Study of Staff Training at Educational Hospitals by Qualitative Approach

The essential resource for all organizations, mostly educational hospitals, for coping with changes is training of human resources. Staff training is accepted not only as an inevitable necessity for the growth and survival of the organization but also as part of the culture of the organization. That is why the research's main goal is to extract and classify concepts in the training of Staff the method of study was qualitative and had an inductive approach. In this regard, after reviewing the research context using semi-structured interviews, the data collected and analyzed. Considering this research's purpose, which is to design a staff-training model in educational hospitals, in-depth interviews were conducted with 13 experts in this field. In three stages, open coding, axial coding, and selective coding were performed. The thematic analysis technique was used to analyze the data from researchers' interviews in a peaceful environment and identify the model. A further advantage, particularly from learning and teaching, is that it is a method rather than a methodology. To ensure the Quality of the findings, the process of extracting concepts and coding monitored by expert researchers. Based on the results obtained from the software, training needs, training targets, training methods, training effectiveness, and educational hospitals identified by 58 codes. The results show that assessing needs of educational hospitals is the highest priority for staff training criteria.


Introduction
Human resources considered the most important asset of organizations and their competitive advantage in the current era (Campbell, 2016).Improving human resources knowledge, abilities, and skills is essential for organizations to deal with the changes (Demirk, 2012).Staff training is considered a critical and strategic issue for organizations.It is seen as a tool by which organizations determine the range in which their human capital is considered sustainable (Gary and Peters, 2016).Training is one of the topics that man has been working on it for ages.With the emergence of communities and the creation of jobs, organizations, and hospitals, staff training became more vital and today the survival of organizations is tied to it.The present age is associated with rapid change, and every day a new change occurs in the world of business.In the meantime, organizations must either accompany them with those changes or witness their death and destruction.(taghipoor et al., 2016).
Continuous training is the key to development in organizations, and the effects of training on the success of educational and research hospitals are not overlooked.Hospitals should always work efficiently and effectively to help Staff and managers develop their skills to develop creative ideas and improve their services (weru et al., 2014).Training in educational hospitals is a fundamental and ongoing task and not an interim task for educational hospitals that use innovative training methods and developing their Staff.They would have a better performance compared to the organizations which do not use such methods.Staff training helps organizations cope with competitive challenges (Kennedy, 2015).

