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Introduction Seeing and treating patients in daily practice forms the basis of general practitioner (GP) training. However, the types of patients seen by GP trainees do not always match trainees’ educational needs. Knowledge about factors that shape the mix of patient types is limited, especially with regard to the role of the professionals who work in the GP practice. Aim We investigated factors affecting the mix of patients seen by GP trainees from the perspective of professionals. Design and setting This qualitative study involved GP trainees, GP supervisors, medical receptionists and nurse practitioners affiliated with a GP Specialty Training Institute in the Netherlands. Methods Twelve focus groups and seven interviews with 73 participants were held. Data collection and analysis were iterative, using thematic analysis with a constant comparison methodology. Results The characteristics of patients’ health problems and the bond between the doctor and patient are important determinants of GP trainees’ patient mix. Because trainees have not yet developed bonds with patients, they are less likely to see patients with complex health problems. However, trainees can deliberately influence their patient mix by paying purposeful attention to bonding with patients and by gaining professional trust through focused engagement with their colleagues. Conclusion Trainees’ patient mix is affected by various factors. Trainees and team members can take steps to ensure that this mix matches trainees’ educational needs, but their success depends on the interaction between trainees’ behaviour, the attitudes of team members and the context. The findings show how the mix of patients seen by trainees can be influenced to become more trainee centred and learning oriented. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective To identify and compare tools to assess Evidence-Based Practice (EBP) behaviour among healthcare professionals. Design Systematic review. Data sources MEDLINE, EMBASE, Cochrane Library, PsychInfo and CINAHL up to July 2011. Study selection Titles, abstracts and eligible full text articles were screened by two reviewers independently. Data extraction Relevant data were extracted by one reviewer and checked by a second reviewer. Eligibility criteria for selecting studies: original studies among all healthcare professionals that described the development or use of EBP behaviour assessment tools. Results Of 19 310 identified articles, 172 studies were included. We identified 117 questionnaires, 10 interviews or focus groups, nine observational studies, 27 chart evaluations and nine studies used a combination of methods. Psychometric properties of the questionnaires used were reported in about half of the studies, in seven studies that assess a single EBM step and in six studies that assess a combination of EBM steps. One of these assessed all five steps of EBP. Conclusions Valid and reliable EBP behaviour assessment tools are available. However, only one questionnaire validly assessed all five EBP steps, covering the entire concept of EBP. [ABSTRACT FROM AUTHOR]

Objective: To identify and compare tools to assess Evidence-Based Practice (EBP) behaviour among healthcare professionals., Design: Systematic review., Data Sources: MEDLINE, EMBASE, Cochrane Library, PsychInfo and CINAHL up to July 2011., Study Selection: Titles, abstracts and eligible full text articles were screened by two reviewers independently., Data Extraction: Relevant data were extracted by one reviewer and checked by a second reviewer., Eligibility Criteria for Selecting Studies: original studies among all healthcare professionals that described the development or use of EBP behaviour assessment tools., Results: Of 19 310 identified articles, 172 studies were included. We identified 117 questionnaires, 10 interviews or focus groups, nine observational studies, 27 chart evaluations and nine studies used a combination of methods. Psychometric properties of the questionnaires used were reported in about half of the studies, in seven studies that assess a single EBM step and in six studies that assess a combination of EBM steps. One of these assessed all five steps of EBP., Conclusions: Valid and reliable EBP behaviour assessment tools are available. However, only one questionnaire validly assessed all five EBP steps, covering the entire concept of EBP.