The study aims to test whether knowledge management (KM) and soft-skill competence (SSC) mediate the effect of training effectiveness (TE) on health-worker performance in Indonesian public healthcare organisations.
A cross-sectional survey of health workers in public healthcare organisations in Indonesia was analysed to test the proposed capability pathway linking training, KM, soft skills and performance.
TE was positively associated with KM (β = 0.756, p < 0.001), SSC (β = 0.213, p = 0.001) and health workforce performance (β = 0.296, p = 0.001). KM strongly predicted SSC (β = 0.799, p < 0.001), while SSC positively predicted health workforce performance (β = 0.638, p < 0.001). Bootstrapping showed that the indirect effect of TE on performance through KM and SSC was significant and stronger than the direct effect (indirect β = 0.522, BC 95% CI [0.372, 0.726], p < 0.001).
The study uses self-reported, cross-sectional data; causal inferences are therefore limited. Future research should incorporate longitudinal designs and objective quality indicators (e.g. adherence to clinical and administrative standards, safety-event reporting and patient experience measures).
Quality improvement leaders should prioritise training transfer. They can use simple KM routines, such as brief after-action reviews, SOP updates and peer learning. They should also reinforce soft skills through handover communication, teamwork practice and patient-centred interaction.
Strengthening knowledge routines and soft skills can support more consistent and respectful care, especially in resource-constrained settings where service reliability and patient trust are critical.
Rather than claiming the broad theoretical novelty, this study offers a context-specific empirical contribution by testing a serial capability pathway through which TE relates to health-worker performance in Indonesian public healthcare organisations. It shows that KM and SSC operate as two complementary and actionable mechanisms that help translate training into performance-relevant routines.
