Done as part of the Master's of Science in Nutrition and Food Science Practicum

1. The overall purpose of this study was to provide employees with non-verbal training materials through the
creation of an internal training manual. Specifically, the aims were to:
• satisfy employees’ needs for an internal training manual
• increase employees’ knowledge of other roles within the system
•change employees’ perception of their preparedness to train new employees on their current role
• Needs assessment
• Baseline measures of knowledge
• Baseline perception of preparedness
AIMS
METHOD
An Evaluation of the Implementation of a Training Manual at
Staten Island University Hospital
Claudia Gonzalez
Day 1:
Retail
manager
2. CROSS-TRAINING: POSITIONAL MODELING
Day 2:
Catering
Associate
Day 3:
Cold Prep Cook
Assistant
Day 4:
Café Porter
Day 5:
Pizza Cook
Assistant
Day 6:
Patient Services
Supervisor
1. ESTABLISH NEEDS AND BASELINE MEASURES
3. COMPOSE, PRINT,
AND SCAN MANUAL
Control:
Café
Cashier
4. DISTRIBUTE MANUAL
AND POST
INTERVENTION SURVEY
•Hard copy of manual
given in person to review
for up to 30 minutes
•PDF version of manual
sent to all participants via
e-mail
• $10.00 Starbucks gift card
given (incentive)
•Hard copy of post
intervention survey given to
take home as well as sent
via e-mail
•Instructions to fill out
survey within a week
• Microsoft Word
• Printer
• Scanner
• Time
5. ESTABLISH SATISFACTION AND POST
INTERVENTION MEASURES
• Satisfaction assessment
• Post intervention measures of knowledge
• Post intervention perception of preparedness

2. Training takes place within every organization and system. Training is effective at increasing
productivity within the workplace and communicating an organization’s goals to new employees (Arthur &
Bennett, 2003). Since training can consist of a variety of trainers and take place within a variety of settings,
training requires components that ensure standardization across trainers and settings. Training manuals can
establish this type of standardization which is known as implementation fidelity (Milne, 2016). According to
Milne (2016), not only do training manuals ensure implementation fidelity, but they also improve adherence to
instruction and specify the resources needed to complete tasks.
While manuals can be investigated individually, working within an organization is rarely a solitary
matter. Instead, organizations such as Northwell Health and Morrison Healthcare within Staten Island
University Hospital require teamwork for the retail and patient service systems to run smoothly. Improving
team performance can be accomplished through cross training which involves training employees on the
duties and roles of other employees and which leads to the development of shared mental models. Shared
mental models indicate a shared understanding of an organization’s goals and purposes, the responsibilities of
others within the organization and their required behaviors, and the connections among different roles within
the organization (Marks, Burke, Sabella, & Zaccaro, 2002). Manuals can be used for cross training purposes
when resources such as time and space are limited. Despite the evidence that training manuals are necessary in
training and that cross training is beneficial to team work efficiency, no such manual currently exists for
employees working in the retail and patient services departments of Staten Island University Hospital. Thus,
there is a need for an internal training manual within these departments. An effective manual will be picture
heavy and accompanied by text for instruction since research has shown that pictures have functions in
enhancing learning (Carney & Levin, 2002) and that according to the multimedia effect, using pictures and
text together in instruction has a positive effect on learning (Eitel, Scheiter, and Schuler, 2013).
The theoretical framework used for the implementation of a training manual in the retail and patient
services departments of Staten Island University Hospital is the Theory of Change (ToC) Model adapted by
Addor et al. (2005). Organizations can use the ToC model to establish long-term goals, known as impacts, and
work backwards to determine which conditions, known as outputs, need to be in place in order for impacts to
manifest. Addor et al. (2005) used the ToC Model to create a curriculum (output) for the National Resources
Leadership Institute to positively influence how leaders in the environmental arena deal with environmental
conflict (impact). In this project, increasing productivity and teamwork efficiency will be the impacts to which
the training manual, the output, will work towards manifesting. Inputs such as resources and participation will
be necessary for creating this manual and meeting the needs of employees.
OUTCOMES
& IMPACTSOUTPUTSINPUTSSITUATION
• Absence of an internal
training manual for
retail and patient
services departments
• Expressed need by
employees of both
departments for better
training
• Expressed need by
employees of both
departments for an
internal training manual
• Work environment
requires team work
• Below average
knowledge rating scores
on others’ roles
• Room for improvement
in preparedness scores
Resources
•Time
•Camera, printer,
paper, ink, and scanner
•Participants
Theories
•Representational
function of pictures
(Carney and Levin,
2002)
•Contiguity principle
(Mayer and Anderson,
1992)
•Dual Coding Theory
(Mayer and Anderson,
1992)
•Multimedia effect
(Eitel, Scheiter, and
Schuler, 2013)
• Internal training
manual for the
following roles:
porter, cook
assistant, patient
services
supervisor, and
retail manager
• Transfer of
learning in person
using a physical
manual for up to
30 minutes
• Transfer of
learning through a
PDF version of the
manual sent via e-
mail
• Increased
employee
knowledge of
other roles
• Increased
employee
perception of
preparedness to
train others on
current role
• Satisfaction with
meeting need for
training manual
Impacts
• Increased
productivity
within the work
place
• Increased team
work efficiency
ASSUMPTIONS
THEORY OF CHANGE: TRAINING MANUAL IMPLEMENTATION
INTRODUCTION
ABSTRACT RESULTS
CONCLUSIONS
• Training increases productivity within the work place (Arthur & Bennett, 2003)
• Non-verbal training material such as a manual can ensure implementation fidelity (Milne, 2016)
• Cross-training increases teamwork efficiency (Marks, Burke, Sabella, & Zaccaro, 2002)
REFERENCES
BASELINE
POST INTERVENTION
Interpretation
Since 8 out of 8 participants indicated that
training can be improved and that they did not
receive non-verbal training materials upon
onboarding, there is room for improvement in the
training department and potential in improving
training through the creation of non-verbal
training materials such as a manual.
