From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery
Abstract Background There is substantial evidence that facilitation can address the challenges of implementing evidence-based innovations. However, facilitators need a wide variety of complex skills; lack of these can have a negative effect on implementation outcomes. Literature suggests that novice...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-021-00138-5 |
| _version_ | 1818328817891016704 |
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| author | Mona J. Ritchie Louise E. Parker JoAnn E. Kirchner |
| author_facet | Mona J. Ritchie Louise E. Parker JoAnn E. Kirchner |
| author_sort | Mona J. Ritchie |
| collection | DOAJ |
| description | Abstract Background There is substantial evidence that facilitation can address the challenges of implementing evidence-based innovations. However, facilitators need a wide variety of complex skills; lack of these can have a negative effect on implementation outcomes. Literature suggests that novice and less experienced facilitators need ongoing support from experts to develop these skills. Yet, no studies have investigated the transfer process. During a test of a facilitation strategy applied at 8 VA primary care clinics, we explored the techniques and processes an expert external facilitator utilized to transfer her skills to two initially novice internal facilitators who became experts. Methods In this qualitative descriptive study, we conducted monthly debriefings with three facilitators over a 30-month period and documented these in detailed notes. Debriefings with the expert facilitator focused on how she trained and mentored facilitation trainees. We also conducted, recorded, and transcribed two semi-structured qualitative interviews with each facilitator and queried them about training content and process. We used a mix of inductive and deductive approaches to analyze data; our analysis was informed by a review of mentoring, coaching, and cognitive apprenticeship literature. We also used a case comparison approach to explore how the expert tailored her efforts. Results The expert utilized 21 techniques to transfer implementation facilitation skills. Techniques included both active (providing information, modeling, and coaching) and participatory ones. She also used techniques to support learning, i.e., cognitive supports (making thinking visible, using heuristics, sharing experiences), psychosocial supports, strategies to promote self-learning, and structural supports. Additionally, she transferred responsibility for facilitation through a dynamic process of interaction with trainees and site stakeholders. Finally, the expert varied the level of focus on particular skills to tailor her efforts to trainee and local context. Conclusions This study viewed the journey from novice to expert facilitator through the lens of the expert who transferred facilitation skills to support implementation of an evidence-based program. It identified techniques and processes that may foster transfer of these skills and build organizational capacity for future implementation efforts. As the first study to document the implementation facilitation skills transfer process, findings have research and practical implications. |
| first_indexed | 2024-12-13T12:38:12Z |
| format | Article |
| id | doaj.art-5bd0c7326d324d8786012d9684fa0694 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-12-13T12:38:12Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-5bd0c7326d324d8786012d9684fa06942022-12-21T23:45:44ZengBMCImplementation Science Communications2662-22112021-04-012111410.1186/s43058-021-00138-5From novice to expert: methods for transferring implementation facilitation skills to improve healthcare deliveryMona J. Ritchie0Louise E. Parker1JoAnn E. Kirchner2VA Behavioral Health Quality Enhancement Research Initiative (QUERI), Department of Veterans AffairsVA Behavioral Health Quality Enhancement Research Initiative (QUERI), Department of Veterans AffairsVA Behavioral Health Quality Enhancement Research Initiative (QUERI), Department of Veterans AffairsAbstract Background There is substantial evidence that facilitation can address the challenges of implementing evidence-based innovations. However, facilitators need a wide variety of complex skills; lack of these can have a negative effect on implementation outcomes. Literature suggests that novice and less experienced facilitators need ongoing support from experts to develop these skills. Yet, no studies have investigated the transfer process. During a test of a facilitation strategy applied at 8 VA primary care clinics, we explored the techniques and processes an expert external facilitator utilized to transfer her skills to two initially novice internal facilitators who became experts. Methods In this qualitative descriptive study, we conducted monthly debriefings with three facilitators over a 30-month period and documented these in detailed notes. Debriefings with the expert facilitator focused on how she trained and mentored facilitation trainees. We also conducted, recorded, and transcribed two semi-structured qualitative interviews with each facilitator and queried them about training content and process. We used a mix of inductive and deductive approaches to analyze data; our analysis was informed by a review of mentoring, coaching, and cognitive apprenticeship literature. We also used a case comparison approach to explore how the expert tailored her efforts. Results The expert utilized 21 techniques to transfer implementation facilitation skills. Techniques included both active (providing information, modeling, and coaching) and participatory ones. She also used techniques to support learning, i.e., cognitive supports (making thinking visible, using heuristics, sharing experiences), psychosocial supports, strategies to promote self-learning, and structural supports. Additionally, she transferred responsibility for facilitation through a dynamic process of interaction with trainees and site stakeholders. Finally, the expert varied the level of focus on particular skills to tailor her efforts to trainee and local context. Conclusions This study viewed the journey from novice to expert facilitator through the lens of the expert who transferred facilitation skills to support implementation of an evidence-based program. It identified techniques and processes that may foster transfer of these skills and build organizational capacity for future implementation efforts. As the first study to document the implementation facilitation skills transfer process, findings have research and practical implications.https://doi.org/10.1186/s43058-021-00138-5FacilitationImplementationSkill transferImplementation strategy |
| spellingShingle | Mona J. Ritchie Louise E. Parker JoAnn E. Kirchner From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery Implementation Science Communications Facilitation Implementation Skill transfer Implementation strategy |
| title | From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery |
| title_full | From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery |
| title_fullStr | From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery |
| title_full_unstemmed | From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery |
| title_short | From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery |
| title_sort | from novice to expert methods for transferring implementation facilitation skills to improve healthcare delivery |
| topic | Facilitation Implementation Skill transfer Implementation strategy |
| url | https://doi.org/10.1186/s43058-021-00138-5 |
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