A person’s behavior is formed by genetic inheritance, their experiential learning history, and their environment. To effect learning, we cannot change a person’s genetic inheritance or their past experiences, but we can change their environment. The science of behavior analysis systematically changes environmental variables to create behavior change that is replicable. Therefore, it is a perfect science for teaching and training.

Training staff and personnel is a key aspect of all organizations that consist of more than one person. Poor performance creates risks for financial solvency, safety, quality, reputation, and more in any organization. A variety of training and teaching methods exist, but they are often not evidence-based. The science of behavior analysis allows for effective and evidence-based behavior change and is therefore perfectly suited for training, whether for individuals new to expectations or for individuals who display poor performance in a position long-held.

The focus of this paper is performance skills, rather than knowledge skills; being able to verbally answer correctly when presented with a question about how to do something or what to do does not mean a person can perform those skills at the time they are needed, it only shows a person has knowledge about those skills. It is the ability to perform skill(s) after being trained on them that is the concern herein addressed.

A wide variety of training methods for staff and personnel exist, and many organizations follow certain formulas. However, despite evidence that many types of training are ineffective, their use persists (Gardner, 1972; Shapiro & Kazemi, 2017). Some training methods appear to be more effective than others, and some training methods are effective as standalone procedures where others are only effective in certain combinations. Feedback, for instance, appears to be an effective training method by itself and can enhance the effectiveness of other methods (Kelley & Gravina, 2018, Shapiro & Kazemi, 2017, Johnson, 2015). However, its timing and association with consequences may be underrealized and necessary for effectiveness (Bucklin, McGee & Dickinson 2004; Kang, Oah & Dickinson 2005; Aljadeff-Abergel, Peterson, Wiskirchen, Hagen & Cole 2017). Furthermore, it appears that feedback may only be effective if it is paired with or serves as a discriminative stimulus for positive reinforcement (Daniels & Bailey, 2014).

Computer-based instruction (CBI) is effective on its own when there is interaction where the learner takes an active role in advancing through the training (Johnson & Rubin, 2011). Reading material or being lectured by another person as a training method is poor on its own, but if the reading contains clear diagrams or pictures it is more likely to be effective (Shapiro & Kazemi, 2017). As an overarching methodology, behavior skills training incorporates multiple methods including modeling and feedback, often in a particular sequence. These sequences may vary slightly based on various practitioner’s outlines, but overall include the same key methods; written description, modeling, practice, and feedback (Parsons, Rollyson & Reid 2012). Interteaching is a method used in educational settings that has shown promise for training and teaching knowledge skills but may be ineffective in teaching performance skills. Throughout this paper, the author will examine various training methods and their relative efficacies as well as key components that allow for or deny efficacy.

Theoretical Underpinnings

Scientific knowledge is sourced from philosophies that when taken together form its basic foundations.  Determinism is one of these key philosophies. The medical definition of the theory of determinism is that acts of the will, occurrences in nature, or social or psychological phenomena are causally determined by preceding events or natural laws (Merriam Webster, 2019). A belief in determinism is required for knowledge to be sought in a scientific manner. Only by believing there are cause and effect in the universe and that natural laws can be predicted from these occurrences can one proceed to discover and predict how one occurrence will affect other occurrences. The basis of science is discovering and describing a phenomenon, predicting how phenomenon will act, and then manipulating phenomenon to confirm or refute interactions.

This is an essential framework of behavior analysis; it is predicated on the concept that behavior is caused by an organism’s environmental interactions. These interactions may be internal or external, sourced from experience or genetic disposition. Most interactions are some combination of these. On a species-wide level, phylogenic selectionism acts to select the survival of certain behavioral and morphological traits through organisms’ interactions with the environment. On a group or community level, cultural selectionism acts to parse out patterns of behavior that interfere with group survival. On an individual level, ontogenic selectionism acts to shape the behavior patterns of an organism during its lifetime. All these forms of selection are caused by organisms’ interactions with their environment. Only with acceptance of determinism can behavior be analyzed to discover the causes of its occurrence and nonoccurrence and predict it based on patterns.

