Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 22 (4) Volume 22, Issue 4, Fall 2002 J Contin Educ Health Prof 2002; 22(4):197-204 THEORETICAL FOUNDATIONS Use of theory to interpret elements of change Slotnick HB Shershneva MB A b s t r a c t Actions useful in reducing unacceptable variation in physicians' clinical activities have been identified through critical reviews of randomized controlled trials, and, from them, Richard Grol proposed six elements of effective change for mounting programs to improve clinical practice. The elements include consideration of the complex reality of clinical practice, attention to the designated change, analysis of the target group and setting, mixed interventions to address needs, and a plan of action. Although empirically based, the elements lack a theoretical underpinning that explains why the elements work. This article interprets the elements using theories separately advanced by Dewey, Slotnick, and Wenger to suggest ways for understanding what studies have shown. Lessons for Practice A theoretical basis should be available to explain educational actions that are taken. Learning theory offers the promise of providing insights into physician behavior, both individually and in communities of practice. MeSH Terms: Attitude of Health Personnel; Behavior; Diffusion of Innovation; Education, Medical, Continuing; Evidence-Based Medicine; Learning; Models, Educational; Physician's Practice Patterns; Problem-Based Learning
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