We are all creatures of habit, and once we establish the most convenient or efficient way of doing something, most of us will repeat the same pattern without even thinking about it. This is an important survival strategy where complex behaviours such as learning to use a computer or driving a car become automatic, with practice and over time.
In the complex world of healthcare, technology is constantly improving and new research is being produced at increasing rates. Most professionals recognise their need to keep up to date. However, there is great variety in using the research evidence to inform what is commonly called ‘continuing professional development’. The 5 steps of evidence-based practice proposes a simple way to frame a research question, search for and appraise the scientific evidence, in order to use research results to maintain the best standards of healthcare. Implicit in these steps is an expectation that healthcare professionals will change their practice when the evidence suggests that a change is necessary. But this process of change is neither easy nor automatic. Many theories suggest that change can be planned and managed in a logical way and there is research that documents this process of change. The diffusion of innovation theory explains how a new idea is gradually spread through a group of people. Initially, there is an awareness of the need for a change, before it is tried out with a few people and then eventually used more broadly. The stages of change theory explains how people need to recognise that they need to change before they are ready to take any action. In an ethnographic study of 2 UK GP practices, it was noted that GPs discussed new ideas with people and resources that they trusted before they were willing to change. Therefore, the processes individuals and organisations use to plan and manage change can also be considered as part of the research evidence. In this way, it is important to be critical as we apply, trial and evaluate our own changes in practice.