Table 1

Example of part of a matrix with intervention objectives for GPs

Barriers and facilitators
Performance objectivesHigh outcome expectation of testsLack of communication skillsUncertainty of GP
In the matrix three performance objectives for GPs (left column) are set against a selection of three barriers and facilitators (top row). The cells show the resulting intervention objectives. If the achievement of a performance objective does not require a barrier or facilitator to be addressed by the intervention, the cell at their intersection remains empty.
Performs adequate history taking and physical examinationGP states that physical examination is a way of taking patients’ complaints seriouslyGP asks patients about reasons for encounter and chooses formulation which he/she feels most comfortable withGP states that testing does not yield more information than performing physical examination
Explains findings and conclusions to patient appropriatelyGP states the importance of explaining findings and conclusions to patientGP demonstrates the use of different formulations to explain findings from history taking and physical examination to patientsGP shows patients he/she is convinced that findings from history taking and examination are sufficient to feel reassured
Discusses a 1 month “wait and see” policyGP uses instruction materials in addition to verbal messageGP shows awareness that his/her own uncertainty is a reason to request blood tests