background means the provider will likely have extensive knowledge of how a variety of training issues have been successfully addressed in other LTC organizations. That knowledge may help the training vendor develop effective training solutions for your organization.

Subject-specific expertise

Training topics in the LTC environment typically span a wide range of information and skill sets. In some organizations, even clinical training of nursing assistants may be provided by outside vendors. In this situation, it is advantageous to choose a training vendor that has highly qualified, experienced trainers on its roster who can provide substantive instruction in subjects such as basic geriatric psychology, nutrition, recognizing elder abuse, bladder control issues, patient dental care, etc.

If outside trainers are primarily used for professional staff education, the range of topics to be covered may still be substantial. In addition to the communication and leadership issues described above, RNs and LPNs coming from other healthcare settings may need training in LTC culture and organizational functions.

Organizational goals represent another key training subject area for many LTC organizations. For example, achieving an outstanding reputation for customer service is often a primary goal of healthcare organizations in today’s competitive environment. To be excellent role models and effective supervisors, nurses may need high-level training in customer service including listening skills, empathy, problem solving, and motivating team members. All employees need to understand specifically what they need to do while performing their jobs in order to help the organization achieve outstanding customer service.

Another critical training subject for many LTC organizations is change management. When a major change such as a merger impacts an organization, all employees must understand and buy into how their jobs will change and what they need to do differently.

On a day-to-day basis, nonclinical management and administrative staff may need training in payroll law, budgeting, use of computer software, and other business topics. In addition, stress management is often a major concern of healthcare employees.

The prospective training vendor should document the qualifications of its trainers to provide in-depth coverage of all needed subjects for your organization. The company should also tell you how it supports its trainers to ensure the quality of training across the subject spectrum.

Customization capabilities

Willingness and ability to customize training programs is a key factor as to whether a training vendor can effectively address your individual organizational needs.

Susan Enyeart

The training company’s representatives should explore with you the organization’s goals and the “before and after” training picture of how employees should work in relation to each goal. It will be helpful if you share specifics on why your organization needs training in each desired subject and, within the scope of each topic, what specific behavioral and performance changes you wish to see among target employees. In addition, any reasons that can be provided for the gap between where employees are and where they should be may be helpful.

Some of this discussion may continue after a training vendor is retained, as seminars are being planned. Including some in-depth assessment in the selection process, however, will enable the training vendor to provide a curriculum plan tailored precisely to your organization’s concerns. Recommendations may include some standard seminars, some slightly customized programs, and some extensively customized programs. Specific recommendations from the training vendor will give you a more complete up-front picture of what to expect, and how much a truly effective training curriculum for your organization will cost.

Responding to concerns

Asking a prospective vendor for suggestions on how trainers will address the employee perspective can yield further insight into how effective the vendor will be as a training provider for your organization.

Managers and supervisors, for example, may perceive that their unskilled workers lack the communication skills needed to work through conflicts with residents’ families. Workers may say that residents and their families cause a large number of problems. An effective trainer will address both perspectives during seminars, based on the reality that both viewpoints are part of the same, larger issue. Identifying common ground and speaking to common concerns can be a good starting point for training under such circumstances. Incorporating the two perspectives into the content of a session on conflict resolution may also be an effective approach. In any case, the training company should offer solutions to the challenge of addressing management concerns, while ensuring that content resonates with the employee and his or her on-the-job experience.

Program sampling, evaluation

The prospective training vendor should have at least one, if not several, options for you and your colleagues to sample its training programs. DVD or Web-based videos showing training sessions, and audio and Web-based seminars may provide a feel for trainer style and handling of content. In addition, a vendor may offer regular seminar sampling events for employers in or near your city, where you can directly experience examples of the company’s standard training programs. At such events, you can closely observe the level of interaction with participants, effectiveness of role-playing or other participant exercises, and other program components that you believe are important for your employees.

On the evaluation side, pre- and post-training assessments as well as employee feedback will demonstrate the effectiveness of training programs. The training vendor should have recommendations for all components of evaluation. The training company should also have the flexibility to use participant feedback and management observations to fine-tune future training programs.


Outstanding continuing education can make an enormous difference in the professionalism, skills, and self-confidence of your employees in every category. It can ultimately contribute greatly to the success of your organization. Investing time in choosing the best available training provider will yield many benefits for you, your employees, and your organization.

Susan Enyeart is Curriculum Development Director for National Seminars Group. The company, affiliated with the Rockhurst University Continuing Education Center, provides on-site, public, and online training programs. Enyeart has spent most of her career as an instructional design specialist for both onsite and public training curricula. She can be reached at (800) 344-4613, ext. 3067 or e-mail Visit for more information and Speaker Showcase dates and locations.

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Long-Term Living 2008 November;57(11):22-26

Topics: Articles , Facility management , Staffing