Advice-seeking during implementation: a network study of clinicians participating in a learning collaborative.
Advice-seeking during implementation: a network study of clinicians participating in a learning collaborative.
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DOI：
10.1186/s13012-018-0797-7
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发表时间：
2018-07-28
期刊：
影响因子：
--
通讯作者：
Birken SA
中科院分区：
文献类型：
--
作者：
Bunger AC;Doogan N;Hanson RF;Birken SA
成功的实施取决于临床医生之间的知识和专业知识的转移，这可能发生在专业人员相互寻求建议时。本研究探讨了心理健康临床医生参与学习协作（多组件实施和质量改进策略），以实施创伤为中心的认知行为治疗（TF-CBT）之间的咨询模式。我们应用交互记忆系统理论，它解释了专业人士如何访问和检索知识，以检查与实施过程中寻求建议的关系的演变相关的因素。我们的目标是通过调查咨询网络如何以及为什么变化来解开学习协作者的机制，这可能有助于我们了解实施策略如何最好地针对网络。使用社交网络分析和前测后测设计，我们研究了来自27个机构的146名参与者（包括5名临床专家）的一般和治疗特定咨询寻求模式，这些参与者参与了TF-CBT的区域扩展。在三次面对面学习会议（相隔10个月）的第一次和最后一次面对面进行调查，这是学习协作的核心组成部分。参与者提名最多5名个人，他们向他们寻求一般和治疗特定的建议。指数随机图模型（ERGMs）测试的可能性，保持或形成咨询关系的基础上，专业知识的质量，可访问性，需要和以前的咨询寻求关系的指标。参与者与那些拥有感知专业知识的人（例如，学习合作的教师专家，主管，以及那些比自己更大的实地经验）。参与者还倾向于向同一组织内和受过类似学科培训的人寻求咨询意见，这突出了获得专门知识的重要性。先前的关系和网络结构特征与寻求建议有关，表明参与者建立在现有的社会关系上。寻求建议并不因参与者的角色或经验而异。考虑到可获得的临床专业知识和持续监督对于提供保真度治疗的重要性，学习协作者可以通过促进临床医生对他人专业知识的认识和访问来支持实施，特别是那些有大量专业知识可以分享的人（例如，教师专家和主管）。未来的对照研究需要验证学习协作的有效性，以建立连接临床医生和专家的网络，并改善实施。本文的在线版本（10.1186/s13012-018-0797-7）包含补充材料，可供授权用户使用。
Successful implementation depends on the transfer of knowledge and expertise among clinicians, which can occur when professionals seek advice from one another. This study examines advice-seeking patterns among mental health clinicians participating in learning collaboratives (a multi-component implementation and quality improvement strategy) to implement trauma-focused cognitive behavioral therapy (TF-CBT). We apply transactive memory system theory, which explains how professionals access and retrieve knowledge, to examine factors associated with the evolution of advice-seeking relationships during implementation. Our aim is to unpack learning collaboratives’ mechanisms by investigating how and why advice-seeking networks change, which may help us understand how implementation strategies can best target networks. Using social network analysis and a pretest-post-test design, we examined patterns in general and treatment-specific advice-seeking among 146 participants (including five clinical experts) from 27 agencies participating in a regional scale-up of TF-CBT. Surveys were administered in-person at the first and last of three in-person learning sessions (10 months apart) that comprise a core component of learning collaboratives. Participants nominated up to five individuals from whom they seek general and treatment-specific advice. Exponential random graph models (ERGMs) tested the likelihood of maintaining or forming advice-seeking relationships based on indicators of expertise quality, accessibility, need, and prior advice-seeking relationships. Participants formed or maintained advice-seeking relationships with those who possess perceived expertise (e.g., learning collaborative faculty experts, supervisors, and those with greater field experience than themselves). Participants also tended to seek advice from those within the same organization and with similar disciplinary training, highlighting the importance of expertise accessibility. Prior relationships and network structural features were associated with advice-seeking, indicating that participants built on existing social ties. Advice-seeking did not vary based on participants’ role or experience. Given the importance of accessible clinical expertise and ongoing supervision for delivering treatment with fidelity, learning collaboratives may support implementation by promoting clinicians’ awareness of and access to others’ expertise, especially those with substantial expertise to share (e.g., faculty experts and supervisors). Future controlled studies are needed to verify the effectiveness of learning collaboratives for building networks that connect clinicians and experts and for improving implementation. The online version of this article (10.1186/s13012-018-0797-7) contains supplementary material, which is available to authorized users.
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影响因子：
10.4
作者：
BURKHARDT, ME;BRASS, DJ
通讯作者：
BRASS, DJ
DOI：
10.1002/asi.4630360504
发表时间：
1985-01-01
期刊：
JOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE
影响因子：
--
作者：
CULNAN, MJ
通讯作者：
CULNAN, MJ
影响因子：
9.9
作者：
Hofmann, David A.;Lei, Zhike;Grant, Adam M.
通讯作者：
Grant, Adam M.
影响因子：
4.1
作者：
Brandon, DP;Hollingshead, AB
通讯作者：
Hollingshead, AB
影响因子：
5.4
作者：
Borgatti, SP;Cross, R
通讯作者：
Cross, R