An-Najah National University 
Faculty of Graduate Studies         

Factors Affecting Transfer of Training within the work 
environment from the perception of workers in 

Palestinian Government Hospitals       

By 
Bashar Ahmed Naji Saleh      

Supervisor 
Dr. Majeed Mansur      

This thesis is submitted in Partial Fulfillment of the Requirements for 
the Degree of Master in Engineering management, Faculty of 
Graduate Studies, An-Najah National University, Nablus, Palestine.  

2011     





iii        

Dedication 

TToo  wwhhoomm  mmyy  lliiffee  iiss  ggiivveenn  aa  ppuurrppoossee  II  wwoouulldd  lliikkee  ttoo  tthhaannkk  AAllllaahh  

aanndd  tthheenn  mmyy  wwoonnddeerrffuull  ffaammiillyy,,  eessppeecciiaallllyy  ttoo  mmyy  lloovviinngg  wwiiffee  

KKeeffaayyaa  wwhhoo  hhaadd  ssaaccrriiffiicceedd  hheerr  ttiimmee  aanndd  ccaarreeeerr  aaccccoommppaannyyiinngg  mmee  

iinn  MMeellbboouurrnnee  ttoo  uunnddeerrttaakkee  mmyy  MMaasstteerr..  HHeerr  eennccoouurraaggeemmeenntt  aanndd  

nneevveerr  eennddiinngg  ffllooww  ooff  mmoorraall  ssuuppppoorrtt  hhaadd  ggiivveenn  mmee  bbaacckk  tthhee  

ccoonnffiiddeennccee  II  ssoo  bbaaddllyy  nneeeeddeedd  bbuutt  hhaadd  lloosstt..  AAllssoo  ttoo  aallll  mmyy  cchhiillddrreenn  

JJaassiimm,,  AAhhmmeedd,,  DDaannaa  aanndd  MMaallaakk ..tthheeyy  aarree  aallll  uunnddeerr  1144  yyeeaarrss  ooff  

aaggee,,  tthheeyy  hhaavveenn tt  ggoott  aannyy  iiddeeaa  wwhhaatt  tthhiiss  ttaasskk  iiss  aallll  aabboouutt  bbuutt  nneevveerr  

ddoouubbtteedd  tthheeiirr  ddaadd  wwiillll  ssuucccceeeedd..  MMyy  pprrooffoouunndd  tthhaannkk  ttoo  mmyy  ppaarreennttss,,  

bbrrootthheerrss  aanndd  ssiisstteerrss  ffoorr  tthheeiirr  nneevveerr  eennddiinngg  eennccoouurraaggeemmeenntt..          



iv        

Acknowledgments 

I am very much thankful to my supervisor, Dr. Majeed Mansour, 

whose encouragement, guidance and support from the initial 

stages of my research to the final level enabled me to develop and 

understand the subject. My thanks and appreciation goes to my 

thesis committee members for their support, interest and valuable 

hints. I acknowledge An-Najah National University for supporting 

this work, and I wish to give my great appreciation to all workers 

in Palestinian hospitals for helping me in filling the study 

questionnaire. Lastly, I offer my regards and blessings to all of 

those who supported me in any respect during the completion of 

this thesis. 



v  

     
:   

Factors Affect Transfer of Training in the work environment 
from the perception of workers in Palestinian Government 

Hospitals in Northern West Bank   

 

  

          

.  

Declaration

 

The work provided in this thesis, unless otherwise referenced, is the 

researcher s own work, and has not been submitted elsewhere for any other 

degree or qualification.  

:   Student's name:

 

: Signature: .. .

: ...

 

Date:   



vi  

Table of Contents 
Page Content No. 

iii Cover page  
iv committee decision  
v Dedication  
Vi Acknowledgement  
vii Declaration  
x Table of Contents  

xii List Of  Table  
1 List of Abbreviations  
2 Abstract  
4 Chapter one: Introduction  
6 Introduction 1.1 
8 Problem Statement  1.2 
10 Importance of the study  1.3 
11 Aims of the study  1.4 
12 Research Questions  1.5 
12 Research Hypotheses 1.6 
12 Research methodology  1.7 
14 Research s sequence 1.8 
14 Study terminology 1.9 
15 Study limitations 1.10 
16 Chapter summary 1.11 
17 Chapter Two Conceptual Framework And Literature Review

  

17 Introduction 2.1 
18 The Training Concept 2.2 
22 Training Outcome 2.3 
25 Training Problems 2.4 
30 Training Transfer 2.5 
31 Evolution of Transfer of Training Concept 2.5.1 
32 Training Transfer Process: 2.6 
33 Factors Affecting Transfer of Training 2.6.1 
33 Training  2.6.2.1 

 

Work Environment: work climate & organization culture 2.6.2.2 
33 Trainees 2.6.2.3 
35 Trainer 2.6.2.4 
36 Training Design 2.6.2.5 
36 Health Sector in Palestine 2.7 
36 Models of Transfer of Training   2.8 
37 Review of Previous Literature 2.9 
37 Arabic & Local Studies 2.9.1 
38 Foreign & International Studies 2.9.2 



vii  

38 Comments On Previous Literature  2.10 
38 Chapter Summary 2.11 
38 Chapter Three Methodology  
39 Introduction 3 
40 Study Design 3.1 
40 Population & Sample Of The Study 3.2 
41 Instrumentation 3.3 
42 Reliability Test  3.3.1 
42 Content validity  3.3.2 
44 Field Work 3.4 
45 Pilot Study 3.5 
47 The Study Fieldwork Procedure 3.6 
48 Statistical Analysis 3.7 
50 Ethical issues 3.8 
52 Chapter Four: Results  
54 introduction: 4.1 
54 Results Related To The First part  4.2 
78 Chapter five Discussion  
79 introduction: 5.1 
79 discussion of the study findings 2.2 
80 Theoretical and practical implications  5.3 
81 Limitations  5.4 
82 Recommendations  
83 References

  

91 Appendixes    

   

   



viii  

List of Tables 

Page Table No. 

34 
Distribution of  the study sample according to the study 
variables 

Table (1) 

34 
Cronbach's coefficient alpha reliability test of the internal 
consistency among the items included in each of the 
formative scales. 

Table (2) 

35 

Mean, standard deviation, and percentages of each item, 
and total score of organization culture factor affecting 
transfer of training within the work environment from the 
perception of Palestinian government hospitals. 

Table (3) 

36 

Mean, standard deviation, and percentages of each item, 
and total score of organization culture factor affecting 
transfer of training within the work environment from the 
perception of Palestinian government hospitals. 

Table (4) 

39 

Mean, standard deviation, and percentages of each item, 
and total score of Training factor affecting transfer of 
training within the work environment from the perception 
of Palestinian government hospitals. 

Table (5) 

43 

Mean, standard deviation, and percentages of each item, 
and total score of Trainee factor affecting transfer of 
training within the work environment from the perception 
of Palestinian government hospitals. 

Table (6) 

45 

Mean, standard deviation, and percentages of each item, 
and total score of trainer factor affecting transfer of training 
within the work environment from the perception of 
Palestinian government hospitals. 

Table (7) 

46 

Mean, standard deviation, and percentages of each item, 
and total score of trainer factor affecting transfer of training 
within the work environment from the perception of 
Palestinian government hospitals. 

Table (8) 

48 

Kaiser-Meyer-Olkin Measure of Sampling Adequacy and 
Bartlett's Test of Sphericity factor affecting transfer of 
training within the work environment from the perception 
of Palestinian government hospitals. 

Table (9) 

49 
Pearson Correlation matrix of factor affecting transfer of 
training within the work environment from the perception 
of Palestinian government hospitals. 

Table (10) 

51 
Total Variance Explained of factor affecting transfer of 
training within the work environment from the perception 
of  Palestinian government hospitals   

Table (11) 

53 
Rotated Component Matrix of factor affecting transfer of 
training within the work environment from the perception 
of  Palestinian government hospitals   

Table (12) 

 

Total Variance Explained of factor affecting transfer of 
training within the work environment from the perception 
of  Palestinian government hospitals    



ix  

54 
Pearson Correlation matrix of factor affecting transfer of 
training within the work environment from the perception 
of Palestinian government hospitals. 

Table (13) 

56 

Modal summer of factors of   organization culture, work 
climate, training, trainee, trainer)in Palestinian public  
hospitals  Operating in northern  Palestine on training 
transfer from the perception of workers in Palestinian 
Government Hospitals 

Table (14) 

58 

One way Analysis of variance of factors of organization 
culture, work climate, training, trainee, trainer)in 
Palestinian public  hospitals  Operating in northern  
Palestine on training transfer from the perception of 
workers in Palestinian Government Hospitals  

Table (15) 

59 

Independent-samples t-test to compare Factors Affecting 
Transfer of Training within the work environment from the 
perception of Palestinian public hospitals in northern 
Palestine due to gender. 

Table (16) 

60 

independent-samples t-test to compare  Factors Affecting 
Transfer of Training within the work environment from the 
perception of Palestinian public hospitals in northern 
Palestine due to Specialized courses 

Table (17) 

61 Ms and SD between education levels Table (18) 

62 

A one-way between subjects ANOVA of the Factors 
affecting transfer of training within the work environment 
from the perception of  Palestinian government hospitals  
due to level of education 

Table (19) 

63 Ms and SD between years of experience Table (20) 

65 

A one-way between subjects ANOVA of the Factors 
affecting transfer of training within the work environment 
from the perception of  Palestinian government hospitals  
due to years of experience 

Table (21) 

67 Post hoc comparisons using the Scheffe test Table (22) 
69 Ms and SD between job title Table (23) 

 

A one-way between subjects ANOVA of the Factors 
affecting transfer of training within the work environment 
from the perception of Palestinian government hospitals

 

due to job title level.  

  



x  

Factors Affecting Transfer of Training within the work environment 
from the perception of workers in Palestinian Government Hospitals in 

northern west bank 
BY 

Bashar Ahmed Naji Saleh 
Supervisor 

Dr. Majeed Mansur 

Abstract 

This study aims at identifying factors that Affect Transfer of 

Training in the work environment from perception of workers (GP, 

technician and nurses) in Palestinian Government Hospitals in northern 

West Bank. 

