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What Kind of Compliance Training Program is the Most Effective?

Richard P. Kusserow | August 2013

What Kind of Compliance Training Program is the Most Effective?

Development and implementation of regular, effective education and training programs is one of the seven critical elements of a compliance program.  The DHHS OIG states that “At a minimum, comprehensive compliance programs should include…the development and implementation of regular, effective education and training programs for all affected employees…The compliance officer’s primary responsibilities should include…developing, coordinating, and participating in a multifaceted educational and training program that focuses on the elements of the compliance program, and seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent Federal and State standards.” They further advise that all affected parties “should be periodically trained in new compliance policies and procedures.”

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The OIG generally calls for between one and three hours annually for basic compliance training with additional training for specialty fields such as billing and coding, however they provide little guidance as to the recommended or best method for delivering compliance training.  They acknowledge that a variety of teaching methods can be used effectively, including using live trainers as well as computer-assisted training programs. They also recognize that the use of both internal and external trainers can be appropriate.

To be able to evidence compliance education and training effectiveness requires addressing two issues: (a) the means of delivering effective programs; and (b) evidencing that they were effective in understanding and acceptance by participants. There are many different ways in which training can be delivered, including the following:

Facilitated Training Using Case Studies

The evidence overwhelmingly suggests that this is the most effective method of delivering effective training.  It involves a live qualified facilitator and depends on participation of the audience.  This begins with the facilitator describing the function and operation of the compliance program, including going over the Code of Conduct and key compliance policies.  The balance of the training can be having participants applying the rules and principles presented to recognizable scenarios or case studies to resolve questionable issues and determine the best way to report suspected problems.  This interactive training is highly effective if a highly trained and skilled facilitator delivers it, however in the hands of someone not properly prepared or equipped for the program, it can have negative consequences.  The biggest downside is that the approach is the most expensive type of training.  As such, it is most often limited to the initial roll out of the compliance program and for new employees.  Refresher training may be delivered by more cost effective approaches.

PowerPoint Lecture Approach

Although this is among the most common methods of delivering compliance training, it is among the least effective.  The amount of content to address the operations of the compliance program, details of the Code of Conduct, and addressing applicable laws and regulations, almost dictates bombarding people with dozens of slides that can have deadening results. To use this method to obtain any kind of useful results will necessitate having someone very knowledgeable on the subject and skilled in presentation. An external lecturer is likely to have higher credibility as an expert but more costly that internal lecturers. In either case, the straight lecture approach has been shown to be among the least effective method and should be used sparingly. This approach is best used to provide more limited information such as updating staff on changes in law and regulations.

Talking Head Videos

Video presentations are among the least effective means for training and can be expensive in production.  Its best use can be to introduce the training program, preferably by the CEO in a personal message.  Other than that, it can be counter-productive.  If this approach is used, the video should be limited to 8-12 minutes.  Evidence suggests that the attention span of participants declines sharply after that.

Written Self-Study

Another method of training sometimes employed is a written self-study program.  It is most often used for specialized training.  Positives of this approach include using professionally prepared material, scheduling flexibility, and high reproducibility (important for the training of new hires). In addition, these materials tend to be update-friendly. Regardless of the training method selected for delivering the training, the questions still remains as to how effective the training program was in delivering the messages.  This has nothing to do with how many people have been training, but how much they learned from the training. There are two recognized way training effectiveness can be evidenced; have a test at the end of the training, or using questionnaires and surveys taken at a later date to find out how much was retained.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.