Table 3 Summary of key barriers and attitudes by theme
Theme | Barriers | Attitudes |
|---|---|---|
• Value of the improvement activity (i.e. audit, SEA, consultation technique) | • Relevance of activity to professional practice and every day work | • Activities are generally helpful, but not to all participants specifically |
|  |  | • Some believe their own improvement methods are sufficient |
• Value of external peer review | • Variation in understanding and purpose of peer review | • More challenging than internal review by close colleagues |
|  | • Viewed as more 'formal' and 'selection and control' | • Standard and validity of work enhanced |
|  | • Informed internal colleagues' views just as valid |  |
• Value of the peer feedback model | • Constrained by defined, structured formats | • Perceived as overly formal and additional work |
|  | • Other peer review options available | • Formalisation seen positively with regard to link with appraisal and regulation |
• Attitudes to external peer review (including appraisal) | • Distrust and suspicion of host organisation | • Face-to-face peer feedback more valuable |
|  | • Lack of awareness of model |  |
|  | • Practical barriers to engagement |  |