Evidence-Based Staff Training: A Guide for Practitioners

Marsha B. Parsons & Jeannia H. Rollyson

J. Iverson Riddle Center, Morganton, North Carolina
Dennis H. Reid
Carolina Behavior Analysis and Support Center

ABSTRACT
Behavior analysts in human service agencies are commonly expected to train
support staff as one of their job duties. Traditional staff training is usually
didactic in nature and generally has not proven particularly effective. We
describe an alternative, evidence-based approach for training performance
skills to human service staff. The description includes a specific means of
conducting a behavioral skills training session with a group of staff followed
by on-the-job training requirements. A brief case demonstration then il-
lustrates application of the training approach and its apparent effectiveness
for training staff in two distinct skill sets: use of most-to-least prompting
within teaching procedures and use of manual signs. Practical issues associ-
ated with applying evidence-based behavioral training are presented with
a focus on providing training that is effective, efficient, and acceptable to
staff trainees.
Keywords: behavioral skills training, evidence-based practices, most-to-least
prompting, staff training

B ehavior analysts often share the job

duty of training support staff in
human service agencies to imple-
ment intervention plans for challenging
behavior (Macurik, O’Kane, Malanga,
examine the effects of staff training strat-
egies to allow for more effective and ef-
ficient use of behavioral procedures with
individuals with disabilities. Despite this
existing research, many staff in human
presented to illustrate its application.
Practical issues often related to the
overall success of staff training are then
offered for consideration.
Before describing the evidence-
& Reid, 2008) or teaching strategies service agencies often do not acquire the based training protocol, it should be
(Catania, Almeida, Liu-Constant, & skills that the procedures are intended to noted that the focus of this training
Reed, 2009; Rosales, Stone, & Rehfeldt, train (Casey & McWilliam, 2011; Clark, model is on training performance skills.
2009) with consumers. In addition, Cushing, & Kennedy, 2004; Sturmey, Staff are trained to perform work duties
staff are often trained in general prin- 1998). Hence, if behavior analysts are that they previously could not perform
ciples and practices of behavior analysis to successfully fulfill their staff-training prior to training. The model stands
(Lerman, Tetreault, Hovanetz, Strobel, responsibilities, additional guidance on in contrast to approaches that focus
& Garro, 2008). Disseminating infor- best-practice implementation of staff primarily on enhancing knowledge or
mation about effective practices among training strategies is warranted. verbal skills, which would allow them to
caregivers in this regard has become a The purpose of this paper is to answer questions about the target skills.
professionally expected responsibility of describe an evidence-based protocol for Though knowledge enhancement is
behavior analysts (Lerman, 2009). training human service staff. Although clearly an important function of certain
The importance of training human this training technology has been dis- training endeavors, the goal of this pro-
service staff was recognized early in the cussed from several perspectives (e.g., tocol is improved performance (Parsons
history of behavior analysis as it became Reid, O’Kane, & Macurik, 2011), & Reid, 2012). The distinction between
clear that making a large-scale impact on the focus here is on describing the training performance versus verbal skills
consumers required effective training of basic components of the training pro- is important because of the different
support staff (Frazier, 1972). Behavioral tocol for behavior analyst practitioners. outcomes expected as a function of the
researchers then began investigating Suggestions are also provided for effec- training process and because different
staff training procedures (see Miller & tively implementing the protocol based training procedures are required. Early
Lewin, 1980; Reid & Whitman, 1983, on our training experience. Following a behavioral research demonstrated that
for reviews of the early research on staff summary of the evidence-based training staff training programs relying on verbal-
training). Researchers have continued to protocol, a brief case demonstration is skill strategies (e.g., lectures, presentation

2 EVIDENCE-BASED STAFF TRAINING Behavior Analysis in Practice, 5(2), 2-11

of written and visual material) are effective for enhancing tar- Table 1. Behavioral Skills Training Protocol for Conducting a
geted knowledge, but often are ineffective for teaching trainees Training Session With a Group of Staff
to perform newly targeted job skills (Gardner, 1972). Thus,
programs that rely heavily on verbal-skill training approaches
typically prove ineffective in creating a meaningful impact on Training step Trainer action
the job performance of human service staff (Alavosius & Sulzer-
Azaroff, 1990; Petscher & Bailey, 2006; Phillips, 1998). Step 1 Describe the target skill

