training need analysis research paper

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Training needs assessment: tool utilization and global impact

Adelais markaki.

1 PAHO/WHO Collaborating Center for International Nursing, Birmingham, AL USA

2 School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294 USA

Shreya Malhotra

3 Stanford University, Stanford, CA USA

Rebecca Billings

Associated data.

All data generated or analyzed during this study are included in this published article.

Global demand for standardized assessment of training needs and evaluation of professional continuing education programs across the healthcare workforce has led to various instrumentation efforts. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire is one of the most widely used validated tools. Endorsed by the World Health Organization, the tool informs the creation of tailored training to meet professional development needs. The purpose of this project was to describe TNA tool utilization across the globe and critically appraise the evidence of its impact in continuous professional development across disciplines and settings.

A systematic integrative literature review of the state of the evidence across PubMed, Scopus, CINAHL, and Google Scholar databases was carried out. Full-text, peer reviewed articles and published dissertations/theses in English language that utilized the original, adapted or translated version of the TNA tool were included. Selected articles were appraised for type and level of evidence.

A total of 33 articles were synthesized using an inductive thematic approach, which revealed three overarching themes: individual, team/interprofessional, and organizational level training needs. Included articles represented 18 countries, with more than two thirds involving high-income countries, and one third middle-income countries. Four studies (12.1%) used the original English version instrument, 23 (69.7%) adapted the original version, and 6 (18.2%) translated and culturally adapted the tool. Twenty-three studies targeted needs at the individual level and utilized TNA to determine job roles and responsibilities. Thirteen articles represented the team/interprofessional theme, applying the TNA tool to compare training needs and perceptions among professional groups. Last, three articles used the tool to monitor the quality of care across an institution or healthcare system, demonstrating the organizational training needs theme.

Conclusions

Overall evidence shows that the TNA survey is widely used as a clinical practice and educational quality improvement tool across continents. Translation, cultural adaptation, and psychometric testing within a variety of settings, populations, and countries consistently reveals training gaps and outcomes of targeted continuous professional development. Furthermore, it facilitates prioritization and allocation of limited educational resources based on the identified training needs. The TNA tool effectively addresses the “know-do” gap in global human resources for health by translating knowledge into action.

Over the last 25 years, a trained workforce has been at the core of success for any organization or industry. Appropriate and systematic approaches to training have been shown to result in skills improvement, which in turn raise the quality of employees [ 1 ]. Assessing and understanding workforce training needs ensures confidence, know-how, and a variety of new skills that bolster preparedness on an individual and team-based level in any organization [ 2 ]. Given the rapid technological advances, persisting workforce shortages, increased disease burden, and shrinking resources, healthcare organizations must methodically survey existing and expected performance levels of their staff [ 3 ]. Yet, evaluation of training and development processes, used until the mid-90’s, showed that healthcare professionals were not acquiring the necessary skills to successfully perform their jobs [ 4 ]. Similarly, healthcare organizations often did not carry out adequate assessments of training needs, due to limited time and resources, or failure to use research evidence to inform practice [ 5 ]. Consequently, training needs analysis (TNA) must be viewed and carried out in the context of existing healthcare systems to be consistent with the needs of employees and relevant to the ever-changing demands of organizations [ 6 ].

Literature on healthcare employee training needs has evolved considerably. Several TNA models were developed to understand and address training deficiencies in the workplace through data collection and analysis from both employees and employers [ 7 ]. The traditional model focuses on job behavior and task analysis, using surveys and formal interviews to gather data [ 8 ]. Its main drawback, besides being time-consuming, is its focus on predetermined outcomes which precludes the possibility of unplanned learning taking place. As an alternative, the practical model considers a trainer-centered, demand-led or supply-led “pedagogical approach” to TNA [ 9 ]. Whilst this model helps the TNA coordinator select the appropriate approach for the desired outcome, it does not provide any guidance as to how to conduct an assessment that is both comprehensive and effective. As a result, this approach could be a waste of time and resources.

Acknowledging the above challenges and limitations, investigators from the United Kingdom (UK) in 1996 initiated efforts towards a cost-effective and psychometrically sound TNA tool for the healthcare industry. The Hennessy-Hicks Training Needs Analysis (TNA) Questionnaire, referred as “TNA” from here on after, was developed to identify individual training needs, organizational requirements, and targeted training strategies [ 10 , 11 ]. Since its development, the TNA tool has been psychometrically tested and used for a variety of purposes among several settings and populations. It has a proven track record for use with primary healthcare teams, district and practice nurses, nurse practitioners (NPs), and health visitors in the UK [ 10 – 13 ]. The TNA has been shown to minimize response bias and provide reliable information about current performance levels, skill areas most in need of further development, and how to best achieve optimal results. This knowledge facilitates organizations with priority-setting and policy development, as well as with evaluation of their continuous professional development (CPD) programs.

In 2011, the TNA developers licensed the tool to the World Health Organization (WHO) for online use and dissemination through the Workforce Alliance website [ 14 ]. With rising calls for evaluating training and competency to regulate nursing practice in the Americas [ 15 ], stemming from the “Global strategy on human resources for health: Workforce 2030” [ 16 ], our motivation for this project was twofold. First, the lead investigator’s experience with translating, adapting, and applying the TNA instrument in another language, as part of an action research PhD dissertation. Second, the team’s affiliation with a WHO Collaborating Center (WHOCC) that promotes global capacity building for nurses and midwives as well as educational quality improvement (QI). Therefore, this integrative review aimed to describe TNA tool utilization across the globe and critically appraise the evidence of its impact in CPD across disciplines and settings.

The Hennessy-Hicks TNA Questionnaire and Manual [ 14 ] was accessed through the WHO Workforce Alliance website and was carefully reviewed to determine initial intended use. The tool consists of a one-page demographics section, an open-ended question, and a 30-item questionnaire which covers core clinical tasks, arranged into five sub-sections; research/audit, administrative/ technical, communication/teamwork, management/supervisory, and clinical activities. Respondents rate each item on a seven-point scale according to two criteria: “ How critical the task is to the successful performance of the respondent’s job” and “ How well the respondent is currently performing the task.” Ratings for criterion A (Criticality Index) provide an overall occupational profile of the job, and those for criterion B (Skill Index) the level of performance. Subtracting the scores (criterion A – criterion B) in each task provides a Training Needs Index. The accompanying manual offers instructions, data analysis, and customization for use in one’s own environment.

To allow for cross-country and cross-setting comparisons, the investigators adopted the Knowledge to Action (KTA) Framework developed by Graham et al. [ 17 ]. Knowledge translation is “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge” [ 18 ]. The KTA process conceptualizes the relationship between knowledge creation and action as a “funnel”. Knowledge is increasingly distilled before it is ready for application whereas, the action cycle represents the activities needed for knowledge application and integration [ 17 ]. By translating knowledge into action, researchers can effectively address the “know-do” gap in healthcare practice [ 19 ].

Search strategy – eligibility criteria

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to in the conduct and reporting of this systematic integrative review [ 20 ]. An electronic database search in PubMed, Scopus, CINAHL, and Google Scholar was performed using the following strategy: ((“Surveys and Questionnaires”[Mesh] OR tool* OR measure* OR questionnaire* OR survey* OR scale* OR instrument*) AND (Hennessy OR Hicks OR Hennessy-Hicks OR “Hennessy-Hicks Training Needs Assessment Questionnaire”) AND (nurs* OR training-needs)).” All full-text, peer reviewed articles, dissertations or theses published in English language since 1996 were included. Additionally, a targeted manual search of grey literature and listed references was carried out. A total of 289 articles were retrieved and duplicates were removed with the use of Sciwheel Reference Manager. The resulting 265 articles were first screened by title/abstract, and then, 97 full-text articles were assessed for eligibility. During screening and eligibility steps, inclusion was determined if any of the following content-specific criteria were met: a) study using the original TNA tool, b) psychometrics study carrying out translation and/or cultural adaptation of the TNA tool in other languages or countries, and c) study applying or integrating an adapted TNA version. The above search strategy, along with reasons for excluding articles, is depicted in Fig.  1 .

PRISMA Search Strategy for TNA Tool

Data extraction and quality appraisal

Initial title and abstract screening was conducted by an independent investigator (SM), with full-text article assessment for eligibility and data extraction carried out by two independent investigators (SM, LT). Any conflicting votes on eligibility of an article were resolved by a third investigator (AM). Appraisal of level of evidence was based on the adapted Rating System for the Hierarchy of Evidence [ 21 , 22 ]. The World Bank Atlas was followed for country classification by income level (high, middle or low) [ 23 ]. An inductive thematic analysis of the literature sample was carried out. Interprofessional education (IPE) and collaborative practice were operationalized based on the Framework for Action on Interprofessional Education and Collaboration , developed by WHO [ 24 ]. Hence, both terms ‘interdisciplinary’ and ‘multidisciplinary’, often used interchangeably, were captured. Given the systematic review methodology of this study, no study approval was required.

A total of 33 articles, published within the last 25 years (January 1996–May 2020), met our inclusion criteria and are presented in Table  1 . A summary of their characteristics and appraised evidence is shown in Table  2 . The majority of the articles (87.9%) were original research, 9.1% were dissertations or theses, and 3% posters. Thirty-two (97%) of the studies were descriptive or mixed methods (level VI evidence), and one (3%) was an expert opinion (level VIII). Study populations included nurses (72.7%), physicians (12.1%), other healthcare professionals (30%), and health insurance employees (3%). Settings ranged from primary healthcare (57.6%), to acute care (51.5%), and other organizations (6.1%) or companies (3%). As shown in Table  3 , a total of 18 countries were represented, with the majority originating from the UK. More than two thirds (69%) focused on high-income countries (HIC), 28% on middle-income countries (MIC), and only 3% on low-income countries (LIC).