Empiricism is the theory that states that it is through observation and our sensory perceptions that knowledge is discovered; scientific knowledge is learned through direct experience. It is from directly observing nature and reality and performing experiments to confirm perceptions through repetition that we learn what causes and natural laws are. This is the action that allows for behavior analysis; objective observation and measurement are required so that causes can be understood. Further, experimentation requires objective observation to confirm or refute what has been understood through observation.

More is required to further the progression of science. A basic tenet is of science is parsimony.  Understanding happenings in the universe have preceding causes and follow natural laws, and that through direct observation and experimentation we can discover and understand those causes and laws, there is no need to elaborate on the whys and hows of the universe. Parsimony reminds the scientific observer to accept simple and apparent explanations unless there is a reason to seek a more complex explanation.

It is through these three theories that humanity could see beyond traditional beliefs and superstitions sufficiently to discover natural laws including those governing the behavior of living things. These theoretical underpinnings allowed for a science of behavior to develop. It is this science of behavior, behavior analysis, that seeks behavior change through learning, that allows for a uniquely accurate assessment of training methods.

History

Training (teaching another person how to do a job) predates written civilization, and its origin cannot be dated. Since at least prehistoric times, people trained other people on how to create objects needed for survival. This evidenced by the complexity of the objects found over widespread areas and the groupings of objects in the archeological record that display cultural consistency in a given area, such as bone and projectile points used to kill game (Frison & Ziemens, 1980). Training and teaching is a part of human survival at its most basic level; with our complex civilizations, it has expanded to include a wide variety of behaviors that are taught from person to person and generation to generation. In capitalist culture, training is particularly concerned with “worth.” Survival may or may not create value or provide reinforcement. Worth is determined by others valuation in a token economy or in exchanges. For this reason, training and teaching practices have been shaped by what is perceived as the best value and subject to patterns of demand.

Prior to the 1900s in the United States, training practices in large organizations and institutions were not driven by safety concerns, and therefore training quality was poor even when it caused risk to life and limb. Workers’ compensation laws did not exist in the United States and were still preliminary in much of Europe (Boggs, 2015). In 1911, Wisconsin passed the first workers compensation law, leading to mandated workers’ compensation insurance for many employers as laws continued to follow this precedent state to state. This change resulted in a clear monetary advantage to provide proper training for individuals in hazardous employment, at least to the extent that it reduced injuries and deaths that could result in litigation and higher insurance premiums or loss of funds in self-insured accounts in states where such options are allowed. By the 1990s, approximately 80% of employers were required to carry workers’ compensation insurance in the form of a purchased insurance plan or a self-insurer account, resulting in the majority of employers having a direct potential correlation between the efficacy of training procedures and monetary reward (Guyton, 1999).

In the United States, the advent of World War II created a demand for a skilled labor force in a short amount of time. This surge caused the government to collaborate with private industry to create training programs throughout the United States, many of which continued after the war or served as models that continued to disseminate (Torraco, 2016). In the 1960s, recognition of the power of people’s knowledge and skills to impact their own earnings and the earnings of organizations they worked for crystallized in the form of Human Capital Theory (Nafukho, Hairston & Brooks, 2004). This theory recognizes the value of teaching skills to individuals because it also creates value for the organizations they are part of, justifying the investment organizations may make in training and development. Unions in the 1960s and beyond furthered aspects of Human Capital Theory and advocated for training for union members both before and during employment (Kochan & Litwin, 2011). Economic pressures from unions, workers’ compensation, and competition in employment have all influenced training methods and practices, and in some instances contributed to a natural selection of sorts for effective training methods. However, common training practices still often include ineffective methods and procedures. A presentation of those methods follows.

Methods

A wide variety of training modalities and combinations exist in the literature. It is not uncommon for research for a given modality to contain direct contradictions, with some researchers finding an aspect significant or beneficial, and others finding it insignificant or detrimental. Combining training methods into packages is standard in research and in practice. Some of these combinations in research are examined with lesser experimental control than would typically be expected for a treatment/intervention package because the researchers often omit component analyses.