A Protocol for Evidence-Based Staff Training Step 2 Provide a succinct, written

Evidence-based staff training consists of performance- and description of the skill
competency-based strategies (Reid et al., 2003). The phrase per-
formance-based refers to what the trainer and trainees do (i.e., Step 3 Demonstrate the target skill
actively perform the specific responses being trained) during the
training. The phrase competency-based refers to the practice Step 4 Require trainee practice of the
of continuing training until trainees competently demonstrate target skill
the skills of concern (i.e., meet established mastery criteria).
Specifically, the training is data-based; observational data are Step 5 Provide feedback during practice
obtained to document that trainees demonstrate the target
skills at established proficiency criteria. More recently, this ap- Step 6 Repeat Steps 4 and 5 to mastery
proach to staff training (i.e., instructions, modeling, practice,
and feedback until mastery is achieved) has been referred to
as behavioral skills training or BST (Miles & Wilder, 2009; reduce challenging behavior. The description should be suc-
Nigro-Bruzzi & Sturmey, 2010; Sarokoff & Sturmey, 2004). cinct and focus on exactly what needs to be done to perform
The procedures and literature described here are generally the target skill.
consistent with the research and procedures described as BST, Many trainers fail to provide a succinct, written descrip-
though the specific procedural steps may vary slightly. A basic tion of the target skill (Reid, Parsons, & Green, 2012, Chapter
protocol for conducting a BST session is presented in Table 1. 4). Instead of providing staff trainees with a written summary,
The protocol consists of six steps, each of which is described they are referred to a lengthier document (e.g., a formal be-
in subsequent sections. This protocol is designed for training havior plan) available in a central location. Our experience
staff using a group format; however, the same basic steps can be suggests that a number of staff typically will not access the plan
used when training an individual staff member though some to review the information when needed. Documents such as
variations may be needed for individual implementation such plans for challenging behavior frequently contain much more
as with behavioral coaching (Rodriguez, Loman, & Horner, information than what staff need to implement the plan (e.g.,
2009) and when all training occurs in-vivo or on the job (Miles background consumer information, assessment processes used
& Wilder, 2009). to develop the plan), though the information is important for
other purposes.
Step 1: Describe the Target Skill
The first training step involves the trainer providing a Step 3: Demonstrate the Target Skill
rationale for the importance of the skill being trained and a de- Once trainees have heard and read a description of the ac-
scription of the behaviors required to perform the skill (Willner, tions to perform the target skill, the trainer should demonstrate
Braukmann, Kirigin, Fixsen, Phillips, & Wolf, 1977). This step how to perform the skill. This step, referred to as modeling in
is generally referred to as instructions in the BST model. To BST, can usually be readily accomplished by using a role-play
adequately complete this step, trainers must behaviorally define process (Adams, Tallon, & Rimell, 1980), and particularly
the target skill using a tool such as a performance checklist of when two trainers are present. One trainer plays the role of a
necessary staff actions (Lattimore, Stephens, Favell, & Risley, staff member and the other trainer plays the role of a consumer
1984). (if the target skill involves interacting with a consumer). It
is critical that role-play demonstrations be well-scripted and
Step 2: Provide a Succinct Written Description of the Target Skill
rehearsed prior to the training session to ensure an accurate
Following a vocal description of the target skill, trainers and fluent demonstration of all key components of the target
should provide each trainee with a written description of the skill. If a second trainer is not available, a trainee can assist in
target behaviors that constitute the skill. The performance the demonstration. In the latter case, the trainer must provide
checklist referred to in Step 1 often serves this function. The detailed instructions to the trainee to ensure the trainee knows
trainer may also need to provide a written summary of pre- exactly what should be done during the demonstration. We
cisely what staff should do in different situations (Macurik et have also found it helpful for trainer(s) to stop or “freeze” at
al., 2008), such as when being trained to implement a plan to certain points and describe what is being done and why to help

