Achieving clinical behaviour change: a case of becoming indeterminate

This paper is based on an empirical study of attempts to achieve change in clinical behaviour across a United Kingdom National Health Service (NHS) Health Authority (HA). We suggest that the evidence based medicine (EBM) movement underpinning such attempts is premised upon a highly rationalistic con...

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Bibliographic Details
Published in:Social science & medicine (1982) 1998-12, Vol.47 (11), p.1729-1738
Main Authors: Wood, Martin, Ferlie, Ewan, Fitzgerald, Louise
Format: Article
Language:English
Subjects:
Behaviourism
Biological and medical sciences
Changes
Clinical practice
Delivery of Health Care
Evidence
evidence based medicine knowledge management of change poststructuralism
Evidence-Based Medicine
Health Behavior
Health care
Health participants
Health services
Health Services Research
Humans
Knowledge
Management
management of change
Medical sciences
Medicine
Models, Theoretical
National Health Service
National health services
Post-structuralism
poststructuralism
Public health. Hygiene
Public health. Hygiene-occupational medicine
United Kingdom
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Summary:This paper is based on an empirical study of attempts to achieve change in clinical behaviour across a United Kingdom National Health Service (NHS) Health Authority (HA). We suggest that the evidence based medicine (EBM) movement underpinning such attempts is premised upon a highly rationalistic conception of change. Here the generation and implementation of research findings into clinical practice is understood as movement between discrete entities. Drawing upon poststructural philosophy, social studies of science and technology, social anthropology, and gender studies, we challenge such linear perspectives through a more immanent alternative. We conceive of change as movement within indeterminate or ambiguous relationships. We then proceed to discuss the implications of this modality for the management of clinical behaviour change.
ISSN:0277-9536
1873-5347
DOI:10.1016/S0277-9536(98)00250-0