Trainer and trainee agency across the work-training continuum in health care: a Safety-II-oriented approach

Purpose This study aims to explore how occupational health and safety (OHS) training can create continuity between health-care workers’ everyday experience and the learning process, transforming the classroom into a reflexive space where operational knowledge becomes a resource for learning and anticipation. Particular attention is given to the role of trainers as facilitators of organisational learning and to the emergence of weak signals during training discussions. The study also highlights the strategic importance of dedicated Train-the-Trainer (TTT) programmes to equip trainers with systemic thinking and sensemaking competencies required to support a Safety-II-oriented training approach. Design/methodology/approach This study draws on 21 in-depth interviews with internal and external OHS trainers. The authors used the reflexive thematic analysis method to investigate how trainers understand Safety-II concepts, weak signals and experiential learning, and how these insights support their pedagogical choices during training discussions. Internal trainers were OHS managers or assistants employed within hospital organisations, while external trainers were freelance professionals or academics invited to deliver specialised safety-related training modules. Findings Four themes are identified: The Training Gym: training as a reflective space revealing tacit, experience-based skills; The Foresight Field: preparedness for the unexpected and sensitivity to weak signals; Situated Professional Competence: integrating technical and non-technical skills in practice; Systemic Safety: trainers helping healthcare workers understand organisational interdependencies. Trainers pragmatically expand programmes, turning training into sensemaking and organisational learning, highlighting the need for TTT initiatives that develop facilitation, systemic thinking and weak signal-related skills. Originality/value This study contributes to the still limited literature on Safety-II and weak signals’ interpretation in health-care OHS training, highlighting trainers as mediators between regulations and Safety-II learning, and guiding Safety-II-focused TTT design.