EVIDENCE-BASED STAFF TRAINING 3

 trainees attend to key actions being demonstrated. Alternatively, correctly (Miles & Wilder, 2009) or perhaps a lower percent-
video models have been effectively incorporated into BST as the age but with identification of certain critical steps that must
demonstration component for teaching staff various skills such be performed at 100% proficiency (Neef, Trachtenberg, Loeb,
as conducting discrete-trial instruction (Catania et al., 2009; & Sterner, 1991). This final step represents the essence of the
Sarakoff & Sturmey, 2004) and use of picture communication competency part of BST. A staff training session should not be
systems (Rosales et al., 2009). considered complete until each trainee performs the target skill
competently.
Step 4: Require Trainee Practice of the Target Skill
On-The-Job Training
After demonstration of the target skill, trainees rehearse
performing the skill in a role play similar to the trainer demon- The group training protocol is designed to train staff at
stration (Adams et al., 1980). Instructions are given to organize one time in a situation that differs from the daily work situa-
trainees such that one can play the role of the consumer (again, tion. The format is commonly used in human service settings
if relevant) and one can demonstrate the target skill while where behavior analysts practice. However, because the training
other trainees observe. All trainees must practice performing involves a simulated situation (e.g., role plays, no consumers
the target skill. present), the overall training process is not complete. The ses-
The trainee practice step, referred to as rehearsal in BST, sion must be followed by on-the-job training.
is frequently omitted during staff training (Reid et al., 2012, On-the-job, or in-vivo, training increases the likelihood
Chapter 4). In many staff training programs, only vocal and that performance of the target skill acquired during the train-
written descriptions of the target skill are provided, perhaps ing session generalizes to the usual work situation (Clark et al.,
supplemented with a demonstration. This omission likely 2004; Smith, Parker, Taubman, & Lovaas, 1992). On-the-job
occurs because the practice component requires significant training involves trainers observing each trainee applying the
time investment for each trainee to practice the skill. However, target skill in the regular work environment and providing
practicing the skill is a critical feature for the success of BST supportive and corrective feedback as described in Step 5 of the
and should be required of each trainee to produce effective training protocol. Observations and feedback should continue
performance (Nigro-Bruzzi & Sturmey, 2010; Rosales et al., until each trainee performs the target skill proficiently during
2009). the typical work routine.
The on-the-job component is another aspect of the train-
Step 5: Provide Performance Feedback During Practice
ing process that can involve a substantial time investment by
The fifth step of the training protocol is for trainers to trainers because they must go to each trainee’s worksite for
provide feedback to the trainees as they practice performing the observation and feedback. In this regard, we have found that
target skill. Trainers should circulate among the trainees to ob- the amount of time trainers will have to spend at trainee work
serve their performance and provide individualized supportive sites will be minimized if each trainee has previously demon-
and corrective feedback (Parsons & Reid, 1995). Supportive strated competence during role plays in the training session;
feedback entails describing to the trainee exactly what s/he proficiency in demonstrating a target skill on the job often
performed correctly and corrective feedback involves specify- parallels the level of proficiency demonstrated during previous
ing what was not performed correctly. Corrective feedback also role plays.
involves providing instruction about exactly how to perform The on-the-job training component completes the training
any aspects of the target skill performed incorrectly in order to process. However, it should also be emphasized that although
facilitate proficient future performance of the skill. Generally completion of training is often a necessary step to promote
we recommend providing feedback following completion of a proficient staff performance on the job, it is rarely a sufficient
given role play in contrast to interrupting an ongoing role-play step (Reid et al., 2012, Chapter 4). Newly acquired job skills
activity to provide feedback. must be addressed from a performance management perspective
Observing trainees and providing feedback to each trainee (Austin, 2000) to ensure they maintain, and particularly with
requires time and effort on the part of trainers. This is another continued presentation of feedback by supervisors and related
reason that it is often beneficial to have two trainers present, personnel. Describing effective on-the-job performance man-
and especially if the number of trainees exceeds four or five. agement is beyond the scope of this paper; however, a number
Providing individualized feedback is as critical to the training of resources describe evidence-based approaches to managing
process as the trainee practice component, and must involve daily work performance of staff (e.g., Austin; Daniels, 1994;
each trainee. Reid et al., 2012).
Step 6: Repeat Steps 4 and 5 to Mastery Case Demonstration of Evidence-Based Staff Training
The final step in a BST session is to repeat Steps 4 and 5 To illustrate how BST can be applied to train staff in a
until each trainee performs the target skill proficiently (Nigro- group format in a human service setting, the following case
Bruzzi & Sturmey, 2010). Trainers should establish a mastery demonstration is presented. The demonstration involved train-
criterion, such as trainees performing 100% of the target steps ing two sets of skills deemed important by the staff supervisor.

