Unit III Annotated Bibliography Using the CSU Online Library, choose at least five articles—two of which must be professional, peer-reviewed journal articles—on the effects of accidents on individuals and the importance of safety and health training (including refresher training). After a careful review of these articles, write an annotated bibliography in proper APA format. The annotated bibliography must be around three pages in length. The CSU Success Center offers a great resource regarding annotated bibliographies. The webinar below is designed to walk you through the process of creating an annotated bibliography. Topics covered will include selecting proper sources, highlighting key points, and summarizing contents of the source. Annotated Bibliographies: https://columbiasouthern.adobeconnect.com/_a1174888831/annotatedbib/ Information about accessing the grading rubric for this assignment is provided below. Relative Effectiveness of Worker Safety and Health Training Methods Michael J. Burke, PhD, Sue Ann Sarpy, PhD, Kristin Smith-Crowe, PhD, Suzanne Chan-Serafin, BA, Rommei 0. Salvador, iVIBA, and Gazi Islam, BA An understanding of how best to implement worker safety and health training is a critical public need in light of the tragic events of September 11, 2001, as well as ongoing ef- forts to prepare emergency responders and professionals in related areas to do their jobs safely and effectively.' The need to gain a better understanding of the effectiveness of safety and health training is also apparent in a broader context given that millions of in- juries and illnesses are reported annually in private industry workplaces,^ and health and safety training is globally recognized as 1 means of reducing the costs assodated with such events."* Indeed, researchers from differ- ent fields, including business, psychology, en- gineering, and public health, have long recog- nized the need for comprehensive, systematic evaluations of safety and health training to address these types of critical public- and private-sector concerns.''"^ The conclusion from several narrative re- views has been that most training interven- tions lead to positive effects on safety knowl- edge, adoption of safe work behaviors and practices, and safety and health outcomes.̂ '*'̂ However, these qucditative reviews are specu- lative as to the specific factors that enhance the relative effectiveness of safety and health trsiining interventions in reducing or prevent- ing worker injury or illness.'°~'^ Notably, a fundamental question remains unresolved within the scientific literature: What is the relative effectiveness of different methods of safety and health tniining in modifying safety- related knowledge, behavior, and outcomes? Attempts to address similar broad-based questions related to the benefits of work- related health and safety interventions'^ have revealed the need for a large-scale, quantita- tive analysis of the extant literature. Results from such a ...

1. Unit III Annotated Bibliography
Using the CSU Online Library, choose at least five articles—
two of which must be professional, peer-reviewed journal
articles—on the effects of accidents on individuals and the
importance of safety and health training (including refresher
training). After a careful review of these articles, write an
annotated bibliography in proper APA format. The annotated
bibliography must be around three pages in length.
The CSU Success Center offers a great resource regarding
annotated bibliographies. The webinar below is designed to
walk you through the process of creating an annotated
bibliography. Topics covered will include selecting proper
sources, highlighting key points, and summarizing contents of
the source.
Annotated Bibliographies:
https://columbiasouthern.adobeconnect.com/_a1174888831/anno
tatedbib/
Information about accessing the grading rubric for this
assignment is provided below.
Relative Effectiveness of Worker Safety and
Health Training Methods
Michael J. Burke, PhD, Sue Ann Sarpy, PhD, Kristin Smith-
Crowe, PhD, Suzanne Chan-Serafin, BA, Rommei 0. Salvador,
iVIBA, and Gazi Islam, BA
An understanding of how best to implement
worker safety and health training is a critical
public need in light of the tragic events of
September 11, 2001, as well as ongoing ef-
forts to prepare emergency responders and

2. professionals in related areas to do their jobs
safely and effectively.' The need to gain a
better understanding of the effectiveness of
safety and health training is also apparent in
a broader context given that millions of in-
juries and illnesses are reported annually in
private industry workplaces,^ and health and
safety training is globally recognized as 1
means of reducing the costs assodated with
such events."* Indeed, researchers from differ-
ent fields, including business, psychology, en-
gineering, and public health, have long recog-
nized the need for comprehensive, systematic
evaluations of safety and health training to
address these types of critical public- and
private-sector concerns.''"^
The conclusion from several narrative re-
views has been that most training interven-
tions lead to positive effects on safety knowl-
edge, adoption of safe work behaviors and
practices, and safety and health outcomes.̂ '*'̂
However, these qucditative reviews are specu-
lative as to the specific factors that enhance
the relative effectiveness of safety and health
trsiining interventions in reducing or prevent-
ing worker injury or illness.'°~'^ Notably, a
fundamental question remains unresolved
within the scientific literature: What is the
relative effectiveness of different methods of
safety and health tniining in modifying safety-
related knowledge, behavior, and outcomes?
Attempts to address similar broad-based
questions related to the benefits of work-
related health and safety interventions'^ have

3. revealed the need for a large-scale, quantita-
tive analysis of the extant literature. Results
from such an analysis would not only help
improve safety and health training programs
but also provide evidence of the benefits
of these programs, securing both new and
Objectives. We sought to determine the relative effectiveness of
different meth-
ods of worker safety and health training aimed at improving
safety knowledge and
performance and reducing negative outcomes (accidents,
illnesses, and injuries).
Methods. Ninety-five quasi-experimental studies (n = 20991)
were included in
the analysis. Three types of intervention methods were
distinguished on the basis
of learners' participation in the training process: least engaging
(lecture, pam-
phlets, videos), moderately engaging (programmed instruction,
feedback inter-
ventions), and most engaging (training in behavioral modeling,
hands-on training).
Results. As training methods became more engaging (i.e.,
requiring trainees'
active participation), workers demonstrated greater knowledge
acquisition, and
reductions were seen in accidents, illnesses, and injuries. All
methods of train-
ing produced meaningful behavioral performance improvements.
Conclusions. Training involving behavioral modeling, a
substantial amount
of practice, and dialogue is generally more effective than other

4. methods of safety
and health training. The present findings challenge the current
emphasis on
more passive computer-based and distance training methods
within the public
health workforce. {Am J Public Health. 2006;96:315-324.
doi:10.2105/AJPH.
2004.059840)
continued support from the public as well as
the private sector.
With these ends in mind, this study was
designed to meta-analytically examine the
effectiveness of different types of worker
safety and health training, across industries
and occupations, from 1971 to the present. In
the section to follow, we describe different
methods of worker safety and health training
and offer hypotheses concerning the relative
effectiveness of these methods.
SAFETY AND HEALTH TRAINING
STRATEGIES
Methods of safety and health training
range from passive, information-based tech-
niques (e.g., lectures) to computer-based,
programmed instruction and learner-
centered, performance-based techniques
(e.g., hands-on demonstrations). Lectures,
one of the least engaging methods of safety
and health training, are commonly used to
present health- and safety-related informa-
tion. Other common passive techniques in-
clude videos and pamphlets or other types

5. of written materials.
Methods of training that cein be categorized
as moderately engaging incorporate knowl-
edge of results, for example feedback inter-
ventions in which performance information is
provided in small groups, allowing learners to
correct their mistakes. Feedback is also a
characteristic of programmed instruction, a
method of training designed to present infor-
mation in a standardized manner, such as on
a personal computer or in a workbook for-
mat An extensively used moderately engag-
ing method, computer-based instruction, has
been created for the entire gamut of work-
place health and safety topics, including occu-
pational safety, industrial safety, systems
safety, fire protection, hazardous materials
and waste disposal and storage, industrial hy-
giene, risk management, and safety engineer-
ing and design.'*
The most engaging methods of safety and
health training focus on the development of
knowledge in stages'^ and emphasize princi-
ples of behavioral modeling.'® Behavioral
modeling involves observation of a role
model, modeling or practice, and feedback
designed to modify behavior These meth-
ods also include hands-on demonstrations
February 2006, Vol 96, No. 2 I American Journal of Public
Health Burke et al. | Peer Reviewed | Research and Practice |
315

