Changing practice: are memes the answer?

Abstract

Nurses are insistent that they have a great deal more to offer than being merely doctors handmaidens. This article examines how nursing education and practice can be changed by increasing our knowledge of 'memes'--the cultural equivalent of genes--and the ways traditional beliefs are passed down to generations of nurses.

Breaking the silence: nurses’ understandings of change in clinical practice

“…Those changes most easily identified or remembered were categorized by participants as formal, dramatic, big, important or sudden. They understood change as a temporary, as well as a permanent, alteration in practice, thus challenging the stasis/change dichotomy that is apparent in the previous literature (Balfour & Clarke 2001, Pediani & Walsh 2000, Rosswurm & Larrabee 1999.…”

“…A considerable body of literature has been devoted to the lack of research utilization in clinical nursing work. This lack, together with the often‐cited explanation of nursing activities as ‘We've always done it that way’ (for example, Walsh & Ford 1989), creates the impression that change in clinical nursing practice is a rare occurrence, with nurses portrayed as inherently resistant to change (Pediani & Walsh 2000, Rafael 2000). While much of this literature was published before the evidence‐based movement became the dominant force it is today, we argue that little has changed in the intervening years.…”

“…The underpinning stasis/ change dichotomy is not always explicit in nursing literature. In this context, change constitutes a permanent alteration of behaviour (Balfour & Clarke 2001, Pediani & Walsh 2000, Rosswurm & Larrabee 1999. The need for change is hence suggested as common sense and inevitable.…”

Dysphagia Training Programmes: ‘Fixes That Fail’ or Effective Inter‐disciplinary Working?

“…We are also employing a variety of t e a c h g styles SO that nurses are encouraged to reflect on their own experience, try t h g s out in practice and apply theoretical learning to practical situations. Pediani and Walsh (2000) outline a number of ways in which 'resident memes'…”

An Epidemiological Model of Knowledge Diffusion in Virtual Learning Networks: An Application to Learning Statistics in Medicine

“…Mathematical models of knowledge diffusion were applied to several contexts, i.e., diffusion of correct life styles (Rogers 1995), nursing training (Pediani and Walsh 2000), choice of sexual partners (Lalana 1994), diffusion of drug addiction (Ferrence 2000), marketing (Milling 1996), development of psychosomatic diseases (Ross 1999), imitative learning (Higgs 2000), nursing (Wallingford et al 1996), diffusion of the results of nursing practice (Dooks 2001), prevention of diseases (Green and Johnson 1996), adoption of new pharmacological treatments in the clinical practice (Steffensen et al 2001), promotion of health (Ferrence 2001), and so on. According to this point of view, the institutions, such as schools and universities, can be conceived as particular networks of 446 U. GIANI ET AL.…”