4 EVIDENCE-BASED STAFF TRAINING

 step for the target trial relative to the preceding trial. Hence,
Method
there were five overall components constituting correct teach-
Setting and participants. The demonstration occurred dur- ing: the three components pertaining to order, reinforcement,
ing ongoing services at an education program for adults with error correction, and the two prompting components.
severe disabilities. The primary locations were classrooms in The five teaching components were observed for each par-
which instructional services and paid work (e.g., contract work, ticipant’s teaching session and each component was scored as
retail manufacturing) occurred. Seven teachers and one teacher’s correct or incorrect for each instructional trial conducted dur-
assistant served as participants; six of these participants were ing the session. To be scored as correct, a component had to be
women. Participant ages ranged from 30 to 53 years (M = 45 performed correctly for each step of the task analysis with which
years) and their experience ranged from 1 to 30 years (M = 14). it was used. If a necessary component was omitted (omission
Each teacher was responsible for services in a given classroom error) or a component was performed incorrectly (commission
and the teacher’s assistant worked in one of the classrooms. error), then that component was scored as incorrect. Following
Each teacher was licensed in special education. Four teachers a teaching session, the percentages of the five teaching compo-
had a bachelor’s degree and three had a master’s degree. nents performed correctly were averaged to obtain a percentage
Behavior definitions and observation systems. The skill sets correct score for the teaching session. Due to the specific focus
targeted for training were selected by the supervisor of the pro- on ML prompting, the percentages of the two prompting com-
gram (experimenter) based on her view of relevant skill targets. ponents performed correctly were also calculated and reported
The first skill set pertained to using a most-to-least (ML) as- separately. Interobserver agreement checks were conducted
sistive prompting strategy (Libby, Weiss, Bancroft, & Ahearn, during 75% of all teaching sessions, involving each participant
2008) while teaching consumers. All participants had previ- and experimental condition. Interobserver agreement was cal-
ously mastered using a least-to-most assistive (LM) prompting culated by dividing the number of agreements on occurrence of
strategy (Parsons & Reid, 1999), which was the most common a correct teaching component by the number of disagreements
prompting approach used in the adult education program. The plus agreements, multiplied by 100. Agreement averaged 95%
supervisor’s intent was to expand the participants’ teaching (range, 86% to 100%).
skills by training them to also be able to use the alternative, ML The skill set for manual signing involved 35 signs. The
prompting strategy. The second targeted skill involved the use signs were selected by the participants’ supervisor based on her
of manual signing in interactions with certain adult students. familiarity with the signs that were used by or with the adult
Only seven participants were involved in this training due to a students and that would likely be applicable within ongoing
medical leave. Each participant interacted, or potentially could activities. The signs pertained to items (e.g., coffee, key, soda),
interact, with a student who responded to and/or used manual actions (e.g., come, stop, work), descriptors (e.g., hot, good,
signs for communication. However, the participants had not slow), and private events (e.g., hungry, pain, thirsty). A correct
received formal training in manual signing for at least several production of each sign required three components (Fitzgerald,
years, if at all. Reid, Schepis, Faw, Welty, & Pyfer, 1984) including (a) move-
The ML prompting protocol involved five teaching com- ments of the fingers and hand(s), (b) shapes of the fingers and
ponents based on previous research on LM prompting (Parsons hand(s), and (c) location of the fingers and hand(s) in respect
& Reid, 1999). First, correct order was defined as teaching the to the body. These components were derived from the pictures
steps of a student program in the exact sequence specified in and descriptions presented in Sign Language Made Simple
the program task analysis. Second, correct reinforcement was (Lewis & Henderson, 1997).
defined as providing a consequence after the last correct step Signs were assessed on a trial-by-trial basis with an observer
in a program and not providing the same consequence for recording a correct production only if the sign met all three of
any incorrectly performed step by the student. Reinforcement the adherence criteria. Incorrect production was scored if an
could be provided for correct student completion of any step error occurred on any one component or if the participant ver-
but must be provided for the last correctly completed step. bally indicated s/he did not know the sign. Interobserver agree-
Third, correct error correction was defined as the teacher inter- ment checks were conducted on a sign-by-sign basis during all
rupting a student’s error and providing increased assistance trials on 36% of assessment sessions, for each participant and
sufficient such that the student then correctly completed the condition. Agreement averaged 89% (range, 67% to 100%).
step. Correct prompting (modified from prior research to target Baseline procedures. Baseline sessions occurred individually
ML) involved two components. The first component, full with each participant. The experimenter explained that, as part
physical guidance on the first teaching trial, was defined as the of the program’s professional development activities, partici-
teacher physically guiding the student through all steps of the pants would be assessed and trained to use an ML prompting
task analysis. The second component, less assistive prompts on strategy and a sample of manual signs. For the ML prompt-
subsequent trials, was defined as the teacher beginning at least ing baseline sessions, the experimenter further explained the
one step on the target trial by guiding the student through the participant would be asked to train three skills during role play
step, stopping the guidance at a point earlier than on the previ- with an experimenter playing the part of a student. The three
ous trial for that step, and not providing more assistance on any skills were wiping the mouth with a napkin (three task-analyzed

