Summary

Background and objective: Given the failure of handler training programs that focus solely on the “straight back, bent knees” safe lifting technique, a new approach called “Integrated Prevention Strategy for Manual Handling” (IPSMH) was proposed in 2011. Part of its originality lies in the use of nine movement principles that make it possible to understand and analyze the many techniques handlers use as a matter of course in their jobs. The main objective of the present study was to observe a group of Occupational Health and Safety (OHS) practitioners trained in the IPSMH and evaluate to what extent they appropriate this approach and transfer it during interventions in actual workplaces.

Methodology: The study was made up of four complementary, sequential parts. First, an online questionnaire was developed in order to survey the occupational health and safety (OHS) intervention practices of a group (n=104) of practitioners in Québec (Part 1). Next, 28 OHS practitioners were trained in the IPSMH. After the training, several indicators predictive of transfer were evaluated by means of a questionnaire (Part 2). A mixed qualitative methodology involving various data-gathering tools was then used to evaluate the subjects’ appropriation and transfer of the IPSMH during actual workplace interventions related to manual material handling (n=19) over a two-year period (Part 3). Appropriation Indicators and determinants made it possible to evaluate and explain three levels of IPSMH transfer: exemplary, satisfactory or poor. In addition, the use made of the action principles during these interventions was further investigated. On the basis of the results obtained, recommendations were formulated to improve the IPSMH and to train trainers in its correct application (Part 4). 

Principal results: Part 1: The survey revealed that the work of OHS practitioners in Québec consists largely in the preparation and delivery of information and training sessions. The predominant pedagogical approach is the transmission of knowledge; rarely is the learners’ active, contextualized involvement solicited. These practitioners may be considered as OHS training specialists, with more than ten years of experience on average. However, since their job is to offer training on many different topics, they are actually generalists rather than experts in any particular field, such as manual material handling. This information made it possible to adapt the IPSMH training to the reality of OHS practitioners.

Part 2: The predictive indicators evaluated after the training suggest that the training has a high potential for encouraging the transfer of knowledge to the workplace. The trainees perceived the content as useful and said they felt they mastered it well, would be able to apply the skills they had learned, and intended to teach them to workers during future interventions. Their confidence in their personal ability to apply the IPSMH—a strong predictor of transfer—was very high, on average. These results led the research team to check the actual extent of the subjects’ transfer of the training content to the workplace.

Part 3: Of the 28 subjects trained, 16 were observed during a training session, some of them on more than one occasion, for a total of 19 cases studied. The interventions took place in various workplaces and involved manual handling tasks that were highly varied in nature and complexity. The trainees benefiting from the interventions were either production workers (n=13) (the IPSMH target group), company employees responsible for training (n=3) (e.g., supervisors) or other (n=3) (e.g., rehabilitation specialists). For 10 of the 13 sessions provided to handlers, the indicators were evaluated in greater detail and showed excellent appropriation by the practitioners in several respects. However, two cases showed a poor level of appropriation. The greatest differences observed between the IPSMH and the training provided mainly concerned their shorter duration, the rarity of actions to transform work situations and certain aspects of the training structure put in place to stimulate learning. A number of determinants were identified, which greatly explain the differences noted between the IPSMH and the handling training practices in use. The practitioners mainly cited factors related to their own job conditions (e.g., excessive work load) or to the client organization’s situation (budget constraints, etc.) that forced them to adapt the IPSMH to fit the context. The research team was able to identify individual factors, some linked to individual subjects, as well as factors related to the nature of the handling tasks, and to the workers being trained (also mentioned by some of the practitioners). The practitioners applied the action principles as they were taught to do, although some principles tended to be emphasized while others were underused (a fairly strong “postural bias” was noted). Finally, rather than incorporating the proposed changes into the results, the discussion was highlighted here and there in insets describing recommendations for improvements to the IPSMH approach and training (part 4).

Discussion: The results suggest an “emergent” form of appropriation. On the one hand, the practitioners showed a strong ability to appropriate and transfer the training content: their use of the action principles and other concepts was very much in line with the IPSMH, although a few lapses were noted. They made obvious efforts to contextualize the training content, to choose suitable pedagogical tools and to apply strategies for eliciting exchanges among participants in order to create a good dynamic. On the other hand, they are faced with a contradiction between two teaching paradigms: one emphasizing the transmission of theoretical knowledge, the other emphasizing the learners’ active involvement in constructing their own knowledge. Practitioners must therefore make difficult transitions, along with the corresponding compromises: a. from a role as “expert trainer” to a new role as mediator of learning, which touches on their professional identity; b. from strict control over content and delivery, to a certain tolerance for uncertainty while taking into account the normative requirements of training; c. from knowledge-based content to content focusing on motor skills related to job requirements and training topics; d. between the needs of the “requesting client” and those of the “target client” in terms of the training mandate and objectives. These transitions can be destabilizing and can hinder the application of the IPSMH if the practitioners do not feel guided and supported.

Key points:

• Despite the complexity of the IPSMH and the obvious paradigm rupture it involves, most of the OHS practitioners trained in the approach were able to appropriate and transfer it to their day-to-day workplace interventions. The IPSMH is appreciated by all stakeholders.
• There are still divergences between certain IPSMH concepts and conventional practice, some of which are attributable to obstacles that the practitioners try to work around. Such adjustments are unavoidable, for the time being.
• Practitioners trained in the IPSMH are transitioning from their old training practices to the new pedagogical requirements of the IPSMH; the resulting contradictions can be destabilizing and even discouraging if practitioners are not well supported.

Note to readers:

This project is the second phase of a research program comprising three main phases.[1] The first phase of this programming consisted in developing a new approach to handling interventions. A research report, published in 2011 (R-690 in French; R-784 in English), presents this approach, called the Integrated Prevention Strategy for Manual Handling (IPSMH). This approach is detailed, as are its underlying theoretical foundations. In this case, the action principles, which are a large part of the IPSMH’s originality, are described in this report with detailed fact sheets, one for each principle. The reader should keep in mind that the IPSMH constitutes a “training intervention,” i.e., it combines a training activity with an intervention to modify the most restrictive working conditions.

The project covered by this report constitutes the second phase of programming, which consists of training practitioners in the use of IPSMH and verifying how well they are able to appropriate and transfer the information in actual intervention contexts. The idea is to verify if the IPSMH, which constitutes a break with the traditional approach to prevention in handling, can be realistically used by safety practitioners in their mandates to prevent handling accidents and injuries.

A final phase to come, which will complete the programming, will consist in evaluating the impacts of IPSMH in terms of preventing musculoskeletal disorders (MSDs).

No one can claim to promote learning and create the conditions necessary for it if they do not seek to develop, construct and clarify their own personal conception of learning.

[Translation] taken from Les théories de l’apprentissage