Jo Hart, Professor of Health Professional Education, Division of Medical Education, University of Manchester, UK.Lucie Byrne-Davis, Professor of Health Psychology, Division of Medical Education, University of Manchester, UK.Wendy Maltinsky, Senior Lecturer, Division of Psychology, Faculty of Natural Sciences, University of Stirling, UK.Eleanor Bull, Senior Health Psychologist, Manchester University NHS Foundation Trust and Derbyshire County Council, UK; Honorary Senior Lecturer, Division of Medical Education, University of Manchester, UK.

• ContentsForeword ixAcknowledgements xiCHAPTER 1 Education and Training as a Behaviour Change Intervention 1Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky, Eleanor Bull, Nicola McCleary and Chris ArmitageWhat Is Continuing Professional Development? 2The Purpose(s) of CPD 2The Challenges of Changing Practice through CPD 3Important Concepts and Theories 4Miller’s Pyramid 4Figure 1: The interaction of capability, opportunity, motivation and Miller’s Pyramid 5A Shared Theoretical Language 6Why Think about Behavioural Theory? 7The COM-B Framework 8Figure 2: Influences on behaviour mapped to capability, opportunity and motivation 8A Focus on Motivation 9Why Is Behavioural Science Important? 10Effective and Enjoyable Training 10Principles for Effective Training 11Principle 1. Starting from Where Learners Are 11Principle 2. Working in Partnership 11Principle 3. Interactive/Active Learning 12Principle 4. Communication 13Principle 5. A Collaborative Learning Environment 13Principle 6. Individual and Group Voices 14Principle 7. Time for Reflection 15Check Your Understanding and Reflect 15Useful Links and Further Reading 16Behavioural theories and types of behaviours 16Dual processing 16The COM-B Framework 16PRIME Theory and other briefings on behaviour change 16References 16CHAPTER 2 Defining the Behaviours That You Want to Change 20Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullIntroduction 21Developing a Theory of Change 22Tips and examples 22Intended Behavioural Outcomes (IBOs) 23Tips and examples 24How to Develop IBOs 24Tips and examples: Topic guide and cues for a behavioural specification focus group 26What Does the Evidence Say? 26Choosing the IBOs on Which to Focus 27Whose IBOs Are They? 27Check Your Understanding 28Useful Links and Further Reading 28Developing A Theory of Change 28References 29CHAPTER 3 Exploring the Influences on Behaviours 30Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullInfluences on Practice 31Figure 3: The COM-B framework 31Capability 31Tips and examples 31Opportunity 31Tips and examples 32Motivation 32Tips and examples 32How to Explore Influences on Each IBO 32Before Developing CPD 33Tips and examples 33Tips and examples 35During CPD 35Check Your Understanding and Reflect 36Further Reading 36More About Exploring Influences on Behaviour 36References 36CHAPTER 4 Developing CPD to Change Behaviour 38Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullThe Active Ingredients of Behaviour Change Activities 39Reminder: What is COM-B Again? 39BCTs and Communication Skills in Education and Training 40Tips and examples 40How to Develop Your Training Activities 41Capability 44What Does the Evidence Say? 45Figure 4: The Johari Window 45Tips and examples 45Figure 5: Post-it notes to illustrate an effective practitioner 46Building Psychological Capability 47Tips and examples 47Building Physical Capability 48Figure 6: A cycle for physical capability improvement (learning a skill) 49Tips and examples 49Opportunity 50Building Physical Opportunity 50Tips and examples 51An Appreciative Inquiry Approach 52Building Social Opportunity 52Tips and examples 53Tips and examples 53Figure 7: Comic book