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

Cooke, Lara; Duncan, Diane; Rivera, Laura; Dowling, Shawn; Symonds, Christopher; Armson, Heather

doi:10.1186/s13012-018-0796-8

Cited by 50 publications

(93 citation statements)

References 27 publications

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“…Here, we extend our previous work, which examined physician responses to a novel type of audit and group feedback (AGF) and presented a conceptual model of physician responses to AGF sessions (AGFS) [ 8 ]. We observed that physicians engaged in planning for change more robustly in some AGFS than in others.…”

Section: Introductionmentioning

confidence: 89%

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The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback

et al. 2018

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BackgroundAudit and feedback interventions may be strengthened using social interaction. The Calgary office of the Alberta Physician Learning Program (CPLP) developed a process for audit and group feedback for physicians. This paper extends previous work in which we developed a conceptual model of physician responses to audit and group feedback based on a qualitative analysis of six audit and group feedback sessions. The present study explored the mediating factors for successfully engaging physician groups in change planning through audit and group feedback.MethodsTo understand why some groups were more interactive than others, we completed a comparative case analysis of the six audit and group feedback projects from the prior study. We used framework analysis to build the case studies, triangulated our observations across data sources to validate findings, compared the case studies for similarities and differences that influenced social interaction (mediating factors), and thematically categorized mediating factors into an organizing framework.ResultsMediating factors for socially interactive AGFS were a pre-existing relationship between the program team and the physician group, projects addressing important, actionable questions, easily interpretable data visualization in the reports, and facilitation of the groups that included reflective questioning. When these factors were in place (cases 1, 2A, 3), the audit and group feedback sessions were dynamic, with physicians sharing and comparing practices, and raising change cues (such as declaring commitments to de-prescribing, planning educational interventions, and improving documentation). In cases 2C–D, the mediating factors were less well established and in these cases, the sessions showed little physician reflection or change planning. We organized the mediating factors into a framework linking the factors for successful sessions to the conceptual model of physician behaviors which these mediating factors drive.ConclusionsWe propose the Calgary Audit and Feedback Framework as a practical tool to help foster socially constructed learning in audit and group feedback sessions. Ensuring that the four factors, relationship, question choice, data visualization, and facilitation, are considered for design and implementation of audit and group feedback will help physicians move from reactions to their data towards planning for change.

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Section: Introductionmentioning

confidence: 89%

“…In a previous study, we described our approach to AF: audit and group feedback sessions (AGFS) [ 8 ]. These AGFS were designed based upon the principles of social learning theory and best practices from the education feedback and implementation science literature [ 7 , 17 , 23 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback

et al. 2018

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“…We allocated the hospitals into monthly feedback group (A hospital) and quarterly feedback group (B and C hospital), based on the requirement of those hospitals. The reason for allocation was that the compliance of measures uctuated unsteadily in one month in B and C hospital due to less MDROs infected patients and limited observed opportunities, which reduced the conviction of feedback for clinical staff [23].…”

Section: Study Settingmentioning

confidence: 99%

Using Audit and Feedback and the Benchmark to Enhance Infection Prevention and Control of Multidrug Resistant Organisms: a Quasi-experiment Study

Zhou

Lai

Zhang

2020

Preprint

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BackgroundInfection prevention and control (IPC) is important to prevent the spread of multidrug resistant organisms (MDROs). We aimed to enhance and explore the implementation of preventing and controlling MDROs using audit and feedback and the benchmark. MethodsThis quasi-experimental design was conducted in three hospitals from 1st March 2018 to 30th September 2019. A multimodal intervention treated audit and feedback and benchmark as key components for MDROs IPC was conducted in Wuhan, China. A checklist of 40 implementation indicators based on IPC measures was formed to guide the audit twice a week. Immediate feedback was verbally given after each audit on the spot, and written feedbacks containing benchmark and individual implementation levels were delivered monthly or quarterly in three hospitals. The intervention effect was evaluated by Chi-square and Poisson segmented linear regression. Impacts of implementation of indicators on the incidence were modeled by mixed-effect regressions. ResultsThe incidence of nosocomial MDROs decreased by 19.39%, 20.55%, and 24.03% in A, B, and C hospital, respectively. The lowest implementation compliance of indicators was the use of personal protective equipment of doctors (50.24%). The highest was isolated warning signs of nurses (96.46%). The implementation on hand hygiene of doctors (Coef. = -27.87, p=0.001) and nurses (Coef. = -35.44, p=0.001), clean of surrounding instruments and bed unit (Coef. = -4.84, p=0.030), education to patients and relatives (Coef. = -59.51, p=0.031), and sending of specimen inspection timely (Coef. = -9.95, p<0.001) were negatively associated with the incidence of nosocomial MDROs infection. Conclusions The multimodal intervention by strengthening the implementation of audit and feedback and the benchmark is feasible and effective in China. The checklist is an effective and practical tool to measure the level of implementation. Education to patients and relatives, hand hygiene, clean of surrounding instruments and bed unit, and sending of specimen inspection timely are especially crucial.

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“…The studies included within our review pertain to a broad range of subjects, methods, and outcomes; our summary of the results is not meant for educators to draw any significant conclusions about the efficacy of coaching methods. Finally, due to the lack of clarity in terminology around coaching and mentorship, certain papers, which may have used coaching‐ or mentorship‐like strategies (e.g., group peer review and discussion of practice patterns during audit and feedback), may have been missed in our present search strategy.…”

Section: Limitationsmentioning

confidence: 99%

Clinical Improvement Interventions for Residents and Practicing Physicians: A Scoping Review of Coaching and Mentoring for Practice Improvement

MacKenzie

Chan

Mondoux

2019

AEM Education and Training

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Background: Graduate medical education (GME) bodies are beginning to mandate coaching as an integral part of the learning process, in addition to current requirements for mentorship. Once an emergency medicine physician transitions beyond graduate training, there is no requirement and little focus on coaching as a method of improving or maintaining clinical practice. Our objective was to understand and describe the current state of the published literature with regard to the use of coaching and mentorship for both GME and practicing physicians. Methods:We conducted a structured review of the literature through PubMed and Google Scholar and included all articles applying coaching or mentorship modalities to GME trainees or practicing physicians. A Google Form was used for standardized data abstraction. Data were collected pertaining to the settings of intervention, the nature of the intervention, its effect, and its resource requirements.Results: A total of 3,546 papers were isolated during the literature review. After exclusion, 186 underwent fulltext review by the authors of which 126 articles were included in the final data analysis. Eighty-two articles (65%) pertained to mentorship and 14 (11%) to coaching; the remainder of the articles discussed a combination or variation of these two concepts. Fifty-three (42%) articles were descriptive studies and 35 (28%) were narrative reviews or commentaries. Forty-seven (37%) articles originated from within surgical specialties and coaching was most commonly applied to procedural or manual skills with 22 (17%) instances among all studies.Conclusions: Most literature on coaching and mentorship is descriptive or narrative, and few papers are in the specialty of emergency medicine. Most interventions are limited to single instances of coaching or mentorship without longitudinal application of the intervention. There is an important need to study and publish further evidence on coaching interventions.

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

Cited by 50 publications

References 27 publications

The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback

The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback

Using Audit and Feedback and the Benchmark to Enhance Infection Prevention and Control of Multidrug Resistant Organisms: a Quasi-experiment Study

Clinical Improvement Interventions for Residents and Practicing Physicians: A Scoping Review of Coaching and Mentoring for Practice Improvement

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