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Uncovering Factors Influencing Instructors' Decision Process when Considering Implementation of a Course-Based Research Experience.

ABSTRACT: Course-based undergraduate research experiences (CUREs) are an effective way to expose large numbers of students to authentic research, yet most laboratory courses still use traditional "cookbook" methods. While barriers to using CUREs have been captured postimplementation, little is known about the decision mindset before implementation or what features of CURE design may mitigate perceived barriers. Perception of an innovation (such as a CURE) influences the likelihood of its adoption, and diffusion of innovations theory posits that the decision to adopt is largely influenced by five perceived features of an innovation: relative advantage, compatibility, complexity, observability, and trialability. We conducted interviews with instructors considering using the Prevalence of Antibiotic Resistance in the Environment (PARE) project to assess their perceptions of CUREs and motivations for using PARE. Instructors viewed CUREs as having relative advantages over traditional methods; however, CUREs were also viewed as complex, with instructors citing multiple barriers. Instructors were motivated to use PARE because of its potential scientific impact and compatibility with their courses' structures and resources. Instructors perceived PARE to have few barriers to implementation compared with other CUREs. Designing CUREs that address common instructor barriers and drivers could increase the rate of diffusion of CUREs.

SUBMITTER: Genne-Bacon EA

PROVIDER: S-EPMC8697655 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The objectives of this paper are to: (1) identify contextual factors such as policy that impacted the implementation of community-based primary health care (CBPHC) innovations among 12 Canadian research teams and (2) describe strategies used by the teams to address contextual factors influencing implementation of CBPHC innovations. In primary care settings, consideration of contextual factors when implementing change has been recognized as critically important to success. However, contextual factors are rarely recorded, analyzed or considered when implementing change. The lack of consideration of contextual factors has negative implications not only for successfully implementing primary health care (PHC) innovations, but also for their sustainability and scalability. For this evaluation, data collection was conducted using self-administered questionnaires and follow-up telephone interviews with team representatives. We used a combination of directed and conventional content analysis approaches to analyze the questionnaire and interview data. Representatives from all 12 teams completed the questionnaire and 11 teams participated in the interviews; 40 individuals participated in this evaluation. Four themes representing contextual factors that impacted the implementation of CBPHC innovations were identified: (I) diversity of jurisdictions (II) complexity of interactions and collaborations (III) policy, and (IV) the multifaceted nature of PHC. The teams used six strategies to address these contextual factors including: (1) conduct an environmental scan at the beginning (2) maintaining engagement among partners and stakeholders by encouraging open and inclusive communication; (3) contextualizing the innovation for different settings; (4) anticipating and addressing changes, delays, and the need for additional resources; (5) fostering a culture of research and innovation among partners and stakeholders; and (6) ensuring information about the innovation is widely available. Implementing CBPHC innovations across jurisdictions is complex and involves navigating through multiple contextual factors. Awareness of the dynamic nature of context should be considered when implementing innovations.

Project description:BackgroundShared decision-making (SDM) is highly relevant in oncology but rarely implemented in routine care. In a stepped-wedge cluster randomized implementation trial, the outcome evaluation of a theoretically and empirically based multi-component SDM implementation program did not show a statistically significant effect on patient-reported SDM uptake. Within this SDM implementation trial, a thorough a priori planned process evaluation was conducted. Thus, the aim of this study was to investigate factors influencing SDM implementation in the context of a multi-component SDM implementation program.MethodsWe conducted qualitative process evaluation of a stepped-wedge SDM implementation trial. Qualitative data included interviews with nurses and physicians of participating departments, field notes by the study team, and meeting minutes. Data were analyzed via deductive and inductive qualitative content analysis on basis of the Consolidated Framework for Implementation Research (CFIR).ResultsTranscripts of 107 interviews with 126 nurses and physicians, 304 pages of field note documentation, and 125 pages of meeting minutes were analyzed. Major factors influencing SDM implementation were found for all domains of the CFIR: a) four regarding characteristics of the individuals involved (e.g., perceived personal relevance, individual motivation to change), b) eleven regarding the inner setting (e.g., leadership engagement, networks and communication, available resources, compatibility with clinical practice), c) two regarding the outer setting (e.g., culture of health care delivery), d) eight regarding characteristics of the intervention (e.g., relative advantage, adaptability), and e) three regarding the implementation process (e.g., integration into existing structures). Furthermore, we found strong interrelations between several of the influencing factors within and between domains.ConclusionsThis comprehensive process evaluation complements the outcome evaluation of the SDM implementation trial and adds to its interpretation. The identified influencing factors can be used for planning, conducting, and evaluating SDM implementation in the future.Trial registrationclinicaltrials.gov, NCT03393351, registered 8 January 2018, https://clinicaltrials.gov/ct2/show/NCT03393351.

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Uncovering Factors Influencing Instructors' Decision Process when Considering Implementation of a Course-Based Research Experience.

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