Marco Boonstra

139 Step 3: Program design For HCPs, we developed a draft of a training with different learning strategies, such as a presentation, videos with patient stories and group discussion. The educators stated the concept training encompassed relevant topics, and were positive about the objectives, the provided information, used video’s and incorporated patient stories to illustrate HL problems. The educators further suggested to develop an e-learning with important theory, and to focus the workshop more on CKD setting and practicing of competences. They suggested to show real consultations, and discuss those, and to provide the HCPs with a patient story, and ask them to identify both HL and self-management problems. Step 4: Program production For HCPs, we developed an e-learning and workshop to teach competences to recognize and communicate with LHL patients. Educators and students suggested improvements for the e-learning and workshop. For example, content on providing simple information on 1) CKD, 2) lifestyle and medication, and 3) causal relations, was combined. Since HCPs often have had communication education already, they also advised to reduce information on basic communication strategies. They considered emphasis on CKD and LHL tailored strategies, such as explaining lab values, and overcoming self-management barriers, more important. Step 5: Evaluation of the intervention HCPs expected the training to improve their knowledge, self-efficacy, and expected use of strategies to recognize and support patients with LHL. All believed the intervention was comprehensible and fitted their needs. Details are in table 4.3. In open comments, multiple HCPs considered two hours for the workshop too short and found it too much of a presentation. They suggested making it longer with more room for interaction, for example with group discussions or role-playing.

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