BACKGROUND: Clinical practice guidelines are intended to improve the process and outcomes of @entity1 care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a @entity1643 guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. @entity1 observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. @entity1 performed three roles: physical therapist, assessor, and @entity1 . This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of @entity1 . METHODS: Dutch physical therapists working in primary care (n   =   49) organized in communities of practice (n   =   6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which @entity1 were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. RESULTS: Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in managing @entity1 with @entity1643 . Learning was facilitated by psychological safety and the quality of feedback. CONCLUSION: The effectiveness of PA can be attributed to the structured and performance-based design of the program. @entity1 showed a strong cognitive and emotional commitment to performing the physical therapist role. That might have contributed to an increased awareness of strength and weakness in clinical performance and a motivation to change routine practice.

Critical features of peer assessment of clinical performance to enhance adherence to a XXXX guideline for physical therapists: a mixed methods design.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'Participants'] @entity1643 :: ('MESH:D017116', 'Disease') :: ['low back pain']
@entity1643 :: (MESH:D017116,Disease) :: ['low back pain']
