Thesis

144 Chapter 6 creating shared ownership during the implementation of MCD was an important focus. We therefore formed a steering committee at each location, consisting of participants from the teams, local management, a coordinator from the Educational Institute, and two researchers. The aim was to facilitate and monitor the research and implementation process of MCD together with all stakeholders involved. To measure the experienced outcomes of MCD and to increase understanding of both the qualitative and quantitative data, we used an embedded mixed-methods design (Creswell, 2014, p. 44). We regulated some conditions for MCD, i.e., 1) set locations with team-based MCD sessions, 2) having a fixed set of facilitators for each of the participating teams, 3) using only one type of MCD conversation method for all sessions, i.e., the dilemma method (Appendix 2, Stolper et al., 2016), and 4) a 12-18-months’ timeframe for all teams to conduct 10 MCD sessions. This helped to create consistency in the organization and process of MCD, and prevented changing session circumstances from influencing our analyses of outcomes too much. This study is part of a broader research project regarding the development of the questionnaires, which shows more general evaluation results. We used three self-developed questionnaires, of which only the items and answers with a specific focus on experienced outcomes are used in the current study. Data collection A single-MCD-session-evaluation form was filled out immediately after a MCD session. There was one version for participants (for this study we used the answers to three closed and three open items), and one for facilitators (of which we used answers to one closed and one open item). In the participant version, two items inquired whether the MCD provided more insight into the discussed moral dilemma and the views and opinions of their direct colleagues. Items were scored on a 5-point Likert scale or rated an overall score between 1-10. We asked participants to formulate as concretely as possible any result the MCD session had for them and whether they could translate the insights into practice. In the facilitator version we asked the facilitators How did participants perceive the Moral Case Deliberation? What did it bring them? What did they say about this themselves? Finally, the survey-after-the-MCD-series was only for the participants and was administered per team in the weeks after the conclusion of the series of 10 MCD sessions. From this questionnaire, we used the responses to 1) one closed item How satisfied are you with the actions taken following the MCD sessions?, and 2) an openended item asking the participants to formulate reasons for the earlier scored satisfaction level of MCD (with the answer-options of positive, neutral or negative). Other items of the

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