6. assodated with behavioral simulations, which
require active participation from the trainee.
In the case of behaviorcd simulations and
hands-on training, interactions between
trainees and trainers will frequently go be-
yond 1 -way feedback to engage trainees in
dialogue concerning knowledge acquired or
actions teiken. Such dialogue, in either a vir-
tual or actual context, is important because it
is posited to enhance quality of reflection
(thinking) with respect to actions taken. "̂ "'̂
This action-focused reflection is regarded as
the key to knowledge acquisition and transfer
of training, in that it forces the trainee to
infer causal and conditional relations between
events and actions, leading to development of
strategies for handling unforeseen events and
initiating and promoting self-regulatory moti-
vational processes (e.g., self-monitoring and
self-efficacy expectations).
Consistent with these arguments, tbere is
ample evidence in the training literature that
active approaches to learning arc superior to
less active approaches.^" Therefore, as train-
ing moves along the continuum from more
passive information-based methods (e.g., lec-
tures) to the most engaging methods (e.g., be-
havioral modeling and hands-on demonstra-
tions), we hypothesize that greater knowledge
acquisition and more transfer of training to
tbe work setting will occur (thereby improv-
ing behavioral safety performance and reduc-
ing negative safety and health outcomes).

7. IVIETHODS
Search and Inclusion Criteria
We identified relevant studies published
between 1971 (i.e., subsequent to passage of
the US Occupational Safety and Health Act
of 1970 [29 USC §651-678]) and 2003
by searching the Psyclnfo, PubMed, and ABI-
Inform electronic databases using phrases
such as "healtb and safely training," "safety
training intervention," and "error manage-
ment and intervention." In addition, we
manucdly searched 19 journals and tbe refer-
ence sections of relevant publications. This
process yielded 709 studies from a wide
variety of fields, including occupational medi-
cine, industrial hygiene, management, and
applied psychology. We assessed all reports
of an empirical nature to determine whether
tbey met our criteria for inclusion in the
meta-analysis.
Inclusion criteria were as follows. First, the
study had to involve a quasi-experimental de-
sign (i.e., a study approximating a true experi-
ment but not allowing for control of all rele-
vant variables because of its field setting).^'
Second, participants had to be recruited from
a working population (tbis population could
include youth workers). Third, tbe method of
intervention (e.g., lecture, programmed instruc-
tion, behavioral modeling, or simulation) had
to be clearly identified and bad to involve tbe

8. development of job-relevant safety knowledge.
Fourth, tbe study was required to include
at least 1 of the following types of dependent
variables: safety knowledge (i.e., self-rating or
test of knowledge), safety performance (i.e.,
self-ratings or supervisor, coworker, or ob-
server ratings of safety-related bebavior), or
safety and health outcome (i.e., measure of
accidents, illnesses, or injuries). Fifth, the
training intervention and data bad to be as-
sessed at tbe individual level of analysis. Fi-
nally, tbe statistical information necessary
to calculate an effect size {d) had to be avail-
able. A large number of studies were ex-
cluded because they contained inadequate
statisticed information or were not field ex-
periments of healtb and safety training effec-
tiveness. Of tbe originally identified 709
studies, 95 met the inclusion criteria.
Coding of Studies
An extensive coding protocol was developed
to include the following information: (1) method
of safety and health training, (2) duration of
training, (3) dependent variable (i.e., safety
knowledge, behavioral safety performance,
or safety and bealth outcomes) used in all
posttraining assessments, (4) reliability of de-
pendent variable, (5) occupational classifica-
tion, and (6) country of study. All reliability
estimates^^ (i.e., estimates of the consistency
with wbicb variables were measured) for
knowledge tests were internal consistency
esdmates^^ (i.e., a coefficients), tind tbe ma-

9. jority of reliability estimates for tbe perform-
ance measures were interrater estimates (e.g.,
correlation between 2 trtdned observers' as-
sessments of workers' performance).
In terms of classification of training meth-
ods, lectures, films, and video-based training
were classified as tbe least engaging methods;
programmed instruction techniques, including
computer-based instruction and feedback
techniques, were classified as moderately
engaging training methods; and behavioral
modeling, simulation, and bands-on training
were categorized as the most engaging train-
ing methods. All study characteristics pertain-
ing to hypothesis tests were double coded;
disagreements between coders were settled
by tbe first author.
Statistical Analyses
Initially, we computed d statistics using
tbe procedures described by Shadish and
coUeagues^^ and Lipsey and Wilson.^^ In
the case of studies in which gains or losses
because of training were expressed as a
proportion or a percentage, we estimated
d statistics via an arcsine transformation,
which results in a conservative estimate of
Subsequently, we employed tbe Raju et
al.̂ ^ meta-analysis procedure because tbis
procedure allows effects to be corrected for
unreliability associated with the dependent
variable. Sucb corrections produce more ac-

10. curate estimates of population-level effects
and permit more appropriate comparisons
of mean effects across different types of de-
pendent variables.^^ In our set of studies,
mean reliability values weighted according to
sample size were 0.67 for safety knowledge,
0.86 for safety performance, and 0.96 for
safety-related outcomes. Notably, the Raju et
al. procedure allows computation of asymp-
totically derived standard errors for mean
corrected (disattcnuated) correlations in
fixed-effect and random-effect forms.̂ *
Therefore, before using this procedure, we
transformed d statistics to correlations via
maximum-likelihood estimates.^'
For most studies that reported multiple ef-
fects witbin our dependent variable categories
(e.g., effects for 2 dimensions of behavioral
performance), we computed an average ef-
fect. In a few exceptions, we judged 1 effect
more appropriate (e.g., because it was based
on a more clearly defined dependent vari-
able), and we included this effect in our
analyses. This procedure ensured independ-
ence of study effects witbin any particular
effect size distribution.
316 I Research and Practice i Peer Reviewed | Burke et al.
American Journai of Public Heaith | February 2006, Voi 96, No.
2
TABLE 1-Effects From Each Study and Each Dependent
Variable: Meta-Analysis of Safety

11. and Health Training Effectiveness, 1971-2003
Disattenuated Effect Size
Study
Alavosius and Sulzer-Azaroff^'
Albers et al.^°
Arcuiy et a l . "
AmetzandArnetz^^
Askari and Mehring'^
Azizi et a l . ^
Baker'*
Barnett et al.^^
BoscoandWagner^'
Calabro et al.™
Caparez et a l . ' '
Carlton*
Carrabba et al."'
Chaffin et al."'
ChhokarandWallin"'

12. Cohen and Jensen""
Plant 1
Plant 2
Cole etal."*
Coutts et al."'
Curwick et al."'
Daltroy et al."'
Daltroy et al."'
Mailhandlers
Clerks
DeVriesetal."
DortchandTrombly*'
Group 1 vs group 3
Group 2 vs group 3
Eckerman et al.*^
Evanoffetal.*'
Ewigman et al.*"
Feldstein et al.**

13. Fox and Sulzer-Azaroff**
Froom et al.*'
Gerbert et al.**
Girgis et al. *'
Goldrick"
78 nurses
66 nurses
Haiduven et a l . "
Hopkins*^
Hultman et a l . * '
Hurlebaus and Link"
Infantino and Musingo**
Safety
Knowledge
0.94
Safety
Performance
0.42
0.90

