Martine Kruijtbosch

148 Chap t e r 4 questions) was moved up one step and (3) the role of the facilitator became more intensive in terms of Socratic questioning of the participants’ reflections. Socratic questioning seeks to encourage other participants to answer their own queries by putting the spotlight on their own thinking and knowledge they are not aware of. Two MCD sessions With the adjusted facilitator manual, two MCD sessions with other groups of pharmacists were held. These sessions were moderated by one facilitator and observed by another facilitator (MK or EvL) and were recorded and transcribed by MK. Evaluation The two MCD sessions were evaluated with a mix of qualitative and quantitative methods. To be able to evaluate the moral reflectivity of the participating pharmacists, we qualitatively analysed if the pharmacists deliberated on the basis of professional values during the MCD sessions, and if so, which values those were. Two researchers (AF and MB) deductively and independently coded all the transcribed quotes with the Dutch profession’s core values (Box 2). Additionally, directly after the MCD session all participants were invited by e-mail to complete an online questionnaire. As there is no validated questionnaire for MCD available, we based our questionnaire on the Maastricht evaluation questionnaire 16 and adapted it to the context of community pharmacy practice (Appendix, Evaluation questionnaire). It contained questions about the general evaluation of the moral case deliberation, the lessons participants learned, the influence on participants’ reflection on moral dilemmas, and the role of the facilitator and other participants. It consisted of closed questions with statements that were to be scored on a 4-point scale or with ‘yes’ or ‘no’ as well as a set of open questions. The answers were analysed in Microsoft Excel. This study followed scientific standards for describing qualitative data (SRQR; Table 4 in the Appendix). 39,40 Ethics and confidentiality This study is compliant with the requirements of the institutional review board of the division of Pharmacoepidemiology and Clinical Pharmacology at Utrecht University. All participants signed a letter of consent to the recording of their reflections and the use of these for the study. Data in the two MCD session transcripts that could give clues about the origin of dilemma cases (e.g. names of patients, cities, pharmacies, pharmacists or physicians) were removed.