Computer-Based Training at a Military Medical Center: Understanding Decreased Participation in Training among Staff and Ways to Improve Completion Rates

Military health care facilities make extensive use of computer-based training (CBT) for both clinical and non-clinical staff.  Despite evidence identifying various factors that may impact CBT, the problem is unclear as to what factors specifically influence employee participation in computer-based training.  The purpose of this mixed method case study was to examine factors that may influence healthcare staff participation in mandatory CBT to provide practical information for hospital educators to design training to improve participation rates.  Participants were surveyed to collect quantitative data to measure the relationship of factors that influenced employees’ participation in training, and interviews were conducted to further explore those factors.  Participants were self-selected from the population of 434 clinical and non-clinical personnel at a large military healthcare facility.  The actual sample size was 193 for a participation rate of less than half (44%).  Based on interpretation of findings from the Mann-Whitney U test, there were no differences in participation in CBT between clinical or non-clinical staff, U = 626.5, p = .11.  Interpretation of findings using Kendall’s Tau indicated there was no relationship between degree of comfort when using the Internet and computer technology and participation in computer-based training, rt (141) = -.081, p = .32.  However, a significant association was found between having a history of some training with the Internet and technology and completion of computer-based training, 2 (df = 1) = 19.63 = p < .01.  Pearson correlation analysis was performed between the number of hours spent weekly on e-learning courses and the completion rate for e-learning courses and no relationship was evident, r (df = 101) = -.11, p = .34.  However, five of the nine interviewees stated there is too much training and the amount does affect training participation.  The study was confined to one military healthcare facility so results are not generalizable.  To improve generalizability, larger studies with higher response rates are needed.  Further refinement of instruments to more accurately address research questions, along with reliability and validity testing, is also recommended.  Future studies with objective data, such as training records from all participants, may provide insight into discrepancies between actual and perceived participation in training.