Learning Together From Uncertainty: An Evaluation of Practice Inquiry Groups in a Nationwide Primary Care Practice.

Abstract

Practice inquiry (PI) is a structured method of discussion that helps primary care clinicians explore uncertainty and learn from challenging cases. An understanding of what aspect of PI primary care clinicians value could guide leaders who are contemplating implementation of collaborative discussion formats in their clinical systems. We administered a survey examining clinicians' perceptions of PI in a large nationwide membership-based primary care service. Two hundred ninety-six surveys (61%, N = 296/482) were received from participants and 69 surveys (75%, N = 69/92) were received from facilitators. Most respondents (>70% across five queries) felt that PI led to enhancement of knowledge and management skills and helped them become more comfortable managing uncertainty. Colleagues in PI groups provided validation and reassurance, valuable health system information, and insights into reasoning and patient-clinician relationships. Participants and facilitators outlined ways PI sessions could be improved (eg, case follow-up) and how the organization could support PI sessions (eg, enhanced facilitator training). This is the first program evaluation of PI in a large, community primary care setting. Future directions include examining what group-level characteristics mediate PI efficacy and how clinicians and patients fare after PI discussions. Such insights could inform enhancements to the group facilitation process.