Article Text

Download PDFPDF

What motivates general practitioners to change practice behaviour? A qualitative study of audit and feedback group sessions in Dutch general practice
  1. Marije van Braak1,
  2. Mechteld Visser2,
  3. Marije Holtrop3,
  4. Ilona Statius Muller4,
  5. Jettie Bont2,
  6. Nynke van Dijk2
  1. 1 General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2 General Practice, Amsterdam University Medical Centre, Amsterdam, The Netherlands
  3. 3 General Practitioners Holtrop and Sieben, Amsterdam, The Netherlands
  4. 4 Ubbens and Statius Muller General Practitioners, Amsterdam, The Netherlands
  1. Correspondence to Marije van Braak; m.vanbraak{at}erasmusmc.nl

Abstract

Objectives Adopting an attributional perspective, the current article investigates how audit and feedback group sessions contribute to general practitioners’ (GPs) motivation to change their practice behaviour to improve care. We focus on the contributions of the audit and feedback itself (content) and the group discussion (process).

Methods Four focus groups, comprising a total of 39 participating Dutch GPs, discussed and compared audit and feedback of their practices. The focus groups were analysed thematically.

Results Audit and feedback contributed to GPs’ motivation to change in two ways: by raising awareness about aspects of their current care practice and by providing indications of the possible impact of change. For these contributions to play out, the audit and feedback should be reliable and valid, specific, recent and recurrent and concern GPs’ own practices or practices within their own influence sphere. Care behaviour attributed to external, uncontrollable or unstable causes would not induce change. The added value of the group is twofold as well: group discussion contributed to GPs’ motivation to change by providing a frame of reference and by affording insights that participants would not have been able to achieve on their own.

Conclusions In audit and feedback group sessions, both audit and feedback information and group discussion can valuably contribute to GPs’ motivation to change care practice behaviour. Peer interaction can positively contribute to explore alternative practices and avenues for improvement. Local or regional peer meetings would be beneficial in facilitating reflection and discussion. An important avenue for future studies is to explore the contribution of audit and feedback and small-group discussion to actual practice change.

  • primary care
  • qualitative research

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Contributors All authors contributed substantially to the conception, design or execution of the reported study. MH and ISM, in collaboration with ND, took initiative for the study. ND, MV, MH and ISM designed the study and collected the data. JB participated in the interpretation of the data. MVB, ND and MV participated in data analysis. MVB was responsible for the write-up of the study. All authors critically revised its content and provided final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data for this paper may be obtained from the authors upon request.

  • Correction notice This article has been corrected since it first published online. The open access licence type has been amended.

  • Patient consent for publication Not required.