By Dr. Elizabeth Burleson, Assistant Professor and Educational Programs Manager, UNT Health, with commentary from Marshall Scabet, Founder of Precision Sales Recruiting
When people think of medical education, they imagine complexity: students memorizing anatomy, diagnosing symptoms, and mastering procedures that affect human lives. What many fail to realize is that medical training is one of the most studied and structured learning environments in the world. It is built on decades of research in competency-based education, adult learning theory, and high-stakes skill development.
In contrast, sales onboarding is often a brief meeting, a product deck, and a general instruction to ask questions if needed.
It is no surprise that many sales hires fail. The issue often has less to do with the person who was hired and more to do with the fact that leaders misunderstand how adults truly learn.
In this post, Dr. Elizabeth Burleson explains the principles that make medical training so effective. I (Marshall) will show you how those principles can transform the way you onboard and develop sales talent.
Adults Learn Best When Instruction Is Purposeful and Relevant
Insights from Medical Education (Dr. Burleson)
Adult learners do not engage simply because material is presented to them. They engage when the purpose is clear, the outcomes are defined, and the training directly supports the responsibilities they will take on. Medical curricula begin by identifying the desired competencies a physician must demonstrate, and instruction is intentionally aligned with those outcomes.
This reflects decades of work in adult learning theory. Adults learn best when they understand why something matters, when learning is problem-centered, and when they maintain a sense of autonomy in the learning process. These conditions strengthen motivation and deeper retention.
Reference: Knowles, M. (1984). The Adult Learner: A Neglected Species.
Application to Sales (Marshall)
This principle explains why many sales onboarding programs fall short. Companies often overload new reps with information without defining what competency looks like.
To apply this principle:
- Build your sales playbook around outcomes. Ask what the rep must be able to do by week 1, week 2, week 4, week 8, and week 12.
- Clearly define competencies such as:
- Conducting a discovery call with structure
- Qualifying a prospect using the company framework
- Handling the top objections
- Demonstrating product value in ten minutes or less
- Creating a territory plan
- Align every onboarding task with one of those competencies.
When onboarding shifts from information delivery to outcome-based instruction, ramp time decreases and performance becomes measurable.
Competency-Based Progression Outperforms Time-Based Learning
Insights from Medical Education (Dr. Burleson)
Medical learners do not advance because they spent a certain number of days in a rotation. They advance once they demonstrate competence in clearly defined tasks. Entrustable Professional Activities, also known as EPAs, describe the essential responsibilities that learners must be trusted to perform without supervision. This approach ties progress to observed performance rather than elapsed time.
Competency based education also acknowledges that learners develop at different rates. It promotes reliability, fairness, and transparency in evaluation, and it protects patient safety by ensuring that only skilled learners advance.
Application to Sales (Marshall)
Many sales leaders expect a rep to be fully ramped at 90 days, even if the rep has not demonstrated the necessary skills.
Instead, use a competency-based progression model:
- Before a rep conducts a live demo, they should demonstrate it internally.
- Before they run their first discovery call, they should pass a mock scenario.
- Before they write proposals, they should show mastery of qualification.
This model allows for predictable ramp timelines, objective evaluation, and fewer performance surprises. It builds confidence for both the manager and the rep.
Spaced Repetition Improves Long-Term Retention
Insights from Medical Education (Dr. Burleson)
Medical education relies heavily on spaced repetition, which is the intentional revisiting of material over time (Brown, Roediger, and McDaniel). This method reduces the forgetting curve and strengthens long-term retention as learners revisit material weeks, months, and sometimes years later through practices, simulation, and repeated assessment. Research in cognitive psychology supports this approach. Brown, Roediger, and McDaniel (2014), authors of Make It Stick, describe spaced practice as one of the most powerful and reliable strategies for building durable learning because the effort of recalling information after time has passed strengthens memory more effectively than massed review.
Reference: Brown, P. C., Roediger, H. L., and McDaniel, M. A. (2014). Make It Stick: The Science of Successful Learning.
Application to Sales (Marshall)
Many sales organizations introduce important concepts only once and assume they have been learned.
To apply spaced repetition in sales:
- Reinforce key messaging weekly.
- Review discovery call frameworks monthly.
- Use call coaching to revisit concepts in practical settings.
- Test skills through quarterly role-play assessments.
Your ongoing training should not rely on annual refreshers. It should consist of planned cycles of reinforcement. This approach helps reps internalize the playbook rather than simply memorize it.