14. 0.32
0.20
0.43
0.30
1.45
2.44
1.53
3.67
0.82
1.27
0.99
0.39
0.96
2.33
0.56
0.29
0.19
0.86

15. 0.12
0.42
0.60
Safety and
Health Outcomes
0.20
2.35
0.43
1.04
0.10
1.65
1.78
0.60
1.60
1.51
0.69
0.72
1.55
0.23

16. 0.37
0.59
1.61
-0.02
0.01
0.39
0.37
0.61
0.58
Continued
A number of effect sizes for combinations
of training method and dependent variable
were based on within-subject designs. To ex-
amine the possible effects of study design on
our results, we conducted separate meta-
analyses of studies involving within-subject de-
signs and studies involving between-subjects
designs (we also conducted sepeirate analyses
for distributions that included both types of
study designs). In addition, because of the
lack of pretraining infonnation in many stud-
ies, effects for between-subjects studies were
based on posttest-only comparisons of control
and training groups. In a few cases in which
the control or comparison group was non-

17. comparable (e.g., the groups had different
amounts of work experience) or the compari-
son group was trained with a less engaging
method than the focal trained group (and in
which pretraining and posttraining data were
available), study effects were based on within-
subject data for the trained group or groups.
RESULTS
Description of Studies
Ninety-five studies^^"'^^ conducted be-
tween 1971 and 2003 in 15 countries were
included in the present meta-analyses
(Table 1). These studies comprised 126 inde-
pendent samples, 20991 participants (the
sum of the independent samples), and 147
safety training effect sizes. The 43 samples
from the health care occupations represented
the largest occupational group.
Safety and Health Training iVIethods
Table 2 presents the results of tests of our
hypotheses based on data gathered within
the first posttraining assessment. For report-
ing purposes, mean effect sizes {d statistics),
along with number of effects {k) and total
sample sizes (n) pertaining to hypothesis
tests, are presented for (1) studies involving
between-subjects designs, (2) studies involv-
ing within-subject designs, and (3) the com-
bined (overall) distributions of effects. As a
result of the complex nature of r-to-rf trans-
formations for d values in our overall analy-

18. sis (which generally fell outside the straight-
forward transformation range for d of -0.41
to 0.41 ),̂ '̂ limits of the confidence intervals
for the mean effects and variances of effect
February 2006, Vol 96, No. 2 | American Journal of Public
Health Burke et al. Peer Reviewed | Research and Practice I
317
TABLE 1-Contlnued
InmanandBlanciforti^'
Knobloch and Broste"
Komaki et al.**
Makeup department
Wrapping department
Komaki e t a l . ' '
Department 1
Department 2
Department 3
Department 4
Leslie and Adams™
LudwigandGeiier"

19. Ludwig and Geiler"
Participative goai setting
Assigned goai setting
Lueveswanij et a i . "
Luskin e t a i . "
Lyncii et a i . "
Combined sampie
Medicai personnel
Nursing personnei
Lyncii and Freund™
Maples et a i . "
Marsh and Kendrick™
Martyny et a l . "
Maternaetai.™
Mattiia"
Mattiia and Hyodynmaa'^
Office buiiding site
Apartment buiiding site

20. McCauiey*^
Melhom*"
Standard rivet gun training
Vibration-dampening rivet gun training
Michaeisetai.''
Carpenters
Construction iaborers and pipe caulkers
Custodial assistants
Dentai assistants/hygienists and dentists
Electricians
Engineers and iiigh-pressure plant tenders
Plumbers
Print shop workers
Traffic device maintainers
NasanenandSaari"'
Parenmark et al.°'
Parkinson et al.™
Peters*

21. Porruetai.'"
1.21
0.91
0.72
0.64
0.76
0.10
0.92
0.52
0.40
0.80
0.79
0.78
0.78
0.56
0.94
0.67
0.35

22. 0.40
0.21
1.02
0.85
0.76
0.37
0.29
0.20
0.26
0.18
0.06
1.15
1.07
0.58
0.43
0.30
1.68
0,29

23. 0.36
0.39
1.27
0.55
0.51
0.91
0.79
0.34
0.13
0.63
0.73
Continued
size distributions are presented only in cor-
relation (r) form in Table 3.
The findings reported in Table 2 are consis-
tent with the expectation that tbe more engag-
ing a method of training, the greater the effects
of safety and heaitb training on knowledge ac-
quisition. Overall, mean knowledge acquisi-
tion effect sizes for the least engaging, moder-
ately engaging, and the most engaging safety
trsuning interventions (for both types of study

24. designs combined) were 0.55, 0.74, and
1.46, respectively. As indicated by the confi-
dence intervals for tbese effects (Table 3), the
effects were significantly different from each
otber. Ftirthermore, cdthough training dura-
tions were, on average, greater in the case
of more engaging training methods, training
duration and level of engagement were only
weakly (and nonsignificEintly) assodated in
the knowledge category studies (as well as tbe
performance category studies). Tbese findings
rule out training duration and a strict observa-
tional learning effect as a plausible rival ex-
planation for the present results.'^''
A small subset of studies (i.e., 7) tbat in-
cluded knowledge measures allowed us to ex-
amine maintenance or decay in terms of the
effectiveness of safety training. In 5 studies
involving training at low levels of engage-
ment, the average effect decreased approxi-
mately 50% (i.e., from 0.55 to 0.28) during
periods ranging from 1 week to 1 year after
the initial assessment The effect in the lone
study involving moderately engaging training
decreased approximately 15% (from 3.37 to
2.85) over 4 weeks, and the effect in the
single study involving highly engaging train-
ing was maintained at 1.84 over a 4-week
period. More researcb and better reporting
of primary study results are needed before
definitive conclusions can be readied about
decay of safety Eind becdth training effective-
ness over time.
With respect to improvements in behav-

25. ioral safety performance, tbe mean overall
effects assodated with safety and heaitb train-
ing interventions in the least engaging, mod-
erately engaging, and most engaging cate-
gories were 0.63, 0.62, and 0.74, respectively.
Although tbese effects were not significantly
different from eacb other, it is notable that
the confidence interval for the latter effect
was predominantly outside the range of the
318 I Research and Practice | Peer Revievi/ed | Burke et al.
American Journal of Public Health I February 2006, Vol 96, No.
2
TABLE l-Contlnued
Ray et a l . "
Ray et al.'^
ReberandWaliin'^
Reber et ai.'''
Reddeiletai,'^
Rhoton"
Rundio"
Saareia™
Saareia et a i . "

26. Tani<ers
Ferries
Saari'"
SaariandNasanen'"'
• Sadier and Montgomery'"'
Leader-directed group
Standard iecture
Sciiwartz™
Setoetai.™
Streffetal.™
Suizer-Azaroff and de Santamaria
Department 1
Department 2
Department 3
Department 4
Department 5
Department 6
Symesetai.'"

