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Table 9 How CP-FIT may explain findings from the Cochrane review

From: Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research

Cochrane review finding: Feedback may be most effective when … Potential explanation according to CP-FIT
… The health professionals are not performing well to start out with. Low Performance level facilitates Intention and Behaviour because it increases Compatibility with recipients’ personal views (i.e. that they want to provide high quality patient care) and Actionability (i.e. low performance implies room for improvement).
… The person responsible for the audit and feedback is a supervisor or colleague. A supervisor or colleague is likely to be perceived to have greater knowledge and skill (Source—knowledge and skill), which facilitates Acceptance by increasing Credibility.
… It is provided more than once. Multiple instances of feedback are inherent to the feedback cycle (Fig. 3).
… It is given both verbally and in writing. Feedback that is actively “pushed” to recipients i.e. verbally (Active delivery) facilitates Interaction by reducing Complexity by ensuring the feedback received. However, solely providing feedback face-to-face (verbally) inhibits Interaction by decreasing Resource match as it requires significant time commitment from recipients, so is enhanced if also provided in other ways.
… It includes clear targets and an action plan. “Targets” in the Cochrane review equated to Benchmarking and Trend, both of which facilitate Perception, Intention, Behaviour by decreasing Complexity (making it easier for recipients to know what constitutes “good performance” and therefore what requires a corrective response) and increasing Social influence (stimulating recipients’ sense of competition). Action planning and Problem solving facilitate Intention and Behaviour by increasing Actionability (providing practical support on how to respond effectively to the feedback message) and Resource match (by addressing health professionals’ general lack of knowledge and skills to perform these behaviours).