Moreover, this study will try to assess the most important factors that 

Affect Transfer of Training in work environment from perception of 

workers in Palestinian Government Hospitals in northern West Bank. Also, 

the study aims at investigating the effect of (organization culture, work 

climate, training design, trainee, and trainer) on Transfer of Training in the 

work environment from the perception of workers in Palestinian 

Government Hospitals in northern West Bank. Furthermore, this study 

tested of the role of (gender, taking specialized courses, education level, 

years of experience, job title, and place of training) on Transfer of Training 

in the work environment from the perception of workers(GP, technician 

and nurses) in Palestinian Government Hospitals in northern West Bank. 



xi  

The study adopts an analytical descriptive Methodology and adopts 

the questionnaire as a data collection instrument.  The study was conducted 

in Palestinian Government Hospitals in northern West Bank.  

The study population included all government hospitals workers 

(GP, technician and nurses) in Northern West Bank hospitals (Rafedia 

government hospital, Al-Watani government hospital, Jenin government 

hospital, Tulkarem government hospital, Qalqylia emergency government 

hospital, Salfeet emergency government hospital), the sample size 

consisted of (n=486) government hospitals workers (GP, technician and 

nurses). 

Study results indicate that the suggested study model explains 78.9% 

of the training transfer. In which trainer, trainee, training design accounted 

for 46,4%. While the second factor came by work climate and organization 

culture which accounted for 32.5% of the variance . 

The study concluded that there are interesting similarities between 

training transfer models in different settings. The study revealed that all the 

factors heighted by the study were indeed affecting the training transfer, p 

value =0.00 . 

On the light of the study findings, the researcher managed to present 

the recommendations and suggestions.  



1         

Chapter One 

Introduction to the Study 



2     

Chapter One 

Introduction to the Domains and the core of the Study 

1. Introduction:  

The world is witnessing a number of changes, transformations, and 

developments which affect different aspects of life. This is not expected to 

stop and it's affecting all organizations. The reason behind these changes is 

that the organizations are subjected to growing pressure to further improve 

the quality of their products or services provided. Additionally, the 

transformations in markets, politics and economic imbalances that have 

resulted from the global recession  have also affected the way in which 

organizations run (Daniels & Radebaugh, 2001). 

The skills and performance of employees in the work place are 

critical to the success of every organization. Organizations spend a large 

amount of time and money in training to maximize productivity and quality 

of work; maximize profits; minimize staff turnover; improve customer 

satisfaction and improve motivation (Velada, et al, 2007)  

Training focuses on changing the behavior or to develop new skills 

and knowledge for individual trainees and is expected to be applied in the 

workplace. Transfer of training is defined as the degree to which trainees 



3     

generalize and apply knowledge, skills and abilities to their jobs (Park, 

et.al, 2007).  

Organizations in all sectors want to ensure that all of their 

investments in human capital provide maximum returns. Unfortunately, the 

rate of transfer of skills learned in training practiced back in the workplace 

has been disappointing for most organizations (Baldwin & Ford, 1988; 

Broad & Newstrom, 1992). The major component of effective training is 

the ability of trainees to apply the knowledge, skills gained from the 

training in to their work and the process of transferring new learning from a 

training course in to the organization of the work place is the most 

important stage in the training process.   

Transfer of training is an area of focus in the field of Instructional 

Technology. Anglin (1995) defines this field as: The systemic and 

systematic application of strategies and techniques derived from behavior 

and physical science concepts and other knowledge to the solution of 

instructional problems . When there is widespread failure of trainees to 

use, in the workplace, what they have been taught in the classroom, then it 

becomes an instructional problem that must be addressed.  

Further, it has been widely accepted that transfer of training will only 

occur when trainees have both the ability (can do) and volition (will do) to 

acquire and apply new skills (Noe 2000; Wexley & Latham 1991). 



4     

Most organizations all over the world have a problem with transfer 

of training in the workplace and whatever the actual level of training, when 

training does not transfer; it is likely that employees waste theirs and their 

organization s time. Billions of dollars are spent on training in an effort to 

increase productivity so businesses can stay competitive in the face of 

fierce global competition and a rapidly changing environment (Seyler, et al, 

2000).  

Different studies findings present a serious problem for 

organizations, given that transfer of training is considered the primary 

leverage point by which training influences organizational-level outcomes 

and results (Saks & Belcourt, 2006).  

To understand the transfer of training process, one needs to 

understand the all the factors affecting trainees during the training process 

and after training when they return to the workplace (Nikandrou, et al, 

2008). 

However, in the context of the Palestinian health Public Sector little 

is known about factors that influence a trainee's decision to use what they 

have learned on the job. As this has a potential impact for return on 

performance, it follows that a better understanding of the factors that 

influence training transfer would be valuable in determining how to 

motivate trainees to use the knowledge and skills that benefit the 



5     

organization .Therefore, this study seeks to find a model for various factors 

affecting training transfer based on the reality of training at Palestinian 

Government Hospitals.  

1.1 Problem Statement  

Training is one of the most commonly employed human resource 

development strategies to improve employee and organizational 

performance. If the management or customers of an organization are not 

satisfied with the work or product from its employees, it must then decide 

to either look for people who can meet organizational needs or improve the 

performance of its existing workforce (Stolovitch & Keeps, 2004). 

Literature suggests that a significant portion of investment in 

organizational training and development is wasted as much of the 

knowledge and skills gained in training are not utilized by employees on 

the job (Broad & Newstrom, 1992; Salas & Cannon-Bowers, 2001;).  

To a large extent, research in the area of transfer of training has been 

hindered by the conceptual lack of clarity, (Baldwin & Ford, 1988). There 

is little evidence in the research or anecdotal training literature to 

convincingly show that training programs transfer knowledge or skills to 

the job as evidenced by significantly changed behaviors (Holton& 

Baldwin, 2003; Salas & Cannon-Bowers, 2001).  



6     

Failure to translate training into high-yield improvements in on-the-job 

behavior and performance is a serious problem for organizations that spend 

billions of dollars each year on training (Baldwin & Ford ) 

Some researchers suggested that even when training is necessary, there 

are inhibiting factors that prevent transfer. In an attempt to clarify the 

transfer issue, Broad and Newstrom (1992) examined factors inhibiting 

transfer of training. This study used surveys to study individual and 

environment factors in a systematic way and identified five inhibiting 

factors, These are: (1) organization culture; (2)  work  environment; (3)  (4) 

trainees ; (5) trainers; (6) training design. Hence, this study examined the 

relationship between the factors Affecting Transfer of Training within the 

work environment in Palestinian Hospitals and the proposed model to 

improve training transfer at Palestinian Government Hospitals. 

1.2 Importance of The Study  

This study is important due to the following: 

- This study is important due to the fact that it is the first study 

 

according to the researcher knowledge- that deals with the transfer of 

training topic in health organizations,  

- This study could fill the gap, since there are no studies in this field in 

the Palestinian territories and there are only a few studies in Arab 

countries as a whole. 



7     

- The researcher hopes that this study would help the management to 

identify the factors affecting the transfer of training within the work 

environment in Palestinian government hospitals to increase the 

human resources efficiency and productivity. This will reflect 

positively on their ability to achieve Government objectives. 

- This study could improve the trainee s perception of supervisors and 

managers of hospitals to facilitate the process of transferring the 

training into the work place in Palestinian Government hospitals.  

- To design a model this can be applied for transfer of training in 

Palestinian Government hospitals. 

- This data should helpfully provide researchers with new avenues to 

pursue that would be beneficial to understand the influences on 

training transfer. 

- Help in developing a future training strategic organizational 

approach at Palestinian Government hospitals based on the study 

results. 

1.3 Aims of the study:  

This study aims to achieve the following objectives: 

- Identify factors affect transfer of training in the work environment 

from the perception of workers in Palestinian Government hospitals 

in northern West Bank. 



8     

- Identify effect of (organization culture, work environment, trainees , 

trainers, and training design) on transfer of training in the work 

environment from the perception of workers in Palestinian 

government hospitals in northern West Bank. 

- identify the role of the study variables of (district, education level, 

years of experience, job title, gender, number of courses, place of 

training) on factors affect transfer of training in the work 

environment from the perception of workers in Palestinian 

government hospitals in northern West Bank. 

- Provide quantitative information on which factor of (organization 

culture, work environment, trainees,   trainers or training design)has 

the most influence on the effectiveness of training transfer in the 

workplace. 

1.4 Research Questions  

This study aims at answering the following questions: 

1. What are the factors that affect the transfer of training in the work 

environment from the perception of workers in Palestinian 

government hospitals in northern West Bank? 

2. Which factors of (organization culture, work environment, trainees,   

trainers or training design) affects the transfer of training in the work 



9     

environment from the perception of workers in Palestinian 

government hospitals in northern West Bank? 

1.5 Research Hypotheses: 

The study aims to investigate the following two main hypotheses and the 

sub-hypothesis: 

1. There is no significant effect ( 0.05) of (organization culture, work 

climate, training design, trainee, and trainer) in Palestinian public hospitals 

in northern West Bank on training transfer from the perception of workers 

(GP, technician and nurses). 

2. There are no significant differences on ( 0.05) in variables of 

(gender, taking specialized training courses, education level, years of 

experience, job title, training place)  in Palestinian public  hospitals  in 

northern  West Bank on training transfer from the perception of 

workers(GP, technician and nurses). 

1.6 Research methodology  

This study mainly relied on the following methodology: 

- The study adopts a descriptive analytical methodology and 

Reviewing and analyzing existing literature and publications on the 

concept of Training transfer .  



10     

- Using questionnaire as an instrument to provide inexpensive, 

efficient and accurate information. 

- Conducting work visits with some trainees in Palestinian 

Government hospitals to add depth to the survey. 

- Survey questionnaires will be distributed to the representative 

population of the study. 

1.7 Research s sequence 

This study is organized into the following five chapters: 

Chapter one: which includes the introduction contains - research's problem, 

research's importance, research's targets, research's hypothesis, research's 

methodology and research's sequence. 

Chapter two: will discuss the theoretical framework and the previous 

studies which are related to the research that will include the study's 

concepts, needs and the hypothetical procedures. 

Chapter three: will discuss the research's methodology including 

Population, study sample, data collection methods, statistical methods used. 

