Training, Education, and Employees Revisited
A sanitarian’s site audit includes two main parts: documenting areas of food safety concern and discussing time schedules and methods of compliance. While reimbursement finances require complete thorough technical analysis, they only recommend the use of education and consultation techniques. Therefore, managers naturally emphasize short-term technical compliance until the sanitarian has moved to other facilities.
There are many occasions where the management is very knowledgeable (‘I told them, over and over, what to do!’), but that information is not communicated effectively to employees. While one part of the enforcement action might involve requiring the manager to be certified a second time, that action usually does not include learning proper education techniques. Long-term compliance, then, becomes problematic. The theme of this posting, then, is proper methods of employee education, including motivation to apply the information and change behaviors.
Education Defined:
First, what exactly is meant by the term ‘education’? The definition dictates how sanitarians and managers treat the process.
The Encyclopedia Britannica definition is a common one: ‘a discipline that is concerned with methods of teaching and learning in schools…’ This is the definition expected in school systems, where knowledge and information is distributed to students, with the expectation that it will be applied in some unknown manner. The term for this concept is andragogy, and it is the education provided to children.
Looking further, however, the Library and Information Science Academic Blog adds to the definition. It states that ‘education is the… process of imparting knowledge, skills, values and attitudes to individuals, empowering them to navigate life successfully…’. This definition, called pedagogy is the process used for adult education: it implies application of knowledge to real life situations. In modern educational training, teachers learn the process of teaching skills mastery, where students demonstrate competency.
Alfred North Whitehead has another definition which emphasizes the importance of application of knowledge….
Education is the acquisition of the art of the utilisation of knowledge. In education, as elsewhere, the broad primrose path leads to a nasty place. This evil path is represented by a book or a set of lectures which will practically enable the student to learn by heart all the questions likely to be asked at the next external examination. It is for this reason that the uniform external examination is so deadly.
The reason is that we are dealing with human minds, and not with dead matter. The evocation of curiosity, of judgment, of the power of mastering a complicated tangle of circumstances, the use of theory in giving foresight in special cases all these powers are not to be imparted by a set rule embodied in one schedule of examination subjects.
The structure of environmental health education will depend on the definition. In the first case, sanitarians provide newsletters, food safety handouts and posters and discuss how they might be used. In the second case, however, sanitarians take time, during their site audits, to review concepts with employees, model ideal behaviors and allow time for practice and reinforcement.
Food Safety Message: It’s Components and Delivery
Look first at the food safety message delivered by sanitarians during their audits. This blog has spent considerable time on the structure of the message: describing the problem, its solutions, the techniques and resources required by the solution and how the new behavior will be monitored.
William McGuire proposed a model where there are different stages involved in processing persuasive communications (e.g. observing safe time and temperature requirements). This idea is addressed by other behavioral science models such as the Health Belief Model and Social Learning Theory.
McGuire distinguished five stages of persuasion and proposed that the probability that a persuasive message will result in behavior change is the joint product of the probability that the message is successful in passing each of these stages: (1) attention, (2) comprehension, (3) yielding, (4) retention, and (5) behavior. To quote McGuire, ‘the receiver must go through each of these steps if the communication is to have an ultimate persuasive impact, and each depends on the occurrence of the preceding step.’
The Health Belief Model also described stages of persuasion, proposing that the student must consider a number of questions before the information is used effectively. These questions are: (1) what the problem or concern is; (2) is the problem serious enough to affect me; (3) is the proposed solution effective; (4) is the solution realistic, are there resources, do the benefits outweigh the costs; and most important, (5) can I do what’s required, am I capable (perceived self-efficacy). Again, as with McGuire’s theory, the student will need to consider each question successfully to get to the end of the process and use the information.
The first important factor is the design and presentation of the information. A short, simple program presented by a credible expert (the food service manager, service technicians) will be much more effective. This will influence how well the other stages are processed, how well employees understand and relate to the information, and how likely they are to remember and use it later. The program goal must be stated precisely in measurable terms.
For example, a food service employee might not be enthused about having to attend a program about handwashing. Perhaps they feel they already are competent in handwashing and the program is not designed for them. The program might be scheduled after the shift change, on unpaid time. They might listen half-heartedly or be unconvinced of the issues (‘we’ve washed our hands this way for years, nothing’s happened’). The success of subsequent steps will be affected. So if attention to the message is less than 100%, comprehension of the message, acceptance of the information, retention of it, and finally, its use, will all be affected.
Solutions:
The program presenter might counter these concerns by scheduling the program partially on paid time, keeping the program short and simple, repeating the information several times, interspersing the program with different types of audio-visual media (videos, posters), and providing demonstrations by trusted fellow employees. The employee will be more convinced if their attitudes, beliefs and objections are considered. This is done by some type of program needs assessment, written or observed.
The Use of Fear Arousal: A frustrated food service manager told the sanitarian, ‘I’ll just scare the hell of them and fire them if they don’t do what I tell them. Everyone knows how to wash their hands!’. A manager attending a food safety certification class, faced with a question about when to wash their hands, answers ‘every time – my god we are all going to get sick and die!’.
Both true stories observed by the author. So what is the truth about fear arousal?
The inappropriate or excessive use of fear arousal, in addition to not producing positive change, may actually trigger relapse or regressive behaviors. While high fear arousal may produce an increased attention to message and perhaps adjustments to negative attitudes, resulting tensions and anxiety may slow any lasting behavioral change. Effective use of these tools will depend on the site personnels’ education, experience and background, as well as the effective communication of a coping solution.
Solution: Always attach an effective solution to any message. If it seems complex, divide up the requirements and allow mastery in each stage before moving forward.
The sanitarian’s presence, real or perceived (e.g. inspections are occurring nearby), naturally carries a residual anxiety level. So much of this concern lies with the site personnels’ perception of their situation. While truly recalcitrant individuals may need a strong message to prompt them to consider change, others, intent to comply, may be pushed into relapse. Again, see Bandura for the failure of verbal persuasion alone:
…efficacy expectations induced in this manner are likely to be weak and short-lived. In the face of distressing threats…whatever success expectations will be rapidly extinguished…several lines of research attest to the weakness of verbal persuasion that creates expectations without providing an authentic experiential base… (emphasis mine)
Sanitarians producing a report of legal citations without including consultation, education and modeling of coping strategies may actually be increasing, not reducing, the rate of noncompliance. If this approach is used over a long time frame, residual effects of any improvements will decay and resistance to further progress will build. The end result will be either a frightened client who remains noncompliant or the evolution of a highly resistance client previously amenable to education and consultation.
Albert Bandura Social Foundations of Thought & Action: A Social Cognitive Theory Englewood Cliffs: New Jersey Prentice-Hall 1986 p. 3 “behavior…commonly attributed to … inner causes can be instated, eliminated and reinstated by varying appropriate social influences…” In that case, these social influences should be included in any intervention design
https://www.wgu.edu/blog/andragogy-pedagogy-key-differences-learning2205.html Western Governors University (Utah).
Janz, Chamption and Strecher The Health Belief Model in Glanz, Rimer and Lewis, editors Health Behavior and Health Education: Theory, Research and Practice, Ed. 3 San Francisco: John Wiley & Sons 2002 pp. 45-66 p. 49-50 Also see Irwin M. Rosenstock, Ph.D, Victor J. Strecher, Ph.D, MPH, and Marshall H. Becker Ph.D, MPH, “Social Learning Theory and the Health Belief Model” Health Education Quarterly V. 15(2) (Summer, 1988) pp. 175-183