"It's when you try to quantify results down to the sales level that it becomes tricky," says Gunning. "In most cases, you can't isolate everything. For every one confounding factor that I can identify, there are probably two or three that I can't. That means you run the risk of not giving accurate ROI."

Although the best scientific studies are double-blind and use control groups, few companies are willing to form a control group-that is, not train their salespeople. Instead, they are turning to Kirkpatrick's Four Levels of Evaluation, which range from simplistic to complex analyses of training effectiveness. (See "Study Without the Sacrifice.") According to the study, most companies are currently at Level II or Level III.

"Using Kirkpatrick's levels probably gives as much, or more, meaningful information, when compared simply to dollars," Gunning says. "While it may not be hard data, it may be hard enough for training."

"When your focus is on quality, you have to determine what metrics define success," says Novartis' Adoff. "A positive ROI is one metric, but we also measure access, customer perceptions of reps, time with physicians, and other quality measures. These metrics help us better understand where opportunities exist to enhance sales reps' skills."

Most companies have a formal system for tracking training performance, but only about a third currently analyze the impact of training on sales performance, which is usually conducted by district managers and the home office. Specialty and biotech companies are much less likely to have such a system in place.

Old-School Methods Many view industry's renewed focus on manager development and ROI as a way for their departments to showcase their ability to affect results in the field. Although many managers have recently focused on cultivating business skills and acumen, they are beginning to realize that the development of sales talent is critical to success. As a result, managers may supplement their focus on spreadsheets with an emphasis on developing people once again. And, if training departments find better ways to measure their programs' effectiveness, sales organizations may be more likely to turn to training for more high-profile initiatives.

Could that be the big break that training departments have been waiting for? Some says so. Although the window of opportunity is open, the future is still uncertain. It's likely that the complexity of the healthcare environment will continue to deepen. New layers of regulations, increasingly complex products, more informed patients, and continued corporate mergers add to an already difficult sales and marketing environment. And, if history serves as a guide, training may be unable to quickly react to incorporate those additional complexities.

One obstacle to getting training the visibility it deserves is the nature of the training career path itself. (See "Trainer Career Paths.") Three-quarters of headquarters training positions last 18 months or less because executives consider them stepping stones to positions in other functions within the company. That doesn't give trainers much time to develop effective training strategies-and mirrors the problems of inexperience in the field. Whether companies will modify trainers' career paths and make it more tempting for talented people to pursue positions as career trainers remains to be seen.

"In the future, what we have to guard against is focusing too much on the training process and not the real purpose," says SPBT's Fagan. "Often, our companies' success causes us, as an industry, to become complacent. We think we're doing everything just fine and we become too comfortable with our own approaches-even when our sales calls become shorter and we make our sales organizations larger. But trainers need to look outside their organizations if they are to contribute real value to their companies and the medical community as a whole. There's a real need for people development, and trainers should be leading the way."