Safety Survival Skills
The Development of Computer Based Safety Training
at the Centers for Disease Control and Prevention
Richard
J. Green & Robert H. Hill, Jr.
Office of Health and Safety
Centers for Disease Control and
Prevention
1600 Clifton Rd., A17
Atlanta, GA 30333
Abstract
Today’s biomedical laboratories are quite
different from those of ten years ago and vastly different from those of twenty
years ago. New chemicals, new microbes,
new technologies, and new attitudes have all contributed to produce a workplace
where safe practices and procedures must be followed to assure the safety of all.
However, providing relevant, interesting and effective safety training to
workers is a tremendous challenge. This
session provides a look at the development and application of “Safety Survival
Skills”, a basic safety orientation course, which was developed at the Centers
for Disease Control and Prevention
(CDC) to ensure that all workers (laboratorians and non-laboratorians)
receive basic safety information relevant to their job functions at CDC.
Introduction
How many of us have ever received
comprehensive job-specific safety training?
More importantly, how many of us are ever required to review and update
this essential training? All too often,
we are ushered into the new worksite without mention of resident safety
procedures, because it is assumed that we “come equipped” with information
about the specific hazards we are likely to encounter. This can be a big mistake, because failure
to train and/or adequately train continue to be among the most frequent grounds
for citation by the Occupational Safety and Health Administration (OSHA). Employers, and more importantly, supervisors
can never assume that their workers share their beliefs about safety unless the
supervisor takes an active role in seeing that the worker is properly trained.
Few of us have firsthand accident
experience, but when we walk into any laboratory we are likely to note even the
most basic safety guidelines being ignored.
Specifically, doors are left open, protective gloves and eyewear are not
being used, and lab coats are unbuttoned, if worn at all! Why is it that people ignore basic safety
guidelines designed to protect them?
One factor is that most workers feel (as
evidenced by grumbling and poor attendance at safety classes) safety is such a
simple and intuitive thing that “everyone” will know what to do if an accident
occurs. Also, there is denial (or
ignorance?), as evidenced by the often repeated “it’s not going to happen to
me” remarks voiced to safety trainers.
The longer workers perform the same tasks, the more routine the tasks
become, and perceived “mastery of the obvious” breeds disregard for the
possibility of hazard. Experienced and
familiar workers tend to become complacent, overlook the risks, take shortcuts,
and assume that they are performing in a safe manner when the exact opposite
might be true.
The behavior of the supervisor plays a big
role in establishing the overall “safety climate”. If the supervisor never wears personal protective equipment when
working in the lab and never enforces these practices with others, then why
should we expect others working in the lab to do any differently? As you might imagine, age and gender also
play a role. Those most likely to adhere to safety procedures
and practice “defensive safety habits” are more likely to be female and
“seasoned” employees, while those least likely to adhere to safety procedures
and likely to take excessive risks are “young” and male (Gershon, 1995).
We should all step back from our daily
routine, look beyond our personal biases, and consider the consequences of “what if it happened to me?” or, “Do my
co-workers and I have the necessary training under these circumstances?” Training has become a complex issue with
many factors (e.g. regulatory changes, accident statistics, personal agendas,
work schedules, costs, perceived needs, and time constraints) impacting its
implementation and the overall safety culture of the organization.
Background
At
the Centers for Disease Control and Prevention (CDC), a decision was made
several years ago to change the organization’s safety culture. Several near misses, combined with
increasing numbers of students, visiting scientists, and contractors, led to a
policy, the “CDC/ATSDR Workforce Safety Training Policy”, that now requires all
new workers at CDC to attend a basic safety orientation before beginning work. This
policy has been endorsed by the CDC Director, conveyed to all Centers,
Institutes, and Offices (CIO’s) by the Office of Health and Safety (OHS), and contains
several important features. To view the policy and a memo of endorsement from
the CDC Director, go to http://www.cdc.gov/od/ohs/ and select Safety Survival
Skills.
1. All CIO’s must participate;
2. All new employees are required to either
attend an introductory safety class entitled “Safety Survival Skills, Part I,
General Responsibilities”, or read the Part I safety manual, or take “Safety
Survival Skills” on the CDC intranet within thirty days of starting work at
CDC;
3. All new employees must receive site-specific
safety instruction before beginning work;
4. All supervisors must ensure that their
employees understand the training policy and CDC safety practices;
5. All employees must complete a “Safety
Checklist” (specific for lab and non-lab areas) with their supervisors, and
6. All supervisors and workers, working in a
“hazardous” work environment (laboratory, wood shop etc.) must have a
“critical” safety element in their work plan for annual evaluation.
