When clinical results matter, why the person with the most knowledge is the wrong person to write the course
If you’ve ever wondered why subject matter experts should not build training, let me be blunt: it’s not because they aren’t smart enough. It’s because expertise and instructional design are not the same job.
In medical device companies, I see this all the time. Training starts with a slide deck, a stack of studies, and a well-meaning expert. The result may look credible, but too often it’s hard to scale, defend, or monetize. Not to mention teach.
I’m not anti-expert. Subject matter experts (SMEs) are indispensable. But that doesn’t mean they should be asked to build the course.
Start with performance
Too often, “build the training” translates to gathering the studies, deciding what clinicians need to know, and turning it into slides. When an expert leads with content, the course usually becomes a content dump. It may be a very smart content dump. It may even be beautifully referenced. But it’s still a content dump. That’s one big reason why subject matter experts should not build training alone.
The result gets called evidence-based training because it includes citations. But a pile of studies is not instructional design. In fact, it might not even be education.
This matters because the goal of training is not to prove that the leaders or presenters have information. The goal is to help someone perform better.
If the learner walks away saying, “That was interesting,” but still can’t use a device correctly, troubleshoot common problems, explain key risks, or apply the information in practice, then the training hasn’t done its job. A five-star review doesn’t fix that. Often, those ratings tell you that people liked the presenter, appreciated the stories, or were enlightened by a few isolated facts. Those ratings don’t necessarily tell you that practice will improve, behavior will change, or outcomes will be better.
An SME usually starts with content. An instructional designer starts with performance. And that starting point changes everything.
Good instructional design asks harder questions — the kind that keep training focused on what learners need to do, not just what the expert wants to say.
- What are the clinical competencies? What should learners be able to do safely and effectively in real patient care?
- What’s the learning gap, and what must change in practice?
- What learning objectives support that change?
- What content is essential for better performance, and what is merely interesting? Because interesting is not the same as useful.
- What methods will help learners apply the information in real life?
- How will we validate whether the learning objectives or clinical competencies were met? Not whether the session was well liked, but whether it changed anything that matters.
That kind of structure doesn’t usually emerge from a slide deck and a stack of studies.
Evidence is not the same as education
This is one of my biggest frustrations with weak healthcare training, and I’ve seen it from both sides. I’ve been hired as the consultant and asked to “turn it into a course” when what the company really has is a few modules, one or more slide decks, and a pile of content they want to stack higher and call complete.
I’ve also lived this as a seasoned nurse. I’ve sat through hours of training where someone rattles off isolated facts from studies, points out results or statistics, and calls it evidence based. But that still doesn’t tell me what to do when I’m standing there with the patient in front of me. I may know a few facts and still not know how to adapt, troubleshoot, or make the more individualized decisions real clinical practice requires. That’s the learning gap, and it’s exactly why content coverage is not the same as training.
Without that design layer, even excellent evidence can land as overload. The learner gets more and more information, but not enough help deciding how to prioritize it, what to do with it, or how to apply it under real conditions. That’s why so many expert-led sessions feel impressive in the moment and disappointing later. They sound smart. They may even be smart. But they don’t reliably produce better performance.
And performance is what matters. That’s why subject matter experts should not build training alone.
Not just a learning problem, but a business problem
If a course is weakly designed, it doesn’t just frustrate learners. It limits what the company can do with that training later.
It may not stand up well to continuing education expectations, which require much more than “expert content.” It may not scale well, because the course depends too heavily on one charismatic expert delivering it live. It may not support future certification, because certification requires structure, defensible objectives, and valid evaluation. It may not be easy to monetize, because buyers don’t want to pay simply for information; they want a learning experience that is credible, usable, repeatable, and tied to outcomes. And it’s unlikely to be defensible, especially in medical device education, where training intersects with risk, correct use, and clinical performance.
That’s why I keep coming back to the same three words: defensible, scalable, and monetizable.
If training isn’t intentionally designed, it’s usually weak on all three.
The right roles
When I say that subject matter experts should not build training, I’m not arguing for removing experts from the process. I’m arguing for putting them in the right role. The expert protects accuracy. The instructional designer shapes that expertise into learning that supports performance.
That partnership is where the real value lives. In many organizations, SMEs are not truly designing training. They’re selecting content, organizing slides, and sharing expertise. That work is valuable, but it is not instructional design.
When companies blur those roles, they get expert content without strong design, and then wonder why the course feels messy, falls short of higher standards, and fails to become a true business asset.
Why leaders should care
If you’re a CEO, product leader, marketing leader, clinical leader, or education leader, your boss probably isn’t judging the training by whether the slides looked polished or whether the presenter was likable (which is what your 5-star reviews show). They’re judging it by whether it worked.
- Did product adoption improve?
- Did clinicians and/or customers use the product correctly?
- Did training support the sales process?
- Did it reduce confusion, misuse, or preventable errors?
- Did it strengthen credibility with customers and partners?
- Did it create something the company can scale, package, defend, or build on?
That’s where design becomes urgent.
Because when companies ask experts to build training without real instructional design behind it, the company often ends up with something that looks finished but doesn’t perform. It doesn’t reliably change behavior. It doesn’t create a durable business asset. And it doesn’t help the leader who owns that training to deliver the bigger win the company actually needs:
- value for the company,
- better real-world use for the clinician, and
- better outcomes for the patient.
And sometimes the company doesn’t even realize it lost these missed opportunities.
Final thoughts
So yes, it’s provocative to assert that subject matter experts should not build training. Good. It should be. Because this isn’t a minor process issue. It’s a structural mistake. If your training begins with a slide deck and a stack of studies, you do not have a course yet. You have raw material, not design. If this hit a nerve, leave a comment and tell me what you’ve seen inside your own organization. And if this gave language to a problem you’ve been feeling for years, give it a clap so more people in healthcare and medical device education see it.