Characteristics of studies using the Hennessy-Hicks TNA tool ( n  = 33)

a Level of evidence appraisal based on the adapted Rating System for the Hierarchy of Evidence [ 21 , 22 ]

b Themes: Individual, Team/Interprofessional (IP), Organizational

Summary of characteristics and evidence appraisal ( n  = 33)

a Some articles involved more than one study population or study setting

Classification of TNA use by country income level and theme

a Income country classification by World Bank [ 23 ]

b Some articles involved more than one country

In terms of TNA tool use, 4 (12.1%) studies used the original English version instrument, 23 (69.7%) adapted the English version, and 6 (18.2%) translated and culturally adapted the tool. Translation and cultural adaptation of the original TNA was carried out in the following languages/countries: a) Bahasa Indonesian - tested among community nurses and midwives in Indonesia [ 31 – 33 ]; b) Greek - tested among rural primary care nurses, midwives, and health visitors in Greece [ 45 , 46 ]. In addition, a modified version of TNA was translated and culturally adapted into the following languages/countries: a) Kiswahili – tested among reproductive, maternal, and newborn healthcare workers in Mwanza, Tanzania [ 48 ]; b) Bulgarian, Polish, Italian, Albanian, and Romanian – tested among formal and informal caregivers across European Union countries and immigrant communities [ 50 ]. Furthermore, a thematic analysis revealed the following three levels in training needs analysis: a) individual level; b) interprofessional or team/unit level; and c) organizational level.

Individual training needs analysis

As listed in Table ​ Table1, 1 , a total of 17 studies centered on identifying or targeting needs at the individual level within a specific population of interest across a variety of settings [ 8 , 12 , 13 , 25 , 30 , 32 , 33 , 37 – 39 , 41 – 44 , 49 , 50 , 53 ]. Nurses, physicians, midwives, and other healthcare professionals were studied in primary healthcare, acute care, healthcare organizations, and other businesses. All 17 articles applied the TNA tool to determine specific job roles and responsibilities within the targeted setting. Hence, an individual’s perceptions about which tasks were most important for performing their jobs were assessed and captured in column A of the TNA tool. For example, Hicks and Tyler [ 38 ] used the tool to determine the required education for family planning nurses in the UK, analyzing the tasks these nurses performed, while also allowing them to indicate their training needs. By comparing the roles of the family planning nurse with the family planning nurse prescriber, the investigators determined the nuances that distinguished the two roles in two consecutive studies [ 38 , 53 ].

Eight articles determined job profile differences in a variety of geographical locations [ 12 , 13 , 30 , 32 , 33 , 38 , 50 , 53 ]. Four of these articles compared training needs across different countries or regions; within the UK, USA, and Australia [ 30 ], across Indonesia [ 32 , 33 ], and across five European countries [ 50 ]. For example, Pavlidis et al. [ 50 ] determined the differences in caregivers’ perceived training needs across the UK, Greece, Bulgaria, Poland, and Italy. Four main training needs were reported as contributing to quality care improvement: a) basic nursing skills; b) specialization in specific conditions (such as diabetes, stroke, dementia); c) training in advanced health care systems; and d) training in psychology-related skills, such as time management, emotion regulation, and communication [ 50 ]. Targeting those skills was deemed to improve European caregivers’ capacity in the health and social services sectors.

Existing knowledge gaps, and the most effective training methods to meet individual training needs, were identified across all articles. For example, a study carried out in Ireland, determined medical doctors’ training needs to inform professional development courses [ 43 ]. Workload/time organization and stress management were identified as the most pressing needs, while doctor-patient communication was ranked highest for importance and level of current performance. The TNA tool allowed for setting priorities that best met individuals’ training needs, and facilitated managers, local governments to allocate scarce budgets and resources to improve the quality of health care [ 43 ]. Similarly, a dissertation study of South African managers in public hospitals revealed that a combination of formal and informal training, enhanced by qualitative research, was the best strategy [ 49 ].

Team/Interprofessional training needs analysis

A total of 13 articles exhibited the team/IP training needs theme, encompassing more than one professional group or focusing on a team or unit as a whole [ 26 , 28 , 29 , 31 , 34 , 35 , 40 , 45 , 46 , 48 , 51 , 52 , 54 ]. Target populations included nurses, physicians, and other healthcare professionals across acute and primary care, as well as healthcare institutions. Twelve of the articles were descriptive, qualitative, or mixed methods studies (level VI evidence) whereas, one was an opinion article (level VIII evidence) [ 34 ].

Articles under this theme utilized the TNA tool for a wide variety of purposes, including to monitor and optimize quality of care. For instance, Singh and colleagues [ 52 ] utilized the TNA tool at a tertiary care hospital in India to evaluate nurses’ training needs. They identified patient care, research capacity, managerial/administrative, and communication as the highest priorities [ 52 ]. Other investigators used the tool to determine perception of job roles by nurses and their managers. TNA developers, Hicks and Hennessey [ 35 ], used the tool to define the newly established NP role in the UK, providing an operational definition and specific training needs to be targeted. The researchers surveyed all nurses working at advanced clinical levels within an acute sector of the National Health System (NHS) trust. Their triangulation results indicated overall consensus between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat differing opinions by the medical staff [ 35 ]. Subsequently, implications in regulating educational provision for NPs in the UK emerged.

The TNA tool was also used to compare training needs and perceptions between different professional groups in the clinical setting, thus allowing for greater analysis of job roles and responsibilities. For instance, Markaki et al. [ 46 ] used the tool in Greek primary healthcare centers to determine the occupational profile differences between nurse graduates from 2-year programs and graduates from 3- or 4-year programs. Collected data were then used to determine training gaps to be targeted by future interventions. Determination of training needs at all levels allowed for budgetary analysis and resource allocation for optimum results. Hicks and Hennessy focused on improving the capacity of the NHS trust and its employees by identifying the training needs of practice nurses [ 34 ]. In this 1997 study, practice nurses considered communication and teamwork to be the most important aspects of their job, and there was overlap in the training needs identified by the nurses themselves and by their managers. In 2005, Hicks and Thomas [ 40 ] analyzed the training needs among professionals delivering community sexual health services and used the data to recommend additional courses within the allocated budget. Similarly, Mwansisya et al. [ 48 ] surveyed reproductive, maternal and neonatal healthcare workers within eight districts in Tanzania and provided a baseline of training needs in a low middle-income country. Another study, carried out at a School of Dentistry in a Sudanese university, showed that faculty and staff prioritized academic student supervision, data analysis, and effective presentation skills [ 54 ]. The survey also revealed knowledge deficits related to legislation and community engagement. The investigators concluded that effective targeting of these group training needs would require development of university-wide policies for training [ 54 ].

Organizational training needs analysis

Three articles focused on improving outcomes for an organization, such as a healthcare system, hospital, or business [ 27 , 36 , 47 ]. Targeted populations were nurses, physicians, other healthcare professionals, and business employees. Barratt and Fulop [ 27 ] applied the TNA tool to improve use of research, and knowledge generation participation, across healthcare and public health organizations in London and Southeast England. In doing so, the investigators identified key tasks, priorities, and barriers to building research capacity, such as assessing the relevance of research and learning about new developments [ 27 ]. An earlier study by Hicks and Hennessey explored the issue of evidence-based clinical care within the context of diminishing resources in the British NHS [ 36 ]. A TNA survey from seven NHS trusts showed common training needs and skill deficits in relevance to locality and clinical area. The authors concluded that targeting the real skill deficits of the workforce, as well as the personnel most in need of training, was essential for effective integration of evidence-based care within routine practice [ 36 ]. Last, Moty [ 47 ] focused on technology improvement at a contract research organization to incorporate user feedback into a portal system through the TNA tool. By incorporating end users’ input to optimize portal design, more positive opinions about portal technology could be solicited, and desire to use technology could be increased [ 47 ]. All three articles demonstrated the tool’s versatility in addressing organizational training needs at a systems level through an integrated approach.

This integrative review synthesized evidence about TNA tool utilization across the globe, and critically appraised its impact in CPD across various disciplines, settings, and countries. The tool proved to be modifiable for different purposes and contexts, without compromising its high validity and reliability. Its flexible design allowed it to be easily adapted to various populations, settings, and cultures while retaining its psychometric characteristics. Hence, the tool’s value as an international instrument for analyzing training needs in the healthcare and education sectors became evident.

TNA tool utilization across the globe

Following initial development and testing, the TNA instrument was successfully used in the UK to identify individual training needs and trends related to demographics, with an emphasis on development of the NP role at the early stages [ 12 , 13 , 30 ]. Carlisle and colleagues [ 8 ] summarized the latent factor structures that affect the occupational profile construct of the TNA scale and examined them within the Australian context. The investigators confirmed the original five-factor model and suggested that the underlying dimensions relating to the occupational profile were perceived to be important for high performance by nurses in Australia [ 8 ]. Nevertheless, the majority of studies reflecting individual training needs struggled with low response rates and self-report bias. Therefore, investigators cautioned about conclusions drawn from data that relied on individuals’ own perceptions of their learning needs. At the team/IP level, perception of training gaps and competences among nurses, midwives, physicians, and public health staff in settings ranging from hospitals to rural health facilities emerged throughout 10 countries. Specifically, in Singapore [ 26 ], Australia [ 28 ], Saint Lucia [ 29 ], Indonesia [ 31 ], UK [ 34 ], Greece [ 45 , 46 ], Tanzania [ 48 ], South Africa [ 51 ], India [ 52 ], and Sudan [ 54 ]. These studies used the TNA tool for primary data collection, with one translation and validation into Bahasa Indonesian language [ 31 ] and another into Greek [ 45 ]. Training needs of a group of interest were compared to those of other professional groups or team members to tailor CE offerings and optimize IP operations. At the organizational level, UK healthcare institutions and NHS trusts [ 27 , 36 ] as well as a US contract research organization [ 47 ] used the TNA instrument to improve research capacity/utilization, identify key barriers, and mitigate resistance to change. By establishing the relationship between organizational factors (hospitals) and demographic variables, individual occupational competency profiles, as well as team professional development, can be planned and executed by HR departments.