EVIDENCE-BASED STAFF TRAINING 5

 steps), activating a CD player (four steps), and placing paper in feedback continued until each trainee demonstrated 100% cor-
a paper shredder (three steps). The participant was instructed rect teaching proficiency one time with the target student skill.
to teach the “student” all task-analyzed steps of a respective skill The second training session involved the same process (i.e.,
using three trials with ML prompting and to fade the prompt- brief vocal description, demonstration, and participant practice
ing across successive trials. No feedback was provided to the with feedback) with two new student skills (i.e., removing trash
participant. from a table and placing it into a trash can, playing the game
During the baseline, the experimenter playing the role of “cornhole” that involved throwing a bean bag through a
of the student followed a set script. The script specified that hole in a board). The third training session involved continued
the “student” should: (1) require full physical guidance for all practice with the student skills covered in the first two sessions
task-analyzed steps on the first trial of a given skill, (2) require until each participant correctly performed 100% of the five
full physical guidance to initiate a step during the second trial teaching components.
and then complete that step independently and subsequently Manual sign training began with 15 signs during the first
require full physical guidance to complete the other steps on training session. The trainer described the importance of sign-
the second trial, and (3) complete the first step independently ing with students who used signs for communication. Next, the
on the third trial and then make an error on a subsequent step trainer described how to make each of five signs according to the
and require partial physical guidance on the remaining steps. three criteria noted earlier while the participants followed along
Baseline sessions for assessing manual signing skills involved with a handout that described making the signs and provided a
the following procedures. First, the experimenter informed the picture of each sign (see Lewis & Henderson, 1997, for illustra-
participant that one word would be spoken at a time and the tions). The trainer then demonstrated each sign. Subsequently,
participant should make the sign that represented the word. the participants were divided into small groups. Participants
Second, the experimenter said one word and waited for the were then instructed to have one participant name the five signs
participant to make a sign or indicate that s/he did not know for the others to produce and provide feedback to each other
how to make the sign. Third, this process was repeated for the using the handout as a guide, and then to alternate the role of
remaining 34 signs. The presentation order of the words for naming the signs. The trainers circulated among the groups
signs was altered across sessions according to a set format. to observe, score each sign production, and provide feedback.
Training and post-training procedures. Training on ML The trainees continued practicing until each trainee correctly
prompting and signing involved the steps of the evidence- produced 100% of the target signs. Five more signs were then
based protocol described earlier and occurred in a group format demonstrated by a trainer and subsequently combined with the
with all participants simultaneously. Each training session initial group of five signs for trainee practice and feedback. This
lasted a maximum of one hour to accommodate staff ’s typical process was then repeated for five more signs.
daily planning time and minimize disruption of delivery of During the second training session, the 15 signs introduced
consumer services. Three training sessions were conducted for in the first session were described and demonstrated again,
ML prompting across different days, and three sessions were along with trainee practice. Next, the process used in the first
conducted for signing, also across different days. Two trainers training session was followed with two more groups of 5 signs.
(experimenters) conducted the training sessions. The third training session replicated the second, along with the
The first training session for ML prompting was initiated introduction of the remaining 10 signs in two groups of five.
by a trainer explaining the rationale for the training, followed The final component of the third training session involved the
by a description of the five components of teaching. A suc- participants practicing all 35 signs and receiving feedback from
cinct, written handout of the definitions was also provided (see each other as well as a trainer until each participant correctly
http://www.abainternational.org/Journals/bap_supplements. demonstrated each sign.
asp to download these definitions). Any questions posed by the Post-training assessments occurred within one week follow-
trainees were answered and included reference to the written ing the last training session and involved conducting individual
description. Next, a trainer demonstrated teaching a task- assessments with participants in the same manner as during
analyzed skill in a role play (i.e., the other trainer in the role of baseline. Additionally, at the end of the assessment praise was
“student”) using the script described previously. The target skill provided for correct performance and if needed, corrective
(i.e., decorating cookies with sprinkles) was different than the feedback for performance errors.
three skills assessed in the baseline assessment. Following each On-the-job assessments. On-the-job assessments were con-
demonstration trial, the trainer paused to explain what she did ducted to evaluate whether competent performance established
and answer participant questions. Subsequently, participants in the training context occurred when trainees used the skills
each practiced teaching a trainer using the same target skill during their routine job duties. For ML prompting, participants
(again, decorating a cookie) and received feedback while the were informed that the supervisor would be coming to their
other trainees observed. Next, participants practiced teaching classroom to observe their use of ML prompting while teaching
each other in a role play. The two trainers circulated among the a student. Participants were asked to select the student and a
participants during the role-play practice to observe, score, and skill to teach that differed from the staff training and role-play
provide feedback. The observation, trainee practice, and trainer skills (examples of skills taught in the classrooms included

