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Changing physicians' behavior: what works and thoughts on getting more things to work.
Jeremy M Grimshaw1, Martin P Eccles, Anne E Walker
1Clinical Epidemiology Program, Ottawa Health Research Institute, Center for Best Practices, Institute of Population Health, University of Ottawa, Ontario.
Summary
Bridging the gap between medical research and clinical practice is challenging due to physician information overload and barriers to change. More research is needed on effective dissemination and implementation strategies for physician behavior change.
Area of Science:
- Health Services Research
- Medical Education
- Behavioral Science
Background:
- A consistent gap exists between evidence-based clinical practice and actual physician behavior.
- Physicians face challenges including limited reading time, inadequate research appraisal skills, information overload, and practice barriers.
Purpose of the Study:
- To summarize initiatives aimed at improving physician information management and evidence synthesis.
- To describe the evidence base for dissemination and implementation strategies in healthcare.
- To explore theoretical frameworks for understanding and influencing physician behavior change.
Main Methods:
- Literature review and synthesis of existing research on dissemination and implementation strategies.
- Analysis of barriers and facilitators to physician adoption of best practices.
- Proposal for integrating behavioral theories and theory-based evaluations into research.
Main Results:
- The evidence supporting the effectiveness and efficiency of current dissemination and implementation strategies is imperfect.
- There is a lack of a strong theoretical foundation for conceptualizing physician behavior change.
- Existing strategies may not be universally appropriate or effective across different contexts.
Conclusions:
- Further research is required to understand provider behavior determinants and identify modifiable factors.
- Developing methods to identify barriers and facilitators is crucial for effective interventions.
- Theory-based approaches and rigorous evaluations are needed to improve dissemination and implementation strategies.