The results demonstrate that the educational intervention has had a positive effect on novice practitioners’ decision making; novices who received the educational intervention were more able to detect cases of financial elder abuse, than those who simply practised making decisions on cases. Through adopting the decision making approach of the experts, the novices were able to change how they used the case features to improve their decision making. In comparing the results with the one other study specifically related to elder financial abuse education , this finding supports the view that practitioners are able to identify cases of financial abuse post training. In the Mills et al. study , practitioners subjectively valued the education provided and continued use of the resources past the point of training; these types of outcome were not measured by our trial. However our study extends the findings in two ways: the effect of training is demonstrated against a control group and against pre-training levels, but most importantly the appropriate identification of cases has been confirmed as trainees’ decisions are validated against experts’ decisions on the same cases.
In comparing our results to those studies that have tested interventions to improve professionals’ ability to detect and manage elder abuse in general, not just financial abuse, our findings are consistent with those that have obtained a positive outcome of training. The advantage of our study is that the educational intervention has been developed from a very extensive and recent study of expert decision making in the field. In addition it has been designed specifically for novices; this meets the recommendation that educational interventions need to be tailored to prior levels of learning .
In our study, where participants read the training materials prior to making decisions about cases in the post-test phase, a positive effect was achieved. In the study by Richardson et al.  paper based educational materials did not have a beneficial effect, only the interactive training. Perhaps when reading educational materials of this nature, participants may not fully process the information and subsequently develop the necessary knowledge unless there is some subsequent interaction or immediate application of the educational materials. Alternatively it could be the depth and breadth of the written information presented or perhaps the expert sources from whom it has been derived that determines whether or not it has an effect on capacity.
In considering limitations of the study, our research was conducted with students rather than practitioners, meaning that the research could not measure the effect on practice; changes in practitioners’ behaviour cannot be assumed. In addition, there was no measurement of whether the effect of the training tool was maintained over time.
The study has contributed to educational research in health and social care; studies where experienced practitioners’ knowledge is captured, and good practice identified, are important in promoting effective decision making capacity relevant to real world environments. It is important that we continue to test educational approaches that can provide effective simulated decision-making environments to enhance clinical expertise . The impact of enhanced ability to detect abuse can not be underestimated; health and social care professionals need to make better detection decisions, so those most at risk can be identified and protected. The detrimental effects of financial abuse and the subsequent impacts of these effects for individuals, their families and their future generations can be reduced through enhanced workforce capacity .
Following completion of the project in August 2012, the educational intervention together with the case scenarios, were launched as web-based decision training aid; the software for statistical analysis was added into the website so that feedback, on ability to judge abuse pre- and post-test, could be given to the user. Additional resources were also developed to accompany the case scenarios: eight podcasts were recorded with individual experts, such as the Chief Executive of Action on Elder Abuse, discussing practitioners’ responses to elder financial abuse; these were hosted alongside more detailed examples of the case scenarios to compliment the training tools. Finally seminar materials were developed and included on the website to complete the training resource repository. The website was made freely available via the World Wide Web at http://www.elderfinancialabuse.co.uk in August 2012; over 1000 individual web users were recorded in the first three months of the web resource being launched.
In Scotland the training has been used as part of the Professional Practitioner Initiative  and in some parts of England, practitioners have been introduced to the resource training aid county-wide . To this end the education resource appears to be seen as a valuable training resource.
A plethora of reports, advice and guidance has been issued by such organisations as the Alzheimer’s Society , Age UK , and Action on Elder Abuse . Comprehensive guides for practitioners have been developed to detail the legal framework, which must be adhered to in such cases . Advice on how the legislation and guidance can be used to optimally support best practice has been produced [30, 31]. The website, which hosts the educational training aids, compliments this range of national resources needed to support this complex area of decision making.
The evidence underpinning the educational package will need to be regularly updated to ensure it keeps pace with changes in policy and practice. For example with the full-scale introduction of Personal Independence Payments , in April 2013, financial abuse may alter how it presents. Prevalence of financial abuse may increase; formerly payments were managed through a system involving social care governance but with the option to receive direct payments, one mechanism for abuse detection will be removed.