Chapter four: will discuss the study results in answering the study questions 

and testing the study's hypothesis.  

Chapter five: the results of the study will be discussed and the researcher's 

recommendations will be included.  



11     

1.8 Study Terminology: 

For this study, the following definitions were used: 

Far Transfer: when prior learning is applied to a new situation in which 

there does not appear to be any clear similarity with the original setting 

(Barnett & Ceci, 2002). 

Feedback: systematic and constructive provision of performance-related 

information to trainees on the quantity and quality of their use of newly 

gained knowledge and skills (Broad & Newstrom, 1992; Kuchinke, 2000). 

Human Resource Development: profession that helps organizations to 

enhance workforce effectiveness and productivity through learning and 

other performance improvement activities (Broad & Newstrom, 1992). 

Interference from Immediate (work) Environment: obstacles (real or 

imagined) preventing trainees from applying skills and knowledge in the 

workplace (Kozlowski & Salas, 1997). 

Instruction: structured activities that aim at learners being able to 

generalize beyond the specifics of what has been taught (Stolovitch & 

Keeps, 2004). 

Organizational Climate: includes work and environment factors that inhibit, 

reduce, or promote training transfer (Lim, 2006). 



12     

Peer: person of equal standing to another; for this study, a coworker 

(Cromwell, 2000). 

Peer Support: extent to which coworkers reinforce and encourage the use of 

learning on the job (Cromwell, 2000). 

Perception: cognitive event by which a person gives meaning to each 

situation/stimulus accordingly to his/her values, beliefs, and attitudes 

(Klimoski & Donahue, 2001). 

Supervisor: an individual in an organization with authority and 

responsibility for accomplishing an objective or mission through the efforts 

of others (Broad & Newstrom, 1992). 

Supervisor Support: defined as the degree to which the trainee s supervisor 

helps set performance goals, provides opportunities to use newly learned 

skills, and recognizes and rewards the use of the skills on the job (Foxon, 

1993; Short, 1997). 

Supportive Organizational Culture: extent to which 

supervisors/management, work groups, and trainers behave in a way that 

optimizes trainee s use of knowledge, skills, and attitudes gained in 

training on the job (Lim & Morris, 2006). 



13     

Trainee: the learner, usually an employee, who's training, education, and 

development are sponsored by the organization to improve organizational 

functioning and productivity (Broad& Newstrom, 1992).  

Trainer: human resource development professional, either internal or 

external to the organization, who analyzes performance problems and 

designs and delivers, evaluates, manages, and /or supports training in a 

variety of ways (Broad & Newstrom, 1992). 

Training: made up of structured learning experiences provided primarily by 

employers for employees and designed to develop new skills and 

knowledge for use on the job (Broad, 2005). 

Transfer Climate: general construct that has been used to describe those 

features of the work environment that directly influence the generalization 

and maintenance of knowledge and skills learned during training (Baldwin 

& Ford, 1988). 

Training Evaluation: system for measuring changes due to training 

interventions; most important to determine whether trainees have achieved 

desired learning outcomes (Goldstein & Ford, 2002). 

Work Environment Factors: refers to factors in the workplace that may 

affect individual application and maintenance of new skills learned in 

training (Dodson, 2004). 



14           

Chapter Two 

Conceptual Framework & 
Literature Review   



15     

Chapter Two 

Conceptual Framework and Literature Review 

2.1 Introduction 

The following section provides a brief overview of the literature 

regarding the importance of training, training transfer problem. In addition, 

it will discuss factors that influence training transfer including: 

organization culture, work climate, training design, trainee and trainer, 

giving special attention to theoretical justification to the relationships that 

will be tested in this study. Moreover, this chapter will discuss some 

models related to training transfer and presentation of related literature.  

2.2 Training importance: 

Training may be defined as a planned learning experience designed 

to bring about permanent change in an individual's knowledge, attitudes, or 

skills (Baharim, 2005).  

A large part of development involves organizational sponsored 

training efforts. As knowledge has become a key economic resource and a 

source of competitive advantage, effective training is most important to 

instill knowledge (Drucker 1995).  



16     

Training is an expensive investment for most organizations. It is fair 

to say that employers aim to ensure that investments in training provide 

maximum returns. (Baharim, 2005) 

It is known that business and technology, especially medical 

technology, is in the process of rapid change and also that individuals must 

be able to adapt to these changes in order to meet the organization goals 

and objectives (Steven, 1998).  

Human resource development is a critical factor for organizational 

success to achieve the desired goals and objectives (Rishard Swanson 1995, 

Sabarudin z., 2011).  

Training is the tool most often used to prepare the individuals for 

these challenges (Miguel A. Quinones). Organization and employee can 

achieve their goals if the learned knowledge and skills from the training is 

transferred to the workplace. Training is the most common form of Human 

Resource Development and the one that helps organizations to enhance 

workforce effectiveness and productivity the most (Yamnill, 2001, Pilar 

Pineda, 2009) by means of specified learning geared towards performance 

improvement. Training is appropriate when an individual's performance 

would be improved with additional skills and knowledge (Zane L. 2008).  

Organizations spend an immense amount of time and money on 

training in order to facilitate employees' learning of job-related 



17     

competencies (Cascio, 2000; Noe et al., 2006). For example, US companies 

spend more than $50 billion annually on formal training (Dolezalek, 2004). 

Moreover, investment in training activities has increased all over the world 

in recent years. As a result of the financial investments organizations make 

in training, it is important to provide evidence that training efforts are being 

fully realized (Cascio, 2000; Dowling & Welch, 2005).  

In the Palestinian context, the sources of finical resources allocated 

to training, especially in the health sector, are approximately 1.5 million 

dollars annually (PMOH, 2010). 

In other words, it is important for organizations to ensure that 

training leads to desired work outcomes such as increases in job 

performance. (Raquel Velada, 2007) 

It has been estimated that only about 10 per cent of all training 

experiences are transferred from the training environment to the job 

(Baldwin & Ford, 1988). Although this is a lower-bound estimate, Wexley 

and Latham (2002) suggest that although approximately 40 per cent of 

content is transferred immediately following training, this falls to 25 per 

cent after 6 months and 15 per cent after 1 year. This suggests that as time 

passes, trainees may be unable or less motivated to retain and use the 

information gained in the training program. As a result, there has been an 



18     

increased effort to understand the antecedents and consequences of the 

transfer of training process .(Raquel Velada, 2007) 

Much of the time and money invested in training is never fully 

realized because only a small percentage of the training given effectively 

results in permanent transferability to the workplace.  

There has been a recognition of a concern of the transfer problem 

(Baldwin & Ford, 1988), that much of the training content is not applied in 

the work setting (Ford & Weissbein, 1997) and investments in learning 

continue to yield deficient results, making transfer a core issue for both 

researchers and practitioners (Burke & Hutchins, 2007;Hamer )2003

 

2.6 Training Transfer: 

Organizations rely on learned knowledge and skills being applied to 

the job. To a large extent, this behaviour constitutes a transfer of training. 

By definition, then, transfer of training, is the degree to which trainees 

apply the knowledge, skills and attitudes gained in training to their job 

(Wexley & Latham 1991). It has also been described as the maintenance of 

those skills, knowledge and attitudes over a certain period of time (Baldwin 

& Ford 1988). In a human resources context, transfer of training represents 

a core element transforming learning into individual performance (Holton 

1996) . 



19     

The scientific bases of transfer of training studies originated in 

planned behaviour theory whose origins were in the field of social 

psychology as a predictor for behaviour. This theory predicts that the most 

important determinant of a person's behavior is behavioral intent. The 

individual's intention to perform a behavior is a combination of his or her 

attitude toward performing the behavior, the prevailing subjective norms 

and the perceived behavioral controls on the individual (Ajzen 1991) . 

"Transfer of training" is defined as the application of new 

knowledge, skills and attitudes learned exactly from training and applied to 

job performance. One major conclusion that emerges from research is that 

training transfer is the degree to which trainees apply what is learnt to their 

workplace (Pidd, 2003). 

Transfer can be viewed as positive or negative. Positive transfer of 

learning is the degree to which trainees effectively apply knowledge, skills, 

and attitudes gained in a training context to the job (Baldwin & Ford, 1988; 

Newstrom, 1986). Negative transfer occurs when learning in one context 

undermines performance in another. Positive transfer refers to the use of 

new learning to enhance outcomes (e.g. quality, productivity etc.) while 

negative transfer occurs when continued use of new learning leads to less 

desired results (Baldwin & Ford, 1988). 



20     

Understanding and improving the transfer of training process has 

become a primary concern for training researchers and practitioners .The 

literature indicates that in the short term only 50% of training transfers to 

the job, and in the longer term, only 10% will ultimately transfer (Kim & 

Lee, 2001).  

Kavanagh (1998) developed a multi-level process to help understand 

the complexities of the transfer of training process. Specifically, he 

suggested that training transfer is influenced by several variables at 

different levels of analysis (e.g. individual, supervisor, workgroup and 

organization) and in different stages in the training process (e.g. pre-

training, training and post-training). (Raquel Velada, 2007)\ 

2.4 Training Transfer models:  

The concept of transfer has a wider meaning in educational 

psychology--a phenomenon, which can exist solely within the boundaries 

of a classroom. In this sense, transfer is the basis of all learning and, 

therefore, it is often referred to as transfer of training Inputs learning 

(instead of just training). In order to perform algebra, one must transfer 

simpler skills, such as addition, multiplication, division, etc., which is an 

example of vertical transfer (Klausmeier & Davis, 1969). An example of 

lateral (horizontal) transfer is found in learning concepts, where one must 

be able to transfer attributes among a class of objects--for instance, to 



21     

distinguish a dog from a cow (Klausmeier & Davis, 1969).   

