CERTPOINT Systems

Scientific knowledge must be combined with relationship-building skills training to prepare representatives for the unique pharmaceutical sales environment; additionally, training must be continued throughout a representative's career.

Shrinking share of voice is making pharmaceutical product detailing increasingly difficult, but steps can be taken at the training stage to help prepare sales representatives for the new reality. Pharmaceutical sales representatives have only a small window of opportunity to make an impression with physicians. Although strong scientific and technical knowledge is vital for establishing credibility and providing value, many companies are failing to provide the relationship-building skills representatives require to understand physicians· needs. Sales representatives must develop listening and appreciation skills and learn how to efficiently probe and ask questions so that messages can be tailored to individual prescribers. Although many companies are falling short by only providing intensive training for newly hired sales representatives, new technologies can help build programs that can extend that training to every phase in a rep's career.

More than 85,000 industry sales reps operate in the United States, according to business-information company Cutting Edge Information (cuttingedgeinfo.com). These analysts say the representatives who innovate and demonstrate their value as conveyors of medical information, as therapeutic-area experts, and as business advisors to physicians t practices earn themselves priority access over competitors. By providing reliable, up-to-date information, sales representatives will build lasting, trusting relationships with their physicians. But the traditional training techniques used by many pharmaceutical companies are failing to prepare sales representatives to deal adequately with the short detailing sessions allotted to them, according to Steven K. Budd, president, global sales and marketing services. PDI Inc. (pdi-inc.conl). PDI is a provider of outsourced sales solutions.

The reality is physicians are pressed for time, and getting access to quality time with doctors is more difficult than ever, U Mr. Budd told Med Ad News. ''Traditional training is all about teaching a rep how to do a very thorough presentation in a three-to-five minute time frame. The new training needs to teach reps how to connect with physician~ within the first 15 seconds and engage them in a way that earns the right for them to get that two-to-three minutes of quality time with the physician to have a more in-depth discussion."

Sales-force training must put a stronger emphasis on determining the needs of the customer. H\VC need to continue to focus on leaching reps how to deal with a customer base that, frankly, is becoming increasingly exasperated with us, the pharmaceutical industry Mr. Budd says. While we understand their needs, we understand our needs better, and I don't think as an industry we've been sensitive enough to the physicians) needs. Therefore, we've alienated them a little bit in this process."

Pharmaceutical sales representatives face challenges unique to their industry. Representatives have a responsibility to have a more detailed set of product knowledge than might be required in many other industries, according to Steven Rauschkolb president of the Society of Pharmaceutical and Biotech Trainers (spbt.org). He is employed by Sanofi-Aventis (sanofi-avenris.com) as head of leadership development and commercial effectiveness.

Mr. Rauschkolb says the most common mistake pharmaceutical companies make in training their representatives is not taking enough time for training the majority of people in the sales force. Typically, training departments in the pharmaceutical industry, and many other industries, focus a lot of training time and effort on a new representative, recognizing that they need to have all the product knowledge and the skills to go out and start doing the job," he says. After that initial bout, however, little time is spent on additional training.

"Companies are starting to, recognize that they need to continue to make investments throughout the life cycle of a representative's career to ensure that not only do they constantly have new skills but they're up to speed on some of the business and market dynamic changes that are taking place," Mr. Rauschkolb told Med Ad News.

Unlike representatives in other industries, pharmaceutical sales reps have to have extensive technical knowledge about their products. Setting the right balance between technical training and sales-technique training can be difficult. "The challenge ,of what to train people around and how to train them is something that most pharmaceutical organizations are struggling with because it's a more challenging environment than it's been in a long time," says Ron Koprowski, senior VP, sales capability development, The Forum Corp. (forurn.com). Mr. Koprowski heads the sales-training practice, which works with Fortune 1000 companies on large-scale training initiatives.

"If you stop to think of what's required in terms of detailing a product and understanding a therapeutic area, being able to then position that to a physician, it's a lot more complex than a lot of other sales situations," Mr. Koprowski says. A lot of pharmaceutical companies spend a lot more time training their people on the technical side, the product side, and probably not a whole lot on the sales side, except some of the fundamentals in terms of selling."

The tendency is to overemphasize product knowledge, according to Bill Gager, president, Gager International, a sales training and coaching firm. "We never want to discount the need for product knowledge and the actual science because of the credibility factor," Mr. Gager says. "But, what happens is the vast majority of the emphasis is placed on the product-knowledge-side of things, and nowhere near enough is placed on the sales technique side of it."