Some combination methodologies have become standardized so far as to be named (Behavior Skills Training, Pyramidal Training, for instance) and are typically examined as a whole procedure rather than separate parts. This complicates a cohesive summation and analysis of discrete methods. However, for the purposes of this paper, common package modalities and individual techniques will be addressed each in turn, as this is the reality in the current research and in what can be expected for practical application methods. It is important to note that when training packages are presented, the discrete components of each package should also be considered as separate entities with essential aspects for efficacy to be gleaned from research in their own right.

Feedback

Feedback as a training method is certainly present in the research literature as an exemplar of some direct contradictions in research findings. What is widely accepted is the general beneficial nature of feedback; learners perform better when they receive it compared to when they do not (Alavosius & Sulzer-Azaroff, 1990; Higbee, Aporta, Resende, Nogueira, Goyos, & Pollard, 2016; O’Neill, O’Neill, Weed, Hartman, Spence & Lewinski, 2018; Shapiro & Kaxemi, 2017; Yeung, Meeks, Edelson, Gao, Soar & Perkins, 2009).

For example, for both healthcare providers and lay responders, CPR training is more effective when a device that provides feedback is used compared to one that does not (Yeung et. al, 2009). Yeung et. al reviewed thirty-three relevant studies and found that CPR feedback devices not only improve skill acquisition, the improvement also carries over into skill retention. This is particularly important for a potentially life-saving skill, but direct assessment of carryover of the presence or lack of feedback on actual patient outcomes was not possible. Future research including this aspect, the ultimate goal of CPR training, would bolster these findings.

In an additional example, O’Neill et. al (2018) compared training methods for police trainees at three police academies in the United States. The typical initial training sessions that all three academies provided did not include planned performance feedback and were not enough to teach skills to an extent that a group could be considered as having mastered the skills in question. Performance feedback at the third police academy improved skill performance so that mastery levels were achieved. Unfortunately, skills taught in the police academy were not reliably maintained after graduation even when performance feedback was provided, indicating that multiple training deficits in police academy training methods likely need to be addressed, and performance feedback may enhance training methods but needs to be considered as one part of effective training methodologies and not a standalone method.

The most effective timing and frequency of feedback is controversial; some research indicates feedback is best directly after a performance (Luke & Alavosius, 2011; Tosti & Jackson, 1981); some research indicates feedback is best directly before the next opportunity to perform that skill (Aljadeff-Abergel, et. al, 2017, Higbee et. al, 2016). Furthermore, some researchers have found that immediate feedback is necessary, and others have found that delayed feedback is no less effective than immediate feedback. Some research indicates that delayed feedback is superior to immediate, at least in certain applications.

In a 2011 study using a multiple baseline design across subjects, Luke and Alavosius found that immediate feedback delivered after skill performance not only improved healthcare workers’ hand hygiene for all participants to mastery levels, it also resulted in the skill being maintained months after the intervention was withdrawn. As early as 1974, Van Houten et. al, using a multiple baseline design, found that immediate feedback after task completion doubled the rate of words produced by young writers while the quality of their overall work remained high.  However, neither of these studies included a direct comparison with delayed feedback.

When feedback is given directly after a performance, for skills that involve memorization of stimuli at least, a very brief delay makes feedback more effective. For example, Carpenter and Vul (2011) found a delay of three seconds, during which nothing else is presented that may distract the learner, makes feedback more effective than when it is presented immediately.

It may be that delayed feedback is effective when it serves as an antecedent just prior to skill performance, as Aljadeff-Abergel et. al suggest. In 2017, Aljadeff-Abergel et. al compared the effects of feedback given immediately after skill performance with feedback given just before the next opportunity to perform the skill and found that providing feedback before the opportunity for skill performance was the superior method.