Training 
Outputs  

Conditions of Transfer      

Trainee Characteristics 

 

Ability 

 

Personality 

 

Motivation     

      

Training Design 

 

Principles of Learning 

 

Sequencing 

 

Training Content   

Learning 
& 

Retention    

Generalization 
& 

Maintenance 

      

Work Environment 

 

Support 

 

Opportunity to Use     
From Transfer of training: A review and directions for future research, by T. T. Baldwin and J. K. 
Ford, 1988, Personnel Psychology, 41, p. 65. 
Figure 1. 1 A model of the transfer process  

2.6.2 Factors Affecting Transfer of Training 

To fully understand the transfer process, it is necessary to understand 

all factors before, during and after training that affect the process when 

trainees return to their work:  

2.6.2.1 Training.    

Since training is a critical precondition of transfer, it will be discussed 

first. Possibly the most obvious reason for such low rates of transfer is that, 

if the skill is not learned in the classroom, it cannot be practiced in the 

workplace.  

Poor design has been considered the main cause of the problem. 



22     

Instructional design textbooks indicate or imply that most instruction is not 

systematically designed or evaluated for effectiveness (Smith & Ragan, 

1999).  

Specifically, trainers are unaware of the systematic instructional-design 

process, and thus they create courses without objectives or use vague 

objectives. Lee and Pucel (1998) have suggested that if trainees feel an 

objective is important that they are more likely to transfer those skills, once 

learned. This cannot take place if objectives are not explicit or 

communicated.  

Poor instructional design skills are also in evidence in the use of 

instructional strategy for all types of learning outcomes (e.g., lecturing), 

failure to ensure that the conditions for learning for a particular type of 

learning outcome are present, teaching at a rule or procedural level instead 

of giving general and deeper principles, failure to give multiple examples 

and non-examples of concepts in a variety of contexts, providing 

inadequate practice time and poor feedback, or employing inadequate test 

designs (Smith & Ragan, 1999).  

Many times during instruction, the trainer does not take the 

opportunity to provide additional or supportive guidance on using the skills 

back on the job. It is often up to the students to translate theoretical 

concepts and models into procedures and practice at the workplace. While 



23     

bright students may be able to do this, it places too great of a cognitive load 

on mediocre and slower students, who will have great difficulty if they can 

do it all (Stevens, & Baveita, 1991). 

2.6.2.2 Work Environment: work climate & organization culture 

Work Environment Factors are factors in the workplace that may 

affect individual application and maintenance of new skills learned in 

training (Dodson, 2004). 

Kozlowski & Salas, (1997) discussed the interference from immediate 

(work) environments as obstacles (real or imagined) preventing trainees 

from applying skills and knowledge in the workplace. 

Raquel Velada, (2007) argued that many training transfer studies  excluded  

environment factors such as continuous learning culture (e.g. Tracey et al., 

1995). 

Research has demonstrated that training efforts are unlikely to result in 

positive changes in job performance unless the newly trained competencies 

are transferred to the work environment (Raquel Velada, 2007) 

In the current literature, work environment has been classified into two  

dimensions that have received attention with regard to transfer of training 

including organizational culture and climate (e.g. Baldwin & Ford, 1988;) 

stressed the importance of both transfer of training climate and continuous 



24     

learning organization culture as work environment variables that have a 

significant impact on the post-training (Raquel Velada, 2007). 

Lim (2006) defined Organizational Climate as a climate that includes 

work and environment factors that inhibit, reduce, or promote training 

transfer.  

Baldwin & Ford (1988) emphasized that a Transfer Climate is a 

general construct that has been used to describe those features of the work 

environment that directly influence the generalization and maintenance of 

knowledge and skills learned during training (Baldwin & Ford, 1988). 

Research has indicated that when employees perceive that the 

organizational climate is supportive, they are more likely to apply their new 

knowledge in the work environment (see Baldwin & Ford, 1988; Tracey et 

al., 1995).  

On other hand, as organization culture is considered to be the second 

dimension of work environment. Lim & Morris (2006) clarify that a 

Supportive Organizational Culture is the extent to which 

supervisors/management, work groups, and trainers behave in a way that 

optimizes trainees use of knowledge, skills, and attitudes gained in 

training on the job  



25     

Supportive organizational culture includes the external environment, 

organization's structure, culture, job supervisor, and upper management of 

the firm (Broad & Newstrom, 1992). Supervisors have more influence than 

coworkers on the leaner s decision to implement training. They are 

responsible for encouraging and setting a model for desired work-related 

behaviors . 

Baldwin and Ford (1988) divided the work environment factors into 

(a) a supportive organizational climate, (b) a pre-training discussion with 

the boss (supervisor or manager () c) the opportunity to use knowledge and 

skills, and (d) post-training goal setting and feedback. Researchers have 

focused on different factors of this work environment. Previous studies 

indicate that practitioners examined the environment first when evaluating 

transfer problems They suggest that the effort and success in the 

application of workplace learning is greater in environments characterized 

by high levels of supervisor and coworker support  found that management 

trainees in supportive, compared to non-supportive, workplaces were more 

likely to demonstrate trained behaviors (Hicks, 2006).   

A number of subsequent studies have substantiated these findings 

and highlighted the importance of organizational support. For example, 

Montesino (2002) found that there was a significant correlation between 

the variables "perceived presence of practices to support usage of training" 

and "perceived alignment of training with the strategic direction of the 



26     

organization" (trainees: r=.29, p<.OOl, managers: r=.38, p<.03) 

(Montesino, 2002 ) . 

Researchers have often cited organizational support as an important 

factor in the transfer process, but very little research has been done to find 

out how support mechanisms work to facilitate transfer. Ford et al., (1992) 

stressed three factors affecting transfer: supervisory attitude towards 

trainee, peer support, and pace of workflow . 

2.6.2.3 Trainees: 

It is important for any organization to know how trainees transfer the 

learned knowledge after a training program to the job environment to 

improve return on investment from training (Salas and Cannon-Bowers, 

2001).  

Broad& Newstrom (1992) defined a trainee as the learner, usually an 

employee, whose training, education, and development are sponsored by 

the organization to improve organizational functioning and productivity.  

The literature on training transfer has identified several trainee 

characteristics that affect the transfer of training process. Some of these 

characteristics include cognitive ability, conscientiousness, motivation to 

learn and to transfer, anxiety and self-efficacy (Colquitt et al., 2000).  



27     

Others studies include job involvement, organizational commitment, 

organizational cynicism and job satisfaction (Raquel Velada, 2007) 

Of these characteristics, performance self-efficacy has been found to 

strongly relate to both learning have indicated that trainees with higher self-

efficacy are more likely to transfer the training to the job. Holton et al. 

(2000) defined performance self-efficacy as an individual's general belief 

that they are able to change their performance when desired. Hence, when a 

trainee feels confident in his or her ability to perform, they will be more 

likely to transfer such knowledge and/ or skills to the job. (Raquel Velada, 

2007). 

Trainees must have the ability to retain the knowledge instilled 

during the training program to facilitate the transfer process. Similar to 

cognitive ability, training retention is the degree to which trainees retain the 

content after training is completed. (Raquel Velada, 2007). 

Baldwin and Ford (1988) argue that learning retention outcomes are 

directly associated with the generalization and maintenance of training 

effects on the job. They argue that in order for trained skills to be 

transferred, they first must be learned and retained. (Raquel Velada, 2007).   



28     

2.6.2.4 Trainer: 

Broad & Newstrom, (1992) define trainer as a human resource 

development professional, either internal or external to the organization, 

which analyzes performance problems and designs and delivers, evaluates, 

manages, and/or supports training in a variety of ways. Sometimes the 

concept is confused with the supervisor who is an individual in an 

organization with authority and responsibility for accomplishing an 

objective or mission through the efforts of others (Broad & Newstrom, 

1992). 

Short, (1997) defined trainer's support as the degree to which the 

trainee s supervisor helps set performance goals, provides opportunities to 

use newly learned skills, and recognizes and rewards the use of the skills 

on the job.  

Trainer success can be described as the extent to which supervisors 

support and reinforce the use of newly learned knowledge and skills on the 

job (Holton et al., 2000). Although there is some contradictory evidence 

(e.g. Russell et al., 1985), the dominant theory suggests that when trainees 

perceive that their supervisors support the application of newly developed 

knowledge and skills, they are more likely to transfer these competencies 

back to the job  (Raquel Velada, 2007) 



29     

Reinforcement on the Job occurs when the management/supervisors 

provide recognition or rewards in the form of incentives, praise, advice, 

coaching, and references for promotion for those who demonstrate on-the-

job application. Most organizations spend huge amounts of money to 

increase employee productivity. However, investing money in the 

productivity of employees is not effective if the supervisor/manager does 

not recognize or reward those who apply what they have learned. When 

workers receive recognition or reward from the supervisor/manager for 

applying newly learned knowledge and skills, they are likely to become 

more motivated to apply what they have learned in the training 

environment to the workplace. Moorhead and Griffin (1992) found that 

when trainees are content and think that rewards are attainable, they value 

the reward system and may transfer learning from training to a greater 

degree than those without such a reward system (as cited by Lim & Morris, 

2006; Moorhead & Griffin, 1992). 

Employees are motivated by both intrinsic and extrinsic rewards. 

Intrinsic rewards are non-monetary rewards for accomplishments that are 

valued internally; extrinsic rewards are externally administered rewards. 

Stolovitch, Clark and Condly (2002), in their Performance Improvement by 

Incentives (PIBI) model, suggest that the greater the utility value a 

performer attributes to a task, the more strongly the intrinsic reward plays a 

role in reinforcing accomplishment. The less utility value the performer 



30     

attributes to a task, the more extrinsic rewards play a role in eliciting 

performance (Stolovitch, Clark, & Condly, 2002). In this study the focus 

was on intrinsic rewards. Employees want to feel that they are performing 

well and to feel that they are recognized and valued for their ability to 

apply newly learned skills and knowledge. When a supervisor recognizes a 

worker's accomplishments and coaches the worker to apply newly learned 

skills in ways the worker values, performance improves and skill and 

knowledge transfer have a higher probability of succeeding. For example, 

Andrzejewski, Kirby, Morral, & Iguchi (2001) examined the effects of 

feedback and positive reinforcement interventions on drug treatment 

counselors' behavior. Initially, counselors were provided with detailed 

feedback about how well they adhered to the prescribed counseling 

protocols. Subsequently, the same counselors participated in a random 

draw for cash prizes. The counselors' protocol adherence performance 

measures increased to 71 % during the feedback intervention and to 81 % 

following the draw for cash. Each counselor's performance improved 

during both intervention conditions (Andrzejewski, Kirby, Morral, & 

Iguchi, 2001). 

