Practice-based Small Group Learning: How health professionals view their intention to change and the process of implementing change in practice

Abstract

Commitment-to-change (CTC) strategies used as part of Continuing Professional Development (CPD) programmes have been found to influence changes in the clinical practice of health professionals. However, there is an unquestioned usage of the term ‘commitment’ to describe the statements made by learners specifying the changes they intend to make following CPD programmes. The Practice-based Small Group Learning (PBSGL) programme is one approach to the CPD of health professionals that includes a CTC instrument. This study reports on a pilot PBSGL programme in Scotland, which composed of mixed groups of General Practitioners (GPs) and Practice Nurses (PNs), as well as PN-only groups. Using qualitative methods, the study examines the meaning that learners ascribe to their statements of intention to introduce changes in their practice. It reveals that for some participants commitment is too strong a word to describe their intention. Nevertheless, others did feel that they were committing to the changes that they identified at PBSGL meetings. This study also explores the factors that influenced the decision of PBSGL participants to introduce practice changes, and the process of implementing change in clinical practice.

Notes

Notes

1. Normally the group log-sheet is completed without identifying the individuals. But for the first meeting of the PBSGLs involved in this study, members were identified according to their overt intention to make specific changes to their practice in relation to the module considered. This information was viewed by only one of the authors and did not form part of the record kept by the PBSGL project.

2. The recording of two face-to-face interviews was faulty. The interviewer managed to recall the essential information, and checked the accuracy of this information with the two participants.

3. The guidelines referred to were the Scottish Intercollegiate Guidelines Network (SIGN) and from the National Institute for Health and Clinical Excellence (NICE)

4. NMC is acronym for the Nursing and Midwifery Council.

Additional information

Notes on contributors

Githa Kanisin Overton

Githa K Overton, PhD., Hon. Research Fellow, University of Dundee; Previously Research Fellow, NHS Education for Scotland. Research interests include conflict resolution, as well as behavioural and psychological change in individuals and groups.

Peter Mccalister

Peter Mccalister, FRCGP: GP, Bonnybridge, Stirlingshire. Clinical Lead PBSGL Scotland

Diane Kelly

Dr Diane Kelly, Assistant Director, Continuing Professional Development, NHS Education for Scotland, General Practice Section, Glasgow

Ronald Macvicar

Dr Ronald Macvicar, Project Lead PBSGL Scotland, Assistant Director of Postgraduate General Practice Education, NHS Education for Scotland, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, Tel: [phone]