Development and evaluation of tailored, theory-informed training to support the implementation of an outcome measure: an explanatory sequential mixed method study

We aimed to describe the development of a tailored, theory-informed training session for an outcome measure (the Mayo-Portland Adaptability Inventory), and evaluate the session’s impact on clinician reactions, learning, and behavioural intent. We developed the training session using an integrated knowledge translation approach with stroke outpatient rehabilitation clinicians in Québec, Canada. We conducted a mixed-method explanatory sequential evaluation informed by the New World Kirkpatrick Model (reaction, learning, behavioural intent) composed of three surveys followed by interviews. We analyzed survey data using cumulative link mixed models, and interviews using directed content analysis. Eighty clinicians attended the training session, of which 51 responded to the surveys and 6 participated in interviews. Odds ratios indicate that individuals were more likely to rate themselves higher post-training on most outcomes. During the interviews, participants indicated that: they experienced positive reactions, learning and behavioural impacts from the session, negative attitudes and commitment were due to perceived limitations in the outcome measure, and training impacts were affected by contextual factors including a provincial mandate for the measure. Implementation teams could adapt this training design process to their context. Further research to understand how educational strategies work would produce more robust guidance. Outcome measures are underused in rehabilitation settings such that their expected benefits are not being realized.Theory-informed educational strategies could be leveraged to facilitate the uptake of outcome measures into practice.In this study, we identified the specific theory-informed components of the training session that produced positive impacts on clinicians’ learning and behavioural intent up to 8-weeks post-training.The theory-informed components of the training session that had positive effects (i.e., those linked to competence including demonstration of the behaviour and behavioural practice) could be adapted by others implementing outcome measures in their setting. Outcome measures are underused in rehabilitation settings such that their expected benefits are not being realized. Theory-informed educational strategies could be leveraged to facilitate the uptake of outcome measures into practice. In this study, we identified the specific theory-informed components of the training session that produced positive impacts on clinicians’ learning and behavioural intent up to 8-weeks post-training. The theory-informed components of the training session that had positive effects (i.e., those linked to competence including demonstration of the behaviour and behavioural practice) could be adapted by others implementing outcome measures in their setting.