2.6.2.5 Training Design:  

Organizational training programs are often an effective way to 

improve employee performance on the job. Training design, the quality of 

instruction, and the content of training are critical elements related to 



31     

training success. But, beyond these elements, employee attitudes related to 

training are likely to affect the degree to which those employees learn. 

Learning 

 

an assessment of knowledge acquired, skills improved, or 

attitudes changed due to training 

 

is a critical part of training effectiveness 

(Robin A. Cheramie, 2010). 

2.7 Health Sector in Palestine: 

Health services in Palestine are of good quantity, but the quality is 

still less than what is necessary. All Palestinians have easy access to health 

services, but this is mostly because of the short distances in the Palestinian 

territories. Gaza Strip and the West Bank have independent health care 

systems, causing duplication of services and increased costs. Hardships in 

the Palestinian Territory have caused a deterioration of the health care 

network. The ministry of health (MOH) is considered the main provider of 

primary health services in Palestine. There are 416 primary health care 

centers owned and supervised by the MOH. These centers are distributed as 

57 centers in the Gaza Strip and 359 centers in the West Bank. These 

observations might be behind the lack of organizational principles in our 

health care system. Such poor organization is expected to result in 

problems that could affect everyone in the health care process (e.g. 

residents, interns, specialized physicians of all sorts, physiotherapists, 

psychologists, specialized nurses, patients, patients' families, and so on). 

However, figuring out how to develop better coordination is tremendously 



32     

difficult when one considers the rapid changes occurring in health care and 

the absence of any established organizational frameworks. Process of care 

should be designed around the needs of patient. The Palestinian health care 

system is a mixture of public, non-governmental, UNRWA, and private 

(profit and not for profit) service delivery, with a developing governmental 

health insurance system (Palestine Ministry of Health, 2003). National 

inputs into health care in Palestine appear to be relatively high. Health 

outcome indicators for the Palestinian people are comparable to those of 

other nations with a similar economic status. These nations appear to be 

investing less in health both in terms of per capita expenditures on health 

and percent of national product interested in health care delivery. In a study 

by the World Bank (1997) they estimated the per capital health expenditure 

in West Bank and Gaza skip at 122 US$ in 1996 which means 8.6% of 

gross domestic product (GDP). For the purpose of comparison, 

expenditures on health care for neighboring countries (1997) were: Egypt 

spent 4.8% and Jordan 7.8% and Israel 8.4% (1999) of GDP, with an 

average annual expenditure of 1384 US$ per person (Palestine Ministry of 

Health, 2009) . 

In Palestine, there are 76 hospitals. The population ratio is 45,585 

populations per hospital. The average bed capacity per hospital is 63.03 

beds. The total number of beds in Palestine is 4792. In the West Bank 

(WB) including Jerusalem, there are 52 hospitals making (68.42%). The 



33     

population/bed ratio is 723 in the whole of Palestine including Jerusalem. 

Hospital bed/ 1000 population is 1.3 in the comparison with the number of 

beds in Israel is 2.27 per 1000 population (Palestine Ministry of Health, 

2009. The occupancy rate 76.8% and the average coast of hospital bed is 

56.8 US$, where the average coast of hospital day is 77.7 US$. The 

average patient cost is 25.7 US$ (Palestine Ministry of Health, 2009).  

The number of physicians in primary and secondary care in the West 

Bank and Gaza is 2897 physicians (1.1 physicians per 1000 population) in 

2009. Number of nursing staff was 2161 in 2009 with a ratio of7.6 nurses 

per 10.000 populations, l.7 nurses per physician and 0.69 nurses working in 

hospitals per bed. For the purpose of comparison, the physician to 1000 

population for neighboring countries 1999 was: Jordan l.54, Egypt 0.77, 

Syria 0.85, and Israel 2.9 (Palestine Ministry of Health, 2009) . 

MOH expenditure as % of GDP was 3.2% about one third of all 

health care expenditure are directed toward ministry of health facilities 

(including capital expenditures), while private providers, non-governmental 

organizations, and UNRWA making up the rest . 

In (2009), about 24.9% of all MOH health care expenditure in 

Palestine was on drugs, vaccines, and medical disposables, about 57.9% of 

MOH budget and nearly half of all expenditures in UNRWA and the non-

governmental sector consisted of wages and salaries and other forms of 



34     

employee remuneration. Finally, about 6.4% and 10.8% of total MOH 

health expenditures were on referral for special treatment and other 

operating coast respectively (Palestine Ministry of Health, 2009) . 

The deduction is to be made here is certainly not that "no further 

increase in inputs into health care are required"! Considerable investment 

will certainly be needed. It is rather that, the mainstay of any improvement 

program should be a plan of action directed at better utilization of existing 

resources and future investments. This can lead to improvements 

irrespective of any future investment, or of its size  .There are several 

factors affecting the quality of health care. These can be categorized into 

three main groups: First, inputs into health care: investment in health care, 

human resources in the health care sectors, facilities, equipment and 

supplies. In Palestine, the problem is not a lack of investment of inputs into 

health care. Quite the contrary, inputs are relatively high. If anything, 

national expenditures on health care are in excess of what would be 

expected from an economy such as that of Palestine. Deficiency in inputs 

cannot be the answer to the poor quality of health care in Palestine. Second, 

response allocation, improper allocation of health resources: into a 

relatively cost-effective program or the contrary. This is difficult to assess 

with available data. However, given the relatively large number of 

community based practices and their staffing (particularly UNRWA and 

NGO services) together with the high immunization coverage as an 



35     

example, it does not appear that effective health care measures are 

neglected. Any assessment of the health services in Palestine leaves no 

doubt that there is room for more effective resource allocation. However, it 

appears unlikely that infective resource allocation is the major contributor 

to the poor quality of health care in Palestine. Third, the efficiency of the 

delivery of health care: the degree to which there exists, or does not exist, 

duplication of efforts, re-work, unnecessary work and spending, and other 

different forms of waste in the system .Efficiency is a measure of the inputs 

invested in a system to the outputs obtained from that system. It is clearly 

not possible to quantify this on a national scale. However, the issue of 

efficiency may be approached in a conceptual sense .In the health care 

sector in Palestine, the investment in inputs is higher than what would be 

expected for the obtained outcomes. Furthermore, given the high 

percentage of GDP spent on health care, increased inputs premises, 

redistribution of resources cannot possibly be suggested as a solution for 

improving health care quality. In other words, there appears to be an over-

investment leading to outcomes that are normally achievable with less 

investment. The real problem seems to be an inefficient system of health 

care delivery .   



36     

2.8 Models of Transfer of Training.   

Kurt Lewin s Field Theory (1935):  

Kurt Lewin s Field Theory (1935) provided a model for viewing 

forces arrayed for and against an initiative that would cause significant 

change. He implied that it is almost mathematical, in that the sum of the 

vectors (for and against) will determine the outcome. This complexity of 

causation in terms of the number of variables--both inhibitors and 

facilitators--makes transfer a difficult problem to conceptualize and, 

therefore, address. In other words, if one could solve the transfer 

problem, a majority of organizational problems would be minimized or 

cease to exist. Several models have been developed to try to understand the 

transfer phenomena. 

Kirkpatrick (1976):   

Kirkpatrick (1976) provided a four-step framework for pinpointing 

where transfer problems can occur, identifying areas where management s 

faulty assumptions have kept them from being fully aware of this problem. 

His model posited a fragile chain of assumptions, any of which, when 

violated, result in ultimate nonperformance.  

The logic of the chain of assumptions in Kirkpatrick s models can be 

summarized as: 



37     

1. The trainee must have the ability and motivation to learn the new skill 

(trainability). 

2. The new skill must first be learned before it can be practiced, although 

frequently the instructional design or delivery is faulty. 

3. Even if a new skill is learned in the classroom, the trainee must 

remember (retain) what they have learned in order to practice it at the 

workplace. 

4. Even if one wants to practice the new skill, there may not be an 

opportunity to do so. 

5. Even if one acquires and remembers a skill and has the opportunity to 

practice it, they may not adapt it to a given work situation where they could 

and should apply it--that is, in a far-transfer situation (where classroom and 

workplace contexts appear very different on the surface). 

6. Even if adaptation is realized, the enabling support system may not be in 

place (via stakeholders and the work environment). 

7. Even if support is present, it may not be maintained over time when the 

novelty wears off or environment factors distract attention or resources, 

often causing a relapse to old behaviors. 

8. Even if the behavior is adapted and maintained, it may have little or no 

impact on the organizational problem that the training was supposed to 

address in the first place--that is, it could have been a system problem, not 

a skill-deficiency problem. 



38     

Noe and Schmitt (1986): While Kirkpatrick provides a useful perspective; 

it is not without its problems. Noe and Schmitt (1986) found that only the 

link between Levels 3 and 4 (see list below) were significant. There was no 

support for linkages between Levels 1, 2, 3.  In 1989, 30 years after the 

model was first published, Alliger and Janak critically examined it by 

attempting to establish the strength of correlations between each of the four 

levels (italicized words are Kirkpatrick s designations): 

1. Trainees immediate (emotional) reaction to the workshop/course  
2. Actual classroom learning that took place (via testing) 
3. Behavior changes on the job 
4. Organizational results  

TRANSFER  EVENT  ASSUMPTION 

    

Trainee Selection   
Trainee is capable and motivated to learn and transfer 
(trainability) 

     

Classroom Training   
Trainee actually learned the skill in the classroom 

     

Retention of Learning   
Trainee remembers what was learned in the classroom 

     

Opportunity    
Trainee has an opportunity to use the new skill in the 
workplace 

    

Generalizing   
Trainee recognizes occasions where the new skill can be 
applied 

     

Support   
Stakeholders and environment support trainee in using 
the new skill 

     

Maintenance   
Practice of new skill is not just a novelty, and trainee is 
not distracted by other influences 

     

Impact on Problem   
The original problem was resolvable by training (it is not 
a system problem) 

Figure 2.2 diagrams the sequence and assumptions of the transfer chain of events. 



