Table 4 Ideal and real conditions for implementation of VIG according to NPT constructs
NPT construct | Ideal conditions | Real conditions |
|---|---|---|
Coherence: Making sense of the intervention | Able to differentiate the intervention from current practice; understanding the aims and expected benefits of the intervention | ‘Positive’ focus of VIG not easy to understand, or believe, until directly involved. Confusion with other video intervention aimed at directly benefitting service users |
Cognitive Participation: Becoming involved with the intervention | Key individuals driving the intervention forward, individuals’ belief that it is right and useful for them to be involved; keeping the intervention in view | Encouragement to receive VIG seen as better coming from staff who had experienced VIG, rather than from senior managers. Staff who had received VIG drove implementation by ‘selling’ the positive experience to colleagues, thus helping to dispel negative Coherence. Mixed picture about how much trainee Guiders incorporated VIG and its discursive principles into other practice |
Collective Action: Enacting the work required by the intervention | Trainee Guiders able to have the time to carry out VIG work alongside daily role; management to support the co-ordination and organization of implementation | Trainee Guiders experienced problems in freeing themselves from daily roles in order to carry out VIG work. Proving staff to cover trainees likely to fail due to sickness cover priority. Senior manager believed logistical issues should be managed locally. Implementation of interventions more generally appeared to be overwhelming for staff with poor co-ordination |
Reflexive Monitoring: Evaluating and appraising the intervention | Able to see the impact of the intervention; able to discuss the impact of the intervention; able to reshape practice as a result of the intervention | Staff who had received VIG directly experienced benefits (e.g. boost to confidence) which was visible to their colleagues. Suggestions of ideas for future practice shaped by influence of VIG, but speculation that these ideas might not come to fruition within perceived organizational culture |