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Table 1 Characteristics of studies using the Hennessy-Hicks TNA tool (n = 33)

From: Training needs assessment: tool utilization and global impact

Author, year [Ref]/ Country Publication type Design/Level of evidencea Study population/Setting/Sample size Used original or adapted or translated TNA tool Findings/ Implications TNA themeb
Adewole et al., 2019 [25]
Nigeria
Article (original research) Cross-sectional survey / Level VI Other healthcare professionals / healthcare organizations / 234 participants Used adapted English TNA tool -Gaps in health insurance industry personnel capacity
- Low performance coverage of the social health insurance scheme
- Preferred training through courses rather than organizational change
-Stakeholders in Nigeria should pay attention to personnel training
Individual
Aw and Drury, 2016 [26]
Singapore
Article (original research) Mixed methods (surveys and focus groups) / Level VI Nurses / acute care / 91 nurses were surveyed and 19 participated in focus groups Used adapted English TNA tool - Training needs for ophthalmic nurses
-Develop tailored education programs to meet workforce needs (clinical exposure, patient education)
Team/IP
Barratt and Fulop, 2016 [27]
UK
Article (original research) Descriptive survey / Level VI Other healthcare professionals / Healthcare organizations / 203 respondents from 20 healthcare and public health organizations Used adapted English TNA tool -Key tasks: evaluation, teaching, making do with limited resources, coping with change and managing competing demands, assessing relevance of research
-Training priorities: evaluation; finding, appraising, and applying research evidence; data analysis
-Key barriers: time and resources, lack of institutional support for research
-Implications: improved ability of health organizations to use research and participate in knowledge generation can lead to improved healthcare and population health.
Organizational
Carlisle et al., 2012 [8]
Australia
Article (original research) Questionnaire survey / Level VI Nurses / acute care / 72 nurses from 3 public hospitals Used original English TNA tool -Tested the occupational profile construct measurement model and found that it fits the original factorial structure determined by Hicks et al. (1996)
- TNA dimensions demonstrated tool’s predictive validity
-Organizational factors and demographic variables play a significant role in determining the occupational profile of nurses and their training needs.
Individual
Eyres and Lima, 2018 [28]
Australia
Poster Cross-sectional survey / Level VI Nurses / acute care / 280 responses from 10 hospital units Used adapted English TNA tool -Nurses performed best in communication and teamwork; this was most important for successful job performance
-Training need areas: cardiovascular, respiratory, pediatrics, diabetes, communication, and mental health
-Survey data used for developing specific training and education
Team/IP
Gaspard and Yang, 2016 [29]
Saint Lucia
Article (original research) Questionnaire survey / Level VI Nurses, other healthcare professionals / health care organizations / 139 respondents Used adapted English TNA tool -Need for continuing professional education was rated as highest priority, followed by research/audit activities
-Most respondents required training in communication, management, clinical skills, and research methods
-Providing training according to needs is vital in developing countries
Team/IP
Hennessey and Hicks, 1998 [30]
UK, USA, Australia
Article (original research) Questionnaire survey /Level VI Nurses / primary and secondary health care/ 216 respondents in five groups: health visitor, district nurse, primary care, NP, hospital nurse Used original English TNA tool -Similar occupational profiles in all three countries
-Results were consistent with the roles and education levels ascribed to the five groups
-Identified training needs: patient-centered activities, general work skills, teamwork, and research activities
Implications:
-No universal trends in training needs according to locus of practice
-Training requirements are specific to the actual role performed and the organizational environment
-Requirements must be assessed on a regular basis before education is commissioned in each country.
Individual
Hennessey et al., 2006a [31]
Indonesia
Article (original research) Questionnaire survey / Level VI Nurses, other healthcare professionals / primary healthcare, acute care / pilot study included 109 respondents, actual study included 524 nurses and 332 midwives Used translated and culturally adapted into Bahasa Indonesian TNA version -Tool was reliable and valid; suited for use with both midwives and nurses
-Baseline measurement of the quality of nursing and midwifery across Indonesia.
Implications: TNA use could ensure that the quality of health service and health professionals is monitored and optimized, which is essential for countries with diminished health status.
