Sales Force Report: Training

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When it comes to training pharmaceutical sales reps, you can say goodbye to blackboards, crowded classrooms and employee downtime associated with traveling to training sessions. Dwindling sales forces, fewer face-to-face encounters with physicians and a more targeted sales approach is forcing pharma companies to re-think how they train their sales reps. The new training mantra: e-learning.

The industry is experiencing a big push toward using computer-based training (CBT) and other self-paced related training followed up by knowledge checks or tests to validate a foundation of learning, according to Kelly Phillips, manager of the learning solutions group at Cegedim Dendrite. “On the content piece for instructor-lead training, there's a significant shift to integrate role playing and real world simulation during the sessions to increase their relevance, effectiveness and retention,” says Phillips. 

Case study
In order to respond to a rapidly changing market and customer needs, AstraZeneca is aggressively pursuing an e-learning strategy. All sales reps at the company are trained on Touchstone and Tablet PCs and the company is incorporating different modalities including, mobile learning, simulations, virtual worlds, and social media. In addition, they are designing different learning methods, according to John Royer, director, sales training strategy, at AstraZeneca. 

“The pharmaceutical industry, in general, does a good job of training representatives, but every company looks nearly identical in how they train their reps, and most training is geared mainly toward new hires,” says Royer, who adds, “at this point, change is what must happen to respond to the changing market and customer needs.”
Royer says that AstraZeneca has one of the industry's leading training programs. “Both our primary care and our specialty care selling teams receive product details, research and data,” he says. “They are both highly trained to have extensive conversations on the brands they carry.”

However, Royer notes that if the company needs to put more resources toward specialists, they will provide additional training to get sales reps where they need them to call on the specialists. “The combination of technology and training has allowed us to be more responsive to customer needs and incorporate the input we receive from the through closed-loop promotion,” he says. “Our selling teams are more flexible in their discussions with their customers and are able to let the customer drive the conversation rather than delivery of a linear message (one-way).” Royer says that AstraZeneca is taking training to an entirely new place.

“Rather than giving a new representative a standard 30-60 minute e-learning module and then have them take a multiple choice exam to test knowledge, we are now taking that same e-learning module and breaking it down in much smaller chunks of information we call ‘Learning Bites' followed up with more behavioral-based assessments,” he says. Royer adds that this allows for a more direct, targeted and individualized learning capability and for more remote options to reach representatives, physicians and patients. 

This more flexible training model, according to Royer, supports a trend toward more of a relationship-driven model with the physician as opposed to the standard reach and frequency model. “What we get by doing this is a representative who is now even more of a value-added resource to the physician and the patient,” he says. “And by taking on a more consultative role requires us to have a much more flexible and personal learning model in place.”

Industry insiders note that e-learning is fast becoming a part of a blended-learning solution strategy that includes some type of interactive learning content. “Pedagogy empowered by digital technology, that's what e-learning is really defined as,” says Suzanne Burrell, VP of operations for Total Learning Concepts (TLC), part of the Publicis Sales Solutions Group. “In order to make the e-learning successful, you have to provide that interactivity component, the ability for the learner to feel that they are involved in the learning and they are not passive learners.”

Another path to interactivity according to Burrell, is “virtual preceptorships.” In the old days reps would spend a couple of hours with docs, but not any more. The FDA regulations have limited the availability for drug reps to go in and do a preceptorship with a doctor or nurse. 

“So we've created interactive virtual preceptorships that can be anywhere from two to six hours of content where the learner visits and interacts with a virtual community that includes doctors offices, pharmacies, hospitals and clinics—depending on what the drug is that they are selling,” says Burrell. She says that in each of these areas, the rep can click into case studies that they have to solve—or get to sit in on live presentations where doctors can answer questions and they also have opportunities to do testing to make sure that the learner understands the environment.

 Another way that TLC is helping to ensure that sales reps are taking in information is through game-based learning. “Research shows that serious game-based learning increases knowledge retention by as much as 10 times,” says Burrell. “Serious game-based learning is gaming that relates directly back to the content that you're trying to understand.” 

After learning a chapter of content, a rep will have a number of games that they could play, some are very linear where it will ask yes or no questions such as hangman and others are open-ended where the rep may go on a scavenger hunt. “The learner may be instructed to read through content like a package insert or clinical reprints, and pull out key information for a doctor that's interested in treating this type of patient,” says Burrell. In other words, the learner has to find that information and type it back into the game and the game tells them how they scored. TLC uses 30-35 different games.

Mike Luby, co-founder of TargetRx, notes that game-based learning is becoming increasingly popular. “More pharma companies are employing physicians into the mix,” he explains. “Training often entails interacting with not only brand mangers but also physicians who are in for the day to provide real world perspective.” 

