Implementation from a learning perspective

For many health care practitioners, implementing an evidence-based practice presents a few interlinked learning challenges: acquiring evidence-based practice skills to be able to problem-solve when faced with clinical uncertainty; adopting specific evidence-based practices, for example, interventions with proven effectiveness; and abandonment of non-evidence-based practices. The chapter describes two modes of learning and uses these as lenses for analysing the challenges of implementing an evidence-based practice in health care. Adaptive learning involves a gradual shift from slower, deliberate behaviours to faster, smoother and more efficient behaviours. Developmental learning is conceptualized as a process in the ‘opposite’ direction, whereby more or less automatically enacted behaviours become deliberate and conscious. The mechanisms by which the two modes of learning occur are explained with reference to habit theory.