Knowledge to action: a qualitative analysis of learners’ experiences of applying the knowledge, skills, and resources of a compassion training program into practice

Compassion is a critical component of quality care. Patients and families expect to receive compassionate care and healthcare providers desire to provide it. Healthcare providers struggle to provide compassionate care within the healthcare system and receive little training. Existing compassion training programs have limitations related to transferability, feasibility, clinical relevance, validity, and sustainability. To address these gaps, we developed and evaluated an E vidence-informed, Compete n cy-based, and A ccredited, C ompassion T raining program (EnACT). This study investigates healthcare providers’ and senior leaders’ experiences of implementing the learnings and resources from the EnACT training into their clinical practice and workplace. The EnACT program was delivered to healthcare providers and senior leaders across two long-term care and hospice settings. Twenty-one participants participated in semi-structured interviews nine-months post training. A theoretically informed thematic analysis was conducted using Braun and Clarke’s original framework. Guided by Graham et al’s Knowledge to Action Cycle, the interview guide was prospectively developed to explore participants’ experiences across the six stages of knowledge implementation: adapting knowledge to the local context; assessing barriers and facilitators to knowledge use; selecting, tailoring, and implementing interventions; monitoring knowledge use; evaluating outcomes; and sustaining knowledge use. Participants were highly satisfied with the EnACT program and felt the program was practical, clinically relevant, evidence-based, impactful, and malleable to both their personal practice and their workplaces. Qualitative analysis identified themes corresponding to the six adapted Knowledge-to-Action stages: (1) Adapt knowledge to the local context; (2) Assess barriers/facilitators to knowledge use; (3) Select, tailor, and implement interventions; (4) Monitor knowledge use; (5) Evaluate outcomes and; (6) Sustain knowledge use. Collectively, across each of the six study themes, participants felt that the key strengths of the EnACT program were its brief, interdisciplinary, evidence-based, clinically relevant, multi-modal approach, which enhanced and sustained learners’ knowledge, attitudes, and skills related to compassion while also addressing systemic barriers to operationalizing compassion in professional practice. The EnACT program addresses existing gaps in compassion education within healthcare. In addition to the evidence-informed and clinically relevant curricula, that not only aim to enhance the attitudes and knowledge of learners, but to equip them with requisite clinical skills–the engagement of senior leaders, the integration of learner resources to sustain learning, and the inclusion of content aimed at addressing the broader organizational and workplace barriers to compassion–were considered essential in sustaining learnings and compassionate care over time.