38
Training for Manual Materials Handling Tasks: Strategies for First Responders and Healthcare Workers CREMSD Webinar October 8, 2020 Tyson Beach, Assistant Professor, University of Toronto Tilak Dutta, Scientist, KITE Research Institute

Training for Manual Materials Handling Tasks: Strategies

  • Upload
    others

  • View
    7

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Training for Manual Materials Handling Tasks: Strategies

Training for Manual Materials Handling Tasks:Strategies for First Responders and Healthcare Workers

CREMSD WebinarOctober 8, 2020

Tyson Beach, Assistant Professor, University of TorontoTilak Dutta, Scientist, KITE Research Institute

Page 2: Training for Manual Materials Handling Tasks: Strategies
Page 3: Training for Manual Materials Handling Tasks: Strategies

Poll question 1

Do you think this type of training would be effective at reducing risk of injury?

a) Yesb) No

Page 4: Training for Manual Materials Handling Tasks: Strategies

Poll question 2

Do you think the training offered by your organization is effective at reducing the risk of injury?

a) Yesb) Maybec) No

Page 5: Training for Manual Materials Handling Tasks: Strategies

Poll question 3

Which type of work are you involved with?

a) Firefightingb) Paramedicc) Healthcared) Other

Page 6: Training for Manual Materials Handling Tasks: Strategies

Denis et al., IRSST: Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Québec

Page 7: Training for Manual Materials Handling Tasks: Strategies

Agenda• Our interpretation of the IRSST’s findings

on training• Our recommendations for implementing

training programs

Page 8: Training for Manual Materials Handling Tasks: Strategies

Injury prevention in the workplace

Fitting the work to the worker

vs

Fitting the worker to the work

More important

Page 9: Training for Manual Materials Handling Tasks: Strategies
Page 10: Training for Manual Materials Handling Tasks: Strategies
Page 11: Training for Manual Materials Handling Tasks: Strategies

Our position• First, fit the work to the worker, then fit the worker

to the work• Worker training is important for injury prevention

particularly for occupations that require manual handling of heavy loads

Page 12: Training for Manual Materials Handling Tasks: Strategies

October 19Steve FisherDan Armstrong

October 30Tyson BeachDave Frost

November 9Catherine BrookmanEmily KingMike Holmes

Page 13: Training for Manual Materials Handling Tasks: Strategies

Our position• First, fit the work to the worker, then fit the worker

to the work• Worker training is important for injury prevention

particularly for occupations that require manual handling of heavy loads

Page 14: Training for Manual Materials Handling Tasks: Strategies

Haslam et al., 2007Martimo et al., 2007Clemes et al., 2009Verbeek et al., 2011Hogan et al., 2014

5 reviews concluded that training doesn’t work

Page 15: Training for Manual Materials Handling Tasks: Strategies

Haslam et al., 2007Martimo et al., 2007Clemes et al., 2009Verbeek et al., 2011Hogan et al., 2014

77 papers

Page 16: Training for Manual Materials Handling Tasks: Strategies

Denis et al. found• The 5 reviews did not consider the quality of

the training programs• Instead, they only considered the quality of

the evaluation

Page 17: Training for Manual Materials Handling Tasks: Strategies
Page 18: Training for Manual Materials Handling Tasks: Strategies

Training Program 1 Training Program 2

Page 19: Training for Manual Materials Handling Tasks: Strategies

High quality training programs had poor quality evaluations

Poor quality training programs had high quality evaluations

Page 20: Training for Manual Materials Handling Tasks: Strategies

Denis et al.’s findings• Conclusions were based on ~10% “high quality”

evaluations• Denis et al. concluded that evidence for training

was stronger than the conclusions of the 5 reviews• Bad training doesn’t work

Page 21: Training for Manual Materials Handling Tasks: Strategies
Page 22: Training for Manual Materials Handling Tasks: Strategies

Individual

Work Environment

Page 23: Training for Manual Materials Handling Tasks: Strategies

To be effective, training should• Help workers apply ergonomic principles in a

changing work environment (rather than focus on specific techniques)

• Include practice that is representative of the real working conditions

• Teach workers how to reduce/eliminate hazardous work when possible

• Handling frequency/duration• Getting help from a co-worker• Rearranging physical obstacles• Etc.

