Table 1 Suggestions for change included in the final training programme

1. Increase the opportunities for group discussion by reducing the amount of formal (didactic) teaching in sessions and move a considerable amount of material from face to face sessions into resources to be used on a personal basis: written papers, PowerPoint slides on CD or other media.

2. Use an experienced clinical facilitator to lead and co-ordinate the programme, with expert contributions that could consist of a short didactic presentation with group discussion as a major component.

3. Explore and build on the trainees’ clinical expertise from the start, supplementing this with specific knowledge about the nature of OA, its management and the role of self-management.

5. Integrate practical application and skills development throughout the programme, particularly around the use of the OA guidebook and the OA toolkit.

6. Dedicate one full day to developing OA specific knowledge and skills with simulated patients, ensuring adequate preparation for this component and allowing sufficient time to develop and reflect on these skills and their application to real practice, particularly with regard to returning patients and helping to address any difficulties which the patients had encountered in putting their plans into practice