title: The effect of an e-learning supported Train-the-Trainer programme on implementation of suicide guidelines in mental health care.
abstract: BACKGROUND
  Randomized studies examining the effect of training of mental health professionals in suicide prevention guidelines are scarce. We assessed whether professionals benefited from an e-learning supported Train-the-Trainer programme aimed at the application of the Dutch multidisciplinary suicide prevention guideline.
  
  
  METHODS
  45 psychiatric departments from all over the Netherlands were clustered in pairs and randomized. In the experimental condition, all of the staff of psychiatric departments was trained by peers with an e-learning supported Train-the-Trainer programme. Guideline adherence of individual professionals was measured by means of the response to on-line video fragments. Multilevel analyses were used to establish whether variation between conditions was due to differences between individual professionals or departments.
  
  
  RESULTS
  Multilevel analysis showed that the intervention resulted in an improvement of individual professionals. At the 3 month follow-up, professionals who received the intervention showed greater guideline adherence, improved self-perceived knowledge and improved confidence as providers of care than professionals who were only exposed to traditional guideline dissemination. Subgroup analyses showed that improved guideline adherence was found among nurses but not among psychiatrists and psychologists. No significant effect of the intervention on team performance was found.
  
  
  CONCLUSIONS
  The ICT environment in departments was often technically inadequate when displaying the video clips clip of the survey. This may have caused considerable drop-out and possibly introduced selection bias, as professionals who were strongly affiliated to the theme of the study might have been more likely to finish the study.
  
  
  CONCLUSIONS
  Our results support the idea that an e-learning supported Train-the-Trainer programme is an effective strategy for implementing clinical guidelines and improving care for suicidal patients.
  
  
  BACKGROUND
  Netherlands Trial Register (NTR3092 www.trialregister.nl).
authors: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands. Electronic address: derekdebeurs@gmail.com.
authors: Derek P
authors: DP
authors: de Beurs
authors: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands. Electronic address: Mariekedegroot@ziggo.nl.
authors: Marieke H
authors: MH
authors: de Groot
authors: Groningen University, Groningen, The Netherlands. Electronic address: Jos.de.keijser@ggzfriesland.nl.
authors: Jos
authors: J
authors: de Keijser
authors: GGZ Foundation for Mental Health Care GGZ inGeest, The Netherlands. Electronic address: mokkenstorm@gmail.com.
authors: Jan
authors: J
authors: Mokkenstorm
authors: GGZ Foundation for Mental Health Care Delfland, The Netherlands. Electronic address: e.vanduijn@ggz-delfland.nl.
authors: Erik
authors: E
authors: van Duijn
authors: GGZ Foundation for Mental Health Care, Parnassia, The Hague, The Netherlands. Electronic address: r.dewinter@parnassia.nl.
authors: Remco F P
authors: RF
authors: de Winter
authors: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands. Electronic address: ajfm.kerkhof@vu.nl.
authors: Ad J F M
authors: AJ
authors: Kerkhof
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003194:Computer-Assisted Instruction; D005260:Female; D019983:Guideline Adherence; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D009426:Netherlands; D017410:Practice Guidelines as Topic; D013663:Teaching / Q000379:methods*; D000092864:Suicide Prevention
keywords: Guideline; Implementation; Suicide; Train-the-Trainer; e-Learning