Further synthesis of sampled participating countries, depicted in Fig.  2 , revealed that two-thirds of the studies occurred in HICs and one-third in MICs, with only one study stemming from an LIC. Out of 11 studies that used translated TNA versions, three were from Indonesia (MIC), two from Greece (HIC), and one study involved six European countries (4 HICs, 2 MICs). Cross-country comparison by income classification and TNA theme allowed for examination of challenges or limitations in usage of the original, adapted, or translated TNA tool version, and how these were addressed by the investigators. According to Gaspard and Yang [ 29 ], how a healthcare professional determines which tasks are essential, and how they perceive their actual performance of that task, may be influenced by several factors. For instance, motivation for continuous learning, a special interest in a particular task, a specific education deficit, and satisfaction or not with unit management. This limitation is addressed by allowing for two ranking systems - where employers also rank employees - to cross-check motivation and establish the need. For example, to determine NP training that would satisfy NHS trust aims, a full training needs analysis of nurses and their immediate supervisors was carried out [ 34 ]. The nurses completed the analysis with their own perceptions of training needs, while their managers completed it on behalf of the identified nurse. The resulting mutually agreed training program enhanced understanding of both parties’ agendas and could be achieved with minimum conflict [ 8 , 33 , 34 , 46 ]. For Greek nurses in rural PHC settings, appropriate training activities, along with organizational changes, had potentially equal impact on short-term staff development and long-term strategic planning programs [ 46 ].

Literature heat map – TNA tool use by country income level. *Income country classification by World Bank [ 23 ]

Reported flaws or limitations of the original or adapted/translated TNA tool included: a) small-scale study [ 8 , 26 , 37 , 40 , 42 , 45 , 46 ]; b) polling only one organization, or specific unit [ 26 , 29 , 37 , 42 , 49 ]; c) not surveying employers or stakeholders [ 28 , 29 , 48 , 51 ]; d) low participation or item completion rates [ 34 , 38 , 45 , 46 , 53 ]; e) lack of consensus at a national level regarding training content [ 45 ]; and f) focus on individual and team assessment, rather than organizational [ 25 , 39 ]. Last, one study included only 10 out of the 30 original TNA items, with the rest of items being newly introduced [ 50 ], which exceeds the developers’ threshold for psychometrics modification [ 14 ]. Furthermore, some investigators recommended further studies to explore TNA’s: a) applicability in a wider healthcare system, b) feasibility as a large-scale survey instrument in secondary and tertiary care settings, and c) usability for collaborative activities, especially through global information technology network teaching programs [ 34 , 45 , 48 ].

The main advantage of the TNA instrument is the accompanying detailed instruction manual, made available by the developers through the WHO Workforce Alliance website [ 14 ]. According to this manual, the standard 30-item questionnaire can be tailored to a particular study focus. Up to 8 of the original items can be changed or omitted, and up to 10 new items can be added. To this direction, the developers have included an example of how to adjust the questionnaire ([ 14 ], p.21-25). The additional items are to be devised according to an accepted psychometric process for developing questionnaires. For example, a literature review, focus group and interview with relevant personnel should be conducted, with the information distilled into themes, using an approved data-reduction method, such as the Thematic Network Analysis [ 55 ]. This provides the core areas from which tailored items are to be constructed. Coverage of the themes (and subsequent items) should be comprehensive and appropriate. These themes will form the basis for new items, which should be in a format similar to that of the standard questionnaire. Modified questionnaires should be piloted with a small sample. The manual includes additional item banks that have been used in other studies, grouped as follows: “Extended nursing role” , “Nurse prescribing” , “Specialist care”, “Child abuse / child protection”, and “Management” ([ 14 ], p.50-55). This item bank allows for easy tailoring to an investigator’s aim and unique context.

Global impact in continuous professional development

Regardless of country and profession surveyed, the tool consistently revealed the perceived and assumed training needs, clarified roles, and facilitated CPD at the individual or team level. Sampled literature revealed that there were no universal trends in training needs according to locus of practice, and that training requirements were specific to the actual role performed within an organizational environment. For example, Hicks & Tyler [ 38 ] and Hicks & Fide [ 39 ] demonstrated that a more targeted, less costly, training program would be optimum, upon surveying the roles and training needs of family planning nurses and breast care nurses in the UK. Organizational factors were shown to determine the occupational profile and training needs of nurses in primary and secondary care across Australia, UK, and the USA [ 8 , 30 , 36 ]. Similarly, most surveyed caregivers in five European countries declared a need for training in the psychosocial aspects of caregiving [ 50 ]. Yet, when dealing with stress, caregivers from Italy and Greece had lower needs than those from Poland, UK, and Turkey. Despite the socio-economic differences among countries, all participants faced increasing demands from caregiver burden [ 50 ]. For employees in the Nigerian health insurance industry, addressing the gaps through an on-the-job training course was deemed to be the optimum approach [ 25 ]. For each country seeking to minimize economic impact and streamline processes, the TNA tool provided an affordable, standardized approach to prioritize and implement an effective CPD program.

Several other studies concurred on the urgent need for flexible and tailored CPD, as an outcome of a comprehensive TNA analysis [ 26 , 33 , 40 , 44 , 46 , 52 – 54 ]. Especially in middle-income and low-income countries, such as Saint Lucia, South Africa and Sudan, strengthening university-level education for nurses and other healthcare professionals was a key recommendation for evidence-based decision making [ 29 , 51 , 54 ]. In the case of Indonesia, the introduction of TNA in a series of studies, carried out by Hennessy and colleagues [ 31 – 33 ], motivated several junior nurse researchers to pursue and study CPD, as reflected in multiple references of the instrument. Given the prevailing budget constraints and limited accessibility to research funds, it was not surprising that training needs in research competences emerged as top priorities across studies conducted in MICs and LICs. In Turkey, building research capacity among public health professionals to tackle prevailing non-communicable diseases, was seen as a national priority [ 42 ]. Following identification of several individual, team and organizational barriers, a comprehensive CPD plan for junior researchers, and a QI plan for governmental institutions were recommended. This latter plan provides a roadmap for addressing the lack of coordination between institutions and researchers, establishing research monitoring and evaluation, and strengthening routine health information systems. Similarly, in Sudan, the top QI priority for university faculty of Dentistry was research, followed by leadership, health professions management, community engagement, and teaching skills [ 54 ]. As demonstrated in a UK study, raising the ability of NHS organizations to use research and generate knowledge was tied to improved services and population health [ 27 ]. The above findings support the argument for research capacity as an essential component of PHC nursing [ 56 ]. Moreover, findings show the critical need for operational integration of standardized QI processes across units or institutions in order to close the gap between theory and practice [ 57 ]. Hence, implementation of a regionally based CPD and QI program, stemming from TNA application, could be the solution to a healthcare system in need of reform.

Strengths and limitations

Integrative reviews allow for the combination of diverse methodologies (i.e., experimental and non-experimental research) in order to more fully understand a phenomenon of concern [ 58 ]. By combining data from the theoretical as well as empirical literature, this review could potentially impact evidence-based practice for nursing and other healthcare professions. The ongoing worldwide interest in the Hennessy-Hicks TNA instrument and manual has been a strong incentive for this review. Following personal communication with the developers, they confirmed receipt of many email enquiries, estimated around 100, from around the world asking for permission or clarification about using the tool and informing about outcomes. Unfortunately, there is no cumulative record of requests during the past 25 years. This lack of usage data and repository was further compounded by inability to obtain webpage metrics (i.e. ‘hits’ and ‘downloads’) due to the hosting Global Health Workforce Alliance (GHWA) webpage no longer being maintained [ 14 ]. Therefore, no information was available on who has been using the tool nor who is resourcing the archived tool on the GHWA website.

This review was based on an extensive search of four major electronic databases and a targeted manual search of grey literature and cross-listed references. The selected databases (PubMed, CINAHL, Scopus, and Google Scholar) capture a variety of international journals in the nursing, social sciences, and biomedical literature, with relevant hand-searched theses and dissertations also included. All articles were independently reviewed and appraised, using an adapted hierarchy scale for level of evidence [ 26 , 27 ]. The main limitation stems from the exclusion of any relevant literature published in languages other than English. According to the developers, TNA has been translated into many other languages, including Arabic and Chinese, but there was scarce evidence published in the English literature. Upon appraisal, variation in criteria application, along with cross-country cultural and linguistic variations are also acknowledged. Last, World Bank rankings [ 23 ] were based on the 2020 index rather than the year when the study was conducted. Because of the relatively small sample size ( n  = 33), the investigators combined the “low-middle income countries” with the “upper-middle income countries” categories under “middle-income countries” (MIC).

Implications

The TNA instrument allows for triangulation of a) assessment (identifying and triaging needs); b) needs (gap between what exists and what is required); and c) training (acquiring knowledge, skills or change attitude). Our literature review synthesized the reported use and value of the Hennessey-Hicks TNA tool across settings, populations, and countries, identified the enablers and barriers to its use, and distilled best practice CPD recommendations. Viewed from the KTA Framework perspective, our findings explain how the scholarship of discovery (TNA tool development, psychometrics of adapted or translated versions) leads to the scholarship of integration (translation and cultural adaptation of TNA), and ultimately to scholarship of application (using different versions of the tool across various settings, populations, or countries). As knowledge moves through each stage, it becomes more synthesized and therefore, useful to end-users. Hence, for healthcare professionals, CE should be based on the best available knowledge, the use of effective educational strategies, and the planned action theories to understand and influence change in practice settings [ 17 ]. A recent metasynthesis of CPD literature highlights nurses’ belief in CPD, as fundamental to professionalism and lifelong learning, and its importance in improving patient care standards [ 59 ]. Yet, it shows a disconnect between nurses’ CPD needs and expectations with the organizations’ approaches to professional development. The authors conclude that access to CPD should be made more attainable, realistic and relevant [ 59 ]. By translating TNA evidence into action, health policy makers, administrators, and educators can effectively design appropriate, cost-effective CPD programs with clear priorities to achieve the desirable knowledge, skills and practice, tailored to local needs.

There is also a high level of fit between the adopted KTA Framework and the affiliated WHOCC’s Terms of Reference. Completion of this review coincided with the start of a project by the Registered Nurses Association of Ontario, aiming to develop a repository of measurement tools that can be mapped to the KTA Framework, and to report on their pragmatic and psychometric properties. Given that the TNA measurement tool has been identified as mappable to the KTA framework, the potential synergy between the two groups is promising. Moreover, our findings are aligned with WHO recommendations based on the “Framework for Action on Interprofessional Education and Collaborative Practice” [ 24 ]. These call for health policy makers to systematically address training needs of the healthcare workforce in order to strengthen IPE and collaborative practice. As tasked by the Pan American Health Organization (PAHO), the affiliated WHOCC aims to enhance the use and dissemination of knowledge resources that build capacity and leadership for nurse and midwife educators. Hence, lessons learned will be used to promote TNA tool application and integration for individual, team/IPE, and organizational improvement across the PAHO region (North/Central/South America and the Caribbean). These steps are both timely and relevant for evaluating training and competency, and for regulating nursing practice in the Americas [ 15 ] during the post-pandemic era.

Since its development in 1996, the TNA instrument has been widely used as a clinical practice and educational quality improvement tool across continents. Translation, cultural adaptation, and psychometric testing within a variety of settings, populations, and countries consistently reveal training gaps along the individual, team/interprofessional, and organizational themes. It is not only applied to identify training needs and demographic trends, but also to prioritize targeted training strategies and CPD programs. Furthermore, it facilitates triaging and allocating limited educational resources, especially in low and middle-income countries. These findings underscore the tool’s effectiveness in addressing the “know-do” gap in global human resources for health by translating knowledge into action.

Acknowledgements

We would like to thank the TNA tool developers, Drs. Deborah Hennessy and Carolyn Hicks, for their input, unwavering support, and strong commitment to sharing their knowledge and expertise with the international community. Also, our appreciation to Dr. Silvia Cassiani, PAHO Regional Officer; Dr. Erica Wheeler, PAHO representative; and the WHO Health Workforce Department representatives for providing helpful background information and connection with stakeholders.

Abbreviations

Authors’ contributions.

AM; concept design, synthesis and interpretation of data, drafting and revision of manuscript. SM; data extraction, appraisal and synthesis, drafting of manuscript. RB; literature search, drafting of manuscript. LT; data extraction and synthesis, drafting of manuscript. All authors reviewed and approved the final manuscript.

Not applicable.

Availability of data and materials

Declarations.

Not applicable (non-human subjects – review study).

The authors declare no competing interests.

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Adelais Markaki, Email: ude.bau@ikakram .

Shreya Malhotra, Email: ude.drofnats@amayerhs .

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Lisa Theus, Email: ude.bau@lsueht .

• Open access
• Published: 31 May 2021

Training needs assessment: tool utilization and global impact

• Adelais Markaki 1 , 2 ,
• Shreya Malhotra   ORCID: orcid.org/0000-0002-8708-5451 3 ,
• Rebecca Billings   ORCID: orcid.org/0000-0001-5203-7217 2 &
• Lisa Theus   ORCID: orcid.org/0000-0001-8886-8768 1 , 2  

BMC Medical Education volume  21 , Article number:  310 ( 2021 ) Cite this article

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Global demand for standardized assessment of training needs and evaluation of professional continuing education programs across the healthcare workforce has led to various instrumentation efforts. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire is one of the most widely used validated tools. Endorsed by the World Health Organization, the tool informs the creation of tailored training to meet professional development needs. The purpose of this project was to describe TNA tool utilization across the globe and critically appraise the evidence of its impact in continuous professional development across disciplines and settings.

A systematic integrative literature review of the state of the evidence across PubMed, Scopus, CINAHL, and Google Scholar databases was carried out. Full-text, peer reviewed articles and published dissertations/theses in English language that utilized the original, adapted or translated version of the TNA tool were included. Selected articles were appraised for type and level of evidence.

A total of 33 articles were synthesized using an inductive thematic approach, which revealed three overarching themes: individual, team/interprofessional, and organizational level training needs. Included articles represented 18 countries, with more than two thirds involving high-income countries, and one third middle-income countries. Four studies (12.1%) used the original English version instrument, 23 (69.7%) adapted the original version, and 6 (18.2%) translated and culturally adapted the tool. Twenty-three studies targeted needs at the individual level and utilized TNA to determine job roles and responsibilities. Thirteen articles represented the team/interprofessional theme, applying the TNA tool to compare training needs and perceptions among professional groups. Last, three articles used the tool to monitor the quality of care across an institution or healthcare system, demonstrating the organizational training needs theme.

Conclusions

Overall evidence shows that the TNA survey is widely used as a clinical practice and educational quality improvement tool across continents. Translation, cultural adaptation, and psychometric testing within a variety of settings, populations, and countries consistently reveals training gaps and outcomes of targeted continuous professional development. Furthermore, it facilitates prioritization and allocation of limited educational resources based on the identified training needs. The TNA tool effectively addresses the “know-do” gap in global human resources for health by translating knowledge into action.

Peer Review reports

Over the last 25 years, a trained workforce has been at the core of success for any organization or industry. Appropriate and systematic approaches to training have been shown to result in skills improvement, which in turn raise the quality of employees [ 1 ]. Assessing and understanding workforce training needs ensures confidence, know-how, and a variety of new skills that bolster preparedness on an individual and team-based level in any organization [ 2 ]. Given the rapid technological advances, persisting workforce shortages, increased disease burden, and shrinking resources, healthcare organizations must methodically survey existing and expected performance levels of their staff [ 3 ]. Yet, evaluation of training and development processes, used until the mid-90’s, showed that healthcare professionals were not acquiring the necessary skills to successfully perform their jobs [ 4 ]. Similarly, healthcare organizations often did not carry out adequate assessments of training needs, due to limited time and resources, or failure to use research evidence to inform practice [ 5 ]. Consequently, training needs analysis (TNA) must be viewed and carried out in the context of existing healthcare systems to be consistent with the needs of employees and relevant to the ever-changing demands of organizations [ 6 ].

Literature on healthcare employee training needs has evolved considerably. Several TNA models were developed to understand and address training deficiencies in the workplace through data collection and analysis from both employees and employers [ 7 ]. The traditional model focuses on job behavior and task analysis, using surveys and formal interviews to gather data [ 8 ]. Its main drawback, besides being time-consuming, is its focus on predetermined outcomes which precludes the possibility of unplanned learning taking place. As an alternative, the practical model considers a trainer-centered, demand-led or supply-led “pedagogical approach” to TNA [ 9 ]. Whilst this model helps the TNA coordinator select the appropriate approach for the desired outcome, it does not provide any guidance as to how to conduct an assessment that is both comprehensive and effective. As a result, this approach could be a waste of time and resources.

Acknowledging the above challenges and limitations, investigators from the United Kingdom (UK) in 1996 initiated efforts towards a cost-effective and psychometrically sound TNA tool for the healthcare industry. The Hennessy-Hicks Training Needs Analysis (TNA) Questionnaire, referred as “TNA” from here on after, was developed to identify individual training needs, organizational requirements, and targeted training strategies [ 10 , 11 ]. Since its development, the TNA tool has been psychometrically tested and used for a variety of purposes among several settings and populations. It has a proven track record for use with primary healthcare teams, district and practice nurses, nurse practitioners (NPs), and health visitors in the UK [ 10 , 11 , 12 , 13 ]. The TNA has been shown to minimize response bias and provide reliable information about current performance levels, skill areas most in need of further development, and how to best achieve optimal results. This knowledge facilitates organizations with priority-setting and policy development, as well as with evaluation of their continuous professional development (CPD) programs.

In 2011, the TNA developers licensed the tool to the World Health Organization (WHO) for online use and dissemination through the Workforce Alliance website [ 14 ]. With rising calls for evaluating training and competency to regulate nursing practice in the Americas [ 15 ], stemming from the “Global strategy on human resources for health: Workforce 2030” [ 16 ], our motivation for this project was twofold. First, the lead investigator’s experience with translating, adapting, and applying the TNA instrument in another language, as part of an action research PhD dissertation. Second, the team’s affiliation with a WHO Collaborating Center (WHOCC) that promotes global capacity building for nurses and midwives as well as educational quality improvement (QI). Therefore, this integrative review aimed to describe TNA tool utilization across the globe and critically appraise the evidence of its impact in CPD across disciplines and settings.

The Hennessy-Hicks TNA Questionnaire and Manual [ 14 ] was accessed through the WHO Workforce Alliance website and was carefully reviewed to determine initial intended use. The tool consists of a one-page demographics section, an open-ended question, and a 30-item questionnaire which covers core clinical tasks, arranged into five sub-sections; research/audit, administrative/ technical, communication/teamwork, management/supervisory, and clinical activities. Respondents rate each item on a seven-point scale according to two criteria: “ How critical the task is to the successful performance of the respondent’s job” and “ How well the respondent is currently performing the task.” Ratings for criterion A (Criticality Index) provide an overall occupational profile of the job, and those for criterion B (Skill Index) the level of performance. Subtracting the scores (criterion A – criterion B) in each task provides a Training Needs Index. The accompanying manual offers instructions, data analysis, and customization for use in one’s own environment.

To allow for cross-country and cross-setting comparisons, the investigators adopted the Knowledge to Action (KTA) Framework developed by Graham et al. [ 17 ]. Knowledge translation is “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge” [ 18 ]. The KTA process conceptualizes the relationship between knowledge creation and action as a “funnel”. Knowledge is increasingly distilled before it is ready for application whereas, the action cycle represents the activities needed for knowledge application and integration [ 17 ]. By translating knowledge into action, researchers can effectively address the “know-do” gap in healthcare practice [ 19 ].

