Table 1 Pedagogical theories and knowledge translation frameworks used to inform the PEAK program

Pedagogical foundations

Observational learning, social experience, and an inner reflective ability are important in the development of self-efficacy [11].

All aspects of PEAK were designed to foster self-efficacy through facilitated step-by-step procedures that offered multiple opportunities for learning. Participants had the opportunity to learn with and from each other in small groups and using the online collaboration tool.

Self-efficacy is reinforced through personal performance, verbal persuasion from credible sources, and observations of others [12].

Individual success in searching for and critically appraising research evidence was shared in small groups and affirmed by the program experts and peers in monthly conferences.

Adults are independent and self-directed learners who draw upon their own experiences to aid their learning [13].

Groups were given an independent task—to develop a Best Practices List around a group-selected clinical problem. They accessed resources as required from a range of online and instructor resources.

Adult learners are motivated to learn by internal drives, when learning is immediate, relevant, and practical [13].

The process of developing the Best Practices List focused on a clinical problem selected by participants as relevant to their collective practice.

Knowledge translation frameworks

PARiHS: Successful implementation is a function of the qualities of the context in which the evidence is being used [15, 16].

Leadership support was secured by encouraging all managers to participate in logistical organization and in the educational program. A physical barrier of three geographic locations was acknowledged and addressed using online resources.

PARiHS: Successful implementation is a function of

the facilitation methods used [15, 16].

Regular communication in small groups was driven by the need for monthly reporting. Additional support from the study librarian and PI was available to all participants on request.

KTA: Key steps include:knowledge creation, problem identification, local adaptation, assessment of barriers, implementation, monitoring, and sustained use [17].

Participants adapted research knowledge to their local environment, using an awareness of key barriers for a group-selected clinical problem. They then agreed that sustained use would be monitored via audits of medical record reporting.