How and why do Quality Circles work for General Practitioners - a realist approach

Objectives: To understand how and why general practitioners in quality circles (QC) reflect on and improve routine practice over time. To provide practical guidance for participants and facilitators to implement and for policy makers to organise this complex social intervention. Design: A theory-driven mixed method Setting: Primary health care Method: We collected data in four stages to develop and refine the programme theory of QCs: 1) co-inquiry with Swiss and European stakeholders to develop a preliminary programme theory; 2) realist review with systematic searches in MEDLINE, Embase, PsycINFO, and CINHAL (1980-2020) to extend the preliminary programme theory; 3) programme refinement through interviews with participants, facilitators, tutors and managers of quality circles; 4) consolidation through interviews and iterative searches for theories enabling us to strengthen the programme theory. Sources of data: The co-inquiry comprised 3 interviews and 3 focus groups with 50 European experts. From the literature search we included 108 papers to develop the literature-based programme theory. In stage 3, we used data from 40 participants gathered in 6 interviews and 2 focus groups to refine the programme theory. In stage 4, five interviewees from different health care systems consolidated our programme theory. Result: Requirements for successful QCs are governmental trust in GPs abilities to deliver quality improvement, training, access to educational material and performance data, protected time, and financial resources. Group dynamics strongly influence success; facilitators should ensure participants exchange knowledge and generate new concepts in a safe environment. Peer interaction promotes professional development and psychological well-being. With repetition, participants gain confidence to put their new concepts into practice. Conclusion: QCs can improve practice, promote professional development, and psychological well-being given adequate professional and administrative support.

The Formation of an Attractive HR-Brand of a Transport Company's Target Audience of 'Young People'

The article is dedicated to studying the HR-brand of a vehicle company, and seeks ways to improve it further. Theoretical and methodological aspects of shaping the image of an organisation as an employer are now widely reflected in the works of domestic and foreign researchers in the field of human resource management. However, the applied aspects of branding in relation to specific employers from different sectors of the economy remain relevant for the study. The practical interest of the company in question is due to the high turnover rate (15%) and the shortage of young workers. For the purpose of studying the formed corporate HR-brand, the author uses an analysis of local regulations on staff management, employee questionnaires, the assessment of the employer’s value proposition, a reputational audit of the company regarding the Internet environment, etc. The analysis of the internal and external image of the employer concludes that the attractiveness of the HR brand of the enterprise among the target audience ‘young people’ needs to be improved. The successful achievement of this goal is possible through the introduction of career management practices, organising participation in professional competitions; for young promising employees already in the company, developing and implementing a preliminary programme and promoting the company on social media: for potential candidates. Forming an attractive HR brand for young people based on the implementation of a value proposition that takes into account the specifics of this target audience, using new channels and formats to promote the employer brand externally, including in the online environment, will optimise staff turnover, attract and retain talented young people and strengthen the company’s position in the market.

Using Realist Interviews to Improve Theory on the Mechanisms and Outcomes of Sport for Development Programmes

The complex nature of Sport for Development (SfD) programmes makes impact evaluation challenging. Realist evaluation has been proposed as a new, theory-driven approach to evaluate complex programmes. The present study aimed to explore the value of conducting realist interviews to gain improved insight into the mechanisms and outcomes of three SfD programmes in the Netherlands: a programme that promotes sports participation among socially vulnerable youth; a combined lifestyle intervention for adults of low social economic status; and a sports-based programme for marginalised adults. In addition, the study aimed to investigate the applicability of a conceptual model from the field of social enterprise (Roy, Baker, & Kerr, 2017) as the preliminary programme theory for those interviews. First, for each programme, a realist interview was conducted with one researcher as the key informant. Thereafter, the findings from and experiences with the individual realist interviews were discussed among the informants in a group meeting. The results revealed that the conceptual model functioned well as preliminary programme theory for the SfD programmes. The realist interviews contributed to theoretical awareness and trustworthiness. Importantly, the interviews highlighted knowledge gaps and generated ideas for programme improvement. Hence, the realist interview technique is recommended as a methodological tool to generate, validate, and improve programme theory in the field of SfD. This study had, however, an explorative character, and more research is needed to confirm and generalize the findings and to learn how a greater number of stakeholders might contribute to this type of realist evaluation.

Preliminary programme evaluation of the Scottish Clinical Leadership Fellowship

BackgroundThe Scottish Clinical Leadership Fellowship (SCLF) is a 1-year programme to help medical and dental specialty trainees develop as future clinical leaders for the National Health Service (NHS) in Scotland. This preliminary programme evaluation combines qualitative and quantitative data from the 2016/2017 SCLF cohort. It will lay the foundation for a future more detailed evaluation study.MethodsData from written reflections were combined with accounts from a residential day and results of an anonymous survey. The survey considered the various personal development activities of the SCLF and how fellows’ perspectives had changed over the year. Results were thematically analysed.ResultsThe 2016/2017 cohort comprised 12 doctors. Fellows were left with highly positive views of the SCLF and their ability to influence their NHS organisation on return to practice. Personal reflections were assessed in six different themes, while the lessons fellows identified felt would shape their future clinical careers centred around personal behaviour, how fellows interacted with teams and their organisation, and improved leadership skills in general.ConclusionThis preliminary programme evaluation is the first such exercise completed on the SCLF. The highly positive findings have helped shape the programme for the subsequent cohort and will inform a future more detailed evaluation study.