Table 4 Individual components of TREAT format most readily sustained and barriers and enablers to sustaining mapped to COM-B model [10]

Articles circulated prior

• Competing demands, often sent late (O)

• Articles previously circulated before TREAT format introduced (O)

• Sense of responsibility to send early (M)

CASP tools

• Knowledge which specific study design CASP tool to use (C)

• Having confident clinician help choose tool (C)

• Perception that tool makes appraisal more accessible & guides session (C)

• CASP tool structure helpful (C)

Consistent time and place

• Less regular scheduling/cancellations/emergent leave (O)

• Unprepared presenters (O)

• Difficulty finding time suits everyone(O)

• Less accountable without academic (O)

• Set time allocated (O)

• Clinician encouraging attendance just prior to meeting (M)

• Manager expectation (M)

• Having JC after another set meeting (O)

Discussing applying evidence

• Difficulty applying to practice for multi-disciplinary team (C)

• Can’t always change practice from article (O)

• Lack of confidence in applying evidence (C)

• Greater understanding of other multidisciplinary team roles with JC (M)

• Members all contribute to discussion (M)

• Senior staff present to assist with application to practice (C)

Group appraisal

• Reduced quality of appraisal without academic (C)

• Less intimidating when appraisal done as a group (M)

• More participation in group discussions than previous format (M)

• Split into smaller groups (O)

Librarian support^

• Lack of awareness or how to access (C)

• Quick turnaround to receive articles (O)

• Perception library can help find higher quality article (M)

• Helpfulness of librarians (M)

Food at meetings

• Perception that motivation should be intrinsic (M)

• Cost of food (O)

• People bring own food/chocolate (O)

• Motivates people to attend (M)