In most direct sales forces there is a focus on closing business and contracting.

More opportunities exist to shape value as the sales representative moves toward the close of the sale. In the pharmaceutical industry, however, representatives are trying to influence a future recommendation rather than trying to close a contract. This means a pharmaceutical representative must compete for time and create value quickly.

"In a lot of the cases, what you're doing is influencing a future recommendation decision as opposed to trying to close to a contract," says Paul Hennessey, executive VP, marketing, research, and development, BayGroup International (baygroup.com), a global training and consulting company. "What that then leads to is a world where what you're closing on is not a contract and a price and a volume but incrementally moving less-tangible commitments down the field toward the goal line. And you only find out whether you score when you see the records at the other end about whether the doctor has actually prescribed."

Mr. Hennessey believes that technical knowledge and sales technique must be weighted equally in the training process. "The demand of the market is you have to do both," he says. "One precedes the other, but one isn't more important than the other." BayGroup consultants have found that representatives must be proficient in sales technique to maximize the number and quality of opportunities to position products effectively. The technical knowledge is important to detail the product once the representative is in the door.

The more product knowledge a representative possesses, the greater value he or she will be able to provide, according to Charles Smith, VP, strategic planning, project management, Publicis Selling Solutions (pscllingsolutions.com). "It's not just product knowledge, it's disease category as well as understanding the practice, understanding the dynamics of what's going on with reimbursement and managed care, and the overall industry," Mr. Smith says.

Another component of the pharmaceutical sales process that differentiates the industry is the need for representatives to possess regulatory knowledge, "Not only do they [representatives] need to train in product knowledge ... and good negotiating, communication, and selling skills as pan of that, but they also have to have an understanding of regulations and guidelines, which is becoming more and more an important part of that process," says Terrell Herring, president, Ventiv Pharma Services LLC (ventiv.com), a provider of contract sales forces to the pharmaceutical industry.

Mr. Rauschkolb says proper understanding of regulatory requirements must frame everything a sales representative docs. "In the pharmaceutical industry, we have to ensure our representatives are conducting themselves according to a whole string of regulatory laws and rules," he says. "We are always trying to ensure that every single representative understands the regulatory environment we're working in and that they can do everything that they have to do on a day-to-day basis in the framework and construct of those regulatory guidelines."

Extensive regulatory knowledge is needed because increased regulatory surveillance and heightened risk management are impacting physician/rep relationships. The landscape in which sales representatives operate has been altered by the guidelines issued in 2002 by PhRMA and in 2003 under the Health Insurance Portability and Accountability Act, or HIPAA. Under the PhRMA guidelines, representatives are limited in the types of promotion items that they can give physicians. HIPAA rules restrict pharmaceutical marketers in the collection of data for marketing purposes.

"Gone are the days of buying prescribing influence," says Jean C. Male, CEO, Emp-Higher Performance Development Inc. "Representatives whose success was a derivative of entertaining and lavish outings are destined to become sales dinosaurs." Emp-Higher Performance Development (emphigher.com) specializes in sales-performance consulting and training for the biopharmaceutical industry.

Ms. Male believes that representatives have become typecast as sample droppers and caterers of office lunches. The opportunity now exists, however, to rebuild the pharmaceutical reputation so that sales representatives are valued as colleagues by physicians.

According to Mr. Rauschkolb, sales reps must be trained to have conversations with customers on multiple levels depending on the needs of that particular customer. "That gets back to the value proposition," he says. '~Many times, that value goes above and beyond just the product that they're selling. It's helping the physician to understand how prescribing a given product will actually benefit their patients and benefit their practice from a business perspective."

Me. Gager believes that one of the ways representatives can differentiate themselves from the competition is to help doctors or practitioners identify and solve problems they mayor may not know they have. "When one sales person comes in after another, basically they're all viewed as being pretty much the same," Mr. Gager says. "They all bring lunches in to the office staff, they all present their products in a certain way, they have the drop-offs and all of that. The way to stand out is by being able to help them identify issues and challenges and problems that maybe they didn't know they had and helping them solve them."

Representatives can achieve this by learning questioning and probing techniques. "What we've got to get sales forces to do is see with what's called an adaptive technique," Mr. Gager told Med Ad News. "That is to first go in and be able to test the waters and evaluate what is the environment of the office I'm going into? What is the individual environment of the individual practitioner with whom I'm speaking? What are their hot buttons? What is important to them? In their eyes, how am I going to differentiate myself? We need to move to much more of an adaptive approach rather than a static approach, which is where we've been traditionally."