Page 24: Training for Manual Materials Handling Tasks: Strategies

1

Page 25: Training for Manual Materials Handling Tasks: Strategies

Contemporarytheoriesandbestavailableresearchevidenceinkinesiologyandimplementationsciencesuggestsapplyingatransdisciplinary,participatoryanditerativeapproachtomanualhandlingtraining.Althoughtherearemanywaystodothis(inprinciple),weproposeusingaprocessmodelconsistingoffourinterdependentphases:(1)assessment;(2)design;(3)implementation;and(4)evaluation.

Anaccompanyingpositionpaperonthetopicisforthcoming,andwillbeavailableontheCRE-MSDwebsite.

2

Page 26: Training for Manual Materials Handling Tasks: Strategies

Assessment focusesongatheringessentialinformationandsupport.Keystakeholdersandcontentexperts(wherepossible/warranted)collaboratetodevelopasharedunderstandingofpriorities,responsibilities,resourcesavailableandexpectedoutcomes/impactsviaanalysesofindividual- andcontextual-levelfactorsrelevanttothedesign,implementationandevaluationofatailoredtraininginitiative.Itiscriticaltomanageexpectations,ascommitmenttoongoingandprogressivetrainingislikelyrequiredtoaffectthebiological,psychological,socialandculturalprocessesthatleadtodesiredoutcomes.

keytasksneeds,prioritiesandresourcesassessmentdetailedanalysesofworktasksandsystems

tipsbeginwithend-in-mind(considerevaluation)leverageexistingprogramsandsystems

commonmistakesunrealistictimelines,expectedresults,etc.insufficientstakeholderinput

commonchallengesachievingandsustainingstakeholderbuy-inmanagingexpectations

3

Page 27: Training for Manual Materials Handling Tasks: Strategies

Design involvescraftingatrainingplan– comprisedofgeneralandspecificcomponents– basedontheassessment.Generaltrainingisdesignedtopromoteandsupporthealth-enhancingbehaviours(e.g.adequatephysicalactivity,nutrition,sleep,stressmanagement,etc.),withprimaryemphasisonusingprogressiveexercisetobuildandmaintainphysicalliteracyandcapacity.Thegeneraltrainingyieldsthefundamental“buildingblocks”neededtoreapbenefitsofspecifictraining.Specifictrainingisdesignedtotrainworkerstofirstidentifyandassesstheirwork-relatedhealthhazardsandrisksbeforetrainingthemto(re)organizetheirworkand/orbodilymovementstoeffectivelyregulateunderpinningbiopsychosocialstressors.Todothiswell,itiscriticaltoco-createandcontinuallyco-evolvetrainingwithinputfromstakeholderswhohavetacitknowledge(especiallyexperiencedworkers).

keytasksadaptresearchtolocalcontextaccommodatebarriers/enablers

tipsconsultresearchandexperiencedpractitioners

commonmistakesone-size-fits-all(“cookie-cutter”)programsincompleteergonomicscontentandpractice

commonchallengescausesandconsequencesofMSDarecomplexincorporatingtrainingintomultimodalMSDpreventionprogram

4

Page 28: Training for Manual Materials Handling Tasks: Strategies

Causes/consequencesofMSDmultifactorialandcomplex– manualhandlingtrainingbyitselfcanonlydosomuch.Assuch,weproposecombiningbothgeneral(health,fitnessandperformance)andjob-/activity-specificcomponents.

generalcomponentpromoteandsupportoverallhealth• nutrition,sleep,physicalexercise*• stressmanagement,emotionalregulation• smokingcessation,limitalcoholconsumption

