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Table 4 Representative examples of change cues and change talk during AGFs

From: How do physicians behave when they participate in audit and feedback activities in a group with their peers?

  Representative quotation
Change cue and ensuing change talk Case 2A participant (discussing data on sedatives and anti-psychotics in the elderly): “… we need support and the region sometimes are not thinking about, so we are all going to have to commit to better, … make sure we are not ordering vitals or meds at night. There’s one. It’s a big one to just keep in our head once in a while, once a week, to just check that.”
Case 2A: In response to the change cue above, participants offered to take leadership on and identify specific action items to address prescribing of sedatives: Speaker 1: “This is a QI project, I can take that one.” Speaker 2: “I just feel like it will need some sustained attention. Otherwise, it’ll be just one of many CMEs we have had all year. I think it’s important.” Speaker 1: “Then can I hear from this group one list of 3 recommendations that I can take down to the group. Three easy to remember QI things that I can do as a whole and email everybody.”
Change cue and ensuing change talk A group participant in an anesthesia study identified a priority issue in clear language: Case 1: Speaker 1: “Our biggest problem post-op is pain.” Speaker 2: “Yeah, it is.” Speaker 1: “If you look at the data. So if we can improve intra-operative management by ketamine it would change my practice.” Speaker 2: “Without jeopardizing the nausea and vomiting.”
Change cue without change talk A group member identifies a key issue and the facilitator moves on to the next topic to explain in the individual data reports. No change talk occurs: Speaker 1: “So this is a really important thing that are resulting in increased usage of sedative, which is really the point, right. Use less of them.”
“…That’s, I think, the whole idea behind this kind of education, right? Okay, well let us go over the individual. And we can always come back at any time to anything else that needs clarification. So, as I said, we limited docs that got included in this to those that had at least 10 visits…”