Table 2.
COM-B factor | BCTs to address this1 | Example and how delivered in phase 2 (didactic or interactive) |
---|---|---|
Capability | 4.1 Instruction on how to perform behaviour | Interactive and didactic: Pharmacist facilitator explained in initial slides how to use international units, then participants instructed others during the game. |
6.1 Demonstration of behaviour | Interactive: Teams demonstrated their drug calculations to each other. | |
8.1 Behavioural practice and rehearsal | Interactive: During the game, repeated practice in calculating drug doses. | |
Opportunity | 12.5 Adding objects to the environment | The partnership provided calculators, pens and notepads to participants and encouraged their use to calculate accurately and show their workings. |
1.1 Goal setting and 1.4 Action planning | Interactive: Time was allocated for participants to set goals and make a specific action plan about where and when they would use their calculator. | |
1.2 Problem Solving | Interactive: Whole group discussion on difficulties distinguishing long and short-acting insulin and strategies to help, supported by lead nurse. | |
Motivation | 5.1 Information about health consequences | Didactic: FJD highlighted some health consequences of medication errors. |
9.1 Credible source | As in phase one, the facilitator was a senior pharmacist in the hospital and therefore a persuasive and perhaps motivating source about medication safety. | |
13.2 Framing/reframing | Interactive: Large group discussion, lively debate and team working in the game may encourage a new perspective, that it is acceptable to ask nursing and pharmacy colleagues for help in drug calculations. | |
1.6 Discrepancy between current behaviour and goal | Didactic: Though a series of whole group questions, pharmacist jokingly pointed out a discrepancy between participants’ perceived and actual competence, highlighting the need to engage in the training. | |
1.9 Commitment | Interactive: The health psychologists asked participants to share their action plan with a neighbour, to promote commitment to accurate drug calculation. | |
2.2 Feedback on behaviour | Didactic + Interactive: The pharmacist facilitator included local audit data to PowerPoint slides as hospital-level feedback on drug calculation errors and outcomes. Also in the game, participants fed back to each other whether their drug calculations were correct. |
1BCT labels taken from Michie et al. [14] Italic BCT labels = technique only observed in phase two