27. TroupandRauiiaia'™
Uwaime™
van Poppei et a i . " "
Vaugiit et a i . ' "
Hands-on training
Computer-based training
Videmanetai.'"
Wangetai."^
Wertzetai.""
Whitbyetal."*
WiiliamsandGeiier"'
WiiiiamsandZahed'"
Lecture method
Computer-based training
Woifordetai."*
Wongetai.'"
Wynn and Black'^°
Yarall'^'

28. Wori(site B
Worksite C
Yassietai."'
Zoharetal."'
1.85
1.45
,106
0.45
0.57
1.74
0.47
0.25
3.67
3.37
0.97
0.67
0.80
0.69

29. 0.38
0.20
0.95 0.68
0.88
0.98
0.46
0.55
0.39
0.25
1.48
0.29
0.97
0.07
0.51
-0.33
1.33
0.73
0.83

30. 0.21
0.44
0.23
1.12
2.07
0.29
1.21
0.20
-0.27
-0.21
0.31
1.39
0.43
0.66
0.62
0.16
0.53
0.13

31. 0.17
O.U
0.58
0.09
Note. Effects are expressed as d statistics corrected for
dependent variabie unreiiabiiity.
respective confidence intervals for the effects
of the least engaging and moderately engag-
ing training methods.
Our findings are generally consistent with
the expectation that as level of engagement in
training increases, training will have greater
effects in terms of reductions in negative
safety and health outcomes. For the overall
distributions, tbe mean effects assodated with
tbe least engaging, moderately engaging, and
the most engaging safety and health training
methods were 0.20, -0.13, and -0.48, re-
spectively, and these effects were significantly
different from each other. It should be noted
that the least engaging and moderately engag-
ing distributions were each influenced greatly
by a single study involving a lai^e sample size
and a small effect.
DISCUSSION
Here we assessed tbeoretical expectations
concerning the relative effectiveness of differ-
ent methods of worker safety and health

32. training aimed at modifying safety-related
knowledge, behaviors, and outcomes. This
is the first investigation focusing on such
training, to our knowledge, that has included
all studies publisbed since 1971 and has in-
volved a scientifically rigorous approach. Al-
though tbe number of studies examining
illnesses, injuries, and acddents was not suffi-
dent to allow separate consideration of tbese
categories of safety and health outcomes, the
quality of the database was adequate for test-
ing general bypotbeses.
As mentioned, our results are consistent
with the proposition that as tbe metbod of
safety and bealtb training becomes more en-
gaging, the effect of training is greater in
terms of knowledge acquisition and reduc-
tions in negative outcomes. Our results con-
cerning behavioral performance were more
equivocal but nevertheless provided consis-
tent support, in the case of botb between-
subjects and within-subject study designs, for
the effectiveness of more engaging training
methods. Together, these findings address
calls for research on safety and health inter-
ventions, induding those of the Nationeil Oc-
cupational Research Agenda.'°"'^'^' More
spedfically, our results speak to the goals of
tbe intervention effectiveness research
February 2006, Vol 96. No. 2 | American Journal of Public
Health Burke et al. | Peer Reviewed | Research and Practice |
319

33. TABLE 2-Training Method Results: Meta-Analysis of Safety
and Health Training Effectiveness, 1 9 7 1 - 2 0 0 3
Safety Knowledge Safety Performance Safety and Health
Outcomes
Training Method/Study Design
Least engaging (overall)
Between-subjects studies
Within-subject studies
Moderately engaging (overall)
Between-subjects studies
Within-subject studies
Highly engaging methods (overall)
Between-subjects studies
Within-subject studies
n
4097
1071
3026
3021

34. 1121
1900
886
609
277
k
18
7
11
19
5
14
12
7
5
MA
0.55
0.58

35. 0.54
0.74
0.66
0.79
1.46
1.27
1.89
n
2356
1509
847
1864
1044
820
2019
• 1 9 1 4
105
k

36. 20
12
8
31
10
21
16
12
4
MA
0.63
0.65
0.58
0.62
0.74
0.47
0.74
0.72

37. 1.14
n
1950
4528
3846
682
3068
1588
1480
k
3
19
7
11
9
6
3
MA

38. 0.2
-0.13
-0.04
-0.66
-0.48
-0.25
-0.74
Note, n - total number of individuals; /(=number of effects; M.
= estimated mean d statistic corrected for dependent variable
unreliability (mean A).
TABLE 3-Training iVIethod Resuits in Correlation Form:
iVIeta-Analysis of Safety and
Heaith Training Effectiveness, 1 9 7 1 - 2 0 0 3
Safety Knowledge Safety Performance Safety and Health
Outcomes
Training Method/Study Oesign
Least engaging (overall)
Between-subjects studies
Within-subject studies
Moderately engaging (overali)

39. Between-subjects studies
Within-subject studies
Highly engaging methods (overall)
Between-subjects studies
Within-subject studies
n
4097
1071
3026
3021
1121
1900
886
609
277
18
7
11

40. 19
5
14
12
7
5
^
0.26
0.27
0.25
0.33
0.29
0.36
0.58
0.52
0.71
95% Cl
0.22,0.29

41. 0.20,0.34
0.21,0.29
0.30,0.37
0.23,0.35
0.32,0.41
0.52,0.64
0.45,0.60
0.59,0.83
0.01
0.02
0.01
0.03
0.06
0.01
0.03
0.02
0.02

42. n
2356
1509
847
1864
1044
820
2019
1553
105
k
20
12
8
31
10
21
16

43. 10
4
^
0.28
0.29
0.28
0.28
0.32
0.22
0.34
0.33
0.46
95% Cl
0.24,0.32
0.24,0.33
0.21,0.35
0.23,0.32
0.26,0.37

44. 0.15,0.27
0.30,0.38
0.29,0.38
0.31,0.61
0.02
0.04
0.00
0.03
0.05
0.00
0.01
0.01
0.03
n
1950
4528
3846
682

45. 3068
1588
1480
k
3
19
7
12
9
6
3
Mp
0.1
-0.06
-0.02
-0.32
-0.23
-0.12

46. -0.34
95% Cl
0.15,0.06
-0.09,-0.03
-0.05,0.01
-0.38,-0.23
-0.26, -0.19
-0.17,-0.07
-0.38,-0.29
0.01
0.01
0.00
0.04
0.01
0.00
0.01
Note, n=total number of individuals; *=number of study effects;

47. estimated M^; V^ = estimated variance of effects.
p=estimated mean correlation corrected for dependent variable
unreliability (mean p); Cl - confidence interval around
agenda, including not only what interventions
are most effective in enhancing worker safety
and health but also why they are effective.
Our findings indicate that the most engag-
ing methods of safety training are, on aver-
age, approximately 3 times more effective
than the least engaging methods in promoting
knowledge and skill acquisition. An alterna-
tive way to differentiate the effects of the
most engaging methods on knowledge gedn
from the effects of other methods is to com-
pute "common language" effect sizes.'̂ ^ In a
given study, the probahility of a randomly se-
lected individual from the most engaging
training group exceeding a randomly selected
individual from the least engaging training
group in terms of knowledge acquired was
0.74; the analogous probability was 0.70 in a
comparison of randomly selected individuals
from the most engaging and moderately en-
gaging groups. The magnitudes of such differ-
ences alone have broad organizational and
public policy implications for the manner in
which safety and health training—in particular,
mandated training—is delivered.
Unexpectedly, the least, moderate, and
most engaging safety and health training
methods had somewhat comparable overall

