Study 4: One size does not fit all: why guideline panels need context-tailored training – a multiple case study

Introduction: Guideline development is a complex, collaborative process in which multidisciplinary panels formulate recommendations. A broad range of competencies is expected of panel members. Many panel members have limited formal training when participating in a panel, even if this can enhance their competencies. An added complexity is that there is a wide variety in guidelines and healthcare contexts in and for which they are developed. Currently, it is unclear how contextual factors shape guideline development processes and panel members’ learning needs. This study, therefore, examined how contextual factors influence the learning needs of panel members in guideline development. Methods: We conducted a qualitative multiple-case study of five Dutch multidisciplinary guideline projects supported by a newly developed training programme. We followed panels longitudinally from their first meeting to the final training session (March 2024–June 2025) and conducted semi-structured interviews with eighteen panel members and ten project leads. Data were thematically analysed using an iterative inductive–deductive approach. Bronfenbrenner’s social-ecological model was used as a sensitising concept to examine contextual influences. Results: Three interrelated themes shaped panel members’ learning needs. First, the guideline topic influenced panel composition, methodological choices, and the extent to which panels had to rely on expert judgment due to limited or low-certainty evidence. Second, participation dynamics, including individual characteristics (i.e. confidence and prior experiences), hierarchy, and psychological safety, affected engagement and whose expertise was voiced, valued and integrated into the guideline. Third, task allocation varied substantially between projects, particularly regarding involvement in evidence searching, appraisal, and drafting recommendations, resulting in different competency requirements. Meeting formats (online versus in-person) further shaped accessibility, interaction, ...