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Table 4 Themes and sub-themes

From: Oilcloth sessions as an implementation strategy: a qualitative study in Denmark

31 Sub-themes Themes Biggs and Tang’s (2011)
Preparation
 Oilcloth as a method was unknown Preparing individually and collectively Teaching method
 Material was sent out to the participants before participation by
 The fact that some participants were involved early in the process (10 years ago) has given them a form of preparation that requires that they are not surprised despite the fact that physical spaces have not been as agreed at that time
 Management and preparation are central to a positive experience with oilcloth sessions
 Management representatives are role models and should appear aligned before participating in oilcloth sessions
 Separation between the organizational and the clinical is not perceived constructively (possible) Conflicting objectives Objectives
 The oilcloth method develops over time (becomes more and more standardized); *strengthens* so that objectives, and purposes become clearer
 Due to the “liquid nature” of oilcloth sessions (experience by participants), a similar and clear objective is required
 Experienced prestige/recognition of being selected by its manager Involving suitable participants The participants prerequisites
 The target group and the right participants for the new ED (becomes unclear as there is  a dual objective with oilcloth sessions; consensus among the managers (management decisions about organization) but professionally close to the practice (the clinics when they are with the patients)
 Relationship between management, habitual ways of acting and the right participants
 Oilcloth made it clear that nursing is not the object of the oilcloth sessions Selecting suitable clinical cases Content
 The case was copied from the medical record, which became an indicator that it was the medical issue that was in focus at oilcloth sessions
 The case should have been more complex
 Oilcloth sessions were controlled by the physicians
Conducting
 LEGO man a mediating artefact Using suitable materials Media
 Whiteboard for challenges as a mediating artefact
 The presence of the board of directors was evaluated positively but assumptions were made as to why they were participating [their purpose in participating could have been clarified] Facilitation the sessions Teaching method
 The presence of the management symbolized that oilcloth sessions are important
 The participants made assumptions about what the board of directors will learn
 Oilcloth sessions became an explicit experience more than practical training Temporal structures Teaching method
 The introduction went too fast when the participants were new to the oilcloth sessions
 New participants lost track along the way. A visit to the new physical buildings would have provided a different insight
 Time and delay for moving into the new ED
 Time for appointments to be in place
Evaluation
 Experiences about trust/mistrust of the implementation of the new ED depending on management and preparation in the oilcloth sessions Follow-up on the sessions Assessment
 Missing plan for follow-up (consequence of an experience that oilcloth sessions are a detached and sporadic activity). The consequence can be uncertainty about the new ED
 Uncertainty about follow-up and responsibilities
 Experiences with previous collaborations in daily practice affect the experience of oilcloth sessions [positive and negative experiences] Adapting to the context Assessment and organizational context
 Oilcloth sessions can be experienced as a game but also as a strategy for implementing the future
 Waste of public funds