In the short time a physician takes to sign for samples, a well-trained representative can grab attention with proper questioning techniques, according to Jeff Thull, CEO and president, Prime Resource Group (primeresource.com), a management consulting firm focused on sales and marketing management and performance.

Mr. Thull has trained representatives to ask physicians questions such as, "Do you ever notice any of your patients that are not covered by insurance stretching their prescription?" or, "Do you have any patients in mind that you think could be putting their care plan at risk?" Questions like these get the physician thinking about a specific patient and can change a two minute presentation into a dialogue.

"Training, historically, has been enabling the rep to communicate value; just present the information to the doctor," Mr. Thull says. "That actually can be done more effectively today with many other mediums. The only reason the docs are still seeing pharmaceutical reps is they have to sign for the samples. The focus today needs to be on creating value. It's uncovering that situation that the doc is not necessarily familiar with or thinking about and then heading into a specific patient classification or group or even, literally, an individual patient that this applies to. Representatives are creating a value for the doc that they would not have thought up on their own." The ability to ask good questions and listen intently to the answers supersedes all technique by building credibility, trust, and confidence in the representative, according to Brian Tracy, chairman, Brian Tracy International (briantracy.com), a human-resource company.

"There is no more powerful way to build relationships than to ask good questions about the doctor and his or her practice and how it's working," Mr. Tracy told Med Ad News. He says representatives should position themselves as an advisor, not a salesperson, give good advice on pharmaceuticals that are available for the doctor's patients, and allow the doctor to make up his or her mind.

Companies are starting to adopt these techniques. "What we've seen these days is a move away from the robot-like-deliver-the-message-and-leave-type selling models of the 1990s, where reps were more or less message boards for product," says Garry O'Grady, VP, sales practice, Campbell Alliance (campbellalliance.com). "For the most part, companies are trying 10 move away and present reps in a slightly more sophisticated way and give them the tools to engage physicians in more-compelling conversations. By developing selling skills training that allows for open-ended, free flowing conversation with physicians that eventually allows representatives to home in on exactly what that physician is thinking or doing vis-à-vis their product or their product class, companies are gaining a strategic advantage."

At Novartis Pharma AG, managers are focusing increasingly on customers and their insights to strengthen the marketing approach. Early in a medicine's development, Novartis managers incorporate patient and physician insights into their strategy to ensure they are addressing all relevant aspects.

"We believe that if we truly understand consumers and customers better than anyone else, it will change our approach to sales, marketing, and DTC," says Thomas Ebeling, CEO, Novartis Pharma.

Novartis is targeting quality with best~ in-class processes in all areas of the organization, including the sales force. "We have implemented a program called Performance Frontier, which is a comprehensive sales training program-based on the idea that the skills and behaviors that are necessary to be a best-in-c1ass sales rep can be taught," Mr. Ebeling told Med Ad News. "The Performance Frontier program, combined with a focus on higher-tier physicians and an increased level of sales call are being utilized to give the Novartis field force a competitive advantage."

Mr. Ebeling agrees that often companies get caught up in training their sales force to be product experts but do not sufficiently emphasize the importance of relationship building skills such as listening, understanding physicians' needs, and adapting the message to best meet those needs.

"In our research, reps trained under the Performance Frontier program are three times more likely to develop relationships with their physicians, compared to average reps, and five times more likely to act as a problem solver to best assist physicians," Mr. Ebeling says.

Novartis managers believe that reps must be able to speak the customer's language, present product information from the customer's point of view, and address the customer's needs. "We train our sales reps to think like a physician to gain better undero standing of what is important to them to best make use of the limited time reps have with an individual physician," Mr. Ebeling says.

Novartis' customer-focused strategy allows managers and representatives to have a deep understanding of what patients and physicians are most concerned with and in turn provide them the information they need in an efficient manner. "Any strategy which is not based on the desire to add value to the physicians might not work," Mr. Ebeling told Med Ad News. "Classical 'brainwashing' sales techniques are outdated, but repeating the key messages that really emphasize the value we bring to physicians and patients will remain critical."

Ventiv takes a similar approach to training the representatives that the company provides to pharmaceutical companies. "We, more time than not, don't emphasize closing." says Peter Marchesini, YP, training and development, Ventiv. "We're talking about mainly working on behaviors: communication skills, their ability to speak intelligently in scientific matters. It's not about closing and making a hard sell, it's about engaging the physician in an intelligent conversation about a product and where it should be appropriately used and giving them the information they need to conduct their business."