Search strategy – eligibility criteria

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to in the conduct and reporting of this systematic integrative review [ 20 ]. An electronic database search in PubMed, Scopus, CINAHL, and Google Scholar was performed using the following strategy: ((“Surveys and Questionnaires”[Mesh] OR tool* OR measure* OR questionnaire* OR survey* OR scale* OR instrument*) AND (Hennessy OR Hicks OR Hennessy-Hicks OR “Hennessy-Hicks Training Needs Assessment Questionnaire”) AND (nurs* OR training-needs)).” All full-text, peer reviewed articles, dissertations or theses published in English language since 1996 were included. Additionally, a targeted manual search of grey literature and listed references was carried out. A total of 289 articles were retrieved and duplicates were removed with the use of Sciwheel Reference Manager. The resulting 265 articles were first screened by title/abstract, and then, 97 full-text articles were assessed for eligibility. During screening and eligibility steps, inclusion was determined if any of the following content-specific criteria were met: a) study using the original TNA tool, b) psychometrics study carrying out translation and/or cultural adaptation of the TNA tool in other languages or countries, and c) study applying or integrating an adapted TNA version. The above search strategy, along with reasons for excluding articles, is depicted in Fig.  1 .

PRISMA Search Strategy for TNA Tool

Data extraction and quality appraisal

Initial title and abstract screening was conducted by an independent investigator (SM), with full-text article assessment for eligibility and data extraction carried out by two independent investigators (SM, LT). Any conflicting votes on eligibility of an article were resolved by a third investigator (AM). Appraisal of level of evidence was based on the adapted Rating System for the Hierarchy of Evidence [ 21 , 22 ]. The World Bank Atlas was followed for country classification by income level (high, middle or low) [ 23 ]. An inductive thematic analysis of the literature sample was carried out. Interprofessional education (IPE) and collaborative practice were operationalized based on the Framework for Action on Interprofessional Education and Collaboration , developed by WHO [ 24 ]. Hence, both terms ‘interdisciplinary’ and ‘multidisciplinary’, often used interchangeably, were captured. Given the systematic review methodology of this study, no study approval was required.

A total of 33 articles, published within the last 25 years (January 1996–May 2020), met our inclusion criteria and are presented in Table  1 . A summary of their characteristics and appraised evidence is shown in Table  2 . The majority of the articles (87.9%) were original research, 9.1% were dissertations or theses, and 3% posters. Thirty-two (97%) of the studies were descriptive or mixed methods (level VI evidence), and one (3%) was an expert opinion (level VIII). Study populations included nurses (72.7%), physicians (12.1%), other healthcare professionals (30%), and health insurance employees (3%). Settings ranged from primary healthcare (57.6%), to acute care (51.5%), and other organizations (6.1%) or companies (3%). As shown in Table  3 , a total of 18 countries were represented, with the majority originating from the UK. More than two thirds (69%) focused on high-income countries (HIC), 28% on middle-income countries (MIC), and only 3% on low-income countries (LIC).

In terms of TNA tool use, 4 (12.1%) studies used the original English version instrument, 23 (69.7%) adapted the English version, and 6 (18.2%) translated and culturally adapted the tool. Translation and cultural adaptation of the original TNA was carried out in the following languages/countries: a) Bahasa Indonesian - tested among community nurses and midwives in Indonesia [ 31 , 32 , 33 ]; b) Greek - tested among rural primary care nurses, midwives, and health visitors in Greece [ 45 , 46 ]. In addition, a modified version of TNA was translated and culturally adapted into the following languages/countries: a) Kiswahili – tested among reproductive, maternal, and newborn healthcare workers in Mwanza, Tanzania [ 48 ]; b) Bulgarian, Polish, Italian, Albanian, and Romanian – tested among formal and informal caregivers across European Union countries and immigrant communities [ 50 ]. Furthermore, a thematic analysis revealed the following three levels in training needs analysis: a) individual level; b) interprofessional or team/unit level; and c) organizational level.

Individual training needs analysis

As listed in Table 1 , a total of 17 studies centered on identifying or targeting needs at the individual level within a specific population of interest across a variety of settings [ 8 , 12 , 13 , 25 , 30 , 32 , 33 , 37 , 38 , 39 , 41 , 42 , 43 , 44 , 49 , 50 , 53 ]. Nurses, physicians, midwives, and other healthcare professionals were studied in primary healthcare, acute care, healthcare organizations, and other businesses. All 17 articles applied the TNA tool to determine specific job roles and responsibilities within the targeted setting. Hence, an individual’s perceptions about which tasks were most important for performing their jobs were assessed and captured in column A of the TNA tool. For example, Hicks and Tyler [ 38 ] used the tool to determine the required education for family planning nurses in the UK, analyzing the tasks these nurses performed, while also allowing them to indicate their training needs. By comparing the roles of the family planning nurse with the family planning nurse prescriber, the investigators determined the nuances that distinguished the two roles in two consecutive studies [ 38 , 53 ].

Eight articles determined job profile differences in a variety of geographical locations [ 12 , 13 , 30 , 32 , 33 , 38 , 50 , 53 ]. Four of these articles compared training needs across different countries or regions; within the UK, USA, and Australia [ 30 ], across Indonesia [ 32 , 33 ], and across five European countries [ 50 ]. For example, Pavlidis et al. [ 50 ] determined the differences in caregivers’ perceived training needs across the UK, Greece, Bulgaria, Poland, and Italy. Four main training needs were reported as contributing to quality care improvement: a) basic nursing skills; b) specialization in specific conditions (such as diabetes, stroke, dementia); c) training in advanced health care systems; and d) training in psychology-related skills, such as time management, emotion regulation, and communication [ 50 ]. Targeting those skills was deemed to improve European caregivers’ capacity in the health and social services sectors.

Existing knowledge gaps, and the most effective training methods to meet individual training needs, were identified across all articles. For example, a study carried out in Ireland, determined medical doctors’ training needs to inform professional development courses [ 43 ]. Workload/time organization and stress management were identified as the most pressing needs, while doctor-patient communication was ranked highest for importance and level of current performance. The TNA tool allowed for setting priorities that best met individuals’ training needs, and facilitated managers, local governments to allocate scarce budgets and resources to improve the quality of health care [ 43 ]. Similarly, a dissertation study of South African managers in public hospitals revealed that a combination of formal and informal training, enhanced by qualitative research, was the best strategy [ 49 ].

Team/Interprofessional training needs analysis

A total of 13 articles exhibited the team/IP training needs theme, encompassing more than one professional group or focusing on a team or unit as a whole [ 26 , 28 , 29 , 31 , 34 , 35 , 40 , 45 , 46 , 48 , 51 , 52 , 54 ]. Target populations included nurses, physicians, and other healthcare professionals across acute and primary care, as well as healthcare institutions. Twelve of the articles were descriptive, qualitative, or mixed methods studies (level VI evidence) whereas, one was an opinion article (level VIII evidence) [ 34 ].

Articles under this theme utilized the TNA tool for a wide variety of purposes, including to monitor and optimize quality of care. For instance, Singh and colleagues [ 52 ] utilized the TNA tool at a tertiary care hospital in India to evaluate nurses’ training needs. They identified patient care, research capacity, managerial/administrative, and communication as the highest priorities [ 52 ]. Other investigators used the tool to determine perception of job roles by nurses and their managers. TNA developers, Hicks and Hennessey [ 35 ], used the tool to define the newly established NP role in the UK, providing an operational definition and specific training needs to be targeted. The researchers surveyed all nurses working at advanced clinical levels within an acute sector of the National Health System (NHS) trust. Their triangulation results indicated overall consensus between the nurses and their managers, regarding both the definition of the NP role and the essential training requirements, with somewhat differing opinions by the medical staff [ 35 ]. Subsequently, implications in regulating educational provision for NPs in the UK emerged.

The TNA tool was also used to compare training needs and perceptions between different professional groups in the clinical setting, thus allowing for greater analysis of job roles and responsibilities. For instance, Markaki et al. [ 46 ] used the tool in Greek primary healthcare centers to determine the occupational profile differences between nurse graduates from 2-year programs and graduates from 3- or 4-year programs. Collected data were then used to determine training gaps to be targeted by future interventions. Determination of training needs at all levels allowed for budgetary analysis and resource allocation for optimum results. Hicks and Hennessy focused on improving the capacity of the NHS trust and its employees by identifying the training needs of practice nurses [ 34 ]. In this 1997 study, practice nurses considered communication and teamwork to be the most important aspects of their job, and there was overlap in the training needs identified by the nurses themselves and by their managers. In 2005, Hicks and Thomas [ 40 ] analyzed the training needs among professionals delivering community sexual health services and used the data to recommend additional courses within the allocated budget. Similarly, Mwansisya et al. [ 48 ] surveyed reproductive, maternal and neonatal healthcare workers within eight districts in Tanzania and provided a baseline of training needs in a low middle-income country. Another study, carried out at a School of Dentistry in a Sudanese university, showed that faculty and staff prioritized academic student supervision, data analysis, and effective presentation skills [ 54 ]. The survey also revealed knowledge deficits related to legislation and community engagement. The investigators concluded that effective targeting of these group training needs would require development of university-wide policies for training [ 54 ].

