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Implementation Science
Published in: Implementation Science 1/2018

Open Access 01-12-2018 | Research

How do physicians behave when they participate in audit and feedback activities in a group with their peers?

Authors: Lara J. Cooke, Diane Duncan, Laura Rivera, Shawn K. Dowling, Christopher Symonds, Heather Armson

Published in: Implementation Science | Issue 1/2018

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Abstract

Background

Audit and feedback interventions may be strengthened using social interaction. With this in mind, the Calgary office of the Alberta Physician Learning Program developed a process for audit and group feedback for physician groups. As a part of a larger project to develop a practical approach to the design and implementation of audit and group feedback projects, we explored patterns of physician behavior during facilitated audit and group feedback sessions.

Methods

Six audit and group feedback sessions were recorded, transcribed, and analyzed thematically to derive a conceptual model of physicians’ behaviors during audit and group feedback sessions.

Results

A predictable cycle of behaviors emerged from audit and group feedback sessions. This cycle would repeat with discussion of each new data element: reacting to the data, questioning and understanding the data, justifying and contextualizing, sharing and reflecting on the data and relevant guidelines, and planning for change. “Change cues” that emerged within groups reliably pivoted the discussion towards action planning.

Conclusions

In audit and group feedback sessions, physicians display a predictable series of behaviors as they move towards commitment to change. Establishing the meaning and credibility of the data is a necessary precursor to reflection. Group reflection leads to “change cues” triggered by group members, which stimulate action planning.
Literature
1.
Mansouri M, Lockyer J. A meta-analysis of continuing medical education effectiveness. J Contin Educ Health Prof. 2007;27(1):6–15.CrossRefPubMed
2.
3.
Ivers NM, Grimshaw JM, Jamtvedt G, Flottorp S, O’Brien MA, French SD, et al. Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care. J Gen Intern Med. 2014;29:1534–41.CrossRefPubMedPubMedCentral
4.
Colquhoun HL, Brehaut JC, Sales A, Ivers N, Grimshaw J, Michie S, Carroll K, Chalifoux M, Eva KW. A systematic review of the use of theory in randomized controlled trials of audit and feedback. Implement Sci. 2013;8:66.CrossRefPubMedPubMedCentral
5.
Colquhoun HL, Carroll K, Eva KW, Grimshaw JM, Ivers N, Michie S, Sales A, Brehaut JC. Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses. Implement Sci. 2017;12:117.CrossRefPubMedPubMedCentral
6.
Colquhoun H, Michie S, Sales A, Ivers N, Grimshaw JM, Carroll K, et al. Reporting and design elements of audit and feedback interventions: a secondary review. BMJ Qual Saf. 2017;26:54–60.CrossRefPubMed
7.
Brehaut JC, Colquhoun HL, Eva KW, Carroll K, Sales A, Michie S, et al. Practice feedback interventions: 15 suggestions for optimizing effectiveness. Ann Intern Med. 2016;164:435–41.CrossRefPubMed
8.
Locke EA, Latham GP. Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. Am Pscychol. 2002;57:705–17.CrossRef
9.
Abraham C, Michie S. A taxonomy of behaviour change techniques used in interventions. Health Psychol. 2008;27:379–87.CrossRefPubMed
10.
Sales AE, Fraser K, Baylon MA, O’Rourke HM, Gao G, Bucknall T, et al. Understanding feedback report uptake: process evaluation findings from a 13-month feedback intervention in long-term care settings. Implement Sci. 2015;10:20.CrossRefPubMedPubMedCentral
11.
French SD, Green SE, O’Connor DA, McKenzie JE, Francis JJ, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. 2012;7:38.CrossRefPubMedPubMedCentral
12.
Cane J, O’Connor D, MIchie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral
13.
Bandura A. Social learning theory. New Jersey: Prentice Hall; 1977.
14.
Vygotsky L. Mind in society: the development of higher psychological processes. Cambridge: Harvard University Press; 1978.
15.
Sargeant J, Lockyer J, Mann K, Holmboe E, Silver I, Armson H, Driessen E, MacLeod T, Yen W, Ross K, Power M. Facilitated reflective performance feedback: developing an evidence- and theory-based model that builds relationship, explores reactions and content, and coaches for performance change (R2C2). Acad Med. 2015;90:1698–706.CrossRefPubMed
16.
Sargeant J, Eva KW, Armson LH, Chesluk B, Dornan T, Holmboe E, et al. Features of assessment learners use to make informed self-assessments of clinical performance. Med Educ. 2011;45:636–47.CrossRefPubMed
17.
Telio S, Ajjawai R, Regehr G. The “educational alliance” as a framework for reconceptualising feedback in medical education. Acad Med. 2015;90(5):609–14.CrossRefPubMed
18.
Watling C, Driessen E, Van Der Vleuten CPM, Lingard L. Learning from clinical work: the roles of learning cues and credibility judgements. Med Educ. 2012;46(2):192–200.CrossRefPubMed
19.
Babenko O, Szafran O, Koppula S, Au L. Motivations for learning of family medicine residents trained in competency-based education. Educ Prim Care. 2018;29(2):86–93.CrossRefPubMed
20.
Ames C, Archer J. Achievement goals in the classroom: students’ learning strategies and motivation processes. J Educ Psych. 1988;80:260–7.CrossRef
21.
Urban TC. Achievement of goal theory: past results, future directions. In: Maehr ML, Pintrich PR, editors. Advances in motivation and achievement, vol. 10. Greenwich: JAI Press; 1997. p. 99–141.
22.
Anderman LH, Anderman EM. Oriented towards mastery: promoting positive motivational goals for students. In: Gilman R, Huebner ES, Furlong MJ, editors. Handbook of positive psychology in schools. New York: Routledge/Taylor & Francis Group; 2009. p. 161–73.
23.
Darnon C, Dompnier B, Poortvliet PM. Achievement goals in educational contexts: a social psychology perspective. Soc Personal Psychol Compass. 2012;6(10):760–71.CrossRef
24.
Madjar N, Bachner YG, Kushnir T. Can achievement goal theory provide a useful motivational perspective for explaining psychosocial attributes of medical students? BMC Med Educ. 2012;12(1):4.CrossRefPubMedPubMedCentral
25.
Silverman D. Interpreting qualitative data. Focus groups. In: Interpreting qualitative data. London: Sage; 2014. p. 213–8.
26.
Eva KW, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, et al. Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes. Adv Health Sci Educ Theory Pract. 2012;17(1):15–26.CrossRefPubMed
27.
Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci. 2016;11:33.CrossRefPubMedPubMedCentral
28.
Sargeant JM, Mann KV, van der Vleuten CP, Metsemakers JF. Reflection: a link between receiving and using assessment feedback. Adv Health Sci Educ Theory Pract. 2009;14(3):399–410.CrossRefPubMed
29.
Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
30.
Wakefield J, Herbert C, Maclure M, Dormuth C, Wright JM, Legare J, et al. Commitment to change statements can predict actual change in practice. J Contin Educ Health Prof. 2003;23(2):81–93.CrossRefPubMed
31.
Armson H, Elmslie T, Roder S, Wakefield J. Is the cognitive complexity of commitment-to-change statements associated with change in clinical practice? An application of Bloom’s Taxonomy. J Contin Educ Health Prof. 2015;35(3):166–75.CrossRefPubMed
Metadata
Title
How do physicians behave when they participate in audit and feedback activities in a group with their peers?
Authors
Lara J. Cooke
Diane Duncan
Laura Rivera
Shawn K. Dowling
Christopher Symonds
Heather Armson
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2018
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-018-0796-8

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