open access publication

Article, 2023

Surrendering to the Process: Innovation in Developing CPD for General Practice

In: Journal of CME, ISSN 2161-4083, 2833-8073, Volume 12, 1, Page 2164141, 10.1080/28338073.2022.2164141

Contributors (4)

Vestergaard, Stense Kromann (Corresponding author) [1] [2] Bjerre-Christensen, Ulla (0000-0002-7426-6755) [1] Mørcke, Anne Mette [3] Risør, Torsten (0000-0002-2018-528X) [2] [4]


  1. [1] Steno Diabetes Center
  2. [NORA names: Steno Diabetes Centers; Hospital; Denmark; Europe, EU; Nordic; OECD]
  3. [2] University of Copenhagen
  4. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD]
  5. [3] Aarhus University
  6. [NORA names: AU Aarhus University; University; Denmark; Europe, EU; Nordic; OECD]
  7. [4] The Arctic University of Norway
  8. [NORA names: Norway; Europe, Non-EU; Nordic; OECD]


In CME/CPD, a significant part of research is about effectiveness. Attention to the development process can be vital to understand how it impacts progress and results. This study aims to explore an innovative process of applying a combined approach using design-based research, collaborative innovation, and program theory to develop CPD about type 2 diabetes for GPs and clinic nurses with a group of interprofessional stakeholders. In particular, the development process of the combined approach and how it impacts the progress and the activities. We applied two qualitative methods. First, we analysed 159 documents from the development process, and second, eight semi-structured key informant interviews. Data were deductively analysed using 15 predefined elements derived from the combined approach combined with open coding analyses. The analysis showed how the combined approach structured the process. And the interviews broadened our understanding of the relationship between the process and the activities. Four additional themes were constructed from the open coding, including surrender to the process. Surrendering was a central part of the interviewees' participation in the process. The combined approach facilitated this unfamiliar experience of surrender. By supporting participants to surrender, the combined approach enabled an expansion of interprofessional collaboration and the development of innovative activities and learning methods in CPD on type 2 diabetes.


CME/CPD, CPD, GPs, activity, additional themes, analysis, approach, attention, central part, clinic nurses, coding, collaboration, collaborative innovation, combined approach, data, design-based research, development, development process, diabetes, documents, effectiveness, elements, expansion, experience, general practice, group, informant interviews, innovation, innovative activity, innovative process, interprofessional collaboration, interprofessional stakeholders, interviews, key informant interviews, method, nurses, open coding, part, participants, participation, practice, process, programme theory, progress, qualitative methods, relationship, research, results, semi-structured key informant interviews, significant part, stakeholders, study, surrender, surrendering, themes, theory, type 2 diabetes, understanding, unfamiliar experiences