The
“key” to the current level of acceptance for this program has been the
corporate buy-in from top-level CDC management which values the Office of
Health and Safety as a group of dedicated and effective professionals. However,
this has not always been the case. As
recently as the early seventies, the Centers for Disease Control had a “Safety
Office” comprised of three people covering everything from radiation safety to
lab safety. At that time, office safety
was of minor importance, ergonomics wasn’t even thought of, and training was offered
infrequently. In spite of the magnitude
of its responsibilities and the tasks to be accomplished, this early group
remained largely invisible to the majority of CDC employees until a 1978
wake-up call which led to the first change in CDC safety culture. Specifically, two employee deaths from Rocky
Mountain Spotted Fever resulted in the decision to overhaul the “Safety
Office”, form the “Office of Biosafety”, reorganize, and commence the
comprehensive process of increasing the “Office of Biosafety’s” expertise. During the next twenty years, the Office of
Biosafety evolved into the current Office of Health and Safety with distinct
branches focused on laboratory safety, radiation safety, industrial hygiene, environmental
protection, physical safety, employee health, and safety training. Today, the
on-going commitment of top management has provided a staff of more than forty
to serve approximately nine thousand government employees and another eight
thousand contractors, students, visiting scientists and others distributed
throughout the U.S. and around the world.
Development
of “Safety Survival Skills”
“Safety
Survival Skills” (S3) began its evolution with the hiring of a full-time safety
trainer and training assistant in the late 80’s. Individually taught classes on
topics ranging from general employee responsibilities to bloodborne pathogens, each one hour in length,
were slowly combined into three highly interactive classroom modules ranging
from three hours (laboratory safety) to two hours (general responsibilities and
supervisory responsibilities). Each course makes use of high quality visuals
and is designed around personal experience, stories, and group discussions of
actual incidents, mostly at CDC.
Comprehensive
training manuals have accompanied the evolving nature of the didactic classroom
sessions, and presently serve as stand-alone modules themselves. Each contains
a comprehensive exam and is written in a procedural and reference guide format,
to answer questions such as, “What do I
do in this situation?” and “Who can I
call to get the answer?” Each also includes brief descriptions of actual
CDC incidents to show workers that accidents really happen to people just like
them. The manuals have been extensively
reviewed and are continually updated with the help of the OHS staff and
Occupational Health and Safety Committee members. To see copies of the manuals,
go to http://www.cdc.gov/od/ohs/ and select Safety Survival Skills.
The contents of each manual are:
n Part I, General responsibilities
-
Regulatory Mandates and Responsibilities
-
Overview of the Office of Health and Safety
-
CDC Safety Guidelines
-
Appendices (e.g. OSH Act, Safety Training Policy, OHS Directory, Injury
Reporting)
n Part II, Laboratory Safety
-
Laboratory Hazards
-
Basic Biosafety
-
Basic Chemical Safety
- Appendices (e.g. Waste Disposal
Chart, hazardous waste forms, packaging/ shipping, Clinic services)
n Part III, Supervisory Responsibilities
- Responsibilities (e.g. general safety,
hazard communication, office safety, safety training)
-
Appendices (e.g. Safety Training Policy, Ergonomics Policy, Corridor Policy, Incident Report Form, Employee Assistance Program)
Reaction
to “Safety Survival Skills” classroom sessions and manuals has been
overwhelmingly positive. Students often state an appreciation for the
forthright sharing of actual incidents to emphasize the importance of
safety. Additionally, students often
express surprise following roundtable discussions that others actually had
ideas different from theirs about the safe way to perform work. In its present
form, these courses and manuals do a good job of providing workers with
practical information which they can use immediately on the job, and in
preparing them to take more in-depth classes (e.g. bloodborne pathogens and
radiation safety).
Movement
of “Safety Survival Skills” Into the Computer Age
Prior
to the development of the Safety Survival Skills courses, a good year saw
approximately 1,000 workers trained. With the development of S3 and the
implementation of the Workforce Safety Training Policy, the numbers have
doubled on average to roughly 2,500. Although this sounds good, in reality, the
OHS Safety Training Activity (Training Manager and Assistant) were falling
farther behind the curve. The CDC community grew from approximately 5,000
workers in the early 80’s to more than 17,000 today. In addition, many of these
new hires were foreign Nationals and contractors with little or no safety
training, and spread out over twelve locations within the U.S. and many more
around the world. As the numbers grew, we found ourselves continually in the
classroom and constantly on the phone being told that the courses were too long
or people did not have the time needed to attend. Classroom training was
rapidly becoming a bleak prospect. It was simply prohibitively expensive to
travel trainers to these many sites or to travel trainees back to Atlanta. In
addition, there was a logistical nightmare brewing when trying to match
training schedules for those in need with the physical availability of trainers
and training facilities.