48. mean levels of effectiveness with respect to
improvements in behavioral performance.
We cautiously interpret this pattem of results
to be a function of the fact that the training
methods classified as least engaging and
moderately engaging were often associated
with more fundamental, routine t}fpes of
tasks (e.g., applying sunscreen, inserting
hearing devices, keeping work areas clear
of obstacles), whereas the methods classified
as most engaging often involved advanced,
complex work activities (e.g., properly han-
dling needles to avoid exposure to blood-
borne pathogens, selecting and using respira-
tors to avoid neurotoxic exposures). We
suspect that differences in the complexity of
performance tasks, coupled with suboptimal
measures of more complex tasks, influenced
our results."'"
Our findings indicate that the most engag-
ing methods of safety training are, on aver-
age, most effective in reducing negative out-
comes such as accidents. The greater
320 I Research and Practice I Peer Reviev^ed | Burke et al.
American Journal of Public Health | February 2006, Vol 96, No.
2
effectiveness of more engaging, hands-on
training in reducing negative outcomes and
increasing knowledge acquisition lends sup-
port to the calls of researchers and practition-

49. ers advocating the design and implementation
of learner-centered, peirticipatory approaches
to vv'orker safety and health training/''''^^"'^°
and such a finding is consistent with the re-
sults of previous meta-analydc studies of
training evaluation in other domains.'^' Fur-
thermore, our findings are consistent with
recommendations in other areas of the litera-
ture advocating for the active involvement of
workers so that the advanced knowledge nec-
essary for fault prevention can he developed
(e.g., anticipatory responses to problem situa-
tions in manufacturing contexts).'''̂ ''•'̂
In a broader sense, the present results pro-
vide guidance for the design and delivery of
educational interventions targeted toward the
public health workforce.'^''"'^^ Efforts to in-
crease the capacity of this workforce as well
as the capacity of the public to respond to
threats, react to emergency events, and sim-
ply engage in safe behavior must be achieved,
in part, through continued education pro-
grams.'''̂ ^"'"*^ Designing and implementing
effective training is central to these efforts.
Our results have important implications
that should he considered in light of the
current push toward greater use of distance
learning training in preparing the public
health workforce.''"'"'''^ Our findings suggest
that, to the extent possible, computer-based
and distance learning methods should, in
some manner, include active participation on
the part of learners (e.g., modeling, feedback,
and dialogue) to enhance their knowledge

50. acquisition and increase their preparedness.
To date, most computer-based and distance
safety training has been rather passive, in-
cluding directional feedback rather than facil-
itating the types of dialogue that would en-
gender action-focused reflection.''*'' Our
recommendations concerning active worker
participation and dialogue as accompani-
ments to computer-based and distance learn-
ing methods of health and safety training are
fully consistent with theoretical models con-
cerning distance learning and education.'''^'''^
Another important finding of this study rel-
evant to the design and evaluation of safety
and health training was that between-subjects
and within-subject study designs yielded simi-
lar results with respect to knowledge acquisi-
tion. Despite cautionary issues concerning
potential threats to the internal and external
validity of within-subject study designs,''"
our results demonstrate that studies involving
such designs provide theoretically inter-
pretable findings that are consistent with find-
ings from between-subjects studies in the
domain of worker safety and health training.
Given that within-subject designs generally
involve greater statistical power than between-
subjects designs^' and that withholding safety
and health training Irom a comparison group
(or locating a control/comparison group) for
the purpose of program evaluation is often
ethically questionable in safety-related work,
our findings encourage greater use of within-
subject designs in evaluating safety and

51. health training.
The meta-analydc results described here
are also necessary building blocks for any
effort aimed at estimadng the incremental
costs or benefits of different types of safety
and health training.'"** Such informadon is
pardcularly importeint given today's increased
pressures to jusdfy and improve health and
safety investments.'^ Our results suggest that
moderately and highly engaging training
methods Eire, on average, more dme consum-
ing and probably more expensive in the short
term but that they are potendally less costly
and more effecdve in the long term while bet-
ter ensuring worker and public safety.
In addition, the trends in the magnitudes
of our results across dependent variable cate-
gories are consistent with predicdons from
job performance theories. Job performance
theories posit that intervendons (e.g., safety
and health training) are expected to have
their greatest impact on more proximal out-
come variables such as knowledge acquisi-
don and their least impact on more distal,
low-base-rate phenomena such as accidents.
The reasoning is that knowledge acquisidon
is expected to mediate the reladonships be-
tween such intervendons and their more dis-
tal outcomes.^'''^ Accordingly, in evaluadng
die effecdveness of intervendons, safety and
healdi training researchers and pracddoners
need to focus much more on the develop-
ment of well-designed, standardized mea-
sures of safety knowledge. Furthermore,

52. because training effects for reladvely distal
outcomes such as on-the-job performance
and injuries are likely to be more affected by
intervening, dme-related variables than train-
ing effects for reladvely proximal measures
such as knowledge assessments, we stress
the need for future research examining the
infiuence of situadonal variables (i.e., organi-
zadonal safety climate, opporUmides to apply
knowledge and skills, type of work, country/
culture, and so on)'^°'^' on safety and health
training effecdveness.
We also encourage future primary empiri-
cal research addressing some of the limita-
dons of the present meta-analysis (e.g., pri-
mary studies related to distribudons with
small numbers of effects). Moreover, we en-
courage primary and meta-analydc research
designed to extend our study cind examine
safety and health training reladve to more
specific safety knowledge, safety performance,
and safety and health outcome variables, in
addidon to examining the role of individual
difference variables (e.g., worker modvadon,
work experience). Our future success in pro-
moting safe work behaviors and reducing the
negadve consequences of unsafe behaviors
will largely depend on our ability to improve
our conceptualizadons and communicadons
of the effecdveness of safety and health train-
ing intervendons. •
About the Authors
Michael J. Burke is with the Organizational Behavior Area.

53. A. B. Freeman School of Business, and the Department of
Environmental Health Sciences, School of Public Health
and Tropical Medicine. Tulane University, New Orleans,
La. Sue Ann Sarpy is with the South Central Center for
Public Health Preparedness and the Department of Envi-
ronmental Health Sciences, School of Public Health and
Tropical Medicine, Tulane University. Kristin Smith-Crowe
is with the David Eccles School of Business, University of
Utah, Salt Lake City. Suzanne Chan-Serafin, Rommel 0.
Salvador, and Gazi Islam are with the Department of
Organizational Behavior, A. B. Freeman School of Busi-
ness, Tulane University. New Orleans.
Requests for reprints should be sent to Michael J. Burke,
PhD, A.B. Freeman School of Business. Tulane University.
New Orleans, LA 70118 (e-mail: [email protected]).
This article was accepted April 1, 2005.
Contributors
M.J. Burke and S.A. Sarpy originated the study, super-
vised the research, interpreted the statistical analyses,
and wrote the article. K. Smith-Crowe organized the lit-
erature searches and the gathering of primary studies
and conducted the statistical analyses with the assis-
tance of S. Chan-Serafin, R.O. Salvador, and G. Islam.
February 2006, Vol 96, No. 2 | American Journal of Public
Health Burke et al. | Peer Reviewed | Research and Practice |
321
All of the authors participated in coding of study char-
acteristics and reviewed and commented on drafts of
the article.

