title: Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  In 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program.
  
  
  METHODS
  In a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments.
  
  
  CONCLUSIONS
  We aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study.
  
  
  BACKGROUND
  Dutch trial register: NTR3092.
authors.affiliation: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands. dp.de.beurs@vu.nl
authors.forename: Derek P
authors.initials: DP
authors.lastname: de Beurs
authors.forename: Marieke H
authors.initials: MH
authors.lastname: de Groot
authors.forename: Jos
authors.initials: J
authors.lastname: de Keijser
authors.forename: Bastiaan
authors.initials: B
authors.lastname: Verwey
authors.forename: Jan
authors.initials: J
authors.lastname: Mokkenstorm
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.forename: Erik
authors.initials: E
authors.lastname: van Duijn
authors.forename: Albert M
authors.initials: AM
authors.lastname: van Hemert
authors.forename: Lia
authors.initials: L
authors.lastname: Verlinde
authors.forename: Jan
authors.initials: J
authors.lastname: Spijker
authors.forename: Bert
authors.initials: B
authors.lastname: van Luijn
authors.forename: Jan
authors.initials: J
authors.lastname: Vink
authors.forename: Ad J F M
authors.initials: AJ
authors.lastname: Kerkhof
mesh_terms: D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D016000:Cluster Analysis; D003194:Computer-Assisted Instruction / Q000592:standards; D004502:Education, Medical, Continuing / Q000379:methods* / Q000592:standards; D004509:Education, Nursing, Continuing / Q000379:methods* / Q000592:standards; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000379:methods* / Q000592:standards; D008505:Medical Staff, Hospital / Q000193:education* / Q000592:standards; D008605:Mental Health Services / Q000592:standards; D009426:Netherlands; D009741:Nursing Staff, Hospital / Q000193:education* / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement / Q000592:standards; D012107:Research Design; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention