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Table 4 Protocol of the guideline training

From: Improving occupational physicians’ adherence to a practice guideline: feasibility and impact of a tailored implementation strategy

Goals of the meetings PDCA Intended approach to achieve the goals
Meeting 1: Introduction of group members, guideline training, and the guideline n/a 1. Introductory game to get to know peers and the trainer
n/a 2. Discuss the aim and structure of the guideline training, and explain the rules of the training (confidential setting, respecting each others’ opinions, constructive feedback, role of the trainer, and role of peers)
n/a 3. Discuss OPs’ expectations of the guideline training
n/a 4. Briefly discuss guideline content, its weaknesses, and its strengths
Meeting 2: Discuss the Preconditions’ of the guideline and recommendations of chapter 1 ‘Problem orientation’; identify related barriers, discuss specific solutions, and draw up an action plan n/a 1. Evaluate the previous meeting: OPs’ experiences
n/a 2. Trainer explains the framework of Cabana et al. [13]
P1-2 3. Discuss ‘Preconditions’ to using the guideline: the trainer asks OPs about their knowledge, attitude, and use of the guideline in practice, as well as the reasons for not using it and what would help them use it in practice
P2-3 4. Group assignment on ‘Problem orientation’: discuss in pairs the questions to be asked to inventory patients’ problems; group discussion and check agreement with guideline recommendation; discuss what would facilitate or hinder using this recommendation; and discuss what would help facilitate use in practice
P4, D 5. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 3: Discuss guideline recommendations of chapter 1 ‘Diagnosis’; identify related barriers, discuss specific solutions, and draw up an action plan C, A 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers? Discuss new solutions for barriers
P1 2. Trainer explains key recommendations related to ‘Diagnosis’
P2-3 3. Case discussion: one OP introduces a case, and other OPs ask questions and set diagnosis, check agreement with guideline recommendation, and discuss facilitators and barriers for use in practice
P4, D 4. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 4: Barrier analysis, and discuss solutions for guideline recommendations of chapter 2 ‘Interventions focusing on patients and Process-based approach’ C, A 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers? Discuss new solutions for barriers
P1 2. Trainer explains key recommendations related to ‘Interventions focusing on patients’ and ‘Process-based approach’
P2-3 3. Case discussion: discuss possible interventions for a case, practice interventions using the case description, and check agreement with the guideline recommendations
P4, D 4. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 5: Barrier analysis, and discuss solutions for guideline recommendations of chapter 2 ‘Interventions focusing on work environment’ C, A 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers? Discuss new solutions for barriers
P1 2. Trainer explains key recommendations related to ‘Interventions focusing on work environment’
P2-3 3. Intervention tools: discussion of tools associated with the guideline; discuss knowledge, attitude, and use of the guideline in practice, as well as the reasons for not using it and what would help with use in practice
P4, D 4. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 6: Barrier analysis, and discuss solutions for guideline recommendations of chapters 3 and 4 ‘Relapse prevention, evaluation, and closure’ C, A 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers? Discuss new solutions for barriers
P1 2. Trainer explains key recommendations related to ‘Relapse prevention, evaluation, and closure’
P2-3 3. Case evaluation: OPs check each others’ cases, give feedback, and discuss agreement with guideline content
P4, D 4. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 7: Barrier analysis, and discuss solutions for guideline element ‘Process-based approach’ C, A 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers? Discuss new solutions for barriers
P1-3 2. Training topics and methods adjusted to the needs of the group
P4, D 3. Action plan: group discussion on what the most important barriers and feasible solutions are; formulate collective learning objectives, strategies, and homework assignments
Meeting 8: (Process) evaluation of the meetings C 1. Evaluate action plan: were solutions tested? What were the implementation facilitators and barriers?
C 2. Evaluate guideline training: OPs’ experiences of guideline training and assurance of what has been learned
  1. Goals of the meetings, related elements of the Plan-Do-Check-Act cycle and intended approach to achieve the goals.
  2. OP = occupational physician; P = Plan; D = Do; C = Check; A = Act; n/a = not applicable.