Parsons et al. (2012) conducted a study entitled Evidence-Based Staff Training: A Guide for
Practitioners.This study provides a proven approach to teaching functional skills training that can assist behavior analysts in successfully training work skills related to human service personnel.
That is why organizations have increasingly focused on training their human resources, and the increasing number of training person-hours and per capita training arepieces of evidence of this claim (Asiayi, 2015).Due to the acceleration of change and increasing competition, organizations are more than ever trying to achieve results and preserve themselves.Designing an appropriate educational model for these two purposes (achieving results and maintaining survival) is significant."Because this is training that improves organizational performance and excellence (Ahamdi et al., 2015).In other words, instructional design as a scientific domain, which teaches how to provide training opportunities for learning in organizations, plays a crucial role in organizations.So, some believe that instructional design is the core part of any educational effort (Karagiorgi, 2005).Changing the paradigm from an industrial economy to a knowledge-based economy and creating an independent spirit for problemsolving amongst staffs, lack of association between training and career activities, lack of attention to critical factors in the training process, organizations' increasing emphasis on staff training, problemoriented approach to Staff occupational design, are the most critical factors which demonstrate the need for providing a unique training model for staffs in educational hospitals (Jennings, 2016) Organizations are mechanisms or tools to achieve the goals of society, in other words, tools and programs that are designed and implemented to meet the basic needs of society (Rajabipour, 2018).Investigating the formation and transformation of organizations shows that in the past, due to the simplicity of human life and technology, the scope of organizations' structures and functions was simple and primitive, and individuals did not need to have professional knowledge of their activities (Rowden, 2007).The changes made in social life later became widespread in the organization's various dimensions, making their goals, tasks, and responsibilities more complicated and making them even more challenging to manage.The consequence of such massive industrial, technological, economic, and.. Changes in the nineteenth and early twentieth centuries made the organization vital (Clifford, 2007).According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), education is all actions, influences, way, and means for working out and developing brain and cognitive abilities and the skills, attitudes, and behaviors of humans.However, in such a way that excels man's personality as much as possible and makes man the positive value of the society in which he lives (Tavakoli, 2008).
Training is an experience based on learning intended to make permanent changes in one to improve himself to perform more effectively (Imran, 2013).Training is one of the most potent weapons we have to build the future.It is inevitable for a human to consider it, since at the dawn of the new century, with the ever-increasing development of communications, exchange of information in a broader level, has made profound changes in social roles if individuals, and as a result, man needs to acquire information in a more organized way.According to the facts mentioned above, training is one of the most critical management tools to increase organizational efficiency.Regarding the importance of training in the restoration and improvement of human resources as the most critical integral element of each organization, managers should provide the necessary support for the organization's training (Rahimian et al., 2017).
In all these definitions, training is the critical factor in human excellence, and this excellence can be useful in the relationship between employees and management.The role of learning in recent organizations has been of great interest, and understanding the learning process and how it affects one's future behavior is useful.That is why many organizations allocate considerable resources for staff training.All problematic human behaviors achieve through learning (Khorasan, 2013).If managers want to justify, predict, or control a person's behavior, they need to know how they learned it.(Saeed et al., 2014).A common weakness in many performance management systems is that managers and supervisors do not pay enough attention to staff training and ultimately do not receive the necessary feedback.Human resource training is a lucrative investment that pays off in the flourishing and development of the organization and plays a vital role in excelling society's culture.The term training is an integral part of the working life principle in any organization, and its main aspects are cultivated skill development and professional expertise.The establishment and continuity of training in today's organizations have an essential role to play in the profession and, in fact, in the organization to be led.Staff training is vital and inevitable and should be continuously noticed along with other management processes so that other management activities can be useful.Training is one of the principals and logical methods of leading staff efforts in organizations and helps hidden talents within organizations flourish and use imagination; moreover, Staff may feel more mentally flexible.That is educating and training human resources, which helps a country to achieve self-sufficiency.However, we should never forget this critical point that training, with all its importance and necessity, can be practiced only when it is in line with the physical, spiritual, psychological, and future needs of Staff and does not contradict them.If done correctly, comprehensive, and thoroughly, staff training can be used to achieve specified goals and can have countless benefits for the organization.Most essential advantages include facilitating achieving organizational goals, qualitative and quantitative improvement of products or services provided by the organization, creating harmony in the way tasks are handled, reducing probability of accidents and incidents in the workplace, improving morale of the personnel and stabilizing the organization can be mentioned (Grossman, 2011), reducing direct and indirect supervision reducing conflicts, rebellion, absenteeism, and other abusive group behaviors in the workplace, reducing public expenditures in an organization, including maintenance costs, prime costs, service costs or recruitment costs (Ghafar, 2016), increasing in profitability and efficiency and allocating the profit for employees' welfare, preventing duty and responsibility conflicts, reinforcing the sense of loyalty and solidarity, flourishing staff' latent talents, creating a sense of flexibility in Staff, creating a platform of growth and success in occupational, social, individual fields (Salas et al, 2012).
Human resource training is a lucrative investment that pays off in the flourishing and optimal development of the organization and plays a vital role in excelling society's culture.The term training is an integral part of the working life principle in any organization, and its main aspects are cultivated skill development and professional expertise.The establishment and continuity of training in today's organizations have an essential role to play in the profession and, in fact, in the organization to be led.Before defining instructional design, defining the components forming this expression (Design and instructional) separately is necessary."Designis a rational, logical, and sequential process for problem-solving.Due to this, the design process can be recognized as the problem-solving process (Crawford, 2004).In his article, Michael Spector (2000), "Towards a Philosophy of Instruction," has defined instruction as supporting and facilitating learning.Reigeluth (1997) stated a similar definition and defined instruction as "whatever is done to help an individual learn." Organizations may be successful regardless of the design and implementation of staff training models.However, this is different from educational hospitals.There are a few educational hospitals that are successful without an instructional design model.In educational hospitals, practical design and staff training, implementation are likely to lead to better education and up-to-date and practical learning.
This is what the philosophy of educational hospitals is (demark, 2012).Smith et al. (2019) in their study entitled "Redesign of Hospital Diabetes Education: A Quality Assessment with Nursing Teams" examined the barriers and facilitators of web-based education for patients with diabetes among nursing units.In relation to training programs, through semi-structured interviews with physicians, nurses and health workers, the subject of training programs and models, content capabilities of the platform, and workflow reviews and considerations related to skills training were identified.
On the other hand, the best instructional design model in the world may lead to no positive change in an organization; due to other issues such as payment and poor conditions, inefficient systems, governmental regulations, economic situations, and (Gary and Peters, 2012).If the instructional design in an organization is worthwhile, the link between instructional design and performance improvement should be clear.The instructional design should be precise, elegant, scholarly, and professional.However, if it does not lead to performance improvement, there would be low or no value for employers and employees (Okin, 2015).Instructional Design in an organization is a broad and diverse system and should help visible and measurable skill development.However, skill development does not necessarily lead to better overall performance or results in an organization.The instructional design should be focused on what the learner can understand or do to improve organizational goals (no one, 1993).Higher education tends to promote knowledge on the one hand and create new knowledge on the other.It is considered the subject of teaching theories and very young and unique (yarmohammadian, 2015).Higher education represents an essential type of investment in human resources that contributes to economic development by enhancing the knowledge, skills, and attitudes required for senior technicians, experts, and managers.Universities and other educational hospitals contribute more to the economy.Economists consider staff training as a type of investment.In the past, training and development were not recognized as activities that could help organizations provide value and face challenges successfully.Nowadays, this mentality has changed.Organizations that benefit from innovative training and development methods are likely to perform better than those who do not use such methods.Training and development also help organizations to cope with competitive challenges better (Sagnak, 2015).Organizations should always rely on effective and efficient training to help their Staff and managers improve and develop their skills to improve and provide genuine and innovative ideas to deliver high-quality services.Also, development and job placement management is essential for preparing employees for managerial and leadership positions and attracting, motivating, and retaining employees at all levels and in all occupations.

