Are All 'Mandatory' Trainings at Hospitals Truly Necessary?

Alok Patel, MD


December 29, 2022

This transcript has been edited for clarity.

Oh look, it's another overdue training, and if I don't get it done on time, I'll be called a delinquent on an email that's sent to my supervisor. Why are there so many mandatory trainings at all times from all of our hospitals?

Usually, when I pose a question or an opinion on social media, I get a bunch of comments on both sides of the argument, whether it's about tort reform, COVID-19 policies, or even virtual residency interviews.

Recently, I made a post on Instagram about how pointless I felt all these mandatory trainings are, and I got over 200 comments both on the post and indirect messages, with not one person supporting the barrage of mandatory trainings we're expected to do. It got me thinking and wanting to do a little bit of research.

I did a little investigating. I logged on to the learning center at one of my hospitals to look at all the mandatory trainings that are required. There are 12 listed here, ranging from trainings in compliance to diversity to equity, inclusion, privacy and security, cybersecurity, HIPAA, professionalism, and preventing harassment.

I'm navigating all over the site, looking at the learner dashboard, the library, and the e-catalog. I can't actually find who or what institution, agency, or governing body is mandating these trainings.

I started clicking through all of them and reading at the top, and the only one to provide that information was the harassment training, which is mandated by Title IX and the Clery Act. In California, it meets a legal requirement set forth by Assembly Bill 1825.

Under AB 1825, "Employers that do business in California and have 50 or more employees, as well as public employers, must provide at least 2 hours of sexual harassment training every 2 years."

I support the underlying mission. I stand by Title IX, but some of these other modules seem to have unclear associated agencies. Is it another legal requirement, the Department of Public Health, the hospital itself? Maybe they all just boil down to accreditation and funding.

Our good friends at the Joint Commission could also be behind some of the trainings that directly involve patient safety, such as pain medication management, fire evacuation, workplace violence, or infectious disease control.

You may recall that I recently made a video about the Joint Commission and whether or not their protocols, which are needed for accreditation, are actually backed by evidence. I asked a similar question here. Do these trainings affect outcomes? I could not find a single study saying that they do.

Now, this doesn't mean that learning about diversity, cybersecurity, or HIPAA isn't important. It just means that there might be a more optimal way to teach and train on these topics rather than these trainings that check some arbitrary box.

The other question I have to ask is, who is actually diligently doing these trainings? I mean, there are some that you have to read or some that you can read and then skip to the quiz sections. There are others that are videos that you can skip. Then, there are those really tricky ones with videos that you can't skip, and if you open up another browser, it freezes the training. We have dozens of these to do in addition to all our other non–patient care–related tasks.

If we have good evidence for anything, our doctor brains motivate us. Take patient handoff or sign-out, for example. I find it boring, tedious, and sometimes too long. Efficient sign-out, such as using the I-PASS method, was recently shown to cut adverse events in half. That's motivation. We need this type of data with these trainings.

At the very least, there should be a conversation about whether we healthcare professionals actually find these trainings useful. Mandatory trainings like CPR or advanced life support, that's a given. I also read two studies about how workplace violence training was well received by nurses. Nurses felt more prepared to both prevent and manage violent incidents at work after the trainings.

It's hard to justify the time it takes to complete all the other ones, especially when you take them so many times for so many different sites, you can't just test out of a module for good, and you're possibly not learning anything.

Also, why can't there just be a centralized site where you go and do all your trainings needed for compliance and accreditation, and every place that you work at can just go and look there to make sure you're up-to-date?

That would make too much sense. The modern, complicated burnout machine that is healthcare does not go in that direction.

Enough ranting. I want to hear what you all think. Do you actually find mandatory trainings useful? Do you think they improve outcomes or prevent harm? Be honest: Do you actually do them or do you just flip through them? Comment below.

Alok S. Patel, MD, is a pediatric hospitalist, television producer, media contributor, and digital health enthusiast. He splits his time between New York City and San Francisco, as he is on faculty at Columbia University/Morgan Stanley Children's Hospital and UCSF Benioff Children's Hospital. He hosts The Hospitalist Retort video blog on Medscape.

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