6 EVIDENCE-BASED STAFF TRAINING

putting materials away in a cabinet, folding washcloths, and = extremely useful), how practical the training was in terms
rinsing dishes). Upon arrival, the supervisor asked to see the of amount of time and work to participate (“1” = extremely
task analysis of the skill and observed the participant’s use of impractical, “7” extremely practical) and how enjoyable the
ML prompting during teaching. One on-the-job session was training was (“1” = extremely not enjoyable, “7” = extremely
conducted for each participant during baseline and one was enjoyable). A fourth question asked if the participant would
conducted during post-training. The post-training session recommend the training to his/her colleagues and used a “yes”
occurred four days after the last simulated post-training assess- or “no” response option.
ment and included feedback following the session. Interobserver
agreement checks occurred during 81% of all on-the-job ses- Results
sions, across all participants and both experimental conditions. The results are presented in graphic form (Figure 1) for the
Agreement for occurrence of correct teaching components entire group and in tabular form (Table 2) for the individual
averaged 97% (range, 82% to 100%). participants. The group-based training program appeared ef-
For the on-the-job sessions with signing, the supervisor fective with both ML prompting and signing skills. The top
informed the participants that she would be coming to their panel illustrates the average percentage of all five teaching
classroom to observe them using a relevant sample of the signs components implemented correctly (open symbols) and the
trained. On-the-job sessions only occurred during the post- average percentage for the two ML prompting components
training condition after the participants had been trained in depicted as an additional data path (closed symbols). During
the manual signs (M = 18 days following the last post-training baseline, the average percentage of overall teaching compo-
session, range 14 to 24 days). No baseline session was conducted nents was relatively high for the group of participants, averag-
for signing because the risk of creating an uncomfortable expe- ing 76% (range, 75% to 77%). However, the average for the
rience for the staff was considered high while the likelihood of prompting components was considerably lower (M = 50%,
correct production of untrained signs was considered very low. range 44% to 56%). During post-training, averages for both
Participants were asked to select signs that were relevant for the skill sets increased, with overall teaching averaging 99% (range,
observed situation and to demonstrate at least five signs (M 98% to 99%) and ML prompting 92% (range, 88% to 94%).
= 6.1 signs, range of 5 to 8). Interobserver agreement checks Similar increases occurred during the on-the-job assessments,
occurred during 43% of the on-the-job observations. There with overall teaching increasing from an average of 74% during
were no disagreements between observers. baseline to 96% in post-training, and ML prompting increasing
Experimental design. The experimental design was a mul- from a baseline average of 56% to 100% in post-training. As
tiple baseline design across behaviors (i.e., ML prompting and indicated in Table 2, the performance of individual participants
signing). corresponded to the group averages depicted in Figure 1 in that
Acceptability measures. Participants anonymously completed all eight participants improved their prompting performances
an acceptability survey after the post-training, on-the-job assess- from baseline to post-training.
ments. Participants placed the completed and unsigned form in The bottom panel of Figure 1 indicates that the average
a folder in a secretary’s office to ensure anonymity. Three ques- percentage of correctly produced signs increased from baseline
tions were posed with a 7-point Likert scale response option, (M = 28%, range 25% to 30%) to post-training (M = 93%,
with “4” representing the neutral point. The questions sampled range 91% to 95%). The on-the-job assessment of a sample
how useful the training was (“1” = extremely nonuseful, “7” of relevant signs indicated the participants correctly produced

Table 2. Average Percentage (and Range) of Target Skills Performed Correctly by Individual Participants for Each
Experimental Condition

ML prompting Signing

Participant Baseline Post-training Baseline Post-training

1 33 (0–100) 83 (50–100) 26 (17–29) 96 (94–97)

2 33 (0–50) 100 29 (20–37) 94 (91–97)
3 67 (50–100) 83 (50–100) 0 93 (91–94)
4 33 (0–50) 100 5 92 (89–94)
5 67 (50–100) 100 45 (37–51) 86 (77–94)
6 67 (50–100) 83 (50–100) absent
7 67 (50–100) 83 (50–100) 49 (43–51) 94
8 33 (0–50) 100 39 (37–40) 97 (94–100)

EVIDENCE-BASED STAFF TRAINING 7

 Figure 1. Mean percentage correct overall teaching components (open symbols) and most-to-least prompting (closed symbols) (top panel)
and signing (bottom panel) for all participants for each assessment session during each experimental condition.

96% of the assessed signs. As with ML prompting correct signs less than what typically occurs with a more rigorous research
increased from baseline to post-training for all participants process. Hence, the results should be considered with a degree
(Table 2). of qualification.
Participants reported both applications of the training As with any intervention or training, there are practical
process to be acceptable. For the ML prompting training and considerations warranting attention when using this training
the sign training, the average rating for each of the Likert-scale protocol in human service settings. For discussion purposes,
questions was between “6” (very) and “7” (extremely) regarding these considerations can be grouped into three categories:
how useful the training was, how practical the training was, and effectiveness, efficiency, and acceptability. The degree to which
how enjoyable the training was for the participants. No rating staff training programs effectively establish target skills, mini-
was below “5” (mostly) for any participant for any question. All mize the requirements for staff time, and are acceptable to the
eight participants indicated they would recommend both the recipients is generally considered critical to the overall success
ML prompting and sign training to their colleagues. and continuation of staff training programs (Daniels, 1994;
Parsons & Reid, 1999; Phillips, 1998).
General Discussion
Ensuring Effectiveness of Staff Training Programs
Results of the case demonstration appear to support the
effectiveness of the training protocol. All participants increased As indicated previously, typical staff training endeavors in
their correct ML prompting and signing skills following train- many human service agencies rely on vocal presentations, per-
ing and all displayed proficient use of the newly acquired skills haps supplemented with written handouts and some modeling.
on the job. From a practical perspective, the training did not These training programs have been criticized due to demon-
involve disruptions in consumer services and reportedly was strated ineffectiveness for establishing the targeted performance
well received by all participants. In considering these results, it skills (Casey & McWilliam, 2011; Clark et al., 2004; Sturmey,
should also be noted that due to the case demonstration nature 1998). The evidence-based protocol described here represents
of the evaluation, the amount of evaluative data collected was an alternative approach that applies the critical components of