strip 54Motivation 55Building Reflective Motivation 55Tips and examples 56Building Automatic Motivation 56Tips and examples 57Planning the ‘How’ of Your Training 57Consider Space 57Consider Numbers 58Consider Acoustics and Visuals 58Consider Time 58Consider Dynamics 58Consider Technical Equipment and Skills 59Consider Administrative Support 59Consider Refreshments 59Consider Culture/Contexts/Countries 59Online 60Blended Learning – Synchronous and Asynchronous 61Figure 8: Considerations for a blending learning course 62The Building Blocks of Your Training 63Figure 9: Overview of training structure 63Introductions 63Welcoming 63Introductory Activities 64Trainee Introductions 64Create Name-Plates 64Introductory Bingo 65Introduce Your Neighbour 65Throw the Soft Toy 65Group Agreements 65Course Expectations, Hopes and Fears 66Balancing Training Energy 66Endings: Reflection, Action Planning and Evaluation 67Check Your Understanding and Reflect 67Further Reading 68References 68CHAPTER 5 Assessing and Evaluating 70Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullProcess vs. Outcome 71Why Are You Evaluating? 72Theories and Frameworks to Help Us Evaluate 72The Kirkpatrick Model 73Tips and examples 73Evaluation of Complex Interventions 74Assessing Behavioural Influences 75Topic guide 76Figure 10: Topic guide example for interviews about the impact of a course on practice at follow-up 76Assessing Behaviour 78Check Your Understanding 79Further Reading 79References 80Guides 81Sample Training Plans 81Aims 88Tips and Examples: Setting up A Session 88Cards for Change 94Index 111

Jo Hart, Professor of Health Professional Education, Division of Medical Education, University of Manchester, UK.Lucie Byrne-Davis, Professor of Health Psychology, Division of Medical Education, University of Manchester, UK.Wendy Maltinsky, Senior Lecturer, Division of Psychology, Faculty of Natural Sciences, University of Stirling, UK.Eleanor Bull, Senior Health Psychologist, Manchester University NHS Foundation Trust and Derbyshire County Council, UK; Honorary Senior Lecturer, Division of Medical Education, University of Manchester, UK.

• ContentsForeword ixAcknowledgements xiCHAPTER 1 Education and Training as a Behaviour Change Intervention 1Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky, Eleanor Bull, Nicola McCleary and Chris ArmitageWhat Is Continuing Professional Development? 2The Purpose(s) of CPD 2The Challenges of Changing Practice through CPD 3Important Concepts and Theories 4Miller’s Pyramid 4Figure 1: The interaction of capability, opportunity, motivation and Miller’s Pyramid 5A Shared Theoretical Language 6Why Think about Behavioural Theory? 7The COM-B Framework 8Figure 2: Influences on behaviour mapped to capability, opportunity and motivation 8A Focus on Motivation 9Why Is Behavioural Science Important? 10Effective and Enjoyable Training 10Principles for Effective Training 11Principle 1. Starting from Where Learners Are 11Principle 2. Working in Partnership 11Principle 3. Interactive/Active Learning 12Principle 4. Communication 13Principle 5. A Collaborative Learning Environment 13Principle 6. Individual and Group Voices 14Principle 7. Time for Reflection 15Check Your Understanding and Reflect 15Useful Links and Further Reading 16Behavioural theories and types of behaviours 16Dual processing 16The COM-B Framework 16PRIME Theory and other briefings on behaviour change 16References 16CHAPTER 2 Defining the Behaviours That You Want to Change 20Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullIntroduction 21Developing a Theory of Change 22Tips and examples 22Intended Behavioural Outcomes (IBOs) 23Tips and examples 24How to Develop IBOs 24Tips and examples: Topic guide and