Negotiation training programs tend to fall into three general categories:

• Programs offered by MBA schools such as Harvard and Northwestern. Instruction is led by academics with impeccable credentials. Typical cost is $10,000 per person.
• Programs conducted by former sales wunderkinds sharing secret tactics they personally used to negotiate BIG deals.
• Programs which are based on the book “Getting to Yes” by Roger Fisher and William Ury. Emphasis is on teaching tips, tricks and formulaic approaches that rely heavily on situational tactics. As an example, one program crams in 197 different steps, rules, approaches, issues and “critical truths” that attendees are asked to learn.

The third category probably offers a good balance between effectiveness and cost for most Life Science companies. However, after surveying over two dozen negotiation training programs it appears that these programs fail in either one or both of these two significant areas:

• No framework is provided to effectively manage an entire negotiation process, including pre and post activities
• Interpersonal skill development in conflict management, emotional intelligence and communication is nonexistent

Fisher and Ury recognized that people’s emotions strongly influence negotiation outcomes. Emotions generate behaviors that can make it difficult to discern the interests of others, that can cloud judgment, and that can create challenges to communicating effectively. It’s not the recall of reactionary tactics but the ability to interact effectively that will improve a sales organization’s negotiation effectiveness.

Perceptum’s Negotiation program teaches universal integrative negotiation concepts and principles. Within the context of an adaptable framework, participants learn to prepare, conduct, and evaluate a successful negotiation, sharpen interpersonal skills that foster cooperation, and improve conflict management and communication skills. Special attention is paid to conducting difficult conversations and understanding emotional intelligence. After attending our program attendees will know how to think critically, communicate effectively, and negotiate masterfully regardless of the situation and people involved.

Medical device sales training programs typically contain important topics such as product, procedure, branding, messaging, market data and competition. This article focuses on best training practices that we have found to be effective in creating clinically competent medical device sales people.

Design with Competence in Mind

A majority of medical device sales people are kinesthetic learners. As such, developing a training curriculum that emphasizes a hands-on approach should be the rule of thumb. A 2:1 learning ratio of hands-on training to didactic instruction should be a minimum goal. Also, include in the training multiple numbers of “touches” on information viewed as most critical to a salesperson’s success. This is based on adult learning principles. The number of touches as well as the variety of how the touches are delivered will help commit the information to long-term memory and influence desired behaviors. Examples of touches include pre-training reading assignments, training exercises that incorporate role-play or competitive games, interactive breakouts or lab hands-on.

It is important that training objectives and expected competencies are clearly defined, for example, “At the end of the training program you should be able to cover a case with a first-time user of Product X.” In addition, prerequisite readings should be assigned as a way of conserving training time. Prerequisites can also have the secondary effect of underscoring expectations and reinforcing standards of accountability.

Consider testing the attendees’ comprehension of their prerequisite assignments using a Web-based application or during the first part of training. The results will establish baseline measurements which help improve the training curriculum. Additionally, results can indicate any knowledge gaps that may exist with the training class or individuals.

It is important that all instructors meet prior to training in order to ensure alignment on roles, learning objectives, expectations, company messaging, branding and accepted standards for procedures and product demos. Instructors communicating inaccurate, non-compliant or conflicting information will undermine training effectiveness. To help instructors, a Leaders Guide on the “what and how” training is delivered should be developed to ensure compliance and consistency with corporate training standards.

Bringing Competence to Life: “See One, Do One, Teach One”

See One: Sales reps should be shown how to competently perform clinical and technical activities correctly, for example, they should be shown how to perform the procedure, how to set up a back table and how to effectively in-service. Demonstrating how things are performed with excellence clearly establishes the company’s accepted baseline and ensures that the sales reps understand that level of competency expected of him/her. In addition, make sure sales reps are able to troubleshoot when difficulties occur with the device or procedure because that too is reality. Problem solving skills are essential and practicing responses to the most common situations that arise in the field should be well covered in training.