However, feedback may draw its power from its relation to differential consequences; feedback and differential reinforcement may have interrelated effects (Bucklin et al, 2004, Kang et al, 2005). This relation to differential consequences may be integral to the effects found by Aljadeff-Abergel et. al above; feedback just prior to skill performance may be a motivating operation affecting behavior that typically results in feedback or a discriminative stimulus for reinforcement during a performance of a skill. By extrapolation, feedback without any differential consequences may be ineffective, and the type or schedule of differential consequences used may be an underestimated variable that could enhance or even negate the efficacy of feedback.

For example, the study by Bucklin et. al (2004) found that incentive-based pay enhanced the effects of feedback where hourly pay did not. Similar results were obtained by Kang et, al (2005); Kang and colleagues used four experimental conditions to evaluate the effects of feedback when combined with hourly and incentive pay while also comparing the effects of continuous versus intermittent feedback. Continuous feedback increased performance in comparison to feedback delivered intermittently, every fourth session, but only when combined with incentive pay, not when combined with hourly pay. It may be that incentive-based pay enhances feedback as a discriminative stimulus for positive reinforcement in the form of access to money, so learners are more likely to attend to and respond to feedback when incentive-pay systems are used.

Feedback can enhance the effectiveness of other interventions. Bucklin, McGee and Dickinson (2004) found that monetary incentives alone were less effective for producing high performance than monetary incentives combined with feedback. After feedback was withdrawn and monetary incentives alone resumed, performance was maintained. While this may be viewed as a failure of experimental control subsequent to reversal, it may also be evidence that feedback can increase performance and then be withdrawn and the differential reinforcement in place will maintain the gains created by feedback. If this is true, it makes feedback an even more valuable tool for organizations because it is efficient; it may be used until skill levels are achieved for a particular skill and then withdrawn, allowing the resources devoted to providing feedback for that skill to be devoted to another skill or another aspect of the organization.

While evidence is present that immediate and delayed feedback can both be beneficial, what also must be considered is the schedule of feedback provided. Much evidence exists to support that when teaching new skills, a continuous schedule of reinforcement is best. In consideration of reinforcement schedules in relation to feedback, it is necessary to recognize that this includes a presumption that feedback would need to serve as reinforcement in a given scenario, and that rather than being presumed, this should be assessed. If feedback does function as reinforcement, a continuous schedule would seem to be best when teaching new performance skills. However, in typical scenarios continuous schedules are challenging if not impossible, and some evidence suggests that continuous schedules are not indicated for certain types of skills.

Specifically, if creativity is sought when teaching a skill, a variable ratio of feedback is likely a better choice rather than a continuous schedule of feedback (Eckerman & Vreeland, 1973). Eckerman and Vreeland found that when subjects were transferred from a continuous reinforcement schedule to a variable schedule where responses were arbitrary (because the variable schedule had been predetermined for the purposes of the study), variability in the responses increased. The subjects were apparently seeking reinforcement by modifying the topography of their response and continued to modify it as the variable schedule continued. Once placed on extinction, where no responses received reinforcement, variability in the responses occurred but then did not continue to increase as it had on the variable schedule. This study indicates that variable reinforcement schedules encourage individuals to vary the topography of their behavior while attempting to emit the correct response. These results are of particular consideration for skills where creativity is likely to create value, such as in the production of art or music.

Other researchers have shown the superiority of a continuous feedback schedule versus an intermittent feedback schedule in order to acquire skills more rapidly. However, both continuous and intermittent schedules can result in performance being maintained equally well (Alavosius & Sulzer-Azaroff, 1990). Alavosius and Sulver-Azaroff used a multiple baseline design and concurrent reinforcement schedules across behaviors to illustrate that continuous feedback resulted in a faster performance increase in the percentage of correct steps for work skills for healthcare workers than an intermittent feedback schedule, while also illustrating that written instruction without feedback was not effective. It may be that continuous versus intermittent feedback affects the rapidity of skill acquisition in training but not the ultimate competency of the performer.