Feedback Loops Drive Behavioral Change
Insights from Medical Education (Dr. Burleson)
Physicians develop skills through a continuous cycle of performance, observation, feedback, and adjustment. In both clinical settings and simulation environments, the most beneficial feedback is timely, behavior-specific, and tied clearly to defined expectations so learners can make actionable changes. Modern health professions education emphasizes feedback as a coaching relationship rather than a one-time correction. Ramani, Könings, Ginsburg, and van der Vleuten (2019) highlight that effective feedback requires a growth-oriented culture where learners feel supported, understand performance standards, and receive ongoing guidance that helps them close the gap between current and desired performance. Their work reinforces that structured, intentional feedback is one of the most powerful drivers of behavioral change.
Reference: Ramani, S., Könings, K. D., Ginsburg, S., & van der Vleuten, C. (2019).
“twelve tips to promote a feedback culture with a growth mindset.”
Medical Teacher, 41(6), 625–631.
Application to Sales (Marshall)
Sales feedback is often inconsistent or vague. To build strong reps, leaders should:
- Review one or two calls per week
- Use a standard rubric that evaluates discovery structure, talk-to-listen ratio, and clarity of next steps
- Provide actionable adjustments instead of general criticism
- Track improvement over time
Feedback loops are essential. They allow reps to grow, develop new habits, and elevate performance.
Psychological Safety Is Foundational for Skill Growth
Insights from Medical Education (Dr. Burleson)
Effective learning requires psychological safety, especially when adults are asked to practice new skills, make mistakes, and receive coaching. In medical education, psychological safety is intentionally cultivated, so learners feel more comfortable speaking up, asking questions, and seeking clarity without fear of embarrassment or punishment. Amy Edmondson, whose work spans healthcare, business, and leadership, describes psychological safety as “a belief that the environment is safe for interpersonal risk taking” (Edmondson, 1999).
This concept has become central to both clinical and corporate education. Edmondson’s research consistently shows that teams with strong psychological safety learn faster, innovate more effectively, surface errors earlier, and engage more deeply in growth-oriented feedback. When learners feel safe, they are more likely to try unfamiliar approaches, analyze mistakes constructively, and adopt new habits that lead to long-term growth.
Application to Sales (Marshall)
When a sales rep fears embarrassment or micromanagement, they avoid practice, hide challenges, and cling to what feels safe. This results in:
- Poor pipeline management
- Hidden performance issues
- Resistance to new techniques
Create psychological safety by:
- Normalizing practice and role-play
- Celebrating improvement rather than perfection
- Encouraging questions
- Making coaching a consistent part of the week
Psychological safety accelerates performance and strengthens loyalty.
Learning Never Stops, Even for Experts
Insights from Medical Education (Dr. Burleson)
Medical professionals engage in lifelong learning through continuing medical education, simulation refreshers, protocol updates, and ongoing assessment. Expertise is not a final destination. It is a continually evolving process that requires intentional, repeated practice. Research on expert performance reinforces this idea. Ericsson (2004) emphasizes that high-level expertise develops through ongoing deliberate practice that is designed to stretch current abilities and refine performance over time.
The same expectation applies to clinicians long after training ends. The Institute of Medicine has argued that lifelong learning is essential for maintaining quality and patient safety in a rapidly changing healthcare landscape (IOM, 2010). These findings demonstrate that even seasoned clinicians must continually update their skills, adapt to new information, and pursue structured opportunities to grow. The most effective educators and practitioners understand that mastery is a journey that requires ongoing curiosity, reflection, and commitment.
References: Ericsson, K. A. (2004). Deliberate practice and the acquisition of expert performance.
Institute of Medicine. (2010). Redesigning Continuing Education in the Health Professions.
Application to Sales (Marshall)
Your sales organization should not rely solely on onboarding. The best teams:
- Review pipelines together
- Study emerging objections
- Update messaging as the market evolves
- Conduct quarterly training workshops
- Maintain a living playbook
Ongoing development ensures your reps remain sharp and your company stays competitive.
Final Thoughts: Structured Learning Builds Stronger Sales Teams
Medical training is rigorous because the stakes are so high. The principles behind that training, including adult learning theory, competency-based progression, spaced repetition, and structured feedback, can elevate performance in any high-stakes environment.
Sales is one of those environments.
Adults thrive when their learning journey is intentional, relevant, and built for mastery. When sales leaders apply these principles, onboarding becomes predictable, reps feel supported, and performance improves.
Precision Sales Recruiting helps growing companies hire great people and prepares them to succeed. The right onboarding plan is just as important as the right hire.
Dr. Elizabeth Burleson, Ed.D.
Guest Expert Contributor
Dr. Elizabeth Burleson is an Educational Program Manager at The University of North Texas Health Science Center at Fort Worth. She has more than 20 years of experience in education and specializes in curriculum design, faculty development, and effective teaching practices. Her expertise focuses on creating learning environments that support performance, communication, and professional growth.
View Dr. Burleson’s bio on the UNT Health Science Center Website.
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