Determinant | Learning objectives for the insurance physician | Theory-based method | Practical strategy |
---|---|---|---|
Knowledge | Familiarity with the content of the guideline | Dissemination of training material Active learning from experts | Making guideline available in combination with practical instruments |
Skills | The ability to apply knowledge in practice | Interactive group training | Interactive training in use of the guidelines |
Attitude | Willingness to accept the guidelines and use them to improve quality | Persuasion by opinion leaders | Benefits highlighted during training and by staff and the Netherlands Association for Insurance Medicine |
Self-efficacy | Belief in ability to use the guidelines in practice and finding answers to questions | Performance-related feedback | Positive individualised feedback during training and subsequently in practice, assistance with questions |
Expectations | Expectation that the guideline will contribute to more evidence-based assessments | Individualized feedback and group performance audit data | Training in use of the guidelines with exercise case-histories, feedback at group and individual level |
 | Change objectives for the environment |  |  |
Availability | The ability to practise, ask questions and work on personal performance | Feedback, personal improvement, planning | Practice in training, feedback on performance, support with questions |
Uniformity | All insurance physicians covered by similar requirements | Quality-monitoring and quality-management | Staff physician appraises all insurance physicians using the same indicators |
Support | Support from colleagues, staff, management and professional association, facilitation and, where necessary, amendment of the work process | In-built process reminders, quality management, support from opinion leaders | Quality evaluation by management, staff quality-oriented direction, promotion by the Netherlands Association for Insurance Medicine |