39     

Broad and Newstrom s (1992):  

Another useful model comes from Broad and Newstrom s landmark 

book on transfer of training (1992). It divided transfer events temporally--

that is, what should be (or is not) happening before, during, and after 

training. It goes on to specify the roles of the three key stakeholders: the 

trainer, the trainee, and the trainee s superior. This 3 x 3 matrix (see Figure 

3) provides a comprehensive framework for conceptualizing transfer 

problem areas and their solutions, thereby making it both descriptive and 

prescriptive. The problem areas raised in the previous assumption chains 

will now be reviewed in more detail. Chains depend on linkages or 

connections. A disconnected set of links cannot be defined as a chain. 

Connection is what is at the heart of the transfer problem: the pieces are 

there, but they are not consciously and deliberately integrated or 

orchestrated. There must be a partnership between the main stakeholders 

(Georgenson, 1982), and an integration of system infrastructure (Broad & 

Newstrom, 1992) that facilitates stakeholder need satisfaction. 

Brinkerhoff and Montesino (1995) suggested that the relationship 

between all the pieces needs to be re-examined. They stressed that the 

transfer stakeholders (trainee, trainer, and superior) do not see any overlap 

in transfer functions. That is, for example, the trainee s supervisor may 

think that anything that is training-related comes under the jurisdiction of 

the trainer and that the supervisor therefore has no transfer role to play. The 

trainer may see his or her worker as finished when training is completed. 



40     

Veldhuis and van Rooij (2001).  

They created a detailed transfer evaluation and improvement model, 

which pits the actors (trainer, trainee, and manager), against phases (input, 

throughput, output) to generate areas of concern.  

The study model: 

Based on previous models but within the Palestinian context, the researcher 

developed the following model. 

 

Figure (3): the study model composed of the five factors that affect training transfer in the 

Palestinian public health sector  



41     

2.9 Review of Previous Literature: 

Over the last 30 years, a lot of conceptual and empirical research has 

been done regarding the transfer problem in training. The following is a 

quick overview of the most important studies in this field: 

2.9.1 Arabic & Local Studies: 

Baddad (2011) at examined the reality of training at the departments of the 

Ministry of Public Works and Housing. The study focused on programs, 

work requirements. The researcher used the descriptive approach, where he 

designed a questionnaire including (118) items distributed to five areas and 

enjoyed a credibility and stability degree reached (0.98). The study results 

showed that most of the implemented training programs at the Ministry of 

Public Works and Housing were specialized programs mostly serving the 

staff departments such as Central Procurement (Project Management) and 

Financial Resources (public money). There were also training programs 

concerned with project follow up and assessment and staff capacity 

building in the field of communication skills. The study results clarified 

that the most important requirements for working were knowledge of 

health and safety, the ability to diagnose weaknesses and to treat them. The 

study showed that the most important impact of training programs on the 

employees knowledge, experience and skills was in developing the 

employees performance efficiency. Moreover, assisting them with using 



42     

their new skills, increasing their motivation to engage in their jobs and 

empowering them to use computer and internet technology. Study results 

indicated that obstacles to training programs were lack of qualified trainers, 

lack of training plans. Rigidity of regulations and rules governing work 

organizations. 

Elbers (2010) investigate the effect of learner, training, and work 

environment characteristics on the transfer of knowledge, skills, and 

attitudes (KSA) from a classroom situation to a work situation, also known 

as transfer of training. The study was carried out in the technical project-

based company Vanderlande Industries (VI) and aimed to address the 

following research question: How to organize the input characteristics (i.e. 

learner characteristics, training characteristics, and work characteristics) in 

order to improve the application of learned KSA in the work setting . 

Findings showed that the highest transfer performance is achieved when 

trainees participate in training programs with intensive feedback during 

training, interactive training methods and a longer training length. Before 

training, trainees should obtain realistic training expectations through clear 

specific goal setting and sufficient provision of training information in 

order to achieve good training outcomes and consequently better transfer 

results. Directly after the training program, trainees should feel comfortable 

with their training expectations and trainees should have the expectation 

that effort devoted to transferring learning will lead to changes in job 



43     

performance. In addition, the support, involvement, and coaching from 

supervisor and colleagues after the training program play an important role 

in the applicability of learned knowledge and skills in the work setting. 

Melaine and K. Saci (2008) focused in their study on trainees 

perception of the work environment in developed countries. The study 

insisted that environment factors, as perceived by the trainees and 

supervisors, can impact on the trainees skills when being applied to the 

job. It is the positive role of organizational culture that represents value in 

the transfer of training, especially when it is used as an indicator to 

determine the differences in the effectiveness of the transfer of training in 

different environments. The study argues that work environment factors 

could play a key role in the understanding of transfer of training. This part 

of the study examines certain factors that could support transfer of training 

in the Libyan Oil Industry in order to understand the influence of work 

environment factors upon motivation to transfer of training. 1) Work 

environment factors toward motivation to transfer Peer support. 

Supervisors generally supported motivation to the transfer of skills. There 

were positive climates for relationships between management and their 

trainees toward motivation in training transfer in two cases (National Oil 

Corporation and Weatherford). However, relationships between trainees 

and their leaders in the other cases (Waha, Millita , Akakus and Mabruk) 

were somewhat limited. Trainees motivation to adapt training to the work 



44     

environment: This showed that there are significant differences between 

companies in the influence of work environment factors on motivation to 

transfer where there were both positive and negative motivations. 

Khasawneh (2004) adapted the constructs of the LTSI for use in 

Jordan. By doing so, HRD practitioners in Jordan could diagnose problems 

early on with learning transfer: the key to training effectiveness and 

individual performance. The LTSI was translated through a rigorous cross-

cultural translation process, which involved forward and back translations, 

pilot testing, and the establishment of equivalency using objective 

measures of evaluation. The ALTSI was tested on 500 workers employed 

by 28 public and private sector organizations operating in Jordan who had 

attended nine different types of training. Responses came from 450 

employees with a response rate of 90%. The results showed that 18 factors 

were valid for use in Jordan. The reliabilities of these factors ranged from 

.70 to .87 with the exception of three factors. The study also investigated 

the perceptions of transfer system characteristics across selected individual 

variables (gender, age, levels of education, and years of experience) and 

situational variables (types of training, choice of training, sector of the 

organization, and task of the organization). The results suggested that the 

learning transfer system perceptions differed across the individual variables 

(except for gender and age) and across situational variables. Private 

organizations and the technical sector appeared to have the strongest 



45     

transfer system. Moreover, employees were more prone toward voluntary 

training, thus expanding their nomological network. The learning transfer 

system explained a significant portion of the total variance in each measure 

of organizational learning. Results suggested that higher levels of learning 

transfer were associated with higher levels of organizational learning. 

2.9.2 Foreign & International Studies: 

Comm (2009) study focused on investment in Continuing Medical 

Education (CME), something which is likely to increase as physicians 

strive to keep up with the professional demands of the medical field 

through lifelong learning. Physicians' transfer of learning takes place when 

they apply learning from CME programs to improve their clinical 

performance and ultimately patient outcomes. However, major 

discrepancies between physicians' actual and ideal performance exist which 

raises uncertainty about the role of CME (Mansouri & Lockyer, 2007) and 

the need for educators and trainers to re-examine physicians' transfer of 

training. The purpose of this study was to explore physicians' transfer of 

learning from CME programs into practice at a large hospital in the US 

Midwest region. A case study research design was used. Nine physicians 

participated in this study. Data were collected through document review, 

in-depth semi-structured interviews and observations. Qualitative data were 

analyzed by obtaining emergent themes. Findings showed that some of the 

transfer-related factors in Holton's model were applicable to the physician 



46     

context: (a) relevance of the CME program to the physicians' practice was 

critical to their attendance and application of learning; (b) follow-up and 

program materials were important to prevent relapse; (c) physicians were 

motivated to transfer learning if they attended programs that were 

potentially useful in their practice; (d) attendance at programs boosted the 

physicians' confidence and practice; (e) physicians had various 

opportunities to apply learning from CME programs into their practice; 

and, (f) support from peers was vital for discussion and integration of new 

learning into practice. To further realize the impact of the Holton model in 

the physician context, physicians may need to be viewed as "sole 

proprietors" of their practice with (a) closer proximity to their practice; (b) 

more direct authority over their transfer of learning capabilities; and (c) 

greater authority over their learning process, compared to employees in 

traditional organizational settings. Pedagogical considerations given this 

new outlook on physicians involve enhancing the program s relevance to 

the physicians' practice; improving program structure to include expert 

speakers and periods for social interaction; and being attentive to the 

physicians' "time crunch". Implications for instructional designers, 

presenters, evaluators and institutional administrators are discussed. 

Williams (2008) performed a meta-analysis of 34 studies to explore 

the magnitude in which work environment affects training transfer. The 

independent variables for this study included supervisor support, 



47     

subordinate support, peer support, transfer climate, relapse prevention, goal 

setting, continuous learning culture, task constraints, and frequency of use. 

These variables were analyzed independently to compare their correlation 

to training transfer. These variables were also combined together (minus 

goal setting and relapse prevention) into a group called environment 

support to compare overall organizational support to goal setting and 

relapse prevention. Finally, this study performed a moderator analysis to 

compare the effect these independent variables had on management and 

non-management training; and on self-reporting versus supervisor or peer 

reporting; and training versus development. Results revealed that relapse 

prevention (.65) had the highest levels of correlation of all independent 

variables to training transfer. The results also showed that managerial 

training (.32) had higher levels of correlation to training transfer as 

compared to non-managerial training (.20). Self-reporting (.28) showed 

higher levels of training transfer than did supervisor or peer reporting (.16). 

Training (.30) showed higher levels of training transfer compared to 

development (.16). 