Feedback can be presented in a graphic form without concurrent direct interaction from the person providing the feedback; this is a common practice in many management scenarios where group or individual performances are posted. Graphics can be presented in a variety of forms, although some individuals may display marked preference for a graphic type even if it is less demonstrative of relevant results than an alternative. Preference is not apparently associated with understanding, as staff in Hardesty et. al understood both preferred and nonpreferred graph types (Hardesty, Orchowitz and Bowman, 2018). Austin, Weatherly and Gravina used a multiple baseline design across subject groups and a partial component analysis to assess the effects of a combination of task clarification, verbal feedback and graphic feedback for restaurant employees. When graphic feedback was added for one group, performance increased. However, task clarification and verbal feedback had already been provided as an initial intervention for  that employee group, so sequence effects or the initial independent variable continuing to improve performance cannot be ruled out.

Another aspect affecting the efficacy of feedback is positive feedback versus corrective feedback, where positive is understood as acknowledging “good” performance and corrective feedback is understood as pointing out “bad” performance. The concern is what is better not only as one versus the other but in what combinations and orders. Some research suggests that while combining positive feedback with corrective feedback may be perceived as more pleasant to the learner and reduce adverse emotional responding, combining positive and corrective feedback together lessens the feedback’s improvement of performance (Choi, Johnson, Moon, & Oah, 2018). Choi et al. suggest that positive feedback should be combined with corrective feedback if the organization’s priority is the experiences of the individuals receiving the feedback, but positive and corrective feedback should be delivered separately if performance is the primary concern.

Feedback may include generic observations (e.g., “well done,”) or specific descriptive details related to the performance being trained. Johnson (2013) found that the most effective feedback included not only basic evaluation of the performance but also objective details about relative aspects of the performance.

Computer-Based Instruction

Human interaction during feedback is not required for effectiveness; CBI often has feedback provided by a computer, and it is effective for learning (Johnson & Rubin, 2011). CBI without feedback either embedded or added may not be effective for a majority of learners, however (Higbee et. al, 2016). For CBI to be an effective method there needs to be interaction where the training does not advance until the learner demonstrates some aspect of or knowledge about the skill (Johnson & Rubin, 2011).  It has been used effectively to train educators on antecedents and consequences surrounding behavior (Scott, Lerman & Luck, 2018). Within virtual reality applications, feedback in the form of simulations of interactions with a physical environment has been effective in training first responders (Jiang, Girotra, Cutkosky and Ulrich, 2005).

Behavior Skills Training

Behavior skills training (BST) is a competency-based training method; in other words, training continues until the trainee displays mastery of the required skill(s). There is variability in procedures implemented; what makes a training procedure BST is inclusion of four things: instructions, modeling, practice (sometimes referred to as rehearsal) and feedback, with the last two recurring as needed until mastery of the skills in question is demonstrated. Instruction often includes verbal instruction and written instruction. Whether written, verbal or both, instruction includes specific description of the behaviors expected from the trainee to show skill mastery. Modeling is often accomplished via role play with individuals as actors and has been successful with video modeling (Sarakoff & Sturmey, 2004) as well as in person modeling (Beidas, Cross, and Dorsey, 2014).

BST has been used to train a variety of skills effectively, such as training on the use of teaching protocols and communication (Parsons & Rollyson, 2012). Parsons and Rollyson demonstrated the effectiveness of BST for teaching two skills using a multiple baseline design across behaviors (each skill taught). Their results indicated the skills increased an average of over 40% and 65%, respectively, after BST was implemented for the participants. In a study by Nigro-Bruzzi and Sturmey (2010) a multiple baseline design across subjects design was used to assess the effectiveness of BST for training staff to provide mand training for children. All staff showed significant increases in performance over baseline when BST was implemented, and their consumers (the children) showed improvement as well.