Do One: Salespeople are kinesthetic learners. The more hands-on time that they have, the more repetitions they experience, the more effective the training. To get the most hands-on training, student to instructor ratio is important. The ideal ratio is 2:1 but 4:1 is acceptable if there are budget restraints. To accommodate larger classes and still maintain an effective learning ratio, rotate small groups of sales reps simultaneously through multiple learning stations.

Teach One: Once sales reps are fully trained, learning and competency can be reinforced by having them verbally teach another person on product use and procedures. Verbalizing instructions helps them to retain knowledge better than just repetitively performing hands-on demonstrations.

Side Note: For med device companies using minimally invasive or percutaneous procedures where there is a reliance on procedural imaging, sales reps need to be competent in reading anatomical landmarks and fully understand how the procedure looks under fluoroscopy. They might find themselves in the OR with an inexperienced radiologic technician or one who is unfamiliar with the procedure, or they may be covering an evaluation case with a physician who went through training sometime ago. These scenarios can be challenges to a good patient outcome, but they can also provide a sales rep, confident in their knowledge of fluoroscopy, an opportunity to elevate themselves from salesperson to valuable resource.

Test for Competence

Practical exam(s) on the final day of training are optimal. A practical exam provides the sales reps an opportunity to demonstrate competency and allows for an objective evaluation. The exam should reflect conditions and situations the sales reps will encounter when they return to their territories. Examples of practical exams include physician product demonstration, in-servicing or replicating case coverage using a simulated clinical or operating room environment.

A formal evaluation checklist with a scoring system should accompany the practical exam. The checklist should consist of items wherein the sales reps need to demonstrate competence. This ensures that everyone is being evaluated on the same items, which is important when using multiple evaluators.

Incorporating these best practices will increase the effectiveness of your training, resulting in greater Competence, Confidence and Credibility for your sales reps…and more sales.

 Don Wright is a Managing Partner with the Perceptum Group LLC, San Francisco, CA. Perceptum Group develops and delivers sales training, physician education, and leadership development programs exclusively for medical device, biotechnology, and specialty pharmaceutical companies. www.perceptumgroup.com

Let’s do the math. Using the above manufacturer as an example, let’s say 120 surgeons are trained in a year – one training class per month, ten surgeons per training. 34 are adopting the technology. If the device has an ASP of $5,000 and each surgeon completes 50 procedures a year, these 34 surgeons would generate $8.5 million in annual sales revenue. Now, if an additional two surgeons (per training class) would adopt the technology, $6 million in additional revenue would be generated – a 70% increase!

Here are some effective no-cost best practices that can achieve this end.

Before Training

Proper targeting and qualifying of surgeons is of utmost importance. Surgeons need to be carefully screened such that sales reps do not offer expensive surgeon trainings to unqualified surgeons.

Surgeons need to commit to performing a series of evaluation cases (we recommend a minimum of 5 to 10) within a specified timeframe. There is a strong correlation between product adoption rates and not only how fast surgeons complete their first case post-training but also how quickly they finish the entire case evaluation series. The surgeon should be willing to schedule the first case(s) before attending training with the goal of having at least one case scheduled within the first two weeks post-training. The longer a surgeon waits to perform a procedure the less likely he/she will adopt the technology.

Surgeon commitment should also include a formal letter from the company confirming their attendance at the training. The sales representative should confirm attendance with the surgeon’s office one month, two weeks and one week prior to the event. This will ensure they do not have any professional or family obligations that would prevent their attending.

Once a sales representative has a surgeon’s commitment he/she should ask the surgeon to identify potential patient candidates and review patient films. It is a good idea to have the surgeon bring patient candidate films to the training for consultation with the faculty trainer.

