April 6, 2021
With the ever-closer scrutiny into incidents of aggression and physical violence, which are often video-recorded, managers in many public-facing organisations are under pressure to get real results from the time and resource which is put in to training in conflict prevention, de-escalation, restraint interventions and personal safety.
A possible answer lies in the area of Trainer Development (aka Train-The-Trainer) and Continuing Professional Development which focusses on the learning environment and how it is created, on practice design, on session design which is authentic, learner-centred and structured, and timed to make long-term changes to behaviour which are positive in the context of violence prevention and restraint reduction.
Trainer preparation, knowledge and behaviour has a disproportionate capacity to create real and lasting change in the workplaces in the face of key challenges:
A recent high-profile case of restraint-related fatality, involving the restraint of Allan Marshall at HMP Saughton in Edinburgh brought the training programme of the Scottish Prison Service into question when the Fatal Accident Inquiry concluded that “the information purported to have been delivered during … training was not … successfully imparted”.
The issue then may not be not one of training content, but instead of training design and delivery method, which is a problem whose root lies in the “how” of the training delivery, not in the “what” of training content or curriculum.
Recognising the Time and Resources Problem
Organisations who have been under pressure to compress their training programmes for Preventing and Managing Violence and Aggression (PMVA) or Personal Safety Training (PST) will have seen years go by where they have had to remove hours and even days from their training schemes of work.
In some cases, an argument that Conflict Management skills are developed ‘on the job’ or with little training time may have won some support, and some workplaces now opt to provide a rudimentary introduction to conflict communications.
The quality and duration of training in communication skills to deal with aggressive or violent behaviour have inexorably moved to large-attendance classroom style lectures on the principles of good customer service, or powerpoint presentations on how to identify escalations from body language cues and behaviour.
In some cases the development of these skills has been reduced to clicking through slides in an online learning management system, with no in-person component at all.
For these reasons, organisations are waking up to the need for deep and effective, high-quality in-person conflict management training. They want to provide training which transfers well to dealing with situations where the patient or visitor at the hospital is emotionally disturbed, for clinical reasons or otherwise.
Learning and Development teams will have to develop effective ways of imparting skills in:
Teams trying to impart these skills need exceptional, tried and tested content to teach, and also be able to deliver that content in a robust way. Trainers need to assess and provide feedback about individual learners and to be transparent in their assessment approach, so that real improvements in workplace encounters can happen.
Good models of this are available, for example with Vistelar Conflict Management programmes in Non-Escalation, De-Escalation and Crisis Management.
Recognising the Context Problem
Recent increased scrutiny into Training Effectiveness
When the coroner looked into the training of the G4S immigration escort team who restrained Jimmy Mubenga during the flight which resulted in his death, she made several key comments in her report.
Referring to the effectiveness of the team’s training, the Coroner found it lacked the appropriate degree of context.
“On any analysis the absence of training in an environment which reflected the context in which C&R might have to be used constituted a significant training gap.”
Although scenario-based training had been provided for in the manual that the instructors were using, the training was carried out in a wide-open space, in a gym or in a dojo, but those environments were not authentic to the close confines of an aircraft cabin, where the training was needed.
Concerns were raised about the utility of the training when it did have to be used in-context on an aircraft, which pointed to the inadequacies and questionable suitability of the training programme.
In another example of increased expert scrutiny into training effectiveness, it was during a recent fatal accident inquiry into the death of Allan Marshall, a prisoner at HMP Saughton in Edinburgh, where training was again scrutinised in great detail.
The sheriff concluded the following:
“The system of training…was defective. The information purported to have been delivered during annual training was not, on the evidence, successfully imparted to some or all … involved in the restraint “
The necessary information was included in the resources provided to the instructor responsible for this team’s training, however there were a scant few minutes allocated for the delivery of this information in the schedule he was working to.
The instructor gave evidence that he had taught the required information to all of the staff present at the incident. However each of the staff denied possessing the knowledge. The sheriff again commented:
“It is recommended…introducing a system…whereby it can be effectively established that the information contained in training provided to [staff] has been successfully imparted to the recipient.”
This suggests that the most effective training methods, which support learning and retention of materia,l must now be sought and implemented. Information-only delivery is not sufficient to prove to a court that training successfully imparted knowledge to staff.
“You haven’t taught until they have learned” - John Wooden
The Health and Safety Executive commissioned report RR440 in 2006 to look at training for managing violence in healthcare settings. This report gave clear guidelines for how training should be designed and delivered, with the focus on the learners and what they get out of the training experience.
RR440 underlined the need to carry out detailed and sufficient Training Needs Analysis in order for training to be effective. Historically, it has not been proven that inherited training programmes from even large and well-known (perhaps even heavily accredited) providers has been more relevant or had greater performance effect on the workplace.
“the content of many training courses is determined by the preferences of the training provider rather than any real assessment of trainees’ need”
HSE Report RR440
“there is frequently a gap between what trainers deliver and what trainees want in terms of their own identified needs.”
