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Related Concept Videos

Obedience01:08

Obedience

According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation, obedience...
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Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Ethical Standards I01:25

Ethical Standards I

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Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
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Ethical Dilemmas II01:30

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Standards of Care II01:19

Standards of Care II

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Related Experiment Video

Updated: Jul 13, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Why don't physicians follow clinical practice guidelines? A framework for improvement.

M D Cabana1, C S Rand, N R Powe

  • 1Department of Pediatrics, Robert Wood Johnson Clinical Scholars Program, Johns Hopkins School of Medicine, Baltimore, MD, USA. mcabana@umich.edu

JAMA
|October 27, 1999
PubMed
Summary

Physician adherence to clinical practice guidelines is limited by various factors, including awareness, agreement, and external barriers. Understanding these barriers is crucial for improving healthcare quality and physician practice.

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Last Updated: Jul 13, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

  • Medical practice and quality improvement
  • Health services research
  • Physician behavior studies

Background:

  • Clinical practice guidelines aim to standardize care but often fail to change physician behavior.
  • Limited understanding exists regarding the specific factors influencing physician adoption of guidelines.

Purpose of the Study:

  • To systematically review and identify barriers hindering physician adherence to clinical practice guidelines.

Main Methods:

  • A comprehensive literature search was conducted across MEDLINE, ERIC, and HealthSTAR databases (1966-1998).
  • 76 relevant studies were selected and analyzed for reported barriers to guideline adherence.
  • Barriers were categorized based on their impact on physician knowledge, attitudes, and behavior.

Main Results:

  • 293 potential barriers were identified across 120 surveys within the 76 studies.
  • Common barriers included lack of awareness (46), familiarity (31), agreement (33), self-efficacy (19), outcome expectancy (8), overcoming practice inertia (14), and external performance barriers (34).
  • Most surveys (58%) focused on only one type of barrier.

Conclusions:

  • Barriers to guideline adherence are context-specific, limiting the generalizability of improvement strategies.
  • This review provides a framework for diagnosing reasons for non-adherence and developing targeted interventions.
  • Further research is needed to address the multifaceted nature of physician guideline adherence.