8 EVIDENCE-BASED STAFF TRAINING

BST (i.e., instructions, modeling, rehearsal, feedback) to staff Salzberg, 2009; Moore & Fisher, 2007). However, there have
training with demonstrated effectiveness. also been reports of inconsistent effectiveness of training ap-
Though practitioners such as behavior analysts may be proaches relying solely on visual media (e.g., Neef et al., 1991;
skilled at interacting with consumers and implementing behav- Nielsen, Sigurdsson, & Austin, 2009). The primary concern
ioral protocols, those same practitioners may not be well-versed in this regard is difficulty with the practice-with-feedback
in conducting staff training using behavior analytic approaches component of BST when using visual media exclusively (Reid
such as that described here. Practitioners must become skilled et al., 2011), although more interactive media formats may
in employing effective behavioral strategies for training staff, address this concern (Frieder, Peterson, Woodward, Crane, &
otherwise training is not likely to effectively equip staff to apply Garner, 2009). At this point, some caution seems warranted
the behavioral procedures of concern (McGimsey, Greene, & when relying solely on visual media for training purposes.
Lutzker, 1995; Reid & Parsons, 1995). However, it seems that as long as the on-the-job component is
still incorporated within the overall training process to ensure
Maximizing Time Efficiency of Training
trainee competence during the regular work routine, it would
Probably the most significant practical consideration with not matter if the initial steps of the training protocol were
implementing this type of performance- and competency-based provided through visual media or by a trainer in a live format
training is the amount of time required for trainers and trainees. (e.g., Macurik et al., 2008).
Implementing all steps of the training protocol requires more A consideration related to training efficiency is the dif-
time than traditional training approaches that rely heavily on ficulty of removing trainees from their direct work with agency
lectures and related verbal-training processes with no perfor- consumers to attend training sessions. Time to conduct train-
mance criteria. The total time necessary to implement the ing sessions that involve disruption to consumer services is a
protocol is increased because of the repeated trainee practice noted concern of agency administrators (Test, Flowers, Hewitt,
with feedback. This increased time investment is a likely expla- & Solow, 2004). This issue can be addressed in some cases by
nation for the continued use of verbal-based training strategies conducting training during relatively brief, 1 hr maximum seg-
in human service agencies, along with lack of familiarity with ments as illustrated in the case demonstration. Often it is easier
the BST alternative (Reid, 2004). Nonetheless, it seems coun- to schedule training time in short sessions without causing
terproductive to opt for more efficient training processes in lieu disruptions to consumer services (e.g., during teacher planning
of less efficient strategies when only the latter are likely to result time, immediately following consumer departure for the day)
in improved performance on the job. Additionally, providing compared to traditional half-day or day-long blocks of time
ineffective training ultimately involves further time investment (Parsons & Reid, 2012).
to correct or improve inadequate performance on the job.
Promoting Staff Acceptance of Training
In light of practical concerns over the amount of time to
conduct BST, efforts must continue to focus on increasing the The long-term survival of staff training programs can be af-
time efficiency of using this training protocol. Training time fected by how acceptable the activities are to participating staff
with the on-the-job component can be reduced by ensuring (Wolf, Kirigin, Fixsen, Blasé, & Braukmann, 1995). In short, if
trainee skill mastery before terminating a group training session. staff express their discontent with certain agency activities, the
Incorporating visual media such as videos within the training activities have an increased likelihood of discontinuation even
protocol may also increase efficiency as the demonstrations if those activities have demonstrated effectiveness. In regard to
might occur more quickly, illustrate identical and accurate pro- the training protocol discussed here, results of investigations
cedures across trainers, and remain available outside of typical have generally indicated a high degree of staff acceptance of
work hours when live trainers are not available. For example, this approach to training (see Reid & Parsons, 2000, for a
Macurik et al. (2008) prepared a DVD that provided the descrip- summary). It has not been experimentally demonstrated why
tion of the target skills and demonstrations for implementing this approach to staff training has generally been associated
treatment plans for consumers with challenging behavior. Staff with such high staff acceptance. However, several reasons seem
trainees viewed the DVD when their work schedule permitted. plausible and might be investigated in future studies. One rea-
The remainder of the training (i.e., trainee practice, feedback) son is the performance-based competency requirement. Staff
occurred on the job. Macurik et al. found that the use of the may find training programs more acceptable when they acquire
DVD required less trainer time and was as effective as the usual skills that can be immediately used on the job to the benefit
process of conducting a group training session (followed by of their consumers relative to training that required time and
on-the-job training). However, the time to prepare a training effort without them becoming confident in their ability to im-
DVD must also be considered and is probably only warranted mediately implement the new skills. Second, the extensive use
for procedures that will need to be taught to many staff in order of supportive feedback (i.e., descriptive praise) during trainee
to obtain a reasonable return on the time investment. practice and on-the-job performance may increase acceptance
Increasing investigative attention is being directed to visual (Daniels, 1994). Finally, active participation in trainee role plays
media for staff training purposes, with a number of successful may enhance staff acceptance relative to traditional trainings,
outcomes reported (Catania et al., 2009; Collins, Higbee, & which often include long periods of sitting and time listening

