Background: The quality of care for persons with intellectual disabilities (ID) is affected by many factors, including the knowledge of the professionals. Educational training in, for example, general communication was identified as a priority issue among healthcare professionals working with persons with IDs, as it is the basis for a better understanding of the clients and their behavior, which can otherwise be perceived as problematic and challenging. Challenging behaviors (CB) have been reported by professionals as problems they frequently witness or experience and/or struggle to manage in the daily work. Yet they do not always have access to such training nor to the resources needed to practice skillful communication when supporting persons with IDs. In addition, challenges concerning the competence provision in the sector are likely to contribute to further deterioration of the situation.

Earlier research has shown that web-based training for staff within healthcare settings can generate good results. In addition to being able to participate during work hours, staff can also overcome access issues in the delivery of training. With this study, we hope to advance an existing web-based training program with the intention to move toward well-evaluated and proven training in order to contribute to competence provision in the context of health and social care.

Aim: To explore staff experiences with a web-based training program in relation to their professional care for persons with ID and CB. 

Methods: Staff working in residences for people with ID within municipal health and social care were offered the web-based training. In total 20 residences in a medium-size city in Sweden were included in this study. After completed training, fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The informants constituted of 11 women and 3 men, aged 27–55. Of the nine informants who had received upper secondary school education, five had specialized in the care of persons with IDs. More precisely, one informant had received higher vocational education, whereas the remaining four had received university education in the social sciences. The work experience with persons with IDs ranged from 8 to 30 years. The interviews were based on two open -ended questions: “What is your experience of attending the web-based training?” and “What do you think about the web-based training in relation to your daily work with persons with IDs and CB?” Follow-up questions were directed in such a way as to encourage the staff to freely share their experiences. 

This study has an inductive approach. The collected data were analyzed using qualitative content analysis as described by Graneheim and Lundman (2014). 

Results: The staff’s experiences with the web-based training program in relation to their professional care for persons with IDs and CB were presented as a single main theme: “Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with IDs and CB”. This theme contained three categories: “Web-based training provides freedom but also requires responsibility, both of which affect the learning outcome”, “The learning process contributes to generating insights about caring” and “The mutual impact of training and the opinions of staff about learning for the care of persons with IDs and CB”. These categories were based on eight sub-categories.

Overall, the staff claimed that they had gained novel insights into the profession and into the caring process for the clients. Opinions about clients and CB changed somewhat, and the staff was inspired to adopt new ways of working which ultimately benefited interactions with the client. At the same time, requests were made for additional group discussions, and the desire for better planning to enhance learning among the staff was expressed.

Discussion: In this study, web-based training seemed to have had a stimulating effect on workplace learning. Sharing self-reflections with group members in addition to individual study is essential for stimulating and consequently extracting knowledge from training. In the preparation of the training, close attention was paid to how to enable both individuals and social processes in learning but, judging from the results, further developments should focus on optimizing the effect of social interaction.

Additionally, organizational support appears to be relevant for improving learning outcomes. However, prior research has shown significant differences in perceived workplace learning support from different occupational groups. Higher-status occupations offer a workplace environment that is more conducive to learning than that of lower-status occupations.These aspects must be addressed and overcome to fully develop the competence provision and counteract potential negative consequences in terms of job satisfaction and well-being among professionals working with persons with IDs.

Conclusions and clinical implications: Our findings illustrate the complexity of providing staff training in the workplace through a web-based training program. Beyond the benefits of web-based training for workplace learning, some challenges also emerged. We conclude that web-based training, workplace organization, and individuals’ opinions each have an important impact on the learning outcome. To reach the best possible outcome, however, resources need to be invested in all three parts concurrently. This knowledge can contribute to the development of competence provision in municipal health and social care services more generally, where similar circumstances in terms of a notable downward trend in competence provision prevail, a pattern that could have negative impact on the welfare of the professionals.In addition to knowledge, cooperation in both healthcare and social services was also highlighted to improve care for persons with IDs and CB. In order to better meet their needs, professional teamwork is critically important. Hence, future research should investigate the views of other professionals e.g. nurses regarding education and competence development. This approach would enrich our knowledge and understanding of how the competence provision could be enhanced in this context to contribute to social sustainability in the sector.