cues for a behavioural specification focus group 26What Does the Evidence Say? 26Choosing the IBOs on Which to Focus 27Whose IBOs Are They? 27Check Your Understanding 28Useful Links and Further Reading 28Developing A Theory of Change 28References 29CHAPTER 3 Exploring the Influences on Behaviours 30Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullInfluences on Practice 31Figure 3: The COM-B framework 31Capability 31Tips and examples 31Opportunity 31Tips and examples 32Motivation 32Tips and examples 32How to Explore Influences on Each IBO 32Before Developing CPD 33Tips and examples 33Tips and examples 35During CPD 35Check Your Understanding and Reflect 36Further Reading 36More About Exploring Influences on Behaviour 36References 36CHAPTER 4 Developing CPD to Change Behaviour 38Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullThe Active Ingredients of Behaviour Change Activities 39Reminder: What is COM-B Again? 39BCTs and Communication Skills in Education and Training 40Tips and examples 40How to Develop Your Training Activities 41Capability 44What Does the Evidence Say? 45Figure 4: The Johari Window 45Tips and examples 45Figure 5: Post-it notes to illustrate an effective practitioner 46Building Psychological Capability 47Tips and examples 47Building Physical Capability 48Figure 6: A cycle for physical capability improvement (learning a skill) 49Tips and examples 49Opportunity 50Building Physical Opportunity 50Tips and examples 51An Appreciative Inquiry Approach 52Building Social Opportunity 52Tips and examples 53Tips and examples 53Figure 7: Comic book strip 54Motivation 55Building Reflective Motivation 55Tips and examples 56Building Automatic Motivation 56Tips and examples 57Planning the ‘How’ of Your Training 57Consider Space 57Consider Numbers 58Consider Acoustics and Visuals 58Consider Time 58Consider Dynamics 58Consider Technical Equipment and Skills 59Consider Administrative Support 59Consider Refreshments 59Consider Culture/Contexts/Countries 59Online 60Blended Learning – Synchronous and Asynchronous 61Figure 8: Considerations for a blending learning course 62The Building Blocks of Your Training 63Figure 9: Overview of training structure 63Introductions 63Welcoming 63Introductory Activities 64Trainee Introductions 64Create Name-Plates 64Introductory Bingo 65Introduce Your Neighbour 65Throw the Soft Toy 65Group Agreements 65Course Expectations, Hopes and Fears 66Balancing Training Energy 66Endings: Reflection, Action Planning and Evaluation 67Check Your Understanding and Reflect 67Further Reading 68References 68CHAPTER 5 Assessing and Evaluating 70Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullProcess vs. Outcome 71Why Are You Evaluating? 72Theories and Frameworks to Help Us Evaluate 72The Kirkpatrick Model 73Tips and examples 73Evaluation of Complex Interventions 74Assessing Behavioural Influences 75Topic guide 76Figure 10: Topic guide example for interviews about the impact of a course on practice at follow-up 76Assessing Behaviour 78Check Your Understanding 79Further Reading 79References 80Guides 81Sample Training Plans 81Aims 88Tips and Examples: Setting up A Session 88Cards for Change 94Index 111

Jo Hart, Professor of Health Professional Education, Division of Medical Education, University of Manchester, UK.Lucie Byrne-Davis, Professor of Health Psychology, Division of Medical Education, University of Manchester, UK.Wendy Maltinsky, Senior Lecturer, Division of Psychology, Faculty of Natural Sciences, University of Stirling, UK.Eleanor Bull, Senior Health Psychologist, Manchester University NHS Foundation Trust and Derbyshire County Council, UK; Honorary Senior Lecturer, Division of Medical Education, University of Manchester, UK.