Team/IP
Hennessey et al., 2006b [32]
Indonesia
Article (original research) Questionnaire survey / Level VI Other health care professionals / primary healthcare, acute care / 332 midwives Used translated and culturally adapted into Bahasa Indonesian TNA version -Midwives’ roles varied significantly by province, but little difference in the roles of hospital and community midwives
-All midwives reported significant training needs for all 40 tasks
Implications: important regional differences in roles of midwives call for suitability of basic and post-basic education
Individual
Hennessey et al., 2006c [33]
Indonesia
Article (original research) Questionnaire survey / Level VI Nurses / primary healthcare, acute care / n = 524 Used translated and culturally adapted into Bahasa Indonesian TNA version -Significant differences in job profile across nurses from different provinces
-Roles of hospital and community nurses were fairly similar
-All nurses reported significant training needs for all 40 tasks
-Nurse role is not as diverse as expected, which may reflect the lack of central registration system and quality framework.
Implications: results provide a rigorous and reliable approach to defining occupational roles and continuing education needs of Indonesian nurses
Individual
Hicks and Hennessey, 1997 (J Adv Nurs) [12]
UK
Article (original research) Questionnaire/ Level VI Practice nurses/ primary healthcare (regional health authority), acute care / n = 420 Used adapted English TNA tool -Communication and teamwork activities were the most important aspect of a practice nurse’s job
-Agreement on how a practice nurse’s role is perceived across the sample
-Differences, similarities, and priorities between the practice nurse and NP were identified
-The use of a psychometrically valid and reliable instrument may establish the parameters for the definition and education of NPs in the UK
Individual
Hicks & Hennessey, 1997 (J Nurs Manag) [34]
UK
Article (original research) Opinion article / Level VIII 47 nurses and their nurse managers Used original English TNA tool −29 nurse/manager pairs showed consensus with respect to training interventions, while the remainder showed no accord.
-Overall agreement within each professional sample suggested a common view of training needs
Implications: a mutually agreed training program that incorporates the organization’s objectives and the individual’s training requirements can be achieved with minimum conflict and an enhanced understanding of both parties’ agendas.
Team/IP
Hicks & Hennessey, 1998 [35]
UK
Article (original research) Questionnaire survey / Level VI Nurses / acute care / 50 nurses and nurse managers Used adapted English TNA tool -Overall high agreement between nurses and managers, regarding NP role definition and the essential training requirements, with somewhat different opinions by medical staff.
-Attempt at a first-stage definition of the NP
Team/IP
Hicks & Hennessey, 1999 [13]
UK
Article
(original research)
Questionnaire survey / Level VI Nurses / primary healthcare, acute care / 49 acute care nurses and 420 community nurses Used original English TNA tool -Both groups perceived advanced clinical activities, including examination and diagnosis, and a range of research activities to be central to NP role.
-The primary care sample reported business and management activities as essential skills, while the acute sector nurses regarded communication skills, autonomy and risk management to be more important
Implications: rather than trying to construct a universal definition of the NP role for all contexts, a generic description, with further specificity added for each of the key contexts of NP service delivery is more realistic.
Individual
Hicks & Hennessey, 1999 [36]
UK
Article (original research) Questionnaire survey / Level VI Nurses / primary healthcare, acute & tertiary care / 100 participants from 7 NHS trusts Used adapted English TNA tool -TNA showed both common training needs and skill deficits relevant to locality and clinical area
-Using more objective information allows for commissioning of customized research skills to meet the needs of both the local organization and its employees
Implications: limited training budgets can be more effectively targeted
Organizational
Hicks & Hennessey, 2001 [37]
UK
Article (original research) Questionnaire survey / Level VI Practice Nurses enrolled in NP program / 15 nurses participated, 11 completed the course of interest Used adapted English TNA tool -Overall, the course reduced skill deficits in all but seven tasks; six related to research and audit and one to clinical examination.
-TNA can identify specific training requirements of a professional group to inform educational curricula
-TNA can assess the degree to which course provision has met training needs and which skill deficits need to be targeted.
