Woodhouse Douglas, Duncan Diane, Ferrie Leah, Omodon Onyebuchi, Mehta Ashi, Pokharel Surakshya, Ambasta Anshula
Physician Learning Program, University of Calgary, Calgary, Canada.
Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Implement Sci Commun. 2024 Dec 18;5(1):140. doi: 10.1186/s43058-024-00679-5.
The Calgary Audit and Feedback Framework (CAFF) is a pragmatic, evidence-based approach for the design and implementation of in-person social learning interventions using Audit and Group Feedback (AGF). This report describes extension of CAFF into the virtual environment as part of a multifaceted intervention bundle to reduce redundant daily laboratory testing in hospitals. We evaluate the process of extending CAFF in the virtual environment and share resulting evidence of participant engagement with planning for practice change.
We describe an innovative virtually facilitated AGF intervention based on the CAFF. The AGF intervention was part of an intervention bundle which included individual physician laboratory test utilization reports and educational tools to reduce redundant daily laboratory testing in hospitals. We used data from recorded and transcribed virtual AGF sessions, post AGF session surveys and detailed field notes maintained by project team members. We used simple descriptive statistics for quantitative data and analyzed qualitative data according to the elements of CAFF.
Eighty-three physicians participated over twelve virtual AGF sessions conducted across four tertiary care hospitals during the study period. We demonstrate that all prerequisite activities for CAFF (relationship building, question choice and data representation) were present in every virtual AGF session. Virtual facilitation was effective in supporting the transition of participants through different steps of CAFF in each session to lead to change talk and planning. All participants contributed to discussion during the AGF sessions. The post AGF session surveys were filled by 66% of participants (55/83), with over 90% of respondents reporting that the session helped them improve practice. 46% of participants (38/83) completed personal commitment to change forms at the end of the sessions.
Virtual AGF sessions, developed and implemented with fidelity to the CAFF approach, successfully engaged physicians in a group learning environment that led to change planning. Further studies are needed to determine the generalizability of our findings and to add to the literature on evidence-based virtual facilitation techniques.
卡尔加里审核与反馈框架（CAFF）是一种实用的、基于证据的方法，用于设计和实施使用审核与小组反馈（AGF）的面对面社交学习干预措施。本报告描述了将CAFF扩展到虚拟环境中，作为减少医院日常重复实验室检测的多方面干预措施组合的一部分。我们评估了在虚拟环境中扩展CAFF的过程，并分享了参与者参与实践变革规划的相关证据。
我们描述了一种基于CAFF的创新型虚拟促进AGF干预措施。AGF干预是干预措施组合的一部分，该组合包括个体医生实验室检测使用报告和教育工具，以减少医院日常重复实验室检测。我们使用了虚拟AGF会议的录音和转录数据、AGF会议后调查以及项目团队成员记录的详细现场笔记。我们对定量数据使用简单描述性统计，并根据CAFF的要素分析定性数据。
在研究期间，83名医生参加了在四家三级护理医院进行的12次虚拟AGF会议。我们证明，CAFF的所有前提活动（建立关系、问题选择和数据呈现）在每次虚拟AGF会议中都存在。虚拟促进有效地支持了参与者在每次会议中通过CAFF的不同步骤进行过渡，以促成改变谈话和规划。所有参与者都在AGF会议期间参与了讨论。66%的参与者（55/83）填写了AGF会议后调查问卷，超过90%的受访者表示该会议帮助他们改进了实践。46%的参与者（38/83）在会议结束时填写了个人变革承诺表。
按照CAFF方法忠实开发和实施的虚拟AGF会议，成功地让医生参与到一个导致变革规划的小组学习环境中。需要进一步研究以确定我们研究结果的普遍性，并补充基于证据的虚拟促进技术方面的文献。
