|Bonus Focus - Training Malpractice #2: Failing to Prescribe Aftercare|
By Andy Jefferson and Roy Pollock
When you have a knee replaced, one of the most important (and painful, as Andy can attest) determinants of success is the physical therapy afterward. It does not matter how good a job the surgeon did, unless the patient actively engages in the post-surgery follow-through, and pushes through the initial pain, they will end up with a permanently limited range of motion and disability. The surgery will be a failure—or at least far less successful—than it should have been.
For that reason, it would be malpractice for a surgeon to fail to prescribe post-surgical physical therapy or to stress its importance to the patient.
Is there an equivalent malpractice in training? We think there is. And that is to imply that training alone is sufficient—that no aftercare is needed.
Do we do that? All too often. Every time we award a “certificate of completion” or award credit for a program as soon as the instruction ends, we imply “you’re done, no more is expected of you.” It would be patently false for an orthopedic surgeon to tell her patients, “as soon as you wake up from the knee replacement, everything will be fine.” It is equally false for us to imply “As soon as you wake up from the training, everything will be fine.”
The New Finish Line
In other words, the real finish line for a knee replacement—the point at which its success can be judged—is not when the patient recovers from anesthesia, but weeks or months later when he or she has recovered mobility and a broad range of motion. Likewise, the real finish line for training—the point at which it can be judged a success or failure is not at the end of class, but weeks or months later when the new skills and knowledge have been transferred and applied to improve performance.
Trainees must continue to practice—to stretch their skills and retrain their mental muscles—after training in very much the same way that knee replacement patients need to stretch their tendons and ligaments, break up scar tissue, and retrain their leg muscles if they are to enjoy the full benefits of the intervention. Thus, the success of both surgery and training depend on the quality of the procedure and the quality of the aftercare; the two are inseparable.
That is why aftercare—physical therapy and exercises—are planned as an integral part of orthopedic surgery. In training, however, aftercare (ensuring practice and providing support) are often neglected or treated as someone else’s responsibility. As a result, even superb training is less effective that it ought to be.
Say it Ain’t So. . . .
Patients, of course, wish they could just wake up from surgery and have everything be all right. Surgeons wish they could just do the surgery and forget the rest. Physical therapists wish they did not have to cause their patients pain. But wishing doesn’t make for a cure. Likewise, trainees wish they could just attend the training and leave it at that. Trainers wish they could just do the training and forget about the rest. Managers wish they did not have to coach and encourage and sometimes prod their direct reports afterward. But wishing doesn’t make for performance.
So what’s the bottom line? If we are serious about helping achieve meaningful and lasting results from training, then we need to do much more to ensure the aftercare essential to achieve those goals. We need to educate managers on their role as performance coaches and we need to provide both trainees and their managers with performance support (think physical therapist) to help them achieve full functionality. Anything less is training malpractice.
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In the 6Ds model these are disciplines D4: Drive Learning Transfer and D5: Deploy Performance Support. Want to learn more? Attend the upcoming LTEN 6Ds workshop. Visit http://www.l-ten.org/?page=6d for more information and to register.
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