*Thereispreliminarysupportforthenotionthatengaginginphysicalexercise canhelppreventandmanageill-effectsthatmanualhandlinghasonworkerhealthandperformance.Basedontheavailableevidence,thespecificexercisedosesrequiredareunknown,asaretheunderlyingmechanisms.However,whenexerciseelicitsimprovementsinphysicalliteracyandstrength,thereisboththeoreticalandempiricalgroundsforitsinclusionasageneralcomplementtoworkplace-specificmanualhandlingtrainingprograms,providedthatoveralllifestressesaremonitoredandmanagedaccordingly.

specificcomponentself-monitorandself-regulateworkstressorsi. hazardidentification&riskassessmentii. interprethazards&risksiii. transformwork(tasks,environments,systems)tocontrolhazards&reducerisks

5

Page 29: Training for Manual Materials Handling Tasks: Strategies

Implementation isputtingthetrainingplanintoaction.Generaltrainingneedsstakeholder-specificmessagingtoconjuresupportnecessarytochangeattitudes,beliefsandhealthbehaviours.Acentralmessageisthatwhenexerciseisadministeredbasedonfoundationalprinciplesandpracticesofkinesiology,itisnotonlyapowerfultooltocultivateoverallworkerhealthandwellbeing,butalsodevelopsthecapacitytomeetdemandsofwork,lifeandplay.Supportfromorganizationalleadershipisneededtofosterworkers’capabilities,opportunitiesandmotivationstoexercise;thisusuallyconsistsofproviding:time;space;equipment;andaccesstohealthprofessionalswhocanhelpmanagelifestressors.Specifictrainingusesexperientiallearning(vs.didacticteaching)methodstotrainworkerstosafelyandeffectivelymeetjobdemandsby:using(in)formalhazardidentificationandriskassessmenttoolsto“read”theirworksituations;andmodifyinghazardousorhigh-risksituationsusingacombinationofergonomicandpersonalmovementstrategies.Itiscriticaltoprovidepracticeactivitiesandenvironmentsthataccuratelyrepresentrealisticworkingconditions,andforworkerstoexperimentwithandreflectontheirmovementstrategiestodevelopsituationalandbodyawarenessrequiredtoregulatework-relatedstresses.

keytaskstrain& coach (vs.teach)workerstohandlesafelyandeffectively

tipsprioritizecompetencyandskilldevelopment(vs.technique-training)

commonmistakesoveremphasizeknowledgetransfer(education&teaching):trainer vs.trainee-centredunderemphasizepractice(training&coaching):manualhandlingisamotor activity,afterall

commonchallengesappropriatecommunication/messagingprioritizinglearning overteachinglackoftimeandexpertise

6

Page 30: Training for Manual Materials Handling Tasks: Strategies

Ononehand,exercisesimplyprovidesthe“rawmaterials”or”ingredients”tomakethemostofspecifictraining.But,usingmoresophisticatedmethodsofexercisedesignandimplementation(i.e.basedonfundamentalkinesiologytheory),wehavealsoshownthatifwe“coach”exercisetochangepreferredmovement“habits”,thesehabitstransfertojob-specificactivitieswithouthavingtorehearse/practicethejob-specificactivitiesthemselves.Thisisespeciallypromisingfortheactivitiesperformedbyemergencyrespondersandhealthcareworkers(esp.in-home)becausetheirworkenvironmentsandtasksareoftenhighlyvariableandunpredictable.

Usingthismoresophisticatedexerciseapproach,traineesessentiallylearntopositionandmovetheirbodiesmoreeffectivelywhenexecutingreal-worldtasksbecausetheyhavedevelopedthecapabilitiestobetter“read”and“interpret”theirtask-environment,andtohavebetterawarenessoftheirowncapabilitiesingivencircumstances(i.e.to“act”basedontheirinterpretation).

7

Page 31: Training for Manual Materials Handling Tasks: Strategies

Experientiallearningparadigmsusedtotrainworkerstodevelopsituational- andself-awareness.Wecomparedthestandard”teaching/educating”(didacticmethod)to“coaching/training”(experientiallearningmethod),andfoundslightadvantageforthelatterapproachforacquisition,retentionandpositivetransferoflearning/traininginacontrivedlaboratorystudy.Eitherapproachmayworkwellwhenthejobtasksaresimilarandpredictabletothetraining/learningsetting,but…[nextslide]

8

Page 32: Training for Manual Materials Handling Tasks: Strategies

…theevidenceisnotconsistentonhowwellcontrivedtraining/learningactivitiestransfertocomplex,real-worldscenariosthatdifferremarkablyfromthepracticesetting.