Baharim (2008) study aimed to discuss our understanding of transfer 

of training variables and how they affect trainees motivation to transfer 

their training. Further, as the role of training has progressively changed 

from a focus on programs to a broader focus on learning, creating and 

sharing knowledge, this thesis tested the hypothesis that knowledge sharing 



48     

behaviour influences a trainee s motivation to transfer their training. Using 

a research framework constructed from an adaptation of two key Human 

Resource Development models (Holton 1996; Holton et al. 2000) and the 

theory of planned behaviour (Ajzen 1991), this thesis explored the 

contention that trainees motivation to transfer training is influenced by a 

number of secondary influence variables, expected utility variables, 

transfer climate variables, enabling variables and ability variables as well 

as by the variables associated with sharing behaviour. Through a 

questionnaire given to 437 government employees attending training 

programs in the National Institute of Public Administration, a central 

training organization for government employees in Malaysia, the thesis 

created an empirical database from which to study the phenomenon of 

transfer of training. This work culminated in the development of a 

structural model for motivation to transfer training, which incorporates 

knowledge sharing behaviour and extends our understanding of the 

operation of the precursors to motivation to transfer. The findings of this 

thesis impact on HRD functions in the Malaysian public sector at two 

broad levels: pre-training and post-training. The thesis makes a 

contribution to both HRD practice by detailing the sorts of HRD activities 

which will enhance transfer of training and secondly, makes a contribution 

to theory through the creation of a new model of motivation to transfer 

training which features knowledge sharing behaviour. 



49     

Shirley (2007) explored the idea of an organization in a state of 

transformation. Due to ongoing operations in Iraq and Afghanistan, the 

focus of Basic Military Training is shifting to basic combat skills, or the 

skills needed to survive and operate in a hostile environment. In this study, 

basic combat skills training was evaluated using a number of training 

factors that potentially affect trainees perception of training transfer, or 

their ability to apply the skills they learned in training on the job or in a 

hostile environment. The analysis used structural equation modeling to 

evaluate the paths between each of the factors and perceived training 

transfer. Of the factors analyzed, transfer enhancing activities and 

perceived utility were found to positively influence perceived training 

transfer for all training types, while organizational support for training was 

positive for Law of Armed Conflict training only. Deployment experience 

was positive for weapons training, but negative for Self-Aid and Buddy 

Care. Realistic job preview was positively related to training transfer but 

was only significant with respect to Self-Aid and Buddy Care training.   

Hobbs (2005) investigated how influences/attitudes/beliefs of LRO 

technical school graduates regarding their training influence their 

perceptions about the transfer of such training back to the job This study 

aimed at discussing training transfer as a concern within the US Air Force, 

and specifically within the Logistics Readiness domain as the new career 

field and Logistics Readiness Officer technical school mature. It employed 



50     

a survey-based methodology and the use of Structural Equation Modeling 

(SEM) for data analysis. The results of the research showed that influences 

such as intrinsic incentives, organizational commitment, pre-training 

motivation, training reputation, subordinate/supervisor support, task 

constraints, and transfer enhancing activities have a significant effect on 

training transfer. Not only does the research illuminate important 

influences on training transfer for the LRO, but it may also aid in directed 

efforts to improve and enhance the LRO technical school curriculum and 

experience. This research has also helped build support for existing theories 

on the influences on training transfer by expanding into a military context 

and by providing a unique opportunity to study such theories within a new 

training program scenario. 

Barnard (2005 study was to determine the effects of a near versus far 

transfer of training approach on trainee s confidence to related and 

unrelated tasks. the study examined whether trainees who are trained using 

a far transfer of training approach have equal confidence to related and 

unrelated tasks. the study scrutinized trainees general self-efficacy prior to 

training and their learning as a result of the training. Two instruments were 

developed to measure the variables. Data was collected over a period of 

two days during four training sessions at two collection points either 

immediately before or immediately after the training sessions. The results 

showed that supervisors who were trained using a far training transfer 



51     

approach had equal confidence to both related and unrelated tasks. The 

results also showed that supervisors who were trained using a near training 

transfer approach had greater confidence to related tasks and lower 

confidence to unrelated tasks. Further, the results showed that supervisors 

who were trained using a far training transfer approach and those who were 

trained using a near training transfer approach acquired similar levels of 

knowledge as a result of participating in the training and had similar levels 

of general self-efficacy prior to the training. This study provides several 

implications for future research important to the theory and practice of 

HRD. 

Derk-Jan J.M. Nijman (2004): study aimed at discussing the effect of 

supervisor support on transfer of training. The results indicated, however, 

that the actual levels of transfer of training programs to the workplace often 

do not match those intended. An important part of research focused on the 

influence of trainees work environment, with one of the main assumptions 

being that support from supervisors significantly affects trainees transfer 

outcomes. Little evidence-based knowledge exists, however, about the 

relationship between supervisor support and transfer outcomes. In order to 

gain a deeper empirical insight into the relationship between supervisor 

support at the workplace and subordinate trainees transfer outcomes, it 

was decided to carry out this study.  



52     

Swartz (2002 investigated the concept of training transfer in light of 

previous studies that found that despite successful learning in the training 

environment, acquired skills are often not translated back to the job. In an 

effort to better investigate the determinants of successful transfer, the two 

temporal facets of training transfer, initiation and maintenance, were 

examined to evaluate their relationships with the trainee characteristics of 

goal orientation and self-efficacy. The findings indicate that goal 

orientation and initiation may both best be conceived as predictors of 

transfer maintenance and interact to affect transfer behavior. The findings 

illustrate the value of examining individual difference variables in the 

prediction of training transfer. The results indicate that trainees and their 

supervisors do not relate individual training programs to a larger 

organizational context, such as organizational goals. Regarding trainees 

work environment, the questionnaires contained scales reflecting the extent 

of supervisor support experienced, the transfer climate and the general 

work environment. And finally, the trainee questionnaires contained scales 

measuring training characteristics and training outcomes. 

Anthony s (1999) discussed the conditions under which transfer of 

training would occur and the processes that are involved in the transfer of 

training to the workplace. He analyzed two studies that assessed the 

individual, situational, and training design factors that impacted on the 

transfer of training to the workplace. He examined the influence of 



53     

individual and situational factors on the achievement of trainees transfer 

goals. Trainees goals for transfer and their commitment to those transfer 

goals were found to act as mediators of the influence of self-efficacy, 

motivation, and situational constraints on transfer goal achievement. This 

result supported previous research that has shown that the impact of 

personal and situational factors on performance is mediated by the personal 

goal level and level of goal commitment (Wofford, Goodwin & Premack, 

1992). 

Thayer & Teachout (1995) based their study on a model of the 

determinants of training transfer. The model was modified to focus on the 

determinants of trainees transfer implementation intentions and 

implementation activities. Climate for transfer was assessed prior to 

training commencing and was found to influence retraining levels of self-

efficacy. However, positive and negative work climates also influenced 

pre-training levels of both self-efficacy and motivation, and the two 

transfer factors (Positive and Negative Work Climate) were found to 

influence positive and negative affectivity, respectively. It was concluded 

that climate for transfer impacts both directly and indirectly on pre-training 

levels of self-efficacy and motivation. The results strongly supported the 

modified model of training transfer that was presented. It was also 

concluded that situational factors do exert an indirect influence on the 

transfer process, apart from simply influencing what trainees are able to do 



54     

after training has been completed (Mathieu & Martineau, 1997, Qui ones, 

1997). 

Short (1997) conducted study at a large mid-western US state 

university. The sample included 19 managers who completed a leadership 

training program and 93 supervisors, peers, and subordinates who assessed 

the degree to which leadership behaviors were performed in the work 

place. Data was gathered to determine a) if differences existed in the degree 

to which leadership behaviors were transferred to the job at one month and 

three months following training, b) if a relationship existed between 

transfer behaviors and transfer climate at one month and three months 

following training and c) to what extent the variance in transfer behaviors 

could be explained by the variables: supervisor support, peer support, and 

subordinate support at one and three months following training. Data was 

gathered twice. The results of the study suggested that transfer behaviors 

were maintained from one month to three months following training, 

indicating that trainees displayed the same degree of leadership behaviors 

at three months following training. Surprisingly, the results suggest that 

trainees do not distinguish between supervisor support, peer support, and 

subordinate support. The results of the principal components analysis 

suggest supervisor support, peer support and subordinate support were 

more accurately defined as an aggregate construct labeled work group 

support. The results of the multiple regression analyses suggest that after 



55     

controlling for the education level of the trainees, work group support 

influenced the transfer and maintenance of leadership behaviors following 

training.  

2.10 Comments on Previous Literature  

Based on a review of the transfer of training literature, we can 

conclude that there are significant gaps in the empirical literature for 

training transfer. Studies have stressed the importance of several factors 

including: organizational environment factors, training design, trainees and 

trainers.  

The current study benefitted from previous efforts in determining the 

most important factors related to transfer of training. It also benefited from 

the statistical treatment which previous studies employed, for example:  

regression analysis, factor analysis and principal component analysis. Most 

of the previous efforts in transfer of training indicate the need for studies to 

investigate the impact of these issues on the transfer of training process. 

Thus, considering the main influences on transfer of training previously 

identified by Holton (1996,2005), this study aims to contribute to the 

theory of training transfer by empirically analyzing how different sets of 

variables simultaneously influence the transfer of training (Velada, 2007) .  



56          

Chapter Three 

Methodology 



57     

Chapter Three 
Methodology 

3.1 Introduction: 

This chapter was devoted to specifying the steps and the methodology 

taken in carrying out the research. The researcher will present the research 

design, study population and sample, instrument and its validity and 

reliability, data collection procedures, and the statistical analysis. 

3.1 Study Design: 

This research uses a quantitative design utilizing a survey method. The 

survey method involves the use of a self-administered questionnaire 

designed to gather specific data via a self-reporting system. The framework 

is based on the factors derived from previous studies e.g. Broad and 

Newstrom (1992). The literature review in Chapter Two provides the 

theoretical and empirical base for this study. The questionnaires allowed 

for confidentiality, in an effort to encourage more honest responses. The 

study was conducted at four governmental hospitals in North West Bank 

(Rafidia Surgical Hospital, Al Watani Governmental Hospital, Jenin 

Governmental Hospital, and Tulkarem Governmental Hospital hospitals, 

Qalqiliah Givernmental Emergency Hospital Salfit Emergency Hospital).   



58     

3.2 Population & Sample of the Study: 

The population of the study was composed of all health workers (GP, 

technician and nurses) in public hospitals in northern Palestine (Nablus, 

Tulkrem, Jenin, Qalqilay, and Salfeet). The selection criteria excluded all 

Governmental hospitals workers in administrative jobs and those who do 

not work in the Northern West Bank governmental hospitals.  