Some organisations or teams may fall into the trap of providing Accredited or Certificated training programmes in the belief that the Accrediting body or Certificated provider has been able to see and understand, to the level required, what the needs of the learners in a specific environment are.
Even heavily scrutinised and accredited curricula require skilled trainers to ensure a high degree of transfer to the workplace.
RR440 defines a successful programme thus:
“A key measure of the success of any training programme is the extent to which a delegate exits the programme with a perceived ability, confidence and self-assurance that they have the necessary knowledge, skills and understanding to be able to deal and cope with the conflict situations that they might face in the work environment.”
HSE Report RR400
This key success factor indicates a strong need for contextualised training.
SCENA is a scenario-driven training approach, which is based on evidence and research about learning. It gives trainers a format for delivering conflict and physical interventions training which is effective, engaging and efficient.
SCENA blends the findings of at least the last 40 years of research about learning environments which prodice the best results when people need to learn skills and put them together with knowledge, understanding and decision making in unforgiving environments - usually team sports or high-stress professions.
It asks questions like: How do we design an effective curriculum? What should a trainer focus on? What should we spend time on in the training room? How do we manage with little time and lots of content? How do we move the needle when it comes to workplace performance?
So we look at programme design, session design, practice design, coaching behaviours, provision of feedback and we teach trainers to use scenarios as the basic format for teaching everything in “an increasingly complex version of the whole task”. That’s how SCENA is called “scenario-driven” and “task-focused”.
And SCENA, uniquely, focuses on conflict management and physical intervention skills, so it is specific to Healthcare PMVA, Police PST, NHS Conflict Resolution Training and Restraint Reduction initiatives.
“Let’s say we’re teaching 20 key things
and people remember 5 of them.
Is that better than teaching them 10 things
and having them remember 8 of them?”
- Robert Bjork
SCENA came out of a collaboration between Gerard O’Dea at Dynamis Training and Prof. Chris Cushion (link to a mini-course) at Loughborough University. We both have a long interest in the real, functional outcomes of training provided to people to deal with conflict, aggression and violence and so our paths converged - we had a few conversations where, on the one hand, Chris could see a way forward for how we could design the training to result in more robust learning, and Gerard was very open to putting those ideas to work with Dynamis learners in ‘live’ settings.
In that way, it was a perfect storm of academic rigour and operational experience. Over a period of several years and many conversations, the changes Gerard was making to the training programmes at Dynamis began to have real effects on our learner satisfaction, and the amount of time it was taking us to get people to proficiency. We were getting at least equal results more quickly, or far better results with equal time spent.
This resulted, in 2018, of all the trainers at Dynamis going through an intensive CPD programme where we transferred the approach across to the team in a single event, and established this ‘scenario-driven, task-focussed’ methodology as a baseline for all of our training going forward.
We now offer this training methodology to teams of trainers in other organisations at the NHS, the Police Services, private Healthcare organisations and Social Care training teams, as well as internationally.
| Inherited Training Programmes | Evidence-Based Training Programme |
| Focuses on Content | Focuses on Outcomes |
| Trainer concerned about WHAT they teach. | Trainer concerned about HOW they teach. |
| Curriculum-centric | Learner-centric |
| Majority of time on Blocked Practice | Majority of time in Random/Variable Practice |
| De-contextualised | Everything in-Context |
| Trainer focussed on inputs | Trainer focussed on outputs |
| Skills are forgotten rapidly | Skills are retained for longer |
| Creates a sense of fluency | Creates a sense of confusion |
| Looks neat on the surface | Looks messy on the surface |
| More Vulnerable to Apparent Learning | More oriented for Authentic Learning |
| Easy and Quick initial progress | Tough and Slow initial progress |
| Matches most people’s experience of Education | Different to most people’s experience of Education |
| Creates Performance in the classroom | Creates Learning in the classroom |
| Tries to minimise or eradicate mistakes | Celebrates mistakes as learning moments |
| Does not place value on prior learning | Values Prior Learning |
| Sees the trainer as an Instructor / Teacher | Sees the trainer as Guide / Coach / Mentor |
| Trainer can get-by with limited subject knowledge | Trainer must have deeper subject knowledge to be successful. |
SCENA as a platform is used at organisational, at training team and at individual trainer level.
Organisationally, when a training programme has SCENA at its heart, this forces the organisation to maintain a tight understanding of what we call its “most-common, most-risky” scenarios, on which the training needs to be built. This encourages all kinds of good data-habits for the organisation, including things like incident recording, post-incident debriefs and in-depth reviews which feed into the training cycle.
At training team level, SCENA encourages the team to be open and transparent about trainer competencies and delivery aspects of the training programme. Delivering training “through the scenario” requires a different approach to the ‘chalk and talk’ model which is still quite prevalent and training teams find the need to support both the approach and the knowledge base of their instructors to deliver it successfully.
