Quality Initiative in Rectal Cancer Strategy: A Qualitative Study of Participating Surgeons
Bibliographic record
Abstract
BACKGROUND: The Quality Initiative in Rectal Cancer (QIRC) Strategy randomized 16 hospitals across Ontario to the QIRC strategy versus minimal intervention. The strategy included a workshop, recruitment of a local opinion leader (OL), operative demonstrations, postoperative checklists, audit, and feedback. Surgeons at each intervention hospital used a standardized approach to select a local OL from their ranks. We assessed the experiences of OL and non-OL surgeons in the QIRC strategy. STUDY DESIGN: Semi-structured qualitative telephone interviews were completed with 8 OLs and 8 non-OL surgeons. Interviews were guided by Grounded Theory. Initial interviews were assessed to ensure that domains of interest were fully explored. Two investigators (FW, MF) independently reviewed all final transcripts and identified themes. Consensus among all investigators was achieved for final themes. RESULTS: All approached surgeons participated in interviews. Seven themes were identified: surgical OLs with subspecialist expertise were supported; surgical OL requires technical expertise; limited role for local OL on changing physician practice in rectal cancer operations; limited effect of identifying local OL on local interactions; operative demonstrations supported; characteristics of operative demonstrator were important; and perceived positive effect of the QIRC strategy on practice. CONCLUSIONS: The experience of local OLs in this trial appears to be mixed. Although some of the themes support the concept of a local OL, other themes suggest the local OL had a limited role and effect. The overall QIRC strategy, and in particular the operative demonstration, was viewed positively and was perceived to have a positive longterm effect on participants' practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".