Organizational training needs analysis

Three articles focused on improving outcomes for an organization, such as a healthcare system, hospital, or business [ 27 , 36 , 47 ]. Targeted populations were nurses, physicians, other healthcare professionals, and business employees. Barratt and Fulop [ 27 ] applied the TNA tool to improve use of research, and knowledge generation participation, across healthcare and public health organizations in London and Southeast England. In doing so, the investigators identified key tasks, priorities, and barriers to building research capacity, such as assessing the relevance of research and learning about new developments [ 27 ]. An earlier study by Hicks and Hennessey explored the issue of evidence-based clinical care within the context of diminishing resources in the British NHS [ 36 ]. A TNA survey from seven NHS trusts showed common training needs and skill deficits in relevance to locality and clinical area. The authors concluded that targeting the real skill deficits of the workforce, as well as the personnel most in need of training, was essential for effective integration of evidence-based care within routine practice [ 36 ]. Last, Moty [ 47 ] focused on technology improvement at a contract research organization to incorporate user feedback into a portal system through the TNA tool. By incorporating end users’ input to optimize portal design, more positive opinions about portal technology could be solicited, and desire to use technology could be increased [ 47 ]. All three articles demonstrated the tool’s versatility in addressing organizational training needs at a systems level through an integrated approach.

This integrative review synthesized evidence about TNA tool utilization across the globe, and critically appraised its impact in CPD across various disciplines, settings, and countries. The tool proved to be modifiable for different purposes and contexts, without compromising its high validity and reliability. Its flexible design allowed it to be easily adapted to various populations, settings, and cultures while retaining its psychometric characteristics. Hence, the tool’s value as an international instrument for analyzing training needs in the healthcare and education sectors became evident.

TNA tool utilization across the globe

Following initial development and testing, the TNA instrument was successfully used in the UK to identify individual training needs and trends related to demographics, with an emphasis on development of the NP role at the early stages [ 12 , 13 , 30 ]. Carlisle and colleagues [ 8 ] summarized the latent factor structures that affect the occupational profile construct of the TNA scale and examined them within the Australian context. The investigators confirmed the original five-factor model and suggested that the underlying dimensions relating to the occupational profile were perceived to be important for high performance by nurses in Australia [ 8 ]. Nevertheless, the majority of studies reflecting individual training needs struggled with low response rates and self-report bias. Therefore, investigators cautioned about conclusions drawn from data that relied on individuals’ own perceptions of their learning needs. At the team/IP level, perception of training gaps and competences among nurses, midwives, physicians, and public health staff in settings ranging from hospitals to rural health facilities emerged throughout 10 countries. Specifically, in Singapore [ 26 ], Australia [ 28 ], Saint Lucia [ 29 ], Indonesia [ 31 ], UK [ 34 ], Greece [ 45 , 46 ], Tanzania [ 48 ], South Africa [ 51 ], India [ 52 ], and Sudan [ 54 ]. These studies used the TNA tool for primary data collection, with one translation and validation into Bahasa Indonesian language [ 31 ] and another into Greek [ 45 ]. Training needs of a group of interest were compared to those of other professional groups or team members to tailor CE offerings and optimize IP operations. At the organizational level, UK healthcare institutions and NHS trusts [ 27 , 36 ] as well as a US contract research organization [ 47 ] used the TNA instrument to improve research capacity/utilization, identify key barriers, and mitigate resistance to change. By establishing the relationship between organizational factors (hospitals) and demographic variables, individual occupational competency profiles, as well as team professional development, can be planned and executed by HR departments.

Further synthesis of sampled participating countries, depicted in Fig.  2 , revealed that two-thirds of the studies occurred in HICs and one-third in MICs, with only one study stemming from an LIC. Out of 11 studies that used translated TNA versions, three were from Indonesia (MIC), two from Greece (HIC), and one study involved six European countries (4 HICs, 2 MICs). Cross-country comparison by income classification and TNA theme allowed for examination of challenges or limitations in usage of the original, adapted, or translated TNA tool version, and how these were addressed by the investigators. According to Gaspard and Yang [ 29 ], how a healthcare professional determines which tasks are essential, and how they perceive their actual performance of that task, may be influenced by several factors. For instance, motivation for continuous learning, a special interest in a particular task, a specific education deficit, and satisfaction or not with unit management. This limitation is addressed by allowing for two ranking systems - where employers also rank employees - to cross-check motivation and establish the need. For example, to determine NP training that would satisfy NHS trust aims, a full training needs analysis of nurses and their immediate supervisors was carried out [ 34 ]. The nurses completed the analysis with their own perceptions of training needs, while their managers completed it on behalf of the identified nurse. The resulting mutually agreed training program enhanced understanding of both parties’ agendas and could be achieved with minimum conflict [ 8 , 33 , 34 , 46 ]. For Greek nurses in rural PHC settings, appropriate training activities, along with organizational changes, had potentially equal impact on short-term staff development and long-term strategic planning programs [ 46 ].

Literature heat map – TNA tool use by country income level. *Income country classification by World Bank [ 23 ]

Reported flaws or limitations of the original or adapted/translated TNA tool included: a) small-scale study [ 8 , 26 , 37 , 40 , 42 , 45 , 46 ]; b) polling only one organization, or specific unit [ 26 , 29 , 37 , 42 , 49 ]; c) not surveying employers or stakeholders [ 28 , 29 , 48 , 51 ]; d) low participation or item completion rates [ 34 , 38 , 45 , 46 , 53 ]; e) lack of consensus at a national level regarding training content [ 45 ]; and f) focus on individual and team assessment, rather than organizational [ 25 , 39 ]. Last, one study included only 10 out of the 30 original TNA items, with the rest of items being newly introduced [ 50 ], which exceeds the developers’ threshold for psychometrics modification [ 14 ]. Furthermore, some investigators recommended further studies to explore TNA’s: a) applicability in a wider healthcare system, b) feasibility as a large-scale survey instrument in secondary and tertiary care settings, and c) usability for collaborative activities, especially through global information technology network teaching programs [ 34 , 45 , 48 ].

The main advantage of the TNA instrument is the accompanying detailed instruction manual, made available by the developers through the WHO Workforce Alliance website [ 14 ]. According to this manual, the standard 30-item questionnaire can be tailored to a particular study focus. Up to 8 of the original items can be changed or omitted, and up to 10 new items can be added. To this direction, the developers have included an example of how to adjust the questionnaire ([ 14 ], p.21-25). The additional items are to be devised according to an accepted psychometric process for developing questionnaires. For example, a literature review, focus group and interview with relevant personnel should be conducted, with the information distilled into themes, using an approved data-reduction method, such as the Thematic Network Analysis [ 55 ]. This provides the core areas from which tailored items are to be constructed. Coverage of the themes (and subsequent items) should be comprehensive and appropriate. These themes will form the basis for new items, which should be in a format similar to that of the standard questionnaire. Modified questionnaires should be piloted with a small sample. The manual includes additional item banks that have been used in other studies, grouped as follows: “Extended nursing role” , “Nurse prescribing” , “Specialist care”, “Child abuse / child protection”, and “Management” ([ 14 ], p.50-55). This item bank allows for easy tailoring to an investigator’s aim and unique context.

Global impact in continuous professional development

Regardless of country and profession surveyed, the tool consistently revealed the perceived and assumed training needs, clarified roles, and facilitated CPD at the individual or team level. Sampled literature revealed that there were no universal trends in training needs according to locus of practice, and that training requirements were specific to the actual role performed within an organizational environment. For example, Hicks & Tyler [ 38 ] and Hicks & Fide [ 39 ] demonstrated that a more targeted, less costly, training program would be optimum, upon surveying the roles and training needs of family planning nurses and breast care nurses in the UK. Organizational factors were shown to determine the occupational profile and training needs of nurses in primary and secondary care across Australia, UK, and the USA [ 8 , 30 , 36 ]. Similarly, most surveyed caregivers in five European countries declared a need for training in the psychosocial aspects of caregiving [ 50 ]. Yet, when dealing with stress, caregivers from Italy and Greece had lower needs than those from Poland, UK, and Turkey. Despite the socio-economic differences among countries, all participants faced increasing demands from caregiver burden [ 50 ]. For employees in the Nigerian health insurance industry, addressing the gaps through an on-the-job training course was deemed to be the optimum approach [ 25 ]. For each country seeking to minimize economic impact and streamline processes, the TNA tool provided an affordable, standardized approach to prioritize and implement an effective CPD program.

Several other studies concurred on the urgent need for flexible and tailored CPD, as an outcome of a comprehensive TNA analysis [ 26 , 33 , 40 , 44 , 46 , 52 , 53 , 54 ]. Especially in middle-income and low-income countries, such as Saint Lucia, South Africa and Sudan, strengthening university-level education for nurses and other healthcare professionals was a key recommendation for evidence-based decision making [ 29 , 51 , 54 ]. In the case of Indonesia, the introduction of TNA in a series of studies, carried out by Hennessy and colleagues [ 31 , 32 , 33 ], motivated several junior nurse researchers to pursue and study CPD, as reflected in multiple references of the instrument. Given the prevailing budget constraints and limited accessibility to research funds, it was not surprising that training needs in research competences emerged as top priorities across studies conducted in MICs and LICs. In Turkey, building research capacity among public health professionals to tackle prevailing non-communicable diseases, was seen as a national priority [ 42 ]. Following identification of several individual, team and organizational barriers, a comprehensive CPD plan for junior researchers, and a QI plan for governmental institutions were recommended. This latter plan provides a roadmap for addressing the lack of coordination between institutions and researchers, establishing research monitoring and evaluation, and strengthening routine health information systems. Similarly, in Sudan, the top QI priority for university faculty of Dentistry was research, followed by leadership, health professions management, community engagement, and teaching skills [ 54 ]. As demonstrated in a UK study, raising the ability of NHS organizations to use research and generate knowledge was tied to improved services and population health [ 27 ]. The above findings support the argument for research capacity as an essential component of PHC nursing [ 56 ]. Moreover, findings show the critical need for operational integration of standardized QI processes across units or institutions in order to close the gap between theory and practice [ 57 ]. Hence, implementation of a regionally based CPD and QI program, stemming from TNA application, could be the solution to a healthcare system in need of reform.