As an individual trainer, SCENA opens the door to a very fulfilling and exciting way to ‘move the needle’ for the organisation (by addressing frequent or re-occurring sitiuations) and to help individuals by recognising their strengths and developing their weaknesses. Most trainers remark on how it helps them break open the ‘silos’ of their older programmes.
“Your training goal is to avoid “apparent” learning. Apparent learning occurs when learners respond correctly to exercises or quizzes in class but fail to apply skills to the job. Instead, your goal is transfer of learning.” - Ruth Clark
We talk about how SCENA delivers more effective, more engaging and more efficient training.
The effectiveness comes because SCENA start with the premise that every tactic or skill we use happens within the context of an encounter. For example, almost all interpersonal encounters start with a verbal component - an initial contact, a conversation, a request - and they then proceed through a series of steps based on the task involved and the decisions made by the people engaged in the encounter. The research behind SCENA says that all training should reflect this context.
The engaging part of SCENA comes because the learners, when they see that the training really replicates their own struggles in their work - with difficult, distressed or dangerous people - and it immediately grabs their attention. They intrinsically feel that the training has value to them - it speaks ot their need - and they engage with it.
The efficient part of SCENA happens because it also focuses on the trainer. The one thing we have control over in a training programme is the trainer behaviours - how they design the session, the practice activities that are in the session, the type and quality of feedback they provide to the learners, the pace and the focus of what everyone is doing in the session. Because SCENA focuses on learning, it delivers more of it, with less wasted resource for learners and trainers.
The ways in which PMVA and conflict management training is conducted across all sectors can reflect the most modern findings about how people learn.
For example we know that:
“An expert is someone who has made all of the mistakes
Neils Bohr
that can be made in a limited domain.”
Much performance-oriented training can be likened to the ‘cramming’ that students do in preparation for an exam - it puts the information into their brain for a short period of time, during which the student can ‘perform’ the target skills for a test or assessment, but without creating any long-term effects on behaviour or skill.
Trainers using an evidence-based approach tend to understand the following key components of effective teaching and learning:
| Learner Centred Curriculum Design | Scenario Driven Session Design | Contextual Interference |
| Integrated Prior Learning | Whole-Task Practice | Desirable Difficulties |
| Variable Practice | Interleaved Practice | Retrieval Practice |
| Intelligent feedback | Positive Mistakes | Extrinsic Directions |
By focussing on learning, we see improvements in 1) verbalisation skills and the 2) functional use of tactics.
Because each scenario replicates a real-world scenario, SCENA-styled training gives the learners many, many opportunities to rehearse and practice effective verbal skills and to guage their effectiveness with live role-players. Trainers who also use our verbalisation skills training from partners Vistelar can shape the scenarios so that it is easy to hear and provide feedback to the learners about how well they are not-escalating, de-escalating or managing someone who is in crisis. So, the scenarios allow us to hear how the officers engage verbally with the clients, customers, patients or service users and to incrementally improve how those interactions are managed by staff. Using Vistelar for this, we see powerful side-benefits such as consistency across teams, reduced incidences of physical confrontation and widespread culture-change based on the values-system at the core of that training.
Further to this, when the outcome of a scenario replication is a physical confrontation, we see teams taking a closer look a tthe tactics they are teaching and how their physical tactics are taught. Once you start injecting realism into the training - for example how real fights start (often with an ambush moment) or how people get free of restraints (often due to poor tactics involving wrist-holds) - then the limitations of some tactical doctrines become more obvious. For teams who learn our Functional Protective Interventions Tactics, which are designed around human behaviour, rather than a historical precedent (martial arts) we see clear difference in the effectiveness of teams who need to gain rapid control of a person - despite not relying on the use of pain or ‘hard’ takedowns.
“Training focussed on performance means
people improve rapidly and forget rapidly.”
- Robert Bjork
To learn about how to access our Scena Train-the-Trainer approach for conflict management and physical interventions, please visit the page here: visit the scena homepage
Related Posts
Conflict is an unfortunate reality that healthcare professionals must navigate daily. Whether you’re running a busy GP practice, managing a clinic, overseeing a pharmacy, or working in primary care, the ability to handle challenging situations effectively is crucial. This post delves into key strategies for managing conflict and ensuring the safety of both staff and
Read MoreA traditional ‘classroom model’, which has been a cornerstone of education for centuries, emphasises learning and performing skills in a neutral setting. In fields like conflict management and physical restraint training, this model may not be the most effective for your people. Here we evaluate some strengths and weaknesses of the classroom model before contrasting
Read MoreIn large-scale organisations, determining who the right people are to send on conflict resolution, personal safety or physical interventions training programmes is critical. In this article, Dynamis offers insight into why this is the case, as well as posing some questions that will help you partner with training providers to develop an efficient, engaging and
Read MoreA group of NHS Highland trainers have been applying Dynamis’ scenario-driven approach to their PMVA training since 2022 and have experienced some startling results, with one cohort reporting a 72% uplift in confidence about safely breaking away from violent contact. The NHS Highland team reported their experiences at an update to the GSA membership’s annual
Read More