Barton et al. (2018) conducted a study entitled
Teaching nurses teamwork: Integrative review of competency-based team training in nursing education.During their study, 19 people were selected and evaluated using quantitative and qualitative evaluation tools and a regular comparative approach.Nursing teamwork knowledge is rooted in the theory of highly reliable teams and crisis management resources.Constructive training is used to practice and improve teamwork skills.Assessing nursing teamwork is complex.This includes the integrated determination of individual knowledge, skills and attitudes.Future initiatives should include front-line leadership, supportive commitment, and an emphasis on skillful communication.Collective stakeholder support is needed to transform teamwork competencies into nursing.
Mobilizing and preparing human resources are especially important for coping with changes since human resources are considered strategic capital.According to their goals and mission, all organizations, mainly educational hospitals, should allocate most financial and time resources to training in various dimensions.Therefore, the integration of these trainings with the changes in the future requirement of the workplace.Training is the most critical process for transferring knowledge to organizations' Staff and help them carry out their tasks effectively.Excellent and practical training would increase job satisfaction, enhances abilities, and reduces teleworking.This will not happen unless all organizational hierarchies understand the importance of training and Staff recognize it as a means for their and their organizations' development.The primary role of training is to change the way people think and behave.Organizations' success derives from the proper and effective use of scarce resources, especially human resources, and their attention to hospital staff training (Clifford, 2007).
Professional training within the workplace indicates complex individual and organizational processes (Ellinger, 2007), described as the relationship between two essential processes of working and learning.In organizational training, occupational activities would become a part of learning, and learning would turn into a part of the occupation.Training in organizations usually focuses on developing key competencies or improving individual and organizational performance (Imran, 2013).

Research Methodology
The current qualitative research is applied in terms of objective and is content-oriented.The method for collecting theoretical backgrounds data and information in this study is desk research.For collecting and presenting media entrepreneurial patterns, it has been field research and in-depth interview.The thematic analysis technique was used to analyze the data from researchers' interviews in a peaceful environment and identify the model.

Conclusion
The purpose of this study was providing a model for staff training in educational hospitals.In a transcendental organization, employees have the task of self-learning, apart from playing an organizational role.As a result of thought exchange, skills would grow so that everyone would play an essential role in his colleagues' development.
Thus, the competencies of Staff are completed, and experts improve them and their organization's knowledge.On the other hand, the content of the training itself would become dynamic.The richness of the contents delivered would increase every day and prevent job repetition and organizational errors.Resources, contents, and training topics in the form of classrooms, seminars, conferences, visits, field trips, academic exchanges, discussions, documented meetings of strategic committees and experts, library resources, Internet searches, databases and software systems, if this information and knowledge are instructed for self-efficient Staff, research-based and training spirit will be created amongst Staff and organizational learning, will take place and interactive and challenging environment, will be created between Staff and their occupation; therefore, the richness of jobs will be increased, and competency matrix for succession planning and talent management will be provided. In

Fig. 1 :
Fig.1: the content network (Maxqda output) Research Objectives Human resources are the strategic capital of any organization.Their training is vital and unavoidable and should be constantly considered along with other management processes to make other management activities useful.Training is one of the main and logical methods to guide the efforts of employees in organizations and helps to develop the talents hidden in organizations and use the imagination.Having an educational model makes it better in the organization.Therefore, this study aims to design a comprehensive model for education, especially in teaching hospitals, which includes the goals and needs of staff.

Table 2 : Classification of Fundamental concepts
After the proper implementation of the training program, the next step is to evaluate both trainer's and trainees' performance right after the program and observe trainees' performance after few months of training to utilize the techniques they learned during training.It will make us aware of whether our training program has proved effective or not.By this, we will come to know about the weaknesses and strengths of our training program (Woodard, 2016).external evaluation and self-assessment are two types of training evaluation.The organization does external evaluation and self-assessment done by Staff.
their study, Chen et al. (2008) investigated the effect of the instructor's role and interaction in the staff training process.Lee et al. (2007) examined the impact of content, evaluation, and environmental, Chong et al. (2005) examined the effect of selflearning contents, the method of presenting lessons, assignments, and evaluations, Martinez Carrow (2008) studied learners interaction.The interaction between learners and instructor in staff training, Issyk (2008) investigated the impacts of usability, value-added for customers, self-efficacy of the computer on staff satisfaction from learning, Kurt et al. (2005) studied the position of educational content production.Peng et al. (2006) examined the effect of educational facilities, instructors, and educational content on staff satisfaction.Sullivan et al. (2021) suggested that the network approach to education promotes growth and success and facilitates the standardization of plans and the training of specialized nurses.It is suggested that to achieve a more practical model of the final research model, quantitative validation of the model should be implemented, and necessary modifications to the model should be made.