Table 2 Theoretical framework of the PA program design

Social constructivist learning theory [48]

Contextual learning, collaborative learning, active participation, and knowledge construction to enhance attention, storage, and retrieval of knowledge from memory.

Presenting a variety of clinical problems that adequately reflect authentic clinical practice, accounting for the case-specifity of clinical competence.

Simulating the context of daily practice in a role-play accounting for the context-specifity of clinical competence.

Enhancing active participation of each participant by assigning pre-defined roles, and by using a performance based format.

Self-regulated learning theory [50, 51]

Applying metacognitive strategies to guide the professional development process.

Self-assessment

Designing an improvement plan based on peer feedback.

Conscious goal setting and action planning

Discussing the improvement plan with peers.

Situated learning theory [40, 52]

Learning in the context of daily practice to bridge the gap between learning context and application context.

Delivering the program within communities of practice that share the same setting or the same interest.

Social cognitive learning theory [33]

Enhancing the development of self-efficacy beliefs.

Performing the new behavior and experiencing the consequences of that behavior (mastery experience).

Performing the new behavior individually, by reasoning aloud and demonstrating diagnostic and treatment skills relevant to the LBP guidelines.

Observing the behavior of others and the consequences of that behavior (vicarious experience).

Observing a peer’s performance and providing individualized improvement feedback.

Stages of change theory [53]

Alligning implementation strategies to the stages of change.

Delivering the program within communities of practice. Peers are involved in the professional development process and are capable of tailoring feedback to stages of change.

Theory of planned behaviour [34]

Changing attitudes and subjective norms toward the new behavior.

Introducing peers to the assessor perspective. In appraising a peers’ performance, peer assessors need to develop an understanding and a mutually accepted quality standard to deliver credible performance feedback.

Enhancing the development of self-effecacy beliefs.