To
address these developing issues, it was decided to convert Safety Survival Skills
into a computer-based training (CBT) course containing modules for
laboratorians, non-laboratorians, and supervisors. These would then be offered
via the CDC intranet to all connected sites and would provide CDC mandated
training to all CDC worksites at any time that CDC workers chose to take
it. This enterprise was entered into
somewhat naively (we had no prior
experience) with the mantra of doing it better, faster, and in the long run,
cheaper. Unfortunately, the result was to create several major issues in design
and implementation which continue even today.
The
conversion/development of the classroom based S3 into a computer based course
began in 1997 and followed a general contract plan of action which included the
following steps:
1. Write a multimedia contract - submit
thru CDC contract process
-
Develop course outlines of subject material
-
Pull together reference material for contractor
-
Identify subject matter experts (SMEs)
-
Identify CDC IT requirements - 486, Windows, IE access, and sound
-
Decide on budget (75K)
2. Meet with the contractor
-
Explain the vision, need, and purpose
-
Provide content and all resource material
-
Discuss IT requirements and CDC integration
3. Course development
-
Meet weekly with writer/editor
-
Develop content with an idea of repeating material three times
-
Review content for completeness, accuracy and interpretation
-
Beta test course content and test “screens” for:
-
Ease of use
-
Relevancy
-
Interactivity
-
“Fun” factor
4. Course Pre-Implementation
- CDC web integration - bring CDC IT
experts into discussions and educate about product
-
Negotiate IT over-site for problem fixes
-
Talk to CDC LAN administrators about:
-
Software requirements
-
Course features
-
Course access
-
Talk to CIO administrative officers about:
-
Safety training requirements
-
Course contents and features
-
Completion tracking
5. Course Implementation
-
CDC-wide announcements
-
Safety Training Policy requirements
-
Course availability and access
-
Respond to feedback and problems
-
Modify course based on feedback to improve performance
Unfortunately,
the actual development and implementation did not go as smoothly as the above
process might indicate. The most frustrating aspect were issues which arose
that were totally beyond our control. Here are our “Top Ten” problems which had
serious impact on the success of this project:
1. Course
designer quit. Halfway thru the project, the original course
designer/writer/editor quit the contract company for a better job and was not
replaced by the contractor. The affect of this was that this persons duties
were now being performed by someone who had no formal training as a
writer/editor, public health educator, or in computer based training development.
And of course, this new person brought a different philosophy of what should be
done and was backed up by the company project manager. Not only was the general
momentum of course development lost, but text and image files were lost as well
which added increased time to the development.
2. “Bells and whistles” were not
delivered. After the contractor was selected, the contractor and writer/editor
were invited in to present ideas on course development and to show ways of
making the training more exciting. The statement of work for the project stated
that the course was to be highly interactive with lots of visuals, video clips,
sound etc. The contractor demonstrated just that, including the use of a voice
expert to provide narration in multiple dialects to enliven the script. We
indicated that we liked what we saw and heard, and to proceed with development.
What the contractor came back with during the first module review was basic
narration without dialects and primarily a “page-turner“ type course. Yes there
were photos (which we provided) and some drag and drop type exercises, but not
the “glitz” which had us excited at the outset. When pressed as to why there
was no multiple dialect narration, their response was that this was only for
demo and not intended for production. And of course, we could add it for an
additional cost if we really wanted it!
3. Multiple plug-ins were required. The
course was designed to utilize multiple plug-ins to play short video clips, and
to allow drag-and-drop and fill-in-the-blank exercises. Unfortunately, there
was and still is no standard for computer configuration and multimedia
capabilities for computers at CDC. A large proportion of users could not
download the plug-ins and when they tried, were sent out to hyperspace, giving
up in frustration. And to make matters worse, this same contractor had already
developed another course for CDC which suffered from the same problems, but
“neglected” to mention this during our initial meetings.
4. Open registration was allowed. Initially
the log-in would allow anyone to log-in with their user ID and email password.
The problem was that there was no security check to determine if this really
was “the” CDC worker or someone taking the course for someone else. This made
tracking a nightmare, because log-ins were accepted no matter what you typed
and created multiple records for some individuals. The registration process has
since been altered to cross check each course user against the CDC active
directory of paid workers. This creates a unique file for each person which is
then used to generate person specific records and certificates of completion.
