It requires placing the desired staff behaviour change within an organisational context that addresses the means by which the current clinical skills are ‘triggered’ and maintained in practice, and how those means need to be redesigned to ensure that the new, desired skills are triggered and maintained.

This requires addressing the means by which ‘the way we do things around here’ is embedded in our paperwork, management conversations and scrutiny and governance systems. As these issues are worked through in designing any ‘up-skilling’ project, it becomes clear that the clinician operates within a web of supporting, enabling and blocking processes that will be critical to ensuring that the path to change in clinical practice and better outcomes for patients/clients is as smooth as possible.

This journey is described in terms of ‘preparation’ prior to any training, the design features of transfer to be incorporated into training and the ‘post-training’ processes for consolidation and maintenance of new skills.