Interpretation
Since the average rating of the need
for the creation of an internal training
manual is 6.5, with 7 being the
highest rating in necessity, it is
evident that employees believe the
need for an internal training manual
is highly necessary.
Interpretation
Since the average rating of
preparedness to train a new employee
on the participants’ current role is
5.625, with 7 being the highest score
in preparedness, it is evident that the
majority of employees feel prepared
in training new employees, but not
very prepared. Therefore, there is
potential to increase perception of
preparedness in employees.
Interpretation
Since the average ratings of
knowledge for the retail manager,
café cashier, catering associate, and
patient services supervisor roles is
below the average knowledge rating
of 4, there is a high potential to
increase knowledge of these roles.
Since the average rating of
knowledge for the cook assistant role
is just slightly above average (4.375),
there is also a high potential to
increase knowledge in this role.
Interpretation
Since the average rating of satisfaction
with the training manual is 5.875, with 7
being the highest rating in satisfaction, it is
evident that employees are highly satisfied
with the manual but not very much so.
Therefore, there is potential to improve the
training manual.
Interpretation
Since the total preparedness score of the
participants increased by 10 points and
therefore by 22.2%, the internal training
manual has increased the perception
employees have of their preparedness to
thoroughly train a new employee on their
role with the aid of the training manual.
Interpretation
Since the average knowledge rate
increased by 34% for the retail
manager role, by 10.6% for the porter
role, by 29% for the cook assistant
role, and by 79% for the patient
services supervisor role, it is evident
that the training manual was able to
greatly increase knowledge of these
roles with the exception of the porter
role which was only slight. Since a
cashier manual was not given, it is not
surprising that the average knowledge
rate for the cashier role only increased
by 3.6%. Despite not receiving a
manual for the catering associate role,
the average knowledge rate increased
by 11% indicating that gaining
knowledge of the other roles may have
indirectly increased knowledge of the
catering associate role.
It is evident that the training manual was able to increase perception of preparedness to train new employees
and increase knowledge of all roles to which a manual was given. Therefore, using a manual as a tool for
training and cross training can be effective within this setting. As indicated by satisfaction scores, the is room
for improvement within the manual. Therefore, it is recommended that participants be resurveyed to determine
how the manual can be improved. Additionally, it is recommended that manuals for roles not covered be
created to ensure comprehensive knowledge of all roles among retail and patient services employees.
1. Addor, M., Cobb, T., Dukes, F., Ellerbrock, M., Smutko, S. (2005). Linking Theory to Practice: A Theory of
Change Model of the Natural Resources Leadership Institute. Conflict Resolution Quarterly, 23(2), 203-223. doi:
10.1002/crq.133
2. Carney, R., Levin, J. (2002). Pictorial Illustrations Still Improve Students’ Learning From Text. Educational
Psychology Review, 14(1), 5-26.
3. Eitel, A., Scheiter, K., Schuler, A. (2013). How Inspecting a Picture Affects Processing of Text in Multimedia.
Applied Cognitive Psychology, 27, 451-461. doi: 10.1002/acp.2922
4. Marks, M., Sabella, M., Burke, S., Zaccaro, S. (2002). The Impact of Cross-Training on Team Effectiveness.
Journal of Applied Psychology, 87(1), 3-13. doi:10.1037//0021-9010.87.1.3
5. Mayer, R., Anderson, R. (1992). The Instructive Animation: Helping Students Build Connections Between Words
and Pictures in Multimedia Learning. Journal of Educational Psychology, 84(4), 444-452.
6. Milne, D. (2016). Guiding CBT supervision: How well do manuals and guidelines fulfill their promise? The
Cognitive Behaviour Therapist, 9, 1-17. doi: 10.1017/S1754470X15000720
A training manual was created to satisfy the need for non-verbal training materials and improved training that
was expressed unanimously among the retail and patient services employees of Staten Island University
Hospital. Training manuals can increase employees’ knowledge of the roles of other team members and
influence perception of preparedness to train others. It was hypothesized that the training manual would
positively influence perception of preparedness and knowledge of all roles with the exception of the cashier role
(control). Eight employees participated in the intervention. Data was collected using a baseline and a post
intervention follow up survey. The results showed that knowledge increased in all roles with the exception of the
cashier role. Despite not creating a manual for the catering associate role due to a lack of data, knowledge of this
role increased by 11%. Since the catering associate role interacts with all roles, it is possible that the training
manual of the other roles indirectly increased knowledge of this role. Moreover, perception of preparedness
increased after the intervention indicating that a training manual can increase confidence in one’s self to train
others on one’s role. It can be concluded that a training manual is an effective cross-training tool. Therefore,
training manuals for roles not covered should be created to ensure comprehensive knowledge of all roles among
retail and patient services employees.
(Addor et al., 2005)