5. No simultaneous Netscape/Internet
Explorer (IE) compatibility. The course was designed for access under IE, the
unofficial CDC web browser, but there was also widespread use of Netscape
across CDC. In one case, even though the person had an IE icon on their
desktop, their IT folks had set the default browser to Netscape even when they
selected the IT button!
6. Multiple intranet configurations
existed. CDC consists of 12 Centers with multiple offices, divisions, branches
etc. with one central “Information Resources Management Office”. Each Center
has its own virtually autonomous IT department which led to a variety of
intranet configurations as well as computer configurations - some had speakers
and some did not, some had the latest equipment, and some were working on 286
and 386 computers.
7. Production/design server the same.
Because the production and design server were physically the same “box”, when
changes were made and needed to be implemented, the entire system had to be
brought down.
8.
Cost “+” contract. The contract mechanism was a “cost plus” contract which
meant that the contractor was within their rights to charge for increases in
work and time beyond what was stipulated in the contract. This meant that the
government had to pay for the contractors time in editing the script for typos,
misspellings, and general inaccuracies which we discovered during script review
and beta testing. All of this led to major cost overruns which ballooned the
final cost by an additional 100K. The better solution would have been a “fixed
price” contract in which additional time, corrections, etc. are simply the
contractors responsibility.
9.
No follow-up support. The contractor provided minimal software support after
implementation of the courseware and even had to be asked to create an
instruction manual for the courseware. In addition, the software was written in
an arcane language which was on its way out of common usage by the time the
course hit the CDC web environment. We have subsequently had to dedicate a CDC
contractor to service the myriad of computer language issues as the CDC
workforce uses the software.
10.
Contractor was bought out three times. Fortunately, the contractor project
manager remained the same, but multiple people revolved thru the project each
time this happened leading to more delays, loss of continuity, and of course,
cost overruns.
Thus ended what we like to call “Phase I”
of the implementation with the acceptance of the course by CDC in 1999.
Reaction to this first iteration of the computer course was overwhelmingly
positive although there was never a day without an access or function question
related to S3. As more people have taken the courses, we have been better able
to refine the workings of S3 and give most people a more pleasant experience.
This “better experience” has been reflected in the numbers of workers taking
the courses on-line and will result in an end-of-year total (FY 2002) that is
fast approaching 6,000 workers trained - a three fold increase over previous
years.
What Does
“Safety Survival Skills” Look Like?
To have a look
at several examples of S3 as it presently exists, go to http://www.cdc.gov/od/ohs/,
select Safety Survival Skills and then look at the S3 Screens. Sorry, but we
are unable to provide access to CDCs’ internal intranet for security reasons,
but this will give you a good idea of what a typical CDC worker sees when they
access the course.
Screen 1. Opening screen and security log-in
Screen 2. Welcoming Screen and Self-identifier Screen where a new user
identifies themselves as to
laboratorian, non-laboratorian, supervisor etc.
Screen 3. LSS Site Map which shows the worker what they are required to
take based on the
user information they supplied before.
Screen 4. S3 Main Menu showing the three courses, General Responsibilities,
Labora- tory Safety,
and Supervisory Responsibilities
Screen 5. S3 screens: supervisory responsibilities topics, OHS web page,
typical inter- active page
Screen 6. Laboratory safety module menu
Screen 7. Typical screens from lab standard practices module
Screen 8. Typical screens from biosafety module
Screen 9. Typical screens from chemical safety module
Screen 10. More screens from chemistry module
Screen 11. Typical screens from radiation safety module
As the student goes thru the courseware, they are presented
with screens which they read (there is no narration), screens which ask them
for a variety of answers, screens which ask them to think about their answer
before they see an answer, and screens
which provide an actual scenario to which they must respond. In
addition, there are tests at the end of each module and a final exam for each
course. When the final exam is passed, the
worker is then allowed to print a certificate of completion which must
then be presented to security to receive a permanent picture ID and access card
(again, required under the CDC Workforce Safety Training Policy).
A CBT Solution
for the New Millennium
Unfortunately, as well as things seemed to
be going with this first iteration, we continued to see cracks open from one
problem after another as all of CDC migrated to newer generation computers,
next generation browsers, new servers, and new workers (mostly contractors) who
for security reasons did not have access to the CDC intranet. A new solution
was needed.
The new solution, or Phase II, was already
present at CDC in the form of video and CD-ROM safety training from Coastal
Training Technologies of Virginia Beach, VA. As the frustration level for the
web version of S3 grew, discussions began with Coastal about the conversion of
S3 into their CD-ROM format with full-motion video. We were already utilizing
Coastal videos and their general safety CD-ROMs for training, and felt that the
power of their courseware would allow us to provide a quality product to our
workers. The benefit of the Coastal product was its fully customizable format,
the use of real-life scenarios in the courseware which could be made site
specific in custom courses, and the cost which was reasonable given the more
dynamic nature of the courses. The downside was the proprietary administrator
which made it all work.