Ventiv blends the communication and behavioral styles into a relationship-selling model. Ventiv typically runs five, seven, and to-day training programs, the longer pro¥ grams provided for situations in which representatives will have more than one product to be communicating to the physician. The first one to two days focus heavily on the sales model, breaking down the individual steps in the process of how to sell. Through the next two to three days of intense product and technical training, those aspects of the model are elaborated and expanded Oil. Each step of the process talks about a specific area of the disease or a unique feature about the drug. Before coming into the classroom training, representatives typically have received a week or two weeks' worth of learning modules that provide an in-depth review of the disease state, anatomy and physiology, the competitive landscape, and the key features of the prescribing information, Trainees are also provided ways to handle specific objections based on the market research that has been done on the product.

Mr. Smith emphasizes the need to provide value without inundating the physician. "This has really become more about the relationship and the value reps provide, not how many lunches they bring in or how many games they take them to," he says. "This is respecting their time and not reiterating the same exact message over and over again, but giving them the best information at the most appropriate time and not hammering them with it."

Mr. O'Grady agrees, calling pharmaceutical sales a game of inches. "The old 'drive them into the ground while you've got them' type of methodology with a doctor who has already asked you to limit your topic to two minutes ... can do more harm than good in the long run," he says. "It's a slow game of influence over time."

One very-common mistake companies make, according to Mr. O'Grady, is training representatives to challenge the physician's choices too strongly. "There are some companies out there who have the reputation of being willing to go toe-to-toe with the physician over what they are doing as a clinical practitioner in terms of the drugs they are using and how they are using them," Mr. O'Grady told Med Ad News. "There are a lot of young, inexperienced reps who only know what they've been taught or only know their company's way of thinking about a certain disease state or therapeutic area, and they can get into a lot of trouble if they're stepping over the bounds ... where they're actually accusing the physician of practicing bad medicine. There are companies whose reps have bad reputations for being too aggressive when it comes to challenging the way doctors are prescribing or practicing medicine."

To avoid creating pushy, aggressive representatives, PDI has developed a training model for its contract sales forces, "selling to excellence." Reps are trained to understand what is going on in physicians' practices to help the reps position the products of PDI's pharmaceutical company customers in a way that physicians can see how they meet the needs of their practice.

"We have built a learning management system, which is a great way to use technology to make the training process more efficient and to enable the individual development of field forces," Mr. Budd says. "Reps and managers can truly be trained and developed at their own pace based on particular gaps they may have in their own skill set."

Mr. Budd believes that a new trend in sales force training that will drive efficiency is a move towards competency-based training. This involves assessing the skill sets and competencies of a sales representative who may be joining the organization to determine his or her baseline and then using training to fill in that person's knowledge gaps.

PDI's learning-management system is designed to make the process easier to execute. "Companies are starting to realize that with a lot of experienced talent out there, they will be more productive and they'll get more mileage from their training dollars if they can assess the current competency level of each employee and train to the gaps," Mr. Budd says. "That will give them the ability to provide advanced training for many of those sales reps and managers for the same dollars, rather than putting them through things that they have already proven to be competent in." According to Scott Erker, VP, selection solutions, DDI (ddiworld.com), the same assessment techniques used in the sales-representative hiring process can be applied to training. DDI provides counsel on how to quickly hire sales forces.

"Good hiring systems gather in a very fair, effective way information about candidates," Mr. Erker says. "You can use the assessments, especially work sample or simulation-assessment exercises, in quasi training environments." The three most-common types of tools used to assess potential for pharmaceutical-sales success are screening and testing content by answering test questions, the interview, and a work sample or simulation exercise. By using assessments before the training, companies accomplish a few things. "First of all, it's an individualized needs analysis, so now the person coming out of assessment knows where their strengths and development needs are and can tailor their training approach," Mr. Erker told Med Ad News. "Secondly, the assessment drives a bit of learning tension. In other words, I'll pay more attention to training if I agree that I need development in a certain area. If I go in believing that I truly have a skill or a knowledge gap, then that drives learning."

Another use of the assessment could be at the conclusion of training to ensure that the trainee received the skill sets needed. "The traditional way is to give the people a test, but with things like relationship skills, it actually would be marc of a valid and accurate approach to look at whether the person can apply those skills in a real-world type of environment, before you set them loose on your most-valued customers," Mr. Erker says.

