Table 1 The logic model illustrating how the reform was realized in practice

Definition: Resources provided to achieve the reform activities but not previously available for this purpose

Definition: Activities, not done before, to achieve reform outputs and outcomes

Definition: Direct products of the reform’s activities that otherwise would not have happened

Definition: Actual benefits – or potential disadvantages – resulting from the reform activities and outputs

*) Steering document clarifying the mandates

*) The project group, the steering committee, and the reference group not mentioned as influential

*) Research and educational competencies not present to the extent that was intended

Resources for coordinators and clinical lecturers

Start-up funding (e.g., for targeted ventures and learning environments)

***) Lack of prerequisites (e.g., time, competence, and facilities) to be able to combine engagement in research, education, and professional development with delivery of care services

Establishment of eight coordinating centres

Establishment of eight networks

Extended mandate to the managers of the coordinating centres

Establishment of eight coordinators for the centres

Establishment of coordination of clinical lecturers

***) Lack of a systems perspective parallel to local APHN development

Students’ clinical training: Improved coordination and structure, improved competencies (e.g., increased number of trained supervisors), more students, improved learning environments (e.g., educational settings, establishment of practices managed by students)

*) Attempts were made to increase students’ inter professional training, but there were difficulties in establishing continued systematic approaches

Continuous professional development (CPD): More opportunities and activities

Research: *) Research projects with connection to primary care were initiated but difficult to run in practice, although some practitioners did become engaged in the research

Other: *) Networks were established but had few activities; some collaboration was established with actors outside the primary care organisation (e.g., social services); **) increased collaboration with actors outside the primary care organisation (e.g., research collaborations, introduction of technical developments), and further specification of the local profiles at the centres

Increased dialogue about improvement of care quality and the use of evidence-based interventions, although in its early stages

More positive attitudes towards students and research in primary care

**) Increased workload (e.g., more tasks and time-consuming activities)

Improved job satisfaction and chances to recruit and keep staff (e.g., job variation, confidence in supervising roles, increased personal development and competence)