Practice-based Small Group Learning: How health professionals view their intention to change and the process of implementing change in practice

Abstract

Commitment-to-change (CTC) strategies used as part of Continuing Professional Development (CPD) programmes have been found to influence changes in the clinical practice of health professionals. However, there is an unquestioned usage of the term 'commitment' to describe the statements made by learners specifying the changes they intend to make following CPD programmes. The Practice-based Small Group Learning (PBSGL) programme is one approach to the CPD of health professionals that includes a CTC instrument. This study reports on a pilot PBSGL programme in Scotland, which composed of mixed groups of General Practitioners (GPs) and Practice Nurses (PNs), as well as PN-only groups. Using qualitative methods, the study examines the meaning that learners ascribe to their statements of intention to introduce changes in their practice. It reveals that for some participants commitment is too strong a word to describe their intention. Nevertheless, others did feel that they were committing to the changes that they identified at PBSGL meetings. This study also explores the factors that influenced the decision of PBSGL participants to introduce practice changes, and the process of implementing change in clinical practice.

Quality circles for quality improvement in primary health care: their effectiveness, gaps of knowledge, origins and significance – a scoping review

“…The groups help them to link evidence to everyday practice (57), learn how to deal with uncertainty (122) and how to improve practice (54). They are a vehicle for discussing issues and reflecting on practice, that may increase self-esteem (123, 124). Frequent participation strengthens team-based strategies for error prevention (125).…”

Clinical Uncertainty in Primary Care

“…Further, 75 physicians reported making 127 practice changes. Similar positive evaluations on the implementation of PBSGL in Scotland suggested that practice change was likely or had happened (Overton et al 2009 ). While evidence of change in knowledge and self-reported changes in practice were encouraging, they did not provide stringent evidence of a change of physician behaviour.…”

Implementation of asthma guidelines to West Australian community pharmacies: an exploratory, quasi-experimental study

“…[42][43][44] Despite the logistical problems encountered, the rationale in choosing small group workshops for interventions in community pharmacy seems to have merit, due to acknowledgement of the team-based environment that community pharmacists practice in. It is recognised that team-based change is likely to be slower and more incremental than changing the practice of an individual healthcare practitioner 45 and hence the difficulty in achieving practice change in the community pharmacy setting, regardless of logistical issues. Results indicated some improvements in individual counselling and medical referral but not in system-level process improvements.…”