54. Acknowledgments
Michael J. Burke would like to express his appreciation
to the Institute of Work Psychology at the University of
Sheffield, which generously supported the completion
of this work during fall 2004. This article was based,
in part, on Michael J. Burke's presidential address pre-
sented at the 19th Annual Conference of the Sodety
for Industrial and Organizational Psychology, April
2004, Chicago, 111.
We would like to thank Ann Anderson (Tulane
University School of Public Health and Tropical Medi-
cine) for commenting on the final version of this article.
In addition, Ronald Landis (Department of Psychology,
Tulane University) and Arthur Brief (Freeman School
of Business, Tulane University) commented on other
aspects of the study, including our interpretation of
the fmdings.
Human Participant Protection
No protocol approval was needed for this study.
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American Journal of Public Health | February 2006, Voi 96, No.
2

74. L A B M A N A G E M E N T
Laboratory training: Safety at any age
By Terry Jo Giie, MT(ASCP), MA Ed
I t has often been said there are three kinds of people in
thisworld: those who make things happen, those who
watchthings happen, and those who say, "Wiiat happened?" All
too often when it comes to laboratory safety, "W'Tiat hap-
pened?" is tbe coiTinion scenario. To avoid this situation, on-
going safety training is ;i must. No successful safet}' program
is complete without it.
Safet' training comes in different versions: orientation,
which is done within the first 10 days of employment or wben
a new safety issue is introduced into the workplace, and man-
dator' training, which is done to meetaecreditation and regu-
latory requirements. The Lah Safety Officer should review
accident and injury reports and the OSI IA 300 log at least
quarterly to determine how effective training has been, and
to identif}' areas where additional training may he needed.
Table I outlines safety training and who needs to attend.
Tbe most obvious criterion for effectiveness is on-tbe-
job results. If a safety-training program is effective, labora-
tory employees have few or no injuries due to unsafe acts. It
is also helpful to verify all employees' knowledge of required
safet}' procedures at least annually, using a form like the one
shown in Form A.

75. After stafF members have eompleted a knowledge eheck-
list, ask the supervisors of each lab section to provide feed-
hack on any areas where staff members appeared to have
tnjuble in answering questions or indicated they did not al-
Table 1.
Topic
All laboratory safety
policies and procedures
[ Fire extinguisher practice
I Spill cleanup
* Fire prevention
and preparedness
' Fire drill evacuation
' Chemical safety
1 Biological hazards
'• Infection control
i Radiation safety
I Ergonomics symptom survey
1 Specimen packaging
i and shipping procedures
Who needs
to be trained
Ail lab staff

76. All lab staff
All technical staff
All lab staff
All lab staff
All staff who handle
or transport chemicals
All lab staff
All lab staff
Only employees that use
or transport radioactive
materials
All tab staff
Staff that packages
specimens for shipping
by ground or air
How often
Upon
employment J
Upon 1
employment
Upon
employment
Annually

77. Annually
Annually
Annually
Annually
Annually
As needed
Every 24 months
A d a p t e d f rom t h e Cumph-re Guide lo l.ahiiriiUiry Safety
hy T e r r y J o ( l i l c ,
IlCPm, iiiL-. Marbkhcaii, MA; 2004'
ways comply. This input may suggest the need to schedule
training in certain areas.
Safety training also occurs when updating staff as regula-
tory requirements change. A good place to find out about
changes that may require additional training are on regula-
tory websites, sueh as OSHA (f); in professional journals; and
at meetings of professional associations serving lab profes-
sionals, such as the Clinical Laboratory Management Asso-
ciation or the Aineriean Society for Clinical Laboratory Sci-
ence. New or amended regulations sometimes speeify a
deadline by whieh training on the changes must be conducted
to bring labs into compliance. Therefore, watch for chang-
ing content in the rules, and he sure to check for any training
deadlines tbat may be imposed.

78. Establish an annual schedule
Beeause safet}' training is so important, and beeause there is
so much ground to cover, it is helpful to lay out a full sched-
ule for the year. Bloek out an annual schedule that ineludes
detailed sessions where special needs have been identified
and awareness/reminder sessions to keep key aspeets of lab
safety in the front of all staff members' minds.
Public healtb associations, such as the Nati(jnal Safety
C^ouncil, often run national safety awareness camjiaigns
that ean be leveraged to make training more effective. Tbe
following arc some suggestions:
January - Specimen transport
February - Personal protective equipment (PPF.)
March - Hoods/F.nvironincntal
April - C-hemical hygiene
May - Bloodhorne pathogens
June - General safety-
July - C^ompressed gases
August - Safe work ]>ractices
September - Ergonomics
October - Fire safety
Novetnber - Electrical safety
December - Waste managL'iiient
Inspection or audit deadlines from accrediting agen-
cies, such as the College of American Pathologists or the
Joint Commission on Accreditation of Health Organiza-
tions, nuiy iilso influence the training schedule.
Designing a training program
When tiesigning any training session or program, what
will be covered anil who will he trained needs to be deter-

79. mined. 'Fhis information will guide decisions about what
delivery formats may work best and what level of detail
sessions should provide.
Create an outline of what will be covered. Factual infor-
28 August 2005 • MLO www.mlo-online.com
L A B S A F E T Y
niation may include:
• An overview ofthe regulation. W^o is covered? What
arc the main requirements? Is the regulation effective now
{or when will it take effect): What are the penalties or
otber risks from noncompliance?
• Potential bealtb bazards. Summarize tbe dangerous prop-
erties of chemicals or equipment, t'pes of potential inju-
ries, routes of entry or infection, and so on.
• Engineering controls. W'bat safet' equipment or physi-
cal safeguards does tbe lab have in placer What must em-
ployees do to take full advantage ofthe safeguards?
• Safe work practices. What are the lab's standard operat-
ing procedures to minimize risk?
• Persotiiil protective equipment. In addition to the stan-
dard lab coat, what other PPE items, sucb as eye protec-
tion, respirators, and special gloves, must be used for tbe
specific task(s) covered in the training?
• Handling accidents and recovery. Who cleans up the spill?

80. U-Tiat emergency medical treatment is available?
The role of age in learning
Labs may have employees ranging in age fi-om 18 to 70 or
more.
All employee's age can play an important role in what metliod
of training is successful. For example: Employees over the age
of 70 have a wealth of knowledge but are slow to change and
prefer to have a live speaker give the infonnation in a small
group,
as opposed to working with a computer or otber technolog)':
• Tbe Swing Generation, ages 56-69, works well under
deadlines but needs additional time to adjust to any changes
required. Training for tbis group is best done with an in-
person speaker or using a video.
• Baby Boomers, ages 36-55, are usually computer literate
and prefer tbeir training via video or online. They like
hands-on learning as well. They value continuing educa-
tion and like to attend seminars and conventions.
• Gen Xers, ages 24-35, are very computer savv'y and ex-
pect training to be fun. Online training at an interesting
site will keep them engaged.
Understanding the content is an important Hrst step, but
staff members need to take that content seriously and apply it
fully in their day-to-day efforts. All employees, regardless of
age, listen to radio station "WlIFxM" ("What's In It For Me?"),
so make sure presentations include reasons wby the training
will benefit them.
Specific learning objectives spell out wbat employees should

81. be able to do after completing the training, and define what
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82. L A B M A N A G E M E N T
constitutes acceptahle performance or competence. Benjamin
Bloom's classic text, Taxonoirty of Educational Objectives: The
Cliimfication nf Editcutional Goah;^ provides an excellent
frame-
work tor developing learning olijectives for training. Each of
the cognitive levels Bloom descrihes huilds on previous levels,
to ensure that the employee understands the content. Bloom's
cognitive levels, from lowest to highest, are:
• Knowledge: Terminology; specific facts; ways and means of
dealing with specific criteria or methods. Kjiowledge en-
ables the employee to remcmlter the safety requirements ot
each tiisk and relate them to previously learned infonnation.
• Comprehension: Understanding the meaning of infor-
mation so that the learner is able to perform a task that
depends on it, such as using PPE or ergonomic equip-
ment as instructed.
• Application: The use of previously learned information
in new concrete situations to solve problems that have
single or best ;mswers.
• Analysis: Breaking down information into its component
parts, trying to develop new conclusions by finding evi-
dence to support them.
• Synthesis: Creatively or divergently applying prior
kjiowiedge and skills to produce something new. Most
iearning objectives that involve synthesis are prepared
for management-level personnel.

