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Academic Detailing (AD) Outreach Visit Assessment Detailer name:
Date:
Type of session:
| Poor or not addressed |
| Fair |
| Good |
| Excellent |
| N/A |
| Average score** |
| Introduction |
| 1. Introduced themselves and/or summarized last visit and asked about experiences or progress made |
| 1 |
| 2 |
| 3 |
| 4 |
| 2. Clearly stated the reason/purpose for the visit |
| 1 |
| 2 |
| 3 |
| 4 |
| 3. Verified time available/allotted for appointment |
| 1 |
| 2 |
| 3 |
| 4 |
Comments:
| Needs assessment |
| 1. Used open-ended questions to gain an understanding of current practice/management strategies |
| 1 |
| 2 |
| 3 |
| 4 |
| 2. Identified and managed barriers/objections |
| 1 |
| 2 |
| 3 |
| 4 |
| 3. Discussed at least 1 key message but did not overwhelm the provider with too many key messages |
| 1 |
| 2 |
| 3 |
| 4 |
| 4. Used AD techniques (e.g. EPE, 3Fs, reflections) to engage clinician in discussion |
| 1 |
| 2 |
| 3 |
| 4 |
| 5. Resisted the righting reflex (avoided phrases like: “yes, but”, “but what about”, “have you tried”) |
| 1 |
| 2 |
| 3 |
| 4 |
Comments:
| Poor or not addressed |
| Fair |
| Good |
| Excellent |
| N/A |
| Average score** |
| Summary & Close |
| 1. Summarized key items discussed |
| 1 |
| 2 |
| 3 |
| 4 |
| 2. Obtained commitment from the clinician to implement a change in behavior(s) |
| 1 |
| 2 |
| 3 |
| 4 |
| 3. Asked if there were additional questions/concerns |
| 1 |
| 2 |
| 3 |
| 4 |
| 4. Thanked the provider for his/her time |
| 1 |
| 2 |
| 3 |
| 4 |
| 5. Identified plan for follow-up (e.g. future appt) |
| 1 |
| 2 |
| 3 |
| 4 |
Comments:
| Overall Review of Detail Visit |
| 1. The detailer’s body language, tone and/or eye contact seemed appropriate |
| 1 |
| 2 |
| 3 |
| 4 |
| 2. The provider seemed engaged |
| 1 |
| 2 |
| 3 |
| 4 |
| 3. Overall, the encounter embodied the elements of a successful AD visit |
| 1 |
| 2 |
| 3 |
| 4 |
| 4. To the best of your judgment, this detail session resulted in building/maintaining a positive relationship with the clinician |
| Extremely unlikely |
Unlikely Likely Extremely Likely
| 5. To the best of your judgment, this detail session will result in a change in behavior |
| Extremely unlikely |
Unlikely Likely Extremely Likely
Comments:
Total Score*
*Total score may be used to assess academic detailing performance over time (e.g. improving skills = increase in total score). Disclaimer: total score has not been directly associated with academic detailing success; **Average Score may be used to help identify a weakness or area needed for improvement within the academic detailing visit