The sample consisted of all of the study population who were (690) 

health workers (GP and nurses). The researcher managed to distribute the 

study instrument to the whole study sample and to managed to retrieve 

(486) valid questionnaires, with a response rate of (70.43%).  

The population for this study was deemed appropriate because health 

workers in public hospitals are first responders in emergency situations and 

it is very important for them to transfer the skills and knowledge learned in 

training to on-the-job situations.  

The survey instruments were administered to health workers at the 

time of data collection.  

Table (1) shows that about one third (39.1%) of the Governmental hospitals 

workers were from Nablus district, (26.8%) were from Jenin district, 

(16.7%) were from Tulkarem district and less than one fifth (12.8%) of 

Governmental hospitals workers were from Qalqiliah.  



59     

Table (1) Distribution of the study sample according to the study 
variables 

Variable Level N

 
% 

District 

Nablus 190 39.1 
Jenin 198 40.7 
Tulkarem 78 16.0 
Salfeet 8 1.6 
Qalqila 12 2.5 

Education level less than secondary 
education 

22 4.5 

Diploma 132 27.2 
B.A 188 38.7 
M.A 34 7.0 
PhD 110 22.6 

Years of experience less than 5 years 188 38.7 
5-less than 10 years 122 25.1 
10-less than 15 years 84 17.3 
more than 15 years 92 18.9 

Marital statues married 336 69.1 
single 148 30.5 
otherwise 2 .4 

gender male 220 45.3 
female 266 54.7 

Training courses non 154 31.7 
2-4 courses 206 42.4 
More than 5 courses 126 25.9 

Specialized training  
courses 

took courses  302 62.1 

 

Did not take any 
courses. 

184 37.9 

 

3.3 Instrumentation 

After conducting an extensive literature review on training transfer 

(Burke & Baldwin, 1999; Clemenz, 2001; Cromwell, 2000; Hicks, 2006; 



60     

Sekowski, 2002), data was collected via a complementary questionnaire 

developed in the native language of respondents (Arabic), that consisted of 

(60) items and covered five factors relating to training transfer 

(organization culture, work climate, trainees, trainers, and training design). 

The questionnaires were organized into four parts:  

-The first part of the questionnaire included a description of the study 

objectives and the importance of the study. This part assured participants of 

the confidentiality of the information.    

-The second part collected demographic information including (district, 

education level, years of experience, job title, marital status, gender, 

number of courses, and place of training.) 

- The third part consisted of (60) items constructed in close ended 

statements on a seven likerat scale in which (7= strongly agree, 6=- 

somewhat agree, 5=agree, 4 =neutral, 3= somewhat disagree, 2=disagree, 

1=strongly disagree). Covering five factors related to training transfer 

(organization culture, work environment, trainees, trainers, and training 

design). 

3.3.1 Reliability Test  

To ensure the reliability of each factor, Cronbach's coefficient alpha 

was estimated to test the internal consistency among the items included in 

each of the formative scales. The resulting alpha values for the study 



61     

domains ranged from (Y = 0.72 to Y = 0.95), which are acceptable 

according to Nunnally and Bernstein's (1994) guidelines for exploratory 

research, making all factors reliable . 

Table (2) Cronbach's coefficient alpha reliability test of the internal 
consistency among the items included in each of the formative scales. 

 

Factor  No. 
Items 

items Cronbach's coefficient 
alpha 

Organization culture  15 1-15 0.72 
Work climate   10 16-25 0.72 
Training 15 26-40 0.88 
Trainee 12 41-52 0.90 
Trainer 8 53-60 0.95 
Total score of training 
transfer 

60 1-60 0.93 

 

3.3.2 Content validity  

Content validity deals with how representative and comprehensive the 

items are in creating the scale. It is assessed by examining the process by 

which scale items are generated. Content validity in this study should be 

relatively acceptable since the various parts of questionnaire were all based 

on the literature review and on the opinions of several experts who 

examined the items. As suggested by Cooper and Schindler (2003), a panel 

of experts was interviewed to judge how well the instrument meets the 

standards. Thus, the researcher conducted independent interviews with 

experts who had more than five years experience in quality management. 

The panel was asked to comment on the length of the instrument, the 

format, and the wording of the scales. They suggested that the procedure 



62     

and Arabic translation of the questionnaire were appropriate, with minor 

modifications in the translated version of the questionnaire. 

3.4 Field Work: 

Face-to-face interviews using a structured questionnaire were conducted. 

The questionnaire collected comprehensive data on a wide range of issues 

related to factor of training transfer for government hospital workers 

(nursing, technician and general practioners).  

3.5 Pilot Study: 

A pilot study was carried out in Al-Rahma Hospital (this hospital was not 

included in the actual study) in order to identify potential problems and to 

revise the methods and logistic of data collection before starting the actual 

field work. (20) Hospital workers were selected randomly, of which 

(58.2%) male and (41.8%) female with a mean district of (55.6) years for 

males and (56.4) years for females. After the pilot study, the questionnaire 

and interview proposed time were revised as it was found that more time 

was needed. In addition, some questions in the questionnaire were revised 

to make it more easily understandable by participants, while preserving 

same objectives of the questions.   



63     

3.6 The Study Fieldwork Procedure: 

Hospitals in Nablus (Rafeida and AL-Watainy), Jenin, Tulkarem, Salfeet 

and Qalqiliah were: visited weekly. During each visit interviews with (10 -

15) health workers were conducted and each interview took (30-40) 

minutes. The field work in this hospital finished within (20) weeks 

resulting in interviews with (486) government hospitals workers. 

3.7 Statistical Analysis: 

Statistical Package for Social Science (SPSS) version 17 was used for 

data analysis. Various statistical processes were used including means, 

frequencies and regression to determine variation significance. Factor 

analysis (principal component analysis) was used to determine the most 

important factors. A P-value of less than or equal to 0.05 was used to test 

the significance of the study hypothesis.  

3.8 Ethical issues: 

Permission to conduct this study was obtained from the Palestinian 

Ministry of Health in Ramallah. In addition, governmental hospital workers 

were informed about the purpose of the study before conducting the 

interview and were told that their participation would be voluntary.  

  



64          

Chapter Four 

Results 



65     

Chapter Four 
Results 

4.1 Introduction: 

The purpose of this chapter is to identify the factors affecting transfer 

of training within the work environment from the perception of workers in 

Palestinian government hospitals. Moreover, this chapter aims to analyze 

which factor (organization culture, work climate, trainees, trainers, and 

training design) has the most influence on transfer of training within the 

work environment from the perception of workers in Palestinian 

government hospitals. This chapter will also analyze the role of the study 

variables (district, education level, years of experience, job title, marital 

status, gender, number of courses, and place of training) on the factors 

affecting transfer of training within the work environment from the 

perception of workers in Palestinian government hospitals.   

4.2. Results Related To the First part: 

This part aims at answering the following question: 

Q1: What are the factors affecting transfer of training within the work 

environment (organization culture, work climate, training design, 

trainee, trainer) from the perception of Palestinian government 

hospital workers in the Northern West Bank? 



66     

To answer the study question descriptive analysis prepossess were 

computed (mean, standard deviation, and percentages) for each item and 

their respective domain and total score.    

(100%-80 %) very high degree of response. 

(70-79.9%) is high degree of response. 

(60 - 69.9 %) is moderate degree of response. 

(50 - 59.9 %) is low degree of response. 

(Less than 50 %) is very low degree of response. 

4.2.1 Organization Culture: 

Results in table (3) indicate that the factor of organization culture has a 

significant effect on the transfer of training within the work environment of 

Palestinian government hospitals M=5.073, SD=0.69, 72.48%. Items (1, 4, 

7, 8, and 14) indicate that language, a lack of necessity for financial 

rewards to enhance performance, and the ability of training to change work 

reality received a very high degree of response. This demonstrates that 

cultural factors play a significant role on the transfer of training process. 

While items (5, 6, 9, 10, 13, 15) received a high degree of response. This 

indicates that the influence an employee s relationship with supervisors, 

colleagues, and other leading people in the training process also play a 

significant role in the transfer of training process. Further, items (3, 11, 12) 

received a moderate degree of response, which shows that the influence of 

gender, direct opposition, colleagues encouragement play only a moderate 

role in the transfer of training process. 



67     

Table (3) mean, standard deviation, and percentages of each item, and 
total score of organization culture factor affecting transfer of training 
within the work environment from the perception of Palestinian 
government hospitals. 

No

 
Order 

 
Items M 

 
SD percent

 
Degree 

1.

 

2 I focus on the 
financial return in 
comparison to 
knowledge and 
experience in 
training. 

3.55 1.853 50.71 Low 

2.

 

11 I face opposition 
during the 
application of skills 
and knowledge I 
leaned. 

4.28 1.583 61.14 moderate

 

3.

 

3 Due to gender factor 
I have a greater 
opportunity to 
participate in training 
programs. 

4.66 1.785 66.57 Moderate

 

4.

 

12 My colleagues 
support and praise 
me when I apply 
what I have learned 
in training. 

4.83 1.590 69.00 Moderate

 

5.

 

15 Training is an 
opportunity to visit 
other countries and 
learn about new 
places. 

4.99 1.690 71.29 High 

6.

 

9 Transferring what I 
have learned during 
training is influenced 
by relations with my 
colleagues. 

5.06 1.684 72.29 High 

7.

 

13 Training for me is a 5.13 1.491 73.29 High 



68     

type of social support 
for my profession. 

8.

 
10 Transferring what I 

have learned during 
training is influenced 
by relations with my 
superiors. 

5.19 1.717 74.14 High 

9.

 

6 My relations with 
other help me in 
applying what I have 
learned. 

5.40 1.326 77.14 High 

10.

 

5 Training process and 
selection is 
influenced by other 
unrelated factors 
such as social 
relations and 
relatives in decision 
making area. 

5.45 1.599 77.86 High 

11.

 

4 I'm ready to join 
training programs 
even if it is without 
any rewards or 
incentives. 

5.61 1.427 80.14 Very 
high 

12.

 

14 Training will change 
the work reality. 

5.77 1.770 83.86 Very 
high 

13.

 

1 Language factors in 
training have a great 
effect on my 
performance. 

5.98 1.211 85.43 Very 
high 

14.

 

8

 

Training for