83. • Evaluation: }uLii;cs the value of material based on per-
sonal values/opinions, resulting in an end product witb a
defined purpose, but which might not have a "right" or
"wrong" answer. Evaluative learning objectives are used
mostly for management-level personnel.
Bloom mentions two other cognitive domains tbat are also
important in designing training:
• Psychomotor: Deals witb motor skills. Laboratory work
is ver' tactile; successtijl lab workers have higbly devel-
oped motor skills and usually do well with tbe psycbo-
motor requirements. Use "bands-on" teaching and prac-
tice metbods for tbe psychomotor domain.
• Affective: Deals with attitudes, feelings, and emotions.
It is more difficult to write clear and meaningful ;iffec-
tive learning objectives tban any otber type of objective.
Affective objectives are motivational ratber than knowl-
edge- or analysis-based. Build these objectives on clear
reasons why the bebavior is good for other employees or
the organization as a whole.
Other training considerations
VVTiile age and knowledge level ot" the audience are impor-
tant considerations in cboosing tbe best format for deliver-
ing a particuhu- type of training, cost is anotber concern. Con-
fer witb management on budget questions, particularly wben
considering engaging an outside trainer or purchasing safety
training products. Options include live presentations to small
or large groups, audiotapes, videotapes, print- or computer-
based self-study, or online courses. We 11-designed games can
also be effective in teacbing some skills or in reminding staff
to remain compliant witb procedures tbey already know.

84. Day-to-day observation by management and tbe Labora-
tory Safety Ofiicer can find breaches of safety before they be-
Purpose: Sjfcij in our hhonlTHm is uf prime impnmncc. A reiie"
trfafcty policies uid ynxc-
ilures SB i>ur siaff helps ensure that safe pnctices are il»i>-i
ftJIiwcd.
InMnKtioos: Keiiev m h appbcabk iieni cm the bllouin^ Ibt »ith
a>ch empknte « the rime of
inltiil hire, and innually thereafter. ITie supeniswr ami ihe
emplo^-ee musi sign "nil JiK the iVinn
when OHnpleteil. lo tlociuntnt the safcw reiie* fric the cinplcn-
ce's fik,
Piinnnl this liinn ni I j b .-yminuandan when compkod.
G m c n l Safely;
LJ State the kjiam and descrihe the US'? ofthe safetj
U Uianf.nstrate the cipciad'in of the eT!«ash
Q Deinunstrate the iiperatHin »f the itiedunical |Hpcttcs
Q State the lucatmn ni the circuit lirealiers
• Destnlie the |iniceilure useii in the cstnt iif
dectricil shiicL in|iin
• State the location of crunprr.sed gas nlinilers and desaihe
pracedures for ttwlT UM
• State the Icication far stiirajie nf wheeled cans
U Wheie is your own hnhh reciinl kitated. and do ynu have a
right tii review it at any tune?
Rn: Safety:
O State tht li>ratii)n of fire eitinBuishcrs and iteiiKHisirjte or
descrihe theit use
d Sute the lotatHin ol the fire liinket and demonstrate or
deacnlie its use

85. [J State the localion of the lire alartn timeN
• lilentih posted tianuliim rtMiti.-. from the labiirattwi'
G Srate the Uionon of the tria^ area where staff is to repon
bllowin); an n-jcuatiiin
l>escril)f pnncdures to follow in the event of a fire
yai doe^ the acnmym RACE stand for-
What doer, the aoimyni PASS slaml liir-
Uave >i)u participateil in a fire dnil in this ficilily?
U
S<mree: Compilfif GWf JP t-Mmatory Stfily h>- Terry Jo Gile.
HCPro, Inc. Marblehead, ^., 2004, pp.
243-245.
Cbcmical Safet)-:
• Locate the MSDS (""jL and ImA up a hmnVms chemical Hith
w+iich you wott
a State the primari- rouie of entn fat this chemical
a EHscuis the ^-niptoms of riveicipiBure
a lilcntih- the pii)tecti« equipment and lentilatiiMi that is
required
Q I^K-ate the iinitecnve equipment in vour work area
• IJescrihf the special pn-cauiicms needed if the chcmital is a
carcinogen
CJ State the emcntiniy first aid jiriitedutes fiH the. chemical
Q Describe llie appropriaie S|H1I ilejiiup f(ir this chemical
• Slate the liK-ation of the Chemical Hypene Plan
(J Uest-ribe the iinUix.-ol liir environmental miinminnf!, if any
Q State the location of the chemiral spill Lit and ILS jHTipcr
use
Q Descnhehow to clean up a chemical spill lan;er thaniiiK (1)
^llon
[J Describe hoa- to dean up a chemical spill of otie (I) pint or
lesi.

86. Bbiodbonic Pathogen Safety:
LJ State the iocatiĉ Hi cif the lahs ciipy of the Blondliorne
fathoeen Standard
• State the l.«,aticini.f the !ab^FjipiRure(Jaitnil Plan
U State the IcKation of the labs Intection Cjintrol Wanual
Stale the percentage nsl of infectioti mth I lepatitis B from
exposure to hlond and hod>* Ihiids
IJescrihe how effective the Hepatitis B vaccine is
Lin lour (4) nimles of transmission for l^l'
Point iHit a Iiii)ha7ard stmbol
Sate ihe difference betu-ern infectious waste and regular trash
Idcntili pniper containers for infectious waste and regular trash
State the prosier method for reportinj; cipifture to IJood and
boiK fluids
Have vou done the ftilUming;
Renewed the hloixlliome pathogen training material? 11 Ves 11
No
Been vaccinated f.ir llepantis B'- | j Yes j | No
Roienfd the risLassdoateil with Uep t i t i sO | j Yes | j No
vc Equipment:
• Descrihe the location <if personal protective equipment
Q DemiHisirate the proper way to put un and take off a lah
_ Detminstrate tbe aseptic remoial of gloves
Q State the IcxratHin of the soiled laundn- contaitter
U Dii you:
o Vear a long-sleeved lab coat. b i « length, buttoned or
snapped dosed at all nmes;
o Not wear the lah Liiat in puhlic areas?
o Change the lab coat when ™hh' soiled?
o Place ihe yiiied lah ciut in the laundry container:
o Wear i plastic apron if die lab coat cannoi lie buttotted

87. or snapped-
o Use a ]dastic apron <i'er the lab ci>at m higb
splash/stain areas;
o Wear gloies when periomiing lah tasks in the area?
o ear gloves that are the mrrect sire?
o Wear pcopei facial protection when necessar;-;
o Wear shoes amt soda/hose at all times in ihe lab:
o Wear shoes, not sandals, ihal adequately cover your feet.
hate no perforations and are not made of canvas?
For liirther explanation of any of rfie above items, please
ciinsult ibe Ijhoratory Safet- Manual or
yiiur imiiieiliate supenisor.
3 O August 2005 • MLO www.mlo-online.com
L A B S A F E T Y
come troublesome. Monitor adherence to recommended pro-
tective measures regularly. When monitoring reveals a failure
to follow recommended precautions, provide counseling and
retraining, and consider appropriate disciplinary action, i? nec-
essary. Make safety training a key part of any quality improve-
ment (QI) initiative at the facility, and design future training to
support QI initiatives.
Management should aiso measure training effectiveness by
requesting employee feedback after each
session. It is extremely shortsighted to say,
"If they didn't fall asleep, it must have
heen effective." Use an evaluation ques-