The decision was made to institute the
Coastal CBT solution across the board and we again began the contractual
process (fixed cost) with Coastal. We brought together the Coastal architects
and CDC IT people to work out the technical details, and began supplying Coastal
with the necessary reference material for the conversion of S3. We also
contracted for the entire off-the-shelf Coastal safety and health catalogue (30
courses) and for three additional courses: conversion of our didactic radiation
safety course into CBT, development of a biosafety CBT, and the development of
a course on the formaldehyde standard. These courses will all reside on the CDC
intranet and utilize Coastals’ current state of their art incorporating short
video clips into the courseware.
The
entire process has gone more smoothly than before, but it has not been without
fault. Most of our current issues center around integration of the courseware
into the ever evolving CDC computer network. Since the process began in 1997,
all CDC locations around the U.S. (there are 12) have become better connected
to headquarters in Atlanta, and we are nearing total penetration of individual
computer workstations with Windows 2002. We have just completed an upgrade to
our third SQL server and are at present ironing out database setup and
functionality issues across the entire CDC intranet.
We
anticipate our safety training platform to be fully functional by October, 2002
and available to all CDC workers in the continental U.S. Training numbers for
the coming FY (2003) should again show a marked increase in users. Security
will be achieved thru the use of individual user IDs and unique number
identifiers, making the courseware available only to individuals with access to
the CDC intranet.
To see what “Safety Survival Skills” is
evolving into, go to http://demo34.claritynet.com/. Use cdc1 for the log-in and cdc1 for
the password. Select “CDC Radiation Safety” to view our most recently developed
course, but feel free to view any of the other projects which Coastal has under
development.
Top Ten Tips
for Developing Computer Based Training
As mentioned
before, we blindly proceeded into the development and implementation of
computer based training at the Centers for Disease Control and Prevention
expecting that all things would integrate as planned. This, as you now know,
was not the case, but we have gleaned the following ideas which may be helpful
to others when pursuing a similar endeavor.
1. Offer
variety - provide multiple ways of taking the training (computer,
classroom, or booklet based), and allow testing out of the training. In
whatever form the training takes, different types of feedback should be
provided or offered.
2.
Offer incentives - provide a
reason/benefit to taking the training.
3.
Provide follow-up/contact numbers -
absolutely essential for many OSHA training courses.
4. Make
it compatible - establish minimum IT standards and bring your IT
department into the project at the outset of the project.
5. Make
it easy to use - course design should provide an intuitive and
self-explanatory method of interaction. Perform as many Beta tests as needed
BEFORE the official release.
6. Provide
real-life examples - design around real-life experience and scenarios,
ideally ones that have happened to you, the student, or the worksite - someone
or place that the student can identify with.
7. Personalize
it - insert your own photos of your workers and facilities to show the
student you are not talking about hypotheticals.
8.
Make it fun - if it is not fun, they
will leave it very soon.
9. Make
it timely - keep the course updated with new information, photos,
current events etc.
10. Make it relevant - forget the
history lesson! Give them what they need when they
need
it and provide references for background information and further reading.
And
finally,
n Write everything down during the
planning and development phases, no matter how trivial.
n Design your course for the lowest
common denominator. Too many bells and whistles may overpower the message and
diminish the focus.
n Test your course development early and
often.
n Do not rush - get it right BEFORE
release.
n Have a web-master to deal with issues
related with course web integration.
n Be available to answer questions and
respond to problems.
And most importantly, do it all with a
smile!
Enjoy!
Richard J. Green
Centers for Disease Control and
Prevention
Office of Health and Safety
Safety Training Manager
rjg1@cdc.gov
404-639-2145
Robert H. Hill, Jr.
Centers for Disease Control and
Prevention
Office of Health and Safety
Deputy Director
rhh2@cdc.gov
404-639-2345
Disclaimer:
Mention of commercial products or companies does not constitute endorsement by
the U.S. Government or these authors.
References
Centers for Disease Control and
Prevention. OhASIS (Office of Health and Safety Information System) -
www.cdc.gov/od/ohs
Gershon, R. M., and Zirkin, B.G.
Behavioral Factors in Safety Training. In: Laboratory Safety: Principles and
Practices, 2nd ed. American
Society for Microbiology, Washington, D.C., 1995.
The
Occupational Safety and Health Act of 1970, Part 1960 - Basic Elements for
Federal Employee OSH
Programs and Related Matters - www.osha.gov