Changing professional behaviours: mixed methods study utilising psychological theories to evaluate an educational programme for UK medical doctors

Abstract

Background The Theory of Planned Behaviour (TPB) has been proposed as a useful framework to investigate professional behaviour, however, was not yet applied to the evaluation of an educational intervention. This study will address this gap by utilising the TPB to evaluate the effectiveness of an education programme delivered by the professional regulator for UK doctors in enhancing three professional behaviours: raising concerns, engaging in reflective practice, and use of regulator confidentiality guidance. Methods This is a comprehensive mixed methods study combining qualitative (interviews) and quantitative (quasi-experiment) data. Intervention participants were asked to complete a survey measuring the variables in the TPB (attitudes, subjective norms, perceived behavioural control, and intention) for the three professional behaviours before, immediately post, and 3-months later following the education programme. Ninety-four doctors completed the survey pre/post intervention and 38 at all three times. One hundred and eleven doctors from the same hospital trust who did not take part in the intervention completed the survey at two time points and formed the control group. Forty-two interviews were conducted with intervention participants. Results The quantitative study revealed that the educational intervention significantly improved attitudes (raising concerns, using confidentiality guidance), subjective norms (raising concerns, reflective practice, using confidentiality guidance), perceived control (raising concerns, using confidentiality guidance), and intentions (using confidentiality guidance) (Group and Time interaction; Fs ≥ 3.996, ps ≤ .047, ηp2 ≥ .020). Non-UK graduate doctors’ subjective norms towards raising concerns and confidentiality guidance increased significantly after the intervention (Fs ≤ 6.602, ps ≥ .011, ηp2 = .032 F = 6.602, p = .011, ηp2 = .032), but not UK graduates (p > .05). Interviews revealed that doctors had positive views about professional behaviours but also mentioned numerous barriers to actually engage in more complex, context dependent behaviours. Conclusions This study demonstrates that an educational intervention was successful in improving the TPB variables of three professional behaviours. It also revealed that teaching professionalism does not happen in isolation and, therefore, personal and contextual factors are crucial to consider. To change complex professional behaviours, barriers at all levels i.e., personal, organisational and system, should be addressed.

Validating a theory of planned behavior questionnaire for assessing changes in professional behaviors of medical students

“…Questionnaires are one of the most frequently utilized media within social, behavioral, and psychological sciences to access participants’ cognitive and social processes. To measure change in PBs, we modified and validated an existing TPB questionnaire ( 20 ). To ensure the robustness of our questionnaire, we conducted a comprehensive literature review to identify similar concepts.…”

“…To ensure the robustness of our questionnaire, we conducted a comprehensive literature review to identify similar concepts. Consequently, we adapted questionnaire items from the published literature ( 20 ) to align with the specific objectives of the PROPER study.…”

“…While TPB and TACT principles provide guidance, the role of curriculum development and curated resource selection cannot be ignored. Thus, we aimed to validate a bespoke questionnaire, modified from Medisauskaite et al ( 20 ), to measure the change in PB; the TPB was adopted to examine a change in intentions by looking into attitudes, subjective norms, and perceived behavioral controls of medical students ( 21 ).…”

Changing Professional Behaviors in the Digital World Using the Medical Education e-Professionalism (MEeP) Framework—A Mixed Methods Multicentre Study

“…The quantitative data from pre-and post- workshop surveys was collected and analyzed using the Statistical Package for Social Sciences (SPSS) 24.0 software. We adopted a TPB questionnaire from the study by Medisauskaite et al ( 19 ) ( Appendix I ). The TPB questionnaire collected demographic information of age, gender, ethnicity, place and year of study, and students' previous exposure to professionalism teaching.…”

The transcultural adaptation and validation of the Chinese version of the Attitudes Toward Recognizing Early and Noticeable Deterioration scale

“…Rather than being innate, it is formed through learning ( Albarracín et al, 2014 ; Shim et al, 2016 ; Cao et al, 2022 ). Individuals’ attitudes reinforce their intentions and change their behavior, making reliable predictions about their likelihood of performing specific behaviors ( Medisauskaite et al, 2021 ; Liu K. S. N et al, 2021 ). An interview with ward nurses who experienced resuscitation shows that nurses’ attitudes toward identifying early and significant deterioration seriously affected their ability to recognize, interpret, and report changes in conditions ( Shearer et al, 2012 ; Chua et al, 2013 ).…”