88. tionnaire or an informal discussion. Ask
whether learning objectives were stated
clearly. Did the learning activity simulate
the actual task? Did the employees par-
ticipate in tbe program? Even if a pro-
gram was well received in previous years,
never assume — without asking — that it
worked justaswell wben presented again.
Post-course assessments also measure
training effectiveness by quantifying how
well each employee retained and under-
stood tbe information. Some states and
accreditation organizations require post-
training quizzes to document retention
and comprebension. Tests can he oral,
written, or ohserved. In all cases, retain
the results in writing in the employee's
personnel record or in a central location
within tbe facility. Written learning ob-
jectives determine tbe best format tor
post-training assessment and tbe right
questions to ask. For example, if after
completing training the employee should
he able to use a fire extinguisher, the as-
sessment would require the employee to
describe or demonstrate tbat task. If the
employee needs to know five steps in the
correct order for conducting a particular
safety task, a written assessment could
simply ask employees to number the
steps. An observed, hands-on assessment
would require the employee to perform
the task with a supervisor watching.
Document, document, document.

89. Regulator)' agencies all agree, if it is not
documented in u riting, it did not occur.
Document wbat was done, wbo partici-
pated, and what the results were. Being
ahle to prove that proper and timely
training was provided may be an inipor-
tLint defense against legal liability after
an adverse incident and keep any labo-
ratory professional from saying, "V'bat
bajipened?" LJ
w w w . m l o - o n l i n e . c o m
Terry Jo Gile, MTIASCPl, MA Ed, The Safety Lady, is a
consultant, speaker, and
author of the Complete Guide lo Laboratory Safety published in
2004 by HCPro
Inc. Gile can be reached through her website
www.safetyiady.com. For a free
copy of the Lab Safety Advisor e-zine, go to:
www.hcmarkBtplace.com
/prod.cfm ?id=3506&s=EE36862A.
References
1, Bloom B. Taxonomy of Educational Objectives: The
Classification of Educational
Goals. United Kingdom: Longman GrQup;1969.
2. Gile TJ. Complete Guide to Laboratory Safety. Marblehead.
MA: HCPro, Inc; 2004.
Take your lab to market.
Harvest the power of outreach with Orchard.
Improve the marketability of your lab by providing your

90. customers with a single, simple, and cost effective, Internct-
ba>ed, outreach solution for remote order entrj' and results
delivery.
Not only do ()u improve outreach, with Orchard, you get
decision-making
and niles-bascd technology to minimize errors and maximize
reimburse-
ments During order entr>'. Orchard s software automatically
reviews each
order for proper diagnosis codes and identifies potential issues.
If problems
exist, it wams the user and generates an ABN.
For multiple lab networks. Orchard's Intelligent routing
capabilit :md test
code management will handle all dccisiun making, sending the
right order to
the right laboratory and making sure the location-dependent test
codes are
correct. When testing is complete. Orchard s software combines
patients'
re.sults from each laborator) into a single report with text
and/or graphs,
which can tben be viewed by your providers from any PC.
Enhance your lab's outreach. Call Orchard for a demonstration
of how our software can help take your lab to market
(800)856-1948
OrchardSoftware
Harvest the Power
Visit www.rsleads.coni/508ml-014

91. MLO
www.orchardtoft.com
August 2005 31
Safety Matters
Wiley Surface Mine
Safety Milestone
CONSOL Energy's Wiley
Surface Mine in Mingo County,
WV, hasn't had a lost-fime ac-
cident since 1986. Since then, it
has celebrated 3 million hours
without a lost-Hme incident, and
has received three R.E. Bailey
Safety Awards, one for each mil-
lion milestone reached. The mine,
which produces steam coal, em-
ployees 50 people, seven of whom
have been with the company
since 1986. Wiley Surface Mine is
part of the Miller Creek Complex
r
Reaches

92. operated by CONSOL Energy's
CONSOL of Kentucky subsidiary.
"No matter what the weather
or mining conditions, the at-
tention Wiley employees pay to
safety is second to none," says
Miller Creek Superintendent
Keith Bartley. "The workforce at
Wiley demonstrates dedication
to safety by being observant and
working safety every day."
For more information, visit
www.consolenergy.com.
NIOSH to Host Prevention Through Design
Conference
From Aug. 22 to 24, NiOSH will host Prevention Through
Design: A New Way of Doing Business—Report on the National
initiative in Washington, DC. The conference marks the
midpoint
of the PTD national initiative, and presentations will showcase
research results, engineering education enhancements, suc-
cessful stakeholder practices, and policy development and ad-
vancement. Find agenda, hotel and registration details at www
.cdc.gov/niosh/topics/ptd/a-new-way.
American Red Cross Unveils
Safety & Health Training
With cost and time saving benefits in mind,
American Red Cross has developed a new wave of
safet)' and health training, which includes a 2-year
certification for first aid and CPR training. The

93. program trains people to respond to breathing
and cardiac emergencies, injuries and sudden ill-
nesses until medical personnel arrive. In includes
free digital refreshers, free digital or affordable
print course materials, learner-centered courses
with hands-on skill practice and an online learn-
ing center where students can register for courses
and instructors can manage course records.
Training is avail-
able in a classroom
environment, on-
line or in a blended
learning option.
Companies can
train employees on
site, at a Red Cross
facility or through
a train-the-trainer model. The Red Cross also of-
fers training covering the use of asthma inhalers,
epinephrine auto-injectors, bloodborne pathogens
training, and it wül release programs including
CPR/AED for professional rescuers and healfh-
care providers, emergency medical response and
lifeguarding. For more information, visit www
.redcross.org.
ANSI Panel to Address Electric Vehicles
Flectric vehicles are gaining steam in the consumer
market, given their potential for energy independence and
reduced carbon emissions. But consumers remain uncertain
about the performance and convenience of these new cars
and charging infra-
structure. According to

94. ANSI, the standard-
ization community
is ready to drive the
technology' to greater
deployment nation-
wide.
To facilitate the
large-scale introduc-
tion of electric vehicles
into the market while
ensuring that the
technologies and infra-
structure are safe and effective, ANSI has formed a cross-
sector Electric Vehicles Standards Panel (FVSP). The panel
is seeking participants with relevant expertise and interest to
develop a standardization roadmap to enable the safe, mass
deployment of electric vehicles and associated infrastructure
in the U.S. The goal is to develop version one of fhe roadmap
this year.
"With our history of bringing diverse stakeholders to-
gether to develop consensus-based solutions for emerging
priorities and new technologies, ANSI is well positioned to
respond to the need for greater standards coordination in
this critical technology area," says ANSI's S. Joe Bhatia. "The
EVSP will provide a mechanism to foster coordination and
collaboration among public- and private-sector stakeholders
. . . to enable the safe, mass deployment of electric vehicles
and associated infrasfructure in the U.S. with international
coordination, adaptability, and engagement."
In addition, the EVSP will liaise and coordinate as appro-
priate with other domestic and internafional electric vehicle

95. initiatives. Many activities are already underway that will
inform the panel's work, including the National Insfitute of
Standards and Technology Smart Grid Interoperability Panel
vehicle-2-grid activity. For more informafion, visit the EVSP
website at www.ansi.org/evsp.
3 8 ProfessionalSafety J U N E 2011 w w i v . a s s e . o r g
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Copyright © 2000. All rights reserved.
Copyright © 2000. All rights reserved.
Copyright © 2000. All rights reserved.