Context: Development and implementation of evidence-based innovations, such as models and practice guides, are strongly incentivized as part of the primary care reform in Canada. In the Province of Quebec, this generated the creation of interprofessional care models involving nurses and social workers as members of family medicine groups (FMGs). To overcome some identified gaps regarding variability of practice, skills, knowledge and roles, experts committee have created two evidence-based practice guidelines that have been disseminated to nurses, social workers, and decision-makers within the FMGs.
Objective: To develop and implement an advanced train-the-trainer strategy to support the appropriation of those guidelines and to evaluate the implementation.
Study Design: Multiple case study using a developmental evaluation approach.
Setting or Dataset: Six FMGs located in three administrative regions of Quebec.
Population studied: Clinical trainers working in healthcare organization and already having a clinical support role in nursing (n=4) and social care (n=4) and patient-trainers (n=6).
Intervention: Implementation and evaluation of a 16 hours training and in-depth professional development program over 6 months, informed by a patient-oriented research approach, the Kirkpatrick learning model, and evidence-based practice guidelines.
Outcome Measures: Quantitative data measuring level 1, 2 and 3 of KirkPatrick model (Reaction, learning and behavior) and qualitative data measuring barriers expected and means to remove it, assessments and thoughts on trainer’s role and training activities achieved.
Results: 75 % of clinical trainers said that the training program met their expectations and was confident to apply what they have learned. Although 11 of 12 trainers said that it was helpful to become a better trainer, they reported some difficulties to appropriate their new role and to improve their level of confidence. They identified an efficient communication plan, co-development, in addition to statutory and capacity building meetings, as elements that favored their success. Patient-trainers’ role was not well understood by clinical trainers and patient-trainers themselves.
Conclusions: First results allowed an improvement of the training program according to the clinical trainers’ comments and expressed needs in order to scale up the intervention in Phase 2. Furthermore, the promotion of the role of patient-trainer in healthcare settings is required.