There are traditional assessment techniques that no longer are effective according to Ara Ohanian, CEO and president, CERTPOINT Com. (vuepoint.com), a provider of comprehensive-knowledge-transfer solutions. "One of the things that happens as there's more and more competition and smaller share of voice, training to the test is something [sales trainers] can no longer do," he says. "By just teaching to a test, you cannot bring that higher value dialogue with physicians." Mr. Ohanian recommends moving away from training to a particular test of skills and instead training on brand value. "The best companies ... have graduated from selling to having value-based brand dialogues with their customers," he says.

According to Mr. O'Grady, companies must establish a culture that encourages training. This requires senior executives to buy in to the belief that training is an important agenda item, deserves the resources required, and deserves an important emphasis in the way that commercial organization operates.

"We want senior executives that are dedicated to ongoing training," Mr. O'Grady says. "We want senior executives dedicated to helping the training organization and the sales organization enforce high standards of performance during training. We want training that synchronizes well with the needs of its core customers, and I view the core customers as sales management and brand management and marketing executives."

Technologies are emerging to make continuous training of sales reps an easier process. "We're seeing more and more sales forces where a higher percentage of the sales force has access to broadband or high speed Internet connections, which has enabled training departments to provide content to them via the Web," Mr. Rauschkolb says. "Some of the synchronous technologies that are out there, such as Centra or WebEx, have also made it easier because now, rather than having to fly people' into a central location for components of a meeting, it can be done in a synchronous way that allows them to stay close to their territory and return to their territory immediately after the meeting."

Centra (centra.com) is a provider of specialized application software and services for online business collaboration. Reliant Pharmaceuticals LLC, a specialty-pharmaceutical company, uses Centra to conduct real-time, online sales training and communications. With hundreds of sales professionals on the road, Reliant (reliantrx.com) needed a more-effective way to disseminate company announcements, product information, and improve overall communications to the field and with business partners. Centra enabled the company to eliminate the need for travel and minimize the impact of taking sales personnel out of the field.

Centra's CentraOne brings together voice, video, data, and graphics in easy-to-use interfaces for Web conferencing, meetings, and virtual classrooms that can be deployed on-site or accessed through a secure global service network. WebEx Communications (webex.com) is a provider of Website infrastructure for business communications. AstraZeneca (astrazeneca.com) uses WebEx to connect its network of employees and communicate with suppliers and partners worldwide. Olympus Medical Systems, a developer of high-quality medical optics and equipment, adopted WebEx Training Center in 2002, a solution that offered collaborative functionality such as real-time chat, polling, white boarding, application sharing, and testing. The WebEx Training Center service supports continuous learning so trainers can develop programs that mix on-demand learning, interactive online classroom instruction, and individual tutoring with remote access to a centralized computer lab.

One company that is heavily using technology to train its sales forces is Pfizer Inc., which has the largest industry sales force. The company has selected iLine Communications and Interactive Alchemy to design and develop a product for Pfizer's Global Learning and Development Group. The Web-based learning solution will be deployed to more than 10,000 U.S. district managers and sales reps and will be used for developing a continuous-performance-improvement program for Pfizer's U.S. pharmaceutical sales personnel, with the overall objective of growing sales revenue.

The program includes ways to optimize opportunities in the field, build upon existing relationships, emphasize the value of Pfizer, and provide continuous-performance-improvement coaching. The learning solution will help transition what was an intensive paper process into an easy-to-use online application that includes Web-based training and online manuals, documentation, and team assessments. Pfizer has started an internal marketing campaign to introduce the application to district managers.

"By working with Interactive Alchemy, we were able to take all of the written materials and transition them to a 100% online application that saves our teams' valuable time in the field," says Joe DeLosa, director, health-care systems, Pfizer Global Learning and Development.

Interactive Alchemy has developed custom, Web-based training solutions for iLinc and its LeamLinc product line. ILinc (Hinc.com) develops conferencing products and services for secure and cost-effective collaborative online meetings, presentations, and training sessions. Interactive Alchemy (interactivealchemy.com) provides custom e-learning courseware solutions.

According to software giant Microsoft Inc., Pfizer has enhanced the productivity and effectiveness of its sales-force interactions by taking advantage of industry-leading technologies. Through enhanced communication, Pfizer is providing health-care professionals with the most up-to-date and visually appealing information so they can make well-informed decisions regarding treatment options for patients.