If the procedure and/or device are new, the sales representative should review and verify the credentialing and value analysis committee process (VAC) with the surgeon in order to get the necessary approvals. The surgeon should submit a request for privileges to the hospital before or immediately after the training, preferably before. Sales representative should be able to describe the credentialing and VAC process of the hospitals in their territory. If they cannot this should be considered a red flag to sales management.

Finally, it is most effective to limit the number of surgeons invited into training. A sales rep should never invite more surgeons than they can effectively support during and after completion of training. Additionally, the sales rep should submit a bio-sketch of their surgeon(s) for the faculty presenter who is delivering the training program

At Training

Physician training accomplishes two goals critical to increasing surgeon adoption rates. The first is increasing surgeon competencies with the new procedure and the second is creating a secure peer relationship between the surgeon and sales representative. In order to accomplish these goals the training must be meticulously planned and executed.

Sales representatives should accompany all surgeons to trainings and have dinner with them the night before the program.  They should invite no more than one or two surgeons – the most that should be assigned to any one table/station. This dynamic allows a sales representative to be fully engaged with their surgeons throughout the lab training.

The faculty presenter should be coached prior to the program presentation in order to reaffirm his/her understanding of the following: patient selection, and indications and surgical technique that ensure compliance and that are aligned with the company’s marketing messages. It is also necessary to make sure the faculty presenter is familiar with each attendee’s bio-sketch.

A company representative should open the program to set expectations for the surgeons. This includes competency needed to gain a certificate of completion, an overview the day’s agenda, an introduction of the faculty and delivering any product messaging about which the faculty might be uncomfortable addressing.

While the faculty presenter is lecturing, the training organizer should hold a meeting with the table trainers to review the lab exercise checklist used for certification and familiarize them with the surgeon bio-sketches. Ideally, the sales reps would function as lab table trainers if they were clinically competent to do so.

Surgeons should be required to demonstrate competency of both product and procedure by successfully completing a lab exercise checklist in order to earn a certificate of completion. Before leaving the lab the sales rep should reconfirm evaluation case commitments and schedule a follow up meeting.

An emphasis on faculty – attendee interaction is important. The faculty surgeon should float between the tables to answer questions, provide direction and review any films of evaluation cases that will be performed post-training.

Post-Training

The sales representative needs to review patient selection criteria and begin planning the first case(s) when meeting with the surgeon post-training. The sales rep should also meet with surgeon’s nurse/Physician Assistant and the surgeon’s scheduler if either is a different person. The reasoning behind this is that the nurse/PA does the chart reviews and needs to be aware that the surgeon is going to perform a series of evaluation cases on your product. It is important to review patient selection criteria and ask him/her to look for good patient candidates. Similarly, contact the hospital surgery scheduler. Make her/him aware that the surgeon is going to be evaluating your product and ask to be called when a case is scheduled.

It is also a good idea to notify the hospital’s Head Nurse/nurse coordinator that the surgeon is going to be evaluating your product. If uncertain about the Head nurse’s loyalties to competitors, it is helpful not to give too much notice in order to reduce the chance of any competitive counter-measures.

Sales reps should call the control desk to get the surgery schedule and find out what techs have been assigned to their case. In-service the surgeon’s clinical team one or two days prior to the first evaluation case. Sales reps should attend all evaluation cases. If a manufacturer is using a distributor sales model and the surgeon is a potential high-value customer, the manufacturer should provide, at a minimum, case coverage support for the first few cases if not the entire evaluation series.

The way in which a sales rep functions both pre and post op during the evaluation cases is crucial.  To drive proper pull-through and build OR team advocacy for a product, he/she should map out the entire OR pull-through process and be aware of the key stakeholders. The sales rep should know who to talk to, in what sequence and what to ask. He/she should anticipate common objections, know how to apply the information gained as well as how to delineate follow up activities that will differentiate your product from that of competitors.

Surgeon conversion must be viewed as a process and not as some event hinged solely on clinical training. If done correctly, incorporating these no-cost best practices before, during and post-training will increase your company’s product adoption rate and sales revenues.

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