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Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation

Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation
Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation
Background: The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entailed exploring the acceptability of the WISE approach and its effectiveness in changing communication within consultations. The study aimed to refine the patient, practitioner, and patient level components of the WISE approach and translate the principles of WISE into an operational intervention deliverable through National Health Service training methods.

Methods: Normalisation Process Theory provided a framework for development of the intervention. Practices were recruited from an inner city Primary Care Trust in NW England. All practice staff were expected to attend two afternoon training sessions. The training sessions were observed by members of the training team. Post-training audio recordings of consultations from each general practitioner and nurse in the practices were transcribed and read to provide a narrative overview of the incorporation of WISE skills and tools into consultations. Face-to-face semi-structured interviews were conducted with staff post-training.

Results: Two practices out of 14 deemed eligible agreed to take part. Each practice attended two sessions, although a third session on consultation skills training was needed for one practice. Fifty-four post-training consultations were recorded from 15 clinicians. Two members of staff were interviewed at each practice. Significant elements of the training form and methods of delivery fitted contemporary practice. There were logistical problems in getting a whole practice to attend both sessions, and administrative staff founds some sections irrelevant. Clinicians reported problems incorporating some of the tools developed for WISE, and this was confirmed in the overview of consultations, with limited overt use of WISE tools and missed opportunities to address patients' self-management needs.

Conclusions: The formative evaluation approach and attention to normalisation process theory allowed the training team to make adjustments to content and delivery and ensure appropriate staff attended each session. The content of the course was simplified and focussed more clearly on operationalising the WISE approach. The patient arm of the approach was strengthened by raising expectations of a change in approach to self-care support by their practice.
15pp
Kennedy, Anne
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Chew-Graham, Carolyn
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Blakeman, Thomas
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Bowen, Andrew
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Gardner, Caroline
d99612f8-f7d7-4b42-9d4b-287202c8117c
Protheroe, Joanne
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Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Gask, Linda
9805a757-54f2-400c-b3f4-b5cc277df509
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Chew-Graham, Carolyn
530beade-2b1c-4eea-846f-1fcef0585ca5
Blakeman, Thomas
c005e534-1e5e-4f74-a3ef-a4f298519399
Bowen, Andrew
fe8d1ae6-3ed9-4f89-b1e9-690a0e479101
Gardner, Caroline
d99612f8-f7d7-4b42-9d4b-287202c8117c
Protheroe, Joanne
ef666365-4f77-4c8c-9471-967b084dff81
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Gask, Linda
9805a757-54f2-400c-b3f4-b5cc277df509

Kennedy, Anne, Chew-Graham, Carolyn, Blakeman, Thomas, Bowen, Andrew, Gardner, Caroline, Protheroe, Joanne, Rogers, Anne and Gask, Linda (2010) Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation. Implementation Science, 5 (7), 15pp. (doi:10.1186/1748-5908-5-7).

Record type: Article

Abstract

Background: The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entailed exploring the acceptability of the WISE approach and its effectiveness in changing communication within consultations. The study aimed to refine the patient, practitioner, and patient level components of the WISE approach and translate the principles of WISE into an operational intervention deliverable through National Health Service training methods.

Methods: Normalisation Process Theory provided a framework for development of the intervention. Practices were recruited from an inner city Primary Care Trust in NW England. All practice staff were expected to attend two afternoon training sessions. The training sessions were observed by members of the training team. Post-training audio recordings of consultations from each general practitioner and nurse in the practices were transcribed and read to provide a narrative overview of the incorporation of WISE skills and tools into consultations. Face-to-face semi-structured interviews were conducted with staff post-training.

Results: Two practices out of 14 deemed eligible agreed to take part. Each practice attended two sessions, although a third session on consultation skills training was needed for one practice. Fifty-four post-training consultations were recorded from 15 clinicians. Two members of staff were interviewed at each practice. Significant elements of the training form and methods of delivery fitted contemporary practice. There were logistical problems in getting a whole practice to attend both sessions, and administrative staff founds some sections irrelevant. Clinicians reported problems incorporating some of the tools developed for WISE, and this was confirmed in the overview of consultations, with limited overt use of WISE tools and missed opportunities to address patients' self-management needs.

Conclusions: The formative evaluation approach and attention to normalisation process theory allowed the training team to make adjustments to content and delivery and ensure appropriate staff attended each session. The content of the course was simplified and focussed more clearly on operationalising the WISE approach. The patient arm of the approach was strengthened by raising expectations of a change in approach to self-care support by their practice.

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Delivering_the_WISE_(Whole_Systems_Informing_Self-Management_Engagement)_training_package_in_primary_care_learning_from_formative_evaluation.pdf - Other
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Published date: 29 January 2010
Organisations: Faculty of Health Sciences

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Local EPrints ID: 344360
URI: http://eprints.soton.ac.uk/id/eprint/344360
PURE UUID: 32b7e37f-1323-45fb-a031-21edbe464d56
ORCID for Anne Kennedy: ORCID iD orcid.org/0000-0003-4570-9104

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Date deposited: 22 Oct 2012 09:46
Last modified: 14 Mar 2024 12:13

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Contributors

Author: Anne Kennedy ORCID iD
Author: Carolyn Chew-Graham
Author: Thomas Blakeman
Author: Andrew Bowen
Author: Caroline Gardner
Author: Joanne Protheroe
Author: Anne Rogers
Author: Linda Gask

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