Individual
Hicks & Tyler, 2002 [38]
UK
Article (original research) Questionnaire survey / Level VI Nurses / primary healthcare/ 388 family planning nurse practitioners (FPNP) Used adapted English TNA tool -Role of FPNP is more extended
-TNA tool is valid and reliable
Implications: FPNP role definition can be used to inform educational programs and assess their efficacy
Individual
Hicks & Fide, 2003 [39]
UK
Article (original research) Questionnaire survey / Level VI Non-specialist breast care nurses / primary healthcare, acute care / n = 119 Used adapted English TNA tool -Significant educational needs were identified across all 30 items
−13 out 14 cancer-related items were among the top 19 training needs
-Most important tasks: communication/team-work, self-management, awareness, of specific psycho-social problems, knowledge of specific clinical issues, and management of care
Implications: results should inform continuing educational development for non-specialist nurses caring for breast cancer patients
Individual
Hicks & Thomas, 2005 [40]
UK
Article (original research) Questionnaire survey / Level VI Nurses, physicians/ primary healthcare/ 54 respondents Used adapted English TNA tool -Both groups of community sexual health professionals required training and CPD in a range of areas, including clinical, research, legal, professional, and communication tasks
-TNA is a valid instrument
-TNA approach allows for optimum use of limited educational budgets by targeting actual training needs of staff and promoting multidisciplinary team working
Implications: potential for reducing variations in the quality of community sexual health care services
Team/IP
Holloway et al., 2018 [41]
New Zealand
Article (original research) Questionnaire survey / Level VI Nurses / primary healthcare/ 18 respondents Used adapted English TNA tool -TNA identified 10 priority training needs for regional primary healthcare nurses
-Preference for organizational development approaches
-Usefulness of TNA structured approach to commissioning for continuing education
Implications: 1) nursing services are expected to respond to changing health care needs, and 2) educational providers should respond with evidence-based curricula that address training needs
Individual
Kilic et al., 2014 [42]
Turkey
Article (original research) Mixed methods / Level VI Other healthcare professionals/ healthcare organizations / 46 participants Used adapted English TNA tool -Considerable research on non-communicable diseases is concentrated in select areas
-Great need for training junior researchers, but training alone is not sufficient
-Lack of coordination between governmental institutions and researchers
Implications: prioritization of financial resources can close the gap in areas which do not receive research attention, such as social determinants of health
Individual
Maher et al., 2017 [43]
Ireland
Article (original research) Descriptive survey / Level VI Physicians / acute care / 547 respondents Used adapted English TNA tool -Doctor-patient communication was ranked highest for importance and level of current performance
-Workload/time organization and stress management were skills with highest deficiency
-Resilience training, management, and communication skills were preferred areas for future continuing professional development (CPD)
-All respondents favored interactive, hands-on sessions
-Course completion and preference patterns differed significantly across clinical specialties
Implications: importance of considering individual needs and preferences across clinical specialties to facilitate more CPD programs.
Individual
Maher et al., 2018 [44]
Ireland
Article (original research) Questionnaire survey / Level VI General practitioners (GPs)/ primary healthcare/ 719 respondents Used adapted English TNA tool -GPs identified doctor-patient communication as the most important and best-performed skill
-Discrepancies between perceived importance (high) and current performance (low) emerged for time/workload management, practice finance and business skills
-GPs preferred primary care and non-clinical topics for future CPD
-Flexible CPD methods were important
-Gender and practice location significantly influenced CPD participation and course preference
Individual
Markaki et al., 2007 [45]
Greece
Article (original research) Questionnaire psychometrics / Level VI Nurses, other healthcare professionals / primary healthcare / 10 healthcare professionals in pilot test and 55 in implementation study Used translated and culturally adapted into Greek TNA version -Translated and culturally adapted TNA Greek version showed good psychometric properties: 1)
satisfactory internal consistency and reproducibility, 2) significant positive correlations between respondents’ current performance levels on each of the research items and research involvement, indicating good validity
Implications: tool is suitable to assess professional development needs of nursing staff in Greek primary healthcare settings.
