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Introduction
Healthcare professionals (HCP) must apply their knowledge to their practice. Consequently, the implementation of research evidence largely depends on HCPs’ knowledge, acceptance of new evidence and choices. Improving patients’ lives and the quality of healthcare requires a strong emphasis on learning by HCP, teams and patients. Mastery of any area is never the result of a single inquiry, but is instead a continuum of inquiries, searches and reflections. Spiral learning is a teaching method in which the learner progressively gains knowledge on a subject with each encounter. Usually, complexity increases with each encounter and previous material is reinforced. Spiral learning, which is currently used in medical curricula, was initially justified because learners gained expertise as they revisited topics during practical applications. Therefore, spiral learning is suggested in this paper as an appropriate process to facilitate inquiry and effective learning.
Healthcare frameworks, such as the Deming Plan-Do-Study-Act problem-solving method (PDSA), evidence-based medicine (EBM) with its five steps and the five steps of patient self-management (SM), have been applied to healthcare to help learners implement best practices in healthcare delivery. Most of these frameworks are presented as a single inquiry. This paper suggests that these frameworks will be more effective than they are at present if they follow a spiral learning approach. The continuum in spiral learning is a factor among many that determines the success of these frameworks. Others include comprehensiveness of an inquiry, learner competencies and learning context. An additional determinant is the reflection on the elements of decision-making in healthcare, such as patient values, risks versus benefits, costs and evidential strength.
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