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Implement Sci. 2018 Jul 31;13(1):104. doi: 10.1186/s13012-018-0796-8.

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

Author information

1
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, UCMC Area 3, 3350 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. lcooke@ucalgary.ca.
2
Cumming School of Medicine, University of Calgary, HSC G302, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
3
Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
4
Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.

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.

KEYWORDS:

Audit and feedback; Feedback; Implementation; Knowledge translation; Physician learning; Practice improvement; Professional development; Social learning theory

PMID:
30064509
PMCID:
PMC6069557
DOI:
10.1186/s13012-018-0796-8
[Indexed for MEDLINE]
Free PMC Article

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