EVIDENCE-BASED STAFF TRAINING 9

 to a lecture (Reid et al., 2012, Chapter 4). Collins, S., Higbee, T. S., & Salzberg, C. L. (2009). The effects of
In considering reports of staff acceptance of BST-based video modeling on staff implementation of a problem-solving
training programs, it should also be noted that research in this intervention with adults with developmental disabilities.
area has received some criticism due to its heavy reliance on ac- Journal of Applied Behavior Analysis, 42, 849–854.
ceptability surveys (Parsons & Reid, 2012). Staff responses on Daniels, A. C. (1994). Bringing out the best in people: How to
a survey conducted by their employer is important (Wolf et al., apply the astonishing power of positive reinforcement. New York:
1995), but may not be a valid indicator of the acceptability of a McGraw-Hill.
training program. To illustrate, survey responses do not always Detrich, R., Keyworth, R., & States, J. (Eds.). (2008). Advances in
correspond with other behavioral measures of acceptance such evidence-based education: Volume 1, a roadmap to evidence-based
as choosing to continue participating in a program when given education. Oakland, CA: The Wing Institute.
an option (Reid & Parsons, 1995; van den Pol, Reid, & Fuqua, Fitzgerald, J. R., Reid, D. H., Schepis, M. M., Faw, G. D., Welty,
1983). Continued research is warranted to more carefully P. A., & Pyfer, L. M. (1984). A rapid training procedure for
evaluate staff acceptance of training programs. teaching manual sign language skills to multidisciplinary
institutional staff. Applied Research in Mental Retardation, 5,
Summary 451–469.
The importance of relying on evidence-based practices Frazier, T. W. (1972). Training institutional staff in behavior
in the provision of supports and services for individuals with modification principles and techniques. In R. D. Ruben,
disabilities is becoming well-accepted (Detrich, Keyworth, H. Fensterheim, J. D. Henderson, & L. P. Ullmann (Eds.),
& States, 2008). It seems counterintuitive that support staff Advances in behavior therapy: Proceedings of the fourth conference
would be expected to become skilled in applying such practices of the Association for Advancement of Behavior Therapy (pp.
when they receive training in ways that are not evidence-based 171–178). New York: Academic Press.
in nature. This paper describes an approach to training perfor- Frieder, J. E., Peterson, S. M., Woodward, J., Crane, J., & Garner,
mance skills that has an established evidence-base and could M. (2009). Teleconsultation in school settings: Linking
help behavior analysts in successfully training relevant work classroom teachers and behavior analysts through web-based
skills to human service staff. Although continued research technology. Behavior Analysis in Practice, 2, 32–39.
is warranted to better refine the training technology, and Gardner, J. M. (1972). Teaching behavior modification to
particularly in regard to its efficiency, the technology seems nonprofessionals. Journal of Applied Behavior Analysis, 5, 517–
sufficiently well-developed to represent an improved training 521.
approach relative to what has historically occurred in many Lattimore, J., Stephens, T. E., Favell, J. E., & Risley, T. R. (1984).
human service agencies. Increasing direct care staff compliance to individualized
physical therapy body positioning prescriptions: prescriptive
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281–294). New York: Guilford Press. Author Note
Reid, D. H., & Parsons, M. B. (1995). Comparing choice and Correspondence concerning this paper should be addressed
questionnaire measures of the acceptability of a staff training to Dennis H. Reid, Carolina Behavior Analysis and Support
procedure. Journal of Applied Behavior Analysis, 28, 95–96. Center, P. O. Box 425, Morganton, NC 28680. Phone: 828-
Reid, D. H., & Parsons, M. B. (2000). Organizational behavior 432-0030. Email: [email protected].
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294). Reno, NV: Context Press. EVIDENCE-BASED STAFF TRAINING 11