Strengths and limitations

Integrative reviews allow for the combination of diverse methodologies (i.e., experimental and non-experimental research) in order to more fully understand a phenomenon of concern [ 58 ]. By combining data from the theoretical as well as empirical literature, this review could potentially impact evidence-based practice for nursing and other healthcare professions. The ongoing worldwide interest in the Hennessy-Hicks TNA instrument and manual has been a strong incentive for this review. Following personal communication with the developers, they confirmed receipt of many email enquiries, estimated around 100, from around the world asking for permission or clarification about using the tool and informing about outcomes. Unfortunately, there is no cumulative record of requests during the past 25 years. This lack of usage data and repository was further compounded by inability to obtain webpage metrics (i.e. ‘hits’ and ‘downloads’) due to the hosting Global Health Workforce Alliance (GHWA) webpage no longer being maintained [ 14 ]. Therefore, no information was available on who has been using the tool nor who is resourcing the archived tool on the GHWA website.

This review was based on an extensive search of four major electronic databases and a targeted manual search of grey literature and cross-listed references. The selected databases (PubMed, CINAHL, Scopus, and Google Scholar) capture a variety of international journals in the nursing, social sciences, and biomedical literature, with relevant hand-searched theses and dissertations also included. All articles were independently reviewed and appraised, using an adapted hierarchy scale for level of evidence [ 26 , 27 ]. The main limitation stems from the exclusion of any relevant literature published in languages other than English. According to the developers, TNA has been translated into many other languages, including Arabic and Chinese, but there was scarce evidence published in the English literature. Upon appraisal, variation in criteria application, along with cross-country cultural and linguistic variations are also acknowledged. Last, World Bank rankings [ 23 ] were based on the 2020 index rather than the year when the study was conducted. Because of the relatively small sample size ( n  = 33), the investigators combined the “low-middle income countries” with the “upper-middle income countries” categories under “middle-income countries” (MIC).

Implications

The TNA instrument allows for triangulation of a) assessment (identifying and triaging needs); b) needs (gap between what exists and what is required); and c) training (acquiring knowledge, skills or change attitude). Our literature review synthesized the reported use and value of the Hennessey-Hicks TNA tool across settings, populations, and countries, identified the enablers and barriers to its use, and distilled best practice CPD recommendations. Viewed from the KTA Framework perspective, our findings explain how the scholarship of discovery (TNA tool development, psychometrics of adapted or translated versions) leads to the scholarship of integration (translation and cultural adaptation of TNA), and ultimately to scholarship of application (using different versions of the tool across various settings, populations, or countries). As knowledge moves through each stage, it becomes more synthesized and therefore, useful to end-users. Hence, for healthcare professionals, CE should be based on the best available knowledge, the use of effective educational strategies, and the planned action theories to understand and influence change in practice settings [ 17 ]. A recent metasynthesis of CPD literature highlights nurses’ belief in CPD, as fundamental to professionalism and lifelong learning, and its importance in improving patient care standards [ 59 ]. Yet, it shows a disconnect between nurses’ CPD needs and expectations with the organizations’ approaches to professional development. The authors conclude that access to CPD should be made more attainable, realistic and relevant [ 59 ]. By translating TNA evidence into action, health policy makers, administrators, and educators can effectively design appropriate, cost-effective CPD programs with clear priorities to achieve the desirable knowledge, skills and practice, tailored to local needs.

There is also a high level of fit between the adopted KTA Framework and the affiliated WHOCC’s Terms of Reference. Completion of this review coincided with the start of a project by the Registered Nurses Association of Ontario, aiming to develop a repository of measurement tools that can be mapped to the KTA Framework, and to report on their pragmatic and psychometric properties. Given that the TNA measurement tool has been identified as mappable to the KTA framework, the potential synergy between the two groups is promising. Moreover, our findings are aligned with WHO recommendations based on the “Framework for Action on Interprofessional Education and Collaborative Practice” [ 24 ]. These call for health policy makers to systematically address training needs of the healthcare workforce in order to strengthen IPE and collaborative practice. As tasked by the Pan American Health Organization (PAHO), the affiliated WHOCC aims to enhance the use and dissemination of knowledge resources that build capacity and leadership for nurse and midwife educators. Hence, lessons learned will be used to promote TNA tool application and integration for individual, team/IPE, and organizational improvement across the PAHO region (North/Central/South America and the Caribbean). These steps are both timely and relevant for evaluating training and competency, and for regulating nursing practice in the Americas [ 15 ] during the post-pandemic era.

Since its development in 1996, the TNA instrument has been widely used as a clinical practice and educational quality improvement tool across continents. Translation, cultural adaptation, and psychometric testing within a variety of settings, populations, and countries consistently reveal training gaps along the individual, team/interprofessional, and organizational themes. It is not only applied to identify training needs and demographic trends, but also to prioritize targeted training strategies and CPD programs. Furthermore, it facilitates triaging and allocating limited educational resources, especially in low and middle-income countries. These findings underscore the tool’s effectiveness in addressing the “know-do” gap in global human resources for health by translating knowledge into action.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Abbreviations

Continuing Education

Continuous Professional Development

High Income Countries

• Interprofessional

Inter-Professional Education

Knowledge to Action

Low Income Countries

Middle Income Countries

National Health System

Nurse Practitioner

Primary Health Care

Quality Improvement

Pan American Health Organization

Training Needs Analysis

World Health Organization

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Acknowledgements

We would like to thank the TNA tool developers, Drs. Deborah Hennessy and Carolyn Hicks, for their input, unwavering support, and strong commitment to sharing their knowledge and expertise with the international community. Also, our appreciation to Dr. Silvia Cassiani, PAHO Regional Officer; Dr. Erica Wheeler, PAHO representative; and the WHO Health Workforce Department representatives for providing helpful background information and connection with stakeholders.

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AM; concept design, synthesis and interpretation of data, drafting and revision of manuscript. SM; data extraction, appraisal and synthesis, drafting of manuscript. RB; literature search, drafting of manuscript. LT; data extraction and synthesis, drafting of manuscript. All authors reviewed and approved the final manuscript.

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Markaki, A., Malhotra, S., Billings, R. et al. Training needs assessment: tool utilization and global impact. BMC Med Educ 21 , 310 (2021). https://doi.org/10.1186/s12909-021-02748-y

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Training needs analysis. A literature review and reappraisal

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How to Conduct a Training Needs Analysis (with examples)

A training needs analysis is a key tool for HR professionals. It helps you establish what areas of L&D you need to focus on in order to improve the skills, knowledge, and abilities of your employees. With the data you acquire, you can build a solid foundation for developing successful training programs that help your company grow and develop. And these programs are more important than ever in our current climate. Training and reskilling your employees has become an essential tool that can help companies emerge stronger from the COVID-19 crisis.

What is a “TNA” (Training Needs Analysis)

Why do a training needs analysis, how do you conduct a training needs analysis best practices, training needs analysis template: an example of the tna process.

• Software for Performance Reviews ✅

In this article, we will discuss how to do a training needs analysis, and why training needs analysis is necessary for companies to succeed. We will also break down the various steps involved in a typical TNA process to help you implement a program that addresses the true needs of your organization.

A training needs analysis (TNA), also known as a training needs assessment, is a process that organizations use to determine the gap between the current and desired knowledge, skills, and abilities of employees.

The information you gather during a training needs analysis helps you get a bird’s eye view of your company and determine which areas of learning and development you need to focus on in order to improve overall performance. In other words, the process enables you to identify the knowledge, skills, and abilities your employees are currently lacking in relation to your goals as a company. You can then use this information to design an effective development plan for employees .

An effective TNA addresses questions such as:

• Which employees need training?
• What kind of training do they require?
• How can you design an effective training program for them?
• What will be the impact of training be on employee performance?
• What level of investment and resources will be required to implement an effective training program?

Now that we’ve addressed the question “what is organizational analysis in training need assessment?”, let’s look at some of the benefits of implementing a process for analyzing your current and future training needs:

• Identify gaps : A training needs analysis can help you determine if your company has any organizational issues that are caused by a lack of skills, knowledge and abilities. Plus, focusing on both training and analysis can help you identify these issues before they become a problem and have a negative impact on your business
• Plan . Conducting a training needs assessment can help you plan your employee training programs for the year in advance so that you can align them with business activities and budgets.
• Get creative . TNA process in HRM can help you think outside the box and highlight training areas you may not have considered before.
• Target the right people . TNA in HRM can also help you target the right people for each training session, helping you design personalized L&D programs and workplace mentorships that keep employees engaged and motivated to learn.

Before we share an example of the TNA process to help you create your own, let’s take a look at a few tips and best practices to keep in mind.

• Use workplace profiles to map out what knowledge and skills workers needed to fulfill the responsibilities of their specific roles.
• Search for performance gaps between current performance and where you would like to be.
• Ask employees for feedback and suggestions. What are their own personal desired learning objectives? What skills would help them perform better? What’s preventing them from performing better now?
• Don’t forget to consider compliance needs during your TNA, especially in terms of training materials. Make sure any training you offer is in compliance with federal, state, and local laws.
• Don’t just consider where you are now. Make sure you take into account your company’s goals for the next year, too.
• The best TNA doesn’t just address skill gaps in your workforce. It should also focus on enhancing existing skills in order to improve performance levels.
• Focus on majority goals. This includes prioritizing new skills that will benefit the whole teams rather than specialized skills that focus on one or two employees. This is especially true if you have a limited budget. These skills will probably have a bigger impact on your business as a whole and your success during the year ahead.

Let’s finish by looking at a training needs analysis example.

For your training needs analysis to be effective, you need to break your training needs analysis process model down into four key stages.

The best way to ensure you cover all bases is to use a training needs analysis template (also known as a training needs assessment template). This will serve as a handy checklist that helps you stay organized so that you can get the most from your L&D initiatives.

Take a look at the following example of what you should be including in each of the four key stages.

Define Your Organizational Goals

The first step, before you conduct your employee needs analysis, is defining your organizational goals. What do you hope to get from the process? You should obviously focus on measurable outcomes like financial performance, revenue, profit, and share price. However, you should also consider softer outcomes like customer satisfaction and organizational culture .