Practice, Role-play, Rehearsal

An essential aspect of BST according to its 4-part package is practice, also known as rehearsal or role-play. Practice, as the author will hereafter term it, allows for opportunities for feedback to be planned for and allocated, and is an effective method when part of the component package of BST and when combined with other methods. The challenge faced in many settings is the lack of opportunity or resources for feedback to occur in real-life opportunities for skill performance. This is where practice using actors can provide a solution. Multiple researchers have found that using trained actors can be effective to accomplish practice opportunities. For example, Beidas et al (2014) found that using trained actors for what they termed “behavioral rehearsal” was effective in teaching cognitive behavior therapy skills to therapists. A variety of cognitive behavior therapy skills were taught effectively using this method. Sarakoff and Sturmey (2004) also used actors effectively for practice during training for teachers and saw a significant improvement in performance after the training package was implemented, with increases from the 40th percentiles in baseline to 90th percentiles after training for all three participants.

Pyramidal Training

Pyramidal training as initially described by Jones, Fremouw and Carples in 1977 includes training individuals who will be present in the working environment of future trainees so that a small number of individuals can be trained by the initial trainer and then go on to disseminate training to subsequent trainees. This is a method that allows for initial trainers to spend less time and resources on training, as may be particularly important in consultative and outsourced roles, especially in terms of cost reduction. The group initially trained can also presumably provide feedback regularly to their trainees since they will be working in the same environment.

In a classic example of pyramidal training well known in behavior analysis, Page, Iwata and Reid (1982) expanded upon this practicality by performing initial training for supervisors, who would already be overseeing their trainees on a regular basis and would already be expected to provide guidance and correction of performance. In this study of pyramidal training in an institutional setting, Page et. al found that pyramidal training was effective for supervisors and their frontline staff. One key aspect of this study to note is that supervisors were provided feedback on their supervisees performance after the supervisors had trained the supervisees; in reality, this means that the trainers received ongoing training in the form of feedback even after training was completed on the original skills to be performed.

Performance Management

Performance management (PM) is a technology based on the science of behavior analysis that improves the performance of individuals to create increased value for organizations (Daniels & Bailey, 2014).  Performance management includes a variety of assessment techniques and uses behavior analytic methodologies to effect change. Part of the processes of performance management often includes training, if poor performance is caused by a skill deficit. Performance management training methods can include all the effective training methods listed above. It enhances these methods by typically including goal setting, clear definitions of behaviors to specify what skills are to be performed, and effective reinforcement strategies for desired skill performance. Performance management as a whole could only be addressed in a paper of this length devoted alone to its content; further guidance is suggested via Daniels & Bailey and other seminal works.

Ineffective Training Methods

Some modalities are agreed upon in the research literature to be ineffective. For instance, despite lecture still being an overwhelmingly common “teaching” method, research indicates that by itself it does not produce effective learning (Gardner, 1972; Yeung, et. al, 2009) Only when used in combination with other methods known to be effective is it effective as part of a training package.

Self-study is not an effective standalone training method either, although it can be better when enhanced with relevant visuals (Shapiro & Kazemi, 2017). While providing written materials for trainees to learn may be enhanced with visuals, it should still not be considered an efficacious training method. When a decision is to be made on how to train performance skills, time should be allocated to active learning (such as rehearsal) rather than these methods so commonly used (Beidas, Cross & Dorsey, 2014). Unfortunately, there is an evident cultural consensus of acceptance of inefficient and ineffective teaching methods in Western society, as self-study, lecture and simple presentation of written materials for review by trainees are standalone training methods widely used by workplaces, educational institutions, and other organizations.

While interteaching is a promising method used in education settings to teach knowledge skills, there is insufficient research at this time to indicate efficacy in regards to performance skills.

Ethics

Behavior analysts have a professional and ethical obligation to provide and advocate for effective training, as evidenced by the behavior analyst certification board’s guidelines for training and teaching. As outlined by Henley & Reed (2015),

Guideline 5.0 The Behavior Analyst as Teacher and/or Supervisor specifies the delivery of training and teaching. This particular guideline does not detail particular training practices and content but establishes an ethical obligation to design training programs that entail proper supervised experiences, competently designed training and supervisory activities, and training programs that meet their goals (Bailey and Burch 2011). Moreover, Guideline 1.0 Responsible Conduct of a Behavior Analyst requires behavior analysts to “rely on scientifically and professionally derived knowledge” in one’s professional activities, which may be interpreted to mean behavior analysts involved in staff training or supervision rely on empirically supported or evidence-based training and performance management practices.