Luby adds, “The nice thing about e-learning solutions, that we see the industry using, is that there is much more consistency and it helps to make sure you're both in line with regs and also that you can test and evaluate along the way.”

Greater efficiencies
Internal studies conducted by Cegedim Dendrite, reveal that blended technologies are clearly helping pharma companies to become more efficient. “We are advising our clients to leverage a blended training curriculum where there is a self-based training upfront followed by high-impact instructor-lead training to achieve significant reductions in their rep support costs,” says Drew Bustos, senior director, global communications at Cegedim Dendrite. 

Bustos says that a blended training strategy has enabled reps to achieve a higher level of proficiency in half the time that traditional instructor-lead training is getting. “It is very significant for a pharma company to be able to see the productivity gains from an effective training strategy. As a result their sales force operates with less-ramp up support so the reps can start detailing prescribers more quickly and effectively,” says Bustos.

So far, feedback from the sales reps regarding the new training models has been positive. “The biggest fear that a representative has as new technology is introduced into their environment, is that they fumble or don't appear to be an expert with the technology as they interact with prescribers, thereby, missing out on a valuable interaction,” says Cegedim Dendrite's Phillips. 

She adds that, in training, “we focus on providing reps with a significant amount of time to practice in a simulated environment, this means focusing on how they'll be using and interacting with the physicians out in the field.” Phillips says that this removes any nervousness, makes them more confident in leveraging the technology and as a result, they have responded very well to this approach.

TLC's Burrell says she is seeing the hiring criterion focusing more on the reps ability to specialize and become an expert in a specific disease state or focus, like diabetes or cardiovascular disease. She predicts that there will be a lot less focus on what is now called a primary care rep who goes in and talks to primary care docs about a number of different drugs. She adds that the training focus is on what the rep needs to do in order to be a specialist in diabetes or cardiovascular disease. 

“Because the docs, nurses and their staff want to talk with sales reps that provide real value, and to them real value means updated clinical info, contraindications or anything that they can provide the office that helps them treat patients,” says Burrell, adding that the pharma industry is really looking at their sales forces and making sure that they can add value within those offices. 

Even smaller pharma firms that may not be able to take advantage of all the technology bells and whistles such as e-detailing—when it comes to the hiring and training of reps. The bottom line: Employ reps that bring value to the doc's office. 

“It's almost more important than ever to have good sales skills; you have to get to that doctor because at the end of the day, docs are still seeing sales reps that are delivering good clinical data,” says John Thievon, president and CEO of Westlake, Texas-based MiddleBrook Pharmaceuticals. In contrast to Big Pharma's almost weekly hemorrhaging of sales reps, MiddleBrook is hiring 270 sales reps in preparation for its March 16 launch of its antibiotic Moxatag. Thievon says that his reps are currently using Tablet PCs and over time his company will likely adopt e-detailing, but for now he says that the biggest bang for the company's buck is getting the rep in front of the physician. “That's where the lion's share of the resources go.”

Some industry insiders contend that in order to gauge the success of a sales training strategy, pharma companies must have the ability to measure that success. “The greatest opportunity for improvement that we see few companies doing—is putting metrics to it,” says TargetRx's Luby, who adds, “at the end of the day the measure of training ought to be are you serving your customers well, are they using your products for appropriate patients.” Luby points out that very few companies have effectively employed metrics to really measure and make sure that they can measure, manage and improve. “So, if your training isn't giving you the results you want—you know what's working or not—you know whether your reps have the right level of product and disease knowledge or good relationships, all the things we know to be parts of the success equation,” he explains.

Luby says that the single biggest unmet need in terms of training getting to the next level is bringing some real world metrics to it. “That helps bring what happens in the classroom whether it's virtual or live to what happens in the real world.”

The future 
How will pharma companies alter their training strategy to keep up with the changing needs of its sales force? “The skill sets companies train for and recruit to will evolve,” says Kelly Myers CEO of Qforma. “I think it will become a broader skill set instead of a more narrow skill set.”

“As we continue to see established and emerging training delivery mechanisms gain acceptance, like WebEx or computer-based training, [the channels] become more adopted by our pharma clients,” says Cegedim Dendrite's Phillips. 

In addition, as the demand for flexibility and nimbleness continue to increase, pharma companies are going to have increased opportunities to deliver training in more of a just-in-time format, notes Phillips. For example, if there is a product launch coming up, pharma companies can deliver very specific, targeted training in a very short snippet to the sales force without needing to remove them from the field, explains Phillips. 

“As new technology becomes available,” says Phillips, “pharma will have a greater opportunity to touch the sales force more frequently and in a more impactful manner.” 

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