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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