SMART, SMARTER, SMARTEST: The influence of peer groups compared to practice visits on the quality of action plans

Figures & data

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Practice points

Assessing SMART criteria is feasible. GP trainers are able to improve their action plans upon feedback. PGs are at least as effective as PVs on quality of action plans written for PDPs. The SMART criterion Specificity seems to benefit most from feedback.

Figure 1. Flow chart of study group.

Table 1.  Personal characteristics of GP trainers and their practices

		PV (n = 25)	PG (n = 32)
Gender (%)	Female	32.0	37.5
	Male	68.0	62.5
Average age (years)		51	49
Part-time GP trainer (%)		52.0	78.1
Practice size (%)	Single handed	24.0	18.8
	Small (up to three doctors)	56.0	56.3
	Health care centres (more than three doctors)	20.0	25.0
Practice setting (%)	City	36.0	53.1
	Urban	48.0	28.1
	Rural	16.0	18.8
In 3rd or 4th year of curriculum for starting GPs (%)		40.0	50.0
Working in appraised practice (%)^a		28.0	40.6

Note: ^aThe Dutch Society of General Practitioners (NHG) appraises practices. In this (voluntary) appraisal GP's are required to use SMART-criteria in defining practice-based goals and therefore have experience in making goals SMART.

Table 2.  Percentage of PDPs in which subheadings of AART were used

	PV			PG
	Baseline (n = 25)	Follow-up (n = 25)	Δ Baseline follow-up	Baseline (n = 32)	Follow-up (n = 32)	Δ Baseline follow-up
Aim mentioned (% of all)	84	100	6	93.8	100	6.2
Action mentioned (% of all)	84	92	6	96.9	100	3.1
Result mentioned (% of all)	80	80	0	90.6	93.8	3.2
Time span mentioned (% of all)	80	84	4	100	96.9	–3.1

Table 3.  Mean SMARTness scores

	PV			PG
Mean	Baseline (n = 25)	Follow-up (n = 25)	Δ Baseline follow-up	Baseline (n = 32)	Follow-up (n = 32)	Δ Baseline follow-up
Specific	1.72 (0.45)	3.16 (0.80)	1.44	2.75 (0.88)	3.66 (0.83)	0.91
Measurable	2.28 (0.84)	2.72 (1.21)	0.44	2.97 (0.93)	3.53 (0.88)	0.56
Realistic	2.32 (1.07)	3.32 (0.81)	1.00	3.03 (0.78)	3.66 (0.90)	0.63
Time-bound	2.64 (0.95)	3.64 (1.04)	1.00	3.38 (0.91)	3.75 (0.88)	0.37

Note: SD values are given within parentheses.

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A	A	R	T

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Specific 1–5	Measurable 1–5	Realistic 1–5	Time-bound 1–5