According to the behavior analyst certification board, behavior analysts have an expectation of providing training that is backed by research supporting its effectiveness. Based on the evidence presented, many training practices in common use have questionable effectiveness or have no empirical evidence of being effective at all. This is a deficit that cannot ethically be ignored, and certainly should not be enacted by behavior analysts in any supervisory or consultative roles.

The ethical concerns of providing ineffective training vary in severity depending on the field and services provided; obviously poor training in the field of emergency medicine has greater potential ethical concerns than poor training in performance art, for example. However, behavior analysts have an ethical adherence to provide evidence-based services, so any behavior analyst providing training or consultative services that include training recommendations should provide research backed, evidence-based practical training. With that acknowledgement, it is arguable that behavior analysts, who have a responsibility to disseminate information (BACB, 2019) about the field responsibly, may have an ethical obligation to advocate for better training methods if they simply encounter substandard training methods while performing in a professional role in situations where health or safety is at stake.

Future Directions

Research indicates some types of training enhance the effects of others and that training packages are reliably superior to trainings that only include one component. It is evident that all training should include some form of feedback. However, more research is needed to analyze feedback and its effects. Many questions remained unanswered, including some in relation to rate of feedback, timing of feedback, and how these relate to the nature of the skill that needs to be performed. For example, further research on the rate of feedback is necessary to determine the break points of rate since rate has been rarely examined in comparison to timing (e.g., immediate or delayed). Also, for some performance skills initially based on memorization, a delay of a few seconds is more effective than immediate feedback. However, in other instances immediate feedback is the best method. In yet other instances, delay in feedback does not appear important as long as feedback is delivered.  In addition, the type of feedback given and what aspects of performance it contains has been explored as by Johnson (2013), who found that the most effective feedback included both evaluation of the performance itself and objective details about the performance. However, analyses like these that look for essential aspects of feedback that determine or enhance effectiveness are too few for a comprehensive scientific understanding to be had, and further research is warranted.

Feedback delivered directly before the next opportunity to perform a skill may be the most effective way to improve skill performance in some situations and when given immediately after a skill in others. It is most likely that rather than a significant portion of the body of research on the timing of feedback being altogether incorrect, science lacks a finer understanding of what feedback is best in what situations. More specifically, feedback timing may have a direct relation to the type of skill being learned, and additional research should examine this potential link while also accounting for the consideration of differential reinforcement in association with feedback.

What can be gathered regarding training is the following: feedback should be provided to improve skill performance, regardless of the skill being taught. Immediate feedback during and just after a performance is suggested for skill improvement. Feedback should also be provided just before the next opportunity to perform the skill in question. Feedback should include specific aspects of the skill being performed, rather than just generic statements of approval or disapproval. Positive feedback (i.e., praise or description of what was done well) should be provided. As long as emotional reactivity is not a primary concern, positive feedback should not be provided at the same time corrective feedback is provided. If emotional reactivity is a concern, positive and corrective feedback may be combined with the understanding that the learning experience is likely to be more aversive (i.e., less pleasant) for the learner but skill performance may improve more rapidly. Special consideration should be given to the future relationship between the trainer and the trainee in these instances; if there is to be an ongoing interaction trainers would be prudent to consider the potential trade-off in avoiding pairing themselves with aversive conditions and having a learner take longer to master a skill than the opposite.

Feedback may be provided using electronic devices or persons, but if electronic devices are used feedback and interaction with the device should be a prerequisite for moving on to the next aspect of the skill. Behavior skills training offers a summative approach that can be used to train a wide variety of skills in a wide variety of environments, and is a good option for providing behavior analytic training methods to non-behavior analysts as it is standardized, methodical and easy for trainers to understand as a method without needing to understand the underlying science. Future research may lead to the discovery of what rate, frequency and order of BST components are most effective to determine the line between efficacy and efficiency.

