Routines mediate educational solutions in clinical practice: A discussion paper on design-based research

This study aimed to explore the appropriateness of using a design-based research approach in inducing change by exploring the research question: How can implementing new learning tools in hospital practice lead to sustainable change?

Although design-based research is conducted with the idea of bridging the theory/practice gap, we perceived a gap between design, enactment and sustainable change. We assume that context-particularly routines-plays a decisive role in this gap.

Qualitative design-based educational research METHODS: Discussion of the design-based research approach based on a case study. The results of the case study are interpreted with a theoretical explanatory model.

We explored theories about practice, routines and routine dynamics. The identified elements of routine dynamics could be related to our context, findings and experiences. From the case data, an eye-opening insight emerged. Context, especially the prevailing routines and new routines to be developed in this context, are significant constituents in all phases of design-based research. Furthermore, elements of routine dynamics can explain the variance in enactment and the difficulties involved in establishing a new educational routine in nursing clinical practice.

The inclusion of routine dynamics in the DBR research protocol is a necessary addition to ensure the successful design and implementation of a new educational tool in clinical practice.