Pfizer's sales and marketing reams leverage compelling content, Proscape software, and Microsoft technology to break through the cluttered marketplace with relevant information for physicians, nurse practitioners, and physician assistants. In August, when FDA approved a new indication for Lipitor for preventing cardiovascular disease, Pfizer disseminated the data electronically to its cardiovascular health-care reps.

"Effective communication between Pfizer's cardiovascular healthcare representatives and our customers regarding the ever-increasing and complicated pharmacological choices is critical in ensuring that physicians have the most current and relevant information available so they can make the best possible decisions about patient care," says David Hegans, senior director/group leader in the cardiovascular/ metabolic group, Pfizer (pfizer.com).

Even with the increase in technology use, the most-successful pharmaceutical sales forces incorporate extensive role play into training. "I've put together programs where we actually simulate a doctor's office or an HMO, a buying environment," says Alan Weiss, Ph.D., president of Summit Consulting Group Inc. (summitconsulting.com). "The rep comes in, we videotape the whole thing, and then we debrief on it. If they make their mistakes in that safe haven, then they're going to be in very good shape when they're in the real world. Too often, they're shown this conceptual stuff in training, and when you go out in the real world, it's a very different kind of environment. So we're able to replicate things like interruptions."

Mr. Smith believes that a continuous learning approach needs to be taken in pharmaceutical sales-force training. "The best companies have a strong commitment to training," he says. "They recognize the cost benefit in terms of time and cost in the face-to-face [training sessions]. They're leveraging technology more, but they're also mandating that it become a much more integral part of the reps' assessments in terms of how they've performed over a year, in terms of their commitment to training, as well as their working on their key development areas."

Total Learning Concepts provides sales training for pharmaceutical and biotechnology companies and is developing assessment tools to help sales managers continue the training process throughout a rep's career. TLC clients include Pfizer, J&J. Merck & Co., Bristol-Myers Squibb, and Abbott Laboratories.

Training sessions are split between classroom instruction and interactive role-playing. "TLC is a huge proponent of practical application," says Shelly Spencer, president, Total Learning Concepts. "We don't want these guys just to be a talking head when they leave there. They've got to know what to do with the information. These are virtual experiences, putting them in every type of experience we can think of."

TLC (tleonline.com) is developing an online solution that will deliver to a sales rep a set of assessment questions about two months after the rep has entered the field. The representative's answers will go directly back to the district manager, who will be able to identify the areas where the rep is struggling. The TLC solution will provide tools the manager can use to help the representative in the problem areas. On the manager's next ridealong with the representative, TLC's solution will provide a tool that determines which skills the rep needs sharpened. The manager will grade the representative throughout the ridealong, and the data will go back to the assessment database.

Sales trainers with ExecuProv put the focus on role-playing. "We work the same way an improv director would work with an actor and use their best talents and get rid of weaknesses," says Cherie Kerr, founder of ExecuProv (execuprov.com), a provider of presentation and communications skills training. "When we do any kind of sales training, we take a look at each person within the group ... and make sure that we're using every bit of potential that they have and getting rid of things that are really impeding their professional delivery system."

Trainees in an ExecuProv class are encouraged to focus on the who and the why of the detail, rather than the what. "It's a very different approach that we use at ExecuProv because it's all about training your mental muscles to be quicker, more agile, more fluid, go with the flow, be in the moment," Ms. Kerr says. "To react and respond to the last thing said or last idea held, your listening skills have to be finely honed as well as to be able to stay in that moment with that particular customer and give them what they need and want."

Role-playing can be an effective assessment technique and should be a major component throughout the training process. "The best companies that I see out there for new rep training emphasize interactive roleplay training," Mr. O'Grady says. "Companies should be at the end of new rep training conducting some sort of mock day in the field either with members of the company who are playing the part of physicians, with actors or other individuals who come in to play the part of physicians or with real physicians if they can get them."

Sales training consultant Andrea Nierenberg, the president of the Nierenberg Group (mybusinessrelationships.com), believes strongly in the need for follow-up in sales training. "I leave them the workbook, and 1 say every week take another challenge or something we talked about and put it into practice," Ms. Nierenberg says. "Because all they get out of a training session is permission to implement some of these techniques and ideas going forward."

Achievement Dynamics LLC, a sales and management training company in Denver, offers ongoing reinforcement training programs to increase sales through nontraditional strategies. "What reinforcement does is create ownership," says Gary Harvey, founder of Achievement Dynamics. "Ownership in a sales call results in almost instinctively starting to do on a sales call what you've been taught in a reinforcement training environment. Whether sales training or any kind of training, studies show that people learn through space repetition and that creates ownership."