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Implementation of evidence-based practice from a learning perspective

Research output: Contribution to journalArticle

Per Nilsen ; Margit Neher ; Per-Erik Ellström ; Benjamin Gardner

Original languageEnglish
JournalWorldviews on Evidence-Based Nursing
Early online date9 Mar 2017
StateE-pub ahead of print - 9 Mar 2017

King's Authors


Introduction: For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions, and abandonment of ingrained non-evidence-based practices. The aim of this article is to describe two modes of learning and use these as lenses for analysing the challenges of implementing EBP in health care.
Theoretical background and applying learning theory to understand the challenges in
implementing EBP: Adaptive learning involves a gradual shift from slower, deliberate behaviours to faster, smoother and more efficient behaviours. Developmental learning is conceptualized as a process in the “opposite” direction, whereby more or less automatically enacted behaviours become deliberate and conscious. The mechanisms by which the two modes of learning occur are explained with reference to habit theory.
Discussion: From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process and/or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response.

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