Methodology of behavioural changes
| Contexts | Mechanisms | Outcomes |
| Shortage of junior doctors resulting in increased recruitment of temporary staff at premium rates and inconsistent clinical care | Employing new entrant international medical graduates at standard NHS salary | A stable workforce leading to improved clinical care and financial position of the trust |
| Poor performance and low level of wellbeing in the initial stages at the workplace among new entrant international medical graduates | Structured intervention during the orientation period including a good learning environment, adequate mentoring and pastoral support | Improvement in the participation, self-efficacy and learning of these doctors |
| Risks to patient safety due to poor knowledge of contextual factors including policies and procedures by the new entrant international medical graduates | Providing clear communication of curriculum competencies along with peer support to these doctors | Improvement in the awareness among these doctors of the contextual factors contributing to the provision of high-quality patient care |
| Managers uncertainty about recruitment and orientation of new entrant international medical graduates | Holding meetings with managers to discuss the design and implementation of the intervention | Increased participation and support of managers for the intervention |
| Lack of standardised communication channels between junior doctors, their supervisors and the trust management | Developing a standardised communication strategy will facilitate effective communication of critical success factors | The stakeholders perceive that their voice is being heard and they are valued resulting in their increased satisfaction |
| Availability of on-site staff accommodation in the trust | Providing free accommodation to doctors doing honorary clinical attachment | Improved cost efficiency of the trust by attracting overseas junior doctors into honorary posts, increasing their recruitment |
| Lack of criteria for assessment and unrealistic expectations from new entrant international medical graduates during their orientation | Tailoring the intervention based on requirements of junior doctors, their supervisors, and managers of the trust | Clarity of roles and requirements and better participation of the stakeholders |