Where cost and time are of particular concern selection of training methods can be used as mitigating factors. Pyramidal training can provide more cost-effective and efficient training for organizations, but if the training of the initial point person(s) does not include the essential aspects of training for efficacy, it is not truly a practical method. Additionally, pyramidal training should always include the original trainer(s) monitoring performance of secondary trainees and providing feedback to primary trainees regarding the secondary trainees’ performance for a time. CBI may be a less expensive alternative than using personnel to provide training, and it is effective when used with embedded feedback and requiring demonstration of a skill before presenting the next skill to be trained. An area for further research may be whether feedback has better efficacy when coming from a person rather than an electronic device or computer and what parameters influence this variance if it does exist.

Future research is needed to create standardized and feasible training practices that can be used in a variety of environments and occupations. For example, in the medical field performance skills are highly dependent on knowledge skills; that is, memorization of terms, chemical interactions, numeric levels associated with abnormal functioning, symptoms characteristic of different maladies, etc. are required to perform skills to address medical concerns that cannot wait for research. Therefore, the immediacy of feedback should likely be specified as delayed for some skill aspects and immediate in others, with clear guidelines delineated. Similarly, BST where skills are practiced as many times as needed so mastery can be obtained would decrease the likelihood of errors, especially in cases that are presentations of rare medical conditions where lack of practice is likely to cause lack of skill retention or loss of skills. This is also true for the law enforcement field, where trainees are likely to fail to perform a skill correctly during follow-up probes despite displaying them correctly during and immediately before graduating from training. In both instances, the safety, wellbeing and lives of individuals are at risk; failing to provide effective training is an ethical failure to do right by one another in the most basic of ways.

It is prudent to acknowledge that advocating for effective and research backed training practices is likely to be difficult. Effective training often requires significant resources and is likely to be more costly on the front end. Continuous reinforcement makes individuals learn faster; in positions where individuals will already be responsible for important duties (healthcare for example) before they are fully trained, continuous reinforcement schedules are best. However, they require someone with expertise to provide monitoring at all or close to all opportunities for reinforcement. In the same vein, to provide immediate feedback, someone with expertise needs to be available to observe performance of essential aspects of a skill and to take the time to provide feedback. To provide continuous and immediate feedback, an individual or program has to be designed whose sole primary purpose is training.

There are ways to streamline these processes, such as to have individuals respond remotely, or to use electronic devices in the place of people, that can reduce investment of time and funds. However, even when streamlined and well-practiced, these procedures are not easy. It is easy to give a person something to read and expect them to then perform the skills described. It is easy to lecture individuals on expectations and skill descriptions and consider training complete.

As often happens, tradition, low response effort and systemic entropy are poised against what is right and best. Simple acknowledgement of what is right and best is not enough. Providing evidence via sound research of what is right and best is a necessary step that must be expanded upon, but it is also not enough. To expect real change, advocates must also be prepared to convince organizations that effective training is not only right and best from a moral and ethical perspective, it is what is right and best for the organization itself and any stakeholders. Research must include what happens when effective training is not in place; the costs of staff or volunteer turnover; the costs of legal difficulties caused by mistakes in service to consumers or injuries or death to personnel; the loss of revenue from cultural perceptions that make interactions with an organization aversive to outsiders; and so on.

Behavior analysis allows for scientific determination of what training methods are the most effective, and what aspects of each method enhance effectiveness or are so key to effectiveness that they should be considered as necessarily inherent in the method. Behavior analysis also offers clear ethical guidelines regarding the importance of using evidence-based training methods that are backed by current and comprehensive research. As a final caveat, behavior analysis self-identifies its responsibility to disseminate information to those outside the field. Therefore, behavior analysis is inextricably linked to effective training methods and has an intrinsic responsibility to continue to research what works, what doesn’t work, and why. The foundations have been laid, but the work will be ongoing, bounded only by the limits of our technology and our research questions. Our technology is ever evolving, so our research questions should only promulgate further from the humble synthesis offered in these pages.

References

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