Addressing the Habitual Practice Issue: The Role of Unlearning in Promoting Evidence-Based Practice and Lifelong Learning

Abstract

Context Habits play a large role in health care professionals' behaviors. Although habitual practice patterns limit cognitive overload, routinized approaches can compromise the provision of quality and contemporary patient care. To address the issue of habit, unlearning has been suggested across health care fields but remains a relatively new concept in athletic training. Objectives This commentary aims to (1) describe the concept of unlearning, including barriers to and facilitators of this process, (2) discuss the steps in the unlearning process via a published unlearning framework, (3) highlight the role of unlearning on improving evidence-based practice and lifelong learning among clinicians, and (4) apply a context-specific example to the unlearning framework to highlight the role of unlearning on improving patient care. Background Although evidence-based practice can result in improved quality of care, literature suggests that routine uptake and incorporation of evidence into patient care is limited. The reason for this gap is likely multifactorial, but may, in part, be related to the need for unlearning. Synthesis Rapid changes in health care delivery require medical professionals to adapt their practice behaviors to maintain competence over time. Unlearning facilitates behavior change because it involves an intentional act of moving away from knowledge and skills that are no longer effective. As such, unlearning may also improve evidence-based practice efforts. Recommendation(s) To abide by changing recommendations, clinicians must unlearn outdated behaviors first before replacing them with evidence-based techniques. As new knowledge is acquired, it is important to reflect on its applicability to one's practice setting and identify what, if any, outdated practices the new knowledge could replace. Conclusion(s) Self-reflection is essential for successful unlearning to occur. Identifying the overall effectiveness of various practice behaviors and acting on areas of improvement can help ensure the care provided to patients is evidence-based while simultaneously optimizing patient outcomes.