9

Page 33: Training for Manual Materials Handling Tasks: Strategies

Wehavestartedtakingourresearchtothefieldtobetterdesignrealisticpracticeconditions(tofacilitatepositivetrainingtransfer).We’vebeenexperimentingwithtrainingfirefighterstorecognizehazards/risksassociatedwiththeirtasks,andlearningtoadapttheirworktasks,environmentsandsystems(usingergonomiccontrols/strategies),andbyadaptingtheirmovementstrategiestoregulatethestressorsimposedonthebodywithoutnegativelyimpactingperformance/safety.Ourinitialresultsarepromising,butwehavealotofanalyseslefttofinish.

10

Page 34: Training for Manual Materials Handling Tasks: Strategies

SomeofthemostpromisingworkisbeingdoneonthistopicisthatdonebyDr.Dutta’steam.They’recombiningdidacticteachingandexperientiallearningmethodstogetherwith“wearables”tofacilitatelearninginrealisticpracticesettings.Biofeedback(vibrotactileand/oraudio)isbeingusedtoalertperformersabouttheirspinalmotionsduringvariouspatienthandlingscenariosinasimulatedhome-livingenvironment.Thisbiofeedbackapproachiscombinedwitheducationandteachingaboutthereasonswhycontrollingspinemotionduringphysicallydemandinghandlingactivitiescanhelpbuildlow-backresilienceandmaintainhealth.

11

Page 35: Training for Manual Materials Handling Tasks: Strategies

Theirinitialresultsareextremelypromising.They’veshownthatusingtheirmulti-modaltechniquecannotonlyfacilitatedesiredchangesinmovementstrategies,butthatthesechangesaresustainedover2months!

12

Page 36: Training for Manual Materials Handling Tasks: Strategies

Evaluation referstotheongoingmonitoringandcriticalreviewoftrainingprocesses,outcomesandimpacts.Processevaluationfocusesonjudgingthequalityoftraininganditsdelivery,andconsistsofindicatorsthattraining:reachesandengagesintendedworkers;isdosedsufficientlytobuildandmaintainrequisiteskillsandcompetencies;andleadstoexpectedchangesinworkpractices.Outcomeevaluationfocusesontheultimategoal(s)oftraining,commonlyevidencedbyreducednumber,severityandimpactofMSDswithoutnegativelyimpactingworkerororganizationalperformancebenchmarks(impacts).Priortodesigningandimplementingtraining,itiscriticaltoagreeontheevaluationindicators,howandwhentheywillbeassessed,andbywhom.

keytasksassesstrainingprocesses,outcomesandvalue

tipsfinalizeevaluationplanbefore trainingstartsidentifyqualityimprovementopportunities(ongoingfeedbackonprocesses)allowtime(behaviourchangeslowprocess)

commonmistakesworkerreactions,learningandbehaviourseldomevaluated(appropriately)

commonchallengesinsufficientresourcesmaintainingcontrolsandobjectivity

13

Page 37: Training for Manual Materials Handling Tasks: Strategies

Manualhandlersshouldreceivehigh-qualitytrainingtopreventandmanagetheassociatedmusculoskeletalhealthrisks.Trainingprogramsareineffectiveiftheyfailtodevelopandmaintainrequisitecompetenciesandskillsoftheseworkersto:recognizeandinterprettheirhealthhazardsandrisks;andadapttheirworksituationsandbodilymovementsaccordingly.Generalguidelinesfordeveloping,deliveringandevaluatinghigh-qualitymanualhandlingtrainingareprovidedonnextslide,buttrainingshouldbetailoredtoaccommodatestakeholderneedsandwants(identifiedviaathoroughassessment).

14

Page 38: Training for Manual Materials Handling Tasks: Strategies

15