A great place to start is by asking yourself the following questions:

What is your organization trying to achieve in terms of overall objectives? Which of your organizational goals require the biggest change in employee behavior? Are any of your departments lagging considerably behind others in terms of goal progress? What about individual performance goals – are there any areas of concern stopping you from achieving your organizational goals?

Identify Specific Issues

The next step is matching your organizational goals with specific issues in your company. This involves observation and assessment. The best way to do this is to get your departmental managers involved. Get them to hold interviews and conduct employee surveys to help them identify areas of concern in terms of L&D. A training needs assessment questionnaire can be a great tool. It can help you find out what areas your employees feel they need more training, support, and resources.

You should also evaluate as much data as you can to establish if there are any common issues that training can address. Your HR records are probably full of valuable information. Look at your exit interviews and performance evaluations to see if you can spot any patterns or trends.

Define the Required Knowledge & Skills

The third step in the process is defining the specific skills you need to get where you want to be. The more specific you can be here, the more effective your training programs will be. And with the right training, you’ll nurture the behavior you want to see and hit your goals in the future.

Remember that not everyone will need the same training. Your finance department will obviously need a very different set of skills, knowledge, and abilities than your sales team. Make sure you identify specific needs for each individual in your company, or at least at a departmental level.

Set Training Timelines and Priorities

The final stage is to develop your training program. Aside from training content, you also need to set training timelines and establish your priorities in line with your budget.

What are your goals and how quickly do you need to get there? What format will you use to provide training? And how will you monitor the effectiveness of your L&D programs to ensure the training you provide is helping you reach your organizational goals?

There are a number of techniques you can use to keep track of the progress of your employees. You can use more traditional organizational surveys and interviews, or more advanced analytical techniques such as data mining.

If you’re just starting out, then the best tip here is to keep it simple. Use an Excel spreadsheet such as Factorial’s free skills matrix template to see how your team members have developed, assess their level of interest in learning particular skillsets, and compare learned competencies with overall objectives. This is the best way to monitor how effective your training is and whether your training needs analysis is helping you reach your goals.

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Research on the Dilemma and Strategy of Training Applied Talents in UAV Specialty

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Ren, M., Wang, B., Tian, Y. (2024). Research on the Dilemma and Strategy of Training Applied Talents in UAV Specialty. In: Qu, Y., Gu, M., Niu, Y., Fu, W. (eds) Proceedings of 3rd 2023 International Conference on Autonomous Unmanned Systems (3rd ICAUS 2023). ICAUS 2023. Lecture Notes in Electrical Engineering, vol 1173. Springer, Singapore. https://doi.org/10.1007/978-981-97-1087-4_3

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Budget 2024 Fairness for every generation

The 2024 federal budget is the government’s plan to build more homes, faster, help make life cost less, and grow the economy in a way that helps every generation get ahead.

How our economic plan can help you

Buy or rent a home.

We’re turbocharging the construction of homes across the country, and protecting the rights of renters, first-time buyers, and homeowners.

Tax-free First Home Savings Account

Over 750,000 Canadians have opened an account to save for their first down payment, and save faster with the help of tax relief.

Protecting Renters’ Rights

Our new Canadian Renters’ Bill of Rights will protect renters from unfair practices, make leases simpler, and increase price transparency.

Enhancing the Canadian Mortgage Charter

The Canadian Mortgage Charter is helping to protect homeowners who are struggling with rising mortgage payments. We are enhancing it to make it easier for younger Canadians to buy their first home, by making sure renters get credit for their rent payments and allowing up to 30-year mortgage amortizations on new builds for first-time home buyers.

Raise your family

Transforming Canada’s social safety net to help young parents with the cost of raising a family.

National School Food Program

A new National School Food Program will ensure that children have the nutritious meals they need to succeed and get a fair start in life.

More $10-a-day Child Care Spaces

We’re on track to securing Canada-wide $10-a-day child care in every province and territory by 2026, and fees have already been cut by 50 per cent everywhere, saving families thousands of dollars. We’re building more spaces and training more early childhood educators to ensure every family can access affordable child care.

Dental Care for Canadians Who Need It

The Canadian Dental Care Plan is already rolling out for uninsured Canadians with a family income of less than $90,000, to ensure everyone can afford the dental care they deserve. By 2025, nine million Canadians will be covered.

Get a good-paying job

Creating new opportunities for younger Canadians to get the education and skills they need for good-paying jobs.

Increasing Interest-Free Student Loans

Increasing Canada Student and Apprentice Loans and Grants, because everyone who wants to go to school should have the support they need to cover the costs.

More Work Experience and Skills Training for Youth

Helping young Canadians develop the skills and gain the work experience they need to achieve their dreams and get a good-paying job.

Canadian Apprenticeship Strategy

Supporting skilled trades workers by tooling up training programs and creating more apprenticeship positions to ensure young apprentices succeed.

Afford everyday essentials

Helping Canadians keep more of their money and build a better life by stabilizing the cost of everyday essentials.

Stabilizing the Cost of Groceries

Enhancing competition and monitoring grocers’ work to help stabilize prices, and lowering costs for the farmers who grow our food.

National Pharmacare Program

New programs to help with the cost of going to the dentist and pharmacy, including the cost of contraceptives and insulin, will further ease the financial burden on Canadians.

Cheaper Internet, Home Phone, and Cell Phone Plans

Lowering costs of plans, reducing junk fees, and giving Canadians more choice to switch providers and find better deals.

Retire safely and securely

After a lifetime of working hard—Canadians deserve to know they will be secure and comfortable in retirement.

A Stronger Canada Pension Plan

Enhancing the CPP to increase pension benefits by up to 50 per cent.

Supporting Long-Term Care

Advancing the Safe Long Term Care Act to support new national long-term care standards.

Bigger Benefits for Seniors

Increased Old Age Security and Guaranteed Income Supplement ensures seniors have the financial support they need in retirement.

Budget 2024 highlights

750,000+ Tax-Free First Home Savings Accounts opened by Canadians

Solving the Housing Crisis: Canada’s Housing Plan

Unlocking 3.87 million net new homes by 2031, to ensure everyone can find an affordable place to call home. And, we’re making it easier to rent while saving for that first home.

• Changing how we build homes
• Unlocking 250,000 new homes on public lands
• The strengthened Canadian Mortgage Charter

Learn more about making homes more affordable .

Fairness for younger generations

The government is helping restore fairness for Millennials and Gen Z by making education, housing, and the everyday costs of living more affordable.

• Increasing student grants and loans to keep up with the costs of an education
• Launching a new Youth Mental Health Fund for access to support they need
• Providing job placement and employment support opportunities through the Youth Employment and Skills Strategy

90,000 new job opportunities for youth

Investing $2.4 billion to secure Canada’s AI advantage

Economic growth and productivity

Budget 2024 makes investments in innovation, growth, and increased productivity in Canada.

Budget 2024 includes new measures to accelerate job growth in Canada’s AI sector and beyond, boost productivity by helping researchers and businesses develop and adopt AI, and ensure this is done responsibly.

• Investing in Canada’s AI ecosystem
• Enhancing research support with $1.8 billion more in core research grant funding
• Creating the Canadian Entrepreneurs’ Incentive

Learn more about the government’s plan to enhance innovation and productivity in Canada .

Unlocking 3.87 million new homes by 2031.

Over 1.1 million more Canadians employed today than before the pandemic.

Affordable child care is supporting a record high 85.4% labour force participation rate for working aged women.

Economic and Fiscal Overview

The state of canada’s economy.

The Canadian economy is outperforming expectations. Both the IMF and the OECD project Canada to see the strongest economic growth in the G7 in 2025. In the face of higher interest rates, Canada has avoided the recession that some had predicted. Headline inflation has fallen significantly from its June 2022 peak of 8.1 per cent to 2.8 per cent in February 2024.

Chart 6 Consumer Price Inflation Outlook

Note: Last data point is 2024Q4.

Sources: Statistics Canada; Department of Finance Canada March 2024 survey of private sector economists.

Economic and Fiscal Projections

We’re asking the wealthiest to pay a bit more, their fair share, to keep taxes lower on the middle class, and ensure the next generation inherits not more debt, but Canada’s prosperity.

Budget 2024 is investing in fairness for every generation while delivering on our fiscal objectives. Canada is maintaining the lowest net debt- and deficit-to-GDP ratios in the G7, preserving Canada’s long-term fiscal sustainability.

Chart 21 Federal Debt-to-GDP Ratio Under Economic Scenarios

Sources: Department of Finance Canada March 2024 survey of private sector economists; Department of Finance Canada calculations.

Improving Tax Fairness for Every Generation

Tax fairness is important for every generation, and it is particularly significant for younger Canadians.

To make the tax system more fair for 99.87 per cent of Canadians, the inclusion rate for capital gains—the portion on which tax is paid—for the wealthiest with more than $250,000 in capital gains in a year will increase from one-half to two-thirds. Only 0.13 per cent of Canadians with an average income of $1.42 million are expected to pay more personal income tax on their capital gains in any given year.

Principal residences will continue to be exempt from capital gains.

Chart 8.4 Canada Has the Lowest Marginal Effective Tax Rate in the G7

Backgrounders

• Key Measures (available in non-official languages)
• Key Measures
• More Affordable Homes
• A Stronger Social Safety Net
• Fairness for Younger Generations
• Economic Growth and Productivity
• Growing Small Businesses
• Safer, Healthier Communities
• A Fair Future for Indigenous Peoples
• Tax Fairness for Every Generation
• The New Canadian Entrepreneurs' Incentive

Related documents

• News Release
• Address by the Deputy Prime Minister and Minister of Finance
• Canada’s Consumer-Driven Banking Framework
• Statement and Impacts Report on Gender, Diversity, and Inclusion
• Legislative Measures
• Tax Measures: Supplementary Information

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