Effect of Training on ConfidenceSeven studies assessed the effect on individuals' confidence (Beech,2001; Beech and Leather, 2003; Deans, 2004; Fernandes et al., 2002;Grenyer et al., 2004; Nau et al., 2009a; Zeller et al., 2006). The overall ef-fect of the training on participants' confidence was positive, with signif-icant increases in confidence reported by three studies (Grenyer et al.,2004; Nau et al., 2009a; Zeller et al., 2006). Grenyer et al. (2004) ob-served increased confidence scores with the number of training mod-ules completed. However, Fernandes et al. (2002) found that staff didnot constantly feel safe when dealing with aggression, feelings varieddepending on the situation, yet overall sta ff reported feeling safer intheir workplace compared with baseline. The feeling of safety alsoseems to decrease with time elapsed after training: Beech and Leather(2003) found significant changes on “maintaining safety” and “predic-tion and prevention”, but no increased confidence in practical abilityto manage PVA: while there was a significant increase in how partici-pants perceived their practical ability to manage PVA before the train-ing, th ere was a drop below baselin e 3 months after the training.Concurring, Nau et al. (2009a) found that participants' confidence indealing with physical patient aggression decreased 4–8 weeks aftertraining, alth ough it remained significantly increased compare d tobaseline