• ContentsForeword ixAcknowledgements xiCHAPTER 1 Education and Training as a Behaviour Change Intervention 1Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky, Eleanor Bull, Nicola McCleary and Chris ArmitageWhat Is Continuing Professional Development? 2The Purpose(s) of CPD 2The Challenges of Changing Practice through CPD 3Important Concepts and Theories 4Miller’s Pyramid 4Figure 1: The interaction of capability, opportunity, motivation and Miller’s Pyramid 5A Shared Theoretical Language 6Why Think about Behavioural Theory? 7The COM-B Framework 8Figure 2: Influences on behaviour mapped to capability, opportunity and motivation 8A Focus on Motivation 9Why Is Behavioural Science Important? 10Effective and Enjoyable Training 10Principles for Effective Training 11Principle 1. Starting from Where Learners Are 11Principle 2. Working in Partnership 11Principle 3. Interactive/Active Learning 12Principle 4. Communication 13Principle 5. A Collaborative Learning Environment 13Principle 6. Individual and Group Voices 14Principle 7. Time for Reflection 15Check Your Understanding and Reflect 15Useful Links and Further Reading 16Behavioural theories and types of behaviours 16Dual processing 16The COM-B Framework 16PRIME Theory and other briefings on behaviour change 16References 16CHAPTER 2 Defining the Behaviours That You Want to Change 20Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullIntroduction 21Developing a Theory of Change 22Tips and examples 22Intended Behavioural Outcomes (IBOs) 23Tips and examples 24How to Develop IBOs 24Tips and examples: Topic guide and cues for a behavioural specification focus group 26What Does the Evidence Say? 26Choosing the IBOs on Which to Focus 27Whose IBOs Are They? 27Check Your Understanding 28Useful Links and Further Reading 28Developing A Theory of Change 28References 29CHAPTER 3 Exploring the Influences on Behaviours 30Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullInfluences on Practice 31Figure 3: The COM-B framework 31Capability 31Tips and examples 31Opportunity 31Tips and examples 32Motivation 32Tips and examples 32How to Explore Influences on Each IBO 32Before Developing CPD 33Tips and examples 33Tips and examples 35During CPD 35Check Your Understanding and Reflect 36Further Reading 36More About Exploring Influences on Behaviour 36References 36CHAPTER 4 Developing CPD to Change Behaviour 38Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullThe Active Ingredients of Behaviour Change Activities 39Reminder: What is COM-B Again? 39BCTs and Communication Skills in Education and Training 40Tips and examples 40How to Develop Your Training Activities 41Capability 44What Does the Evidence Say? 45Figure 4: The Johari Window 45Tips and examples 45Figure 5: Post-it notes to illustrate an effective practitioner 46Building Psychological Capability 47Tips and examples 47Building Physical Capability 48Figure 6: A cycle for physical capability improvement (learning a skill) 49Tips and examples 49Opportunity 50Building Physical Opportunity 50Tips and examples 51An Appreciative Inquiry Approach 52Building Social Opportunity 52Tips and examples 53Tips and examples 53Figure 7: Comic book strip 54Motivation 55Building Reflective Motivation 55Tips and examples 56Building Automatic Motivation 56Tips and examples 57Planning the ‘How’ of Your Training 57Consider Space 57Consider Numbers 58Consider Acoustics and Visuals 58Consider Time 58Consider Dynamics 58Consider Technical Equipment and Skills 59Consider Administrative Support 59Consider Refreshments 59Consider Culture/Contexts/Countries 59Online 60Blended Learning – Synchronous and Asynchronous 61Figure 8: Considerations for a blending learning course 62The Building Blocks of Your Training 63Figure 9: Overview of training structure 63Introductions 63Welcoming 63Introductory Activities 64Trainee Introductions 64Create Name-Plates 64Introductory Bingo 65Introduce Your Neighbour 65Throw the Soft Toy 65Group Agreements 65Course Expectations, Hopes and Fears 66Balancing Training Energy 66Endings: Reflection, Action Planning and Evaluation 67Check Your Understanding and Reflect 67Further Reading 68References 68CHAPTER 5 Assessing and Evaluating 70Jo Hart, Lucie Byrne-Davis, Wendy Maltinsky and Eleanor BullProcess vs. Outcome 71Why Are You Evaluating? 72Theories and Frameworks to Help Us Evaluate 72The Kirkpatrick Model 73Tips and examples 73Evaluation of Complex Interventions 74Assessing Behavioural Influences 75Topic guide 76Figure 10: Topic guide example for interviews about the impact of a course on practice at follow-up 76Assessing Behaviour 78Check Your Understanding 79Further Reading 79References 80Guides 81Sample Training Plans 81Aims 88Tips and Examples: Setting up A Session 88Cards for Change 94Index 111