| Category |
Description/relevance to the project |
| Barriers |
| Variable trainee rotations |
Frequent movement of IMTs between hospitals limited continuity and awareness of the handbook across successive cohorts. |
| Dependence on regular updates |
The handbook’s usefulness depended on maintaining accurate clinic timetables and contact details, requiring ongoing review and administrative input. |
| Limited initial awareness |
Some trainees were unaware of the handbook’s existence during the initial rollout, particularly those who already had their clinic week. |
| Facilitators |
| Trainee-led design |
The project was developed by IMTs who understood local barriers, increasing engagement, ownership, and practical relevance. |
| Low-cost, easy-to-distribute format |
The digital format enabled rapid, cost-free dissemination across departments and specialities. |
| Alignment with curriculum goals |
The handbook directly supported IMT curriculum objectives for outpatient experience, enhancing its educational legitimacy. |
| Positive trainee feedback |
Qualitative feedback described the handbook as helpful and time-saving, reinforcing continued use. |
| Perceived relevance and usability |
The handbook’s clear layout and concise content made it an accessible, user-friendly resource for trainees at all levels. |