Team/IP
Markaki et al., 2009 [46]
Greece
Article (original research) Questionnaire survey / Level VI Nurses, other health care professionals / primary health care / 119 participants Used translated and culturally adapted into Greek TNA version -Significant training needs were reported by all staff, mainly in research/audit and clinical skills
-No significant differences between 2-year degree graduates and 3- or 4-year degree graduates (RNs, midwives, and health visitors)
Implications: regional health authorities should implement a systematic overview of skill deficits in relation to skill requirements to enhance on-the-job training targeting group-specific, local needs
Team/IP
Moty, 2013 [47]
USA
Thesis Questionnaire survey / Level VI Other / Contract Research Organization / 33 participants in first survey and 26 in second Used adapted English TNA tool -Incorporating end users’ input through surveys to optimize portal design led to more positive opinions about portal technology and an increase in desire to use technology in the future
Implications: utilizing change management methodology could mitigate resistance to change
Organizational
Mwansisya et al., 2020 [48]
Tanzania
Article (original research) Questionnaire survey / Level VI Nurses, other healthcare professionals / primary healthcare, acute care / 153 participants Used translated and culturally adapted into Kiswahili TNA tool -Adapted tool was reliable and valid for identifying training needs in Reproductive, Maternal and Neonatal Health care settings
Implications: large sample size studies are required to test the use of this translated version in wider health care systems
Team/IP
Ngidi, 2012 [49]
South Africa
Dissertation for MBA (School of Business) Questionnaire survey / Level VI Medical managers in public hospitals / acute care / 30 respondents in KwaZulu-Natal Used adapted English TNA tool -All audited tasks were relevant and overall performance was perceived as high
-Training initiatives targeting medical managers should combine informal and formal training methods
Implications: 1) need for well-trained hospital managers in developing countries, and 2) more qualitative research could provide insight into the context of training needs
Individual
Pavlidis et al., 2020 [50]
UK, Greece, Bulgaria, Poland, Italy
Article (original research) Questionnaire survey / Level VI Formal and informal caregivers in health and social care (nurses, nursing assistants, home care aides) / primary healthcare / 550 caregivers Used adapted English TNA tool (UK) – only 10/30 items were used
Used translated and culturally adapted TNA tool (Greek, Bulgarian, Polish, and Italian language versions) – only 10/30 items used
-Basic nursing skills, specialization, and training in psychology-related skills emerged as common training needs with some variation by country
-Training in advanced health care systems, time management, emotion regulation and communication raise capacity of caregivers employed in health and social care
Implications: training in basic nursing skills for managing non-communicable diseases (diabetes, stroke, dementia) should be part of CPD programs for European caregivers.
Individual
Shongwe, 2019 [51]
South Africa
Article (Research report) Questionnaire survey / Level VI Nurses and qualified nursing assistants (QNAs) / acute care / 103 RNs and QNAs from pediatric and neonatal units in 6 hospitals Used adapted English TNA tool -TNA identified 15 high level learning needs
-Learning needs were skewed towards clinical skills and direct care of neonates and children
-There was no statistically significant difference in the overall learning needs between RNs and QNAs
-In-service planners and providers should be aware of what nurses in pediatric settings need to learn
Implications: strengthening of undergraduate curriculum on pediatric nursing and introduction of child nursing specialty programs in the Eswatini nursing education is recommended.
Team/IP
Singh, 2015 [52]
India
Article (original research) Questionnaire survey / Level VI Nurses, physicians/ Acute care / 274 faculty, senior residents, and nurses Used adapted English TNA tool -Studied at the micro level (tasks/job analysis) nurses’ training needs in a tertiary care specialty hospital in Northern India
-TNA identified training needs in patient care, research domain, managerial/administrative domain, and communication domain
-Nurses identified their needs relevant to their positions and perceived their performance as higher than physicians
Team/IP
Tyler & Hicks, 2001 [53]
UK
Article (original research) Questionnaire survey / Level VI Nurses / primary healthcare/ 388 family planning nurses Used adapted English TNA tool -The nurse prescribing role was defined primarily in terms of prescribing functions, although advanced professional issues, communication, teamwork and business/administration were also mentioned
-Research was not identified as being important
-The top 15 training needs included 7 research tasks, advanced clinical activities, applied pharmacology, administration and technical activities
Implications: study offers a role definition of the nurse prescriber in family planning, which can help with curriculum planning and CPD programs.
Individual
Yousif et al., 2018 [54]
Sudan
Article (original research) Questionnaire survey / Level VI Other healthcare professionals / school / 29 faculty of Dentistry at University of Gezira in Sudan Used adapted English TNA tool -TNA showed an urgent need for all competencies except three
-Priorities for improvement were ranked as follows: research, leadership, health professional education, managerial, community development, teaching and learning skills.
-University-level education and development center should focus on emerged training needs of staff
Team/IP
  1. aLevel of evidence appraisal based on the adapted Rating System for the Hierarchy of Evidence [21, 22]
  2. bThemes: Individual, Team/Interprofessional (IP), Organizational