Specifying the behaviours you want to change

Not all education and training is about changing practice. Some focuses purely on increasing levels of knowledge or development of skills that might be of use at some future, undefined, time. However, much education and training is aimed at changing what people do, how they do things, how frequently they do things.

What are the behaviours that you are trying to change with your course?

Not all education and training is about changing practice. Some focuses purely on increasing levels of knowledge or development of skills that might be of use at some future, undefined, time. However, much education and training is aimed at changing what people do, how they do things, how frequently they do things. If your training course is one of these then there are benefits for you in thinking behaviourally.

The kinds of behaviours that might be of interest are those discrete and specific parts of practice that, if done differently, would lead to an improvement in something important. Examples of behaviours include:

• Prescribing fewer antibiotics for upper respiratory tract infections.
• Washing hands at appropriate times i.e., the five moments of hand hygiene.
• Vocalising concerns during complex procedures like rapid sequence induction or advanced life support.
• Putting on appropriate personal protective equipment when seeing a patient suspected of having a highly infectious disease.
• Using an ABCDE approach when someone might be acutely unwell
• Discussing concerns with parents / carers when a child might be abused or neglected.

Can you identify the healthcare professional behaviours?

A patient comes to a primary care facility and seems to be feverish and a little confused. The nurse takes him into a side room and he collapses on the floor. The nurse quickly checks him over using an ABCDE approach and calls for help. Other members of her team enter the side room and after washing their hands they begin to work together on the patient. A junior member of the team notices something important about the patient’s condition but doesn’t mention it for fear of seeming stupid or of contradicting the more senior members of staff.

Show behaviours

• “the nurse takes him into a side room” – the nurse has taken him into a side room
• “the nurse quickly checks him over using an ABCDE approach” – the nurse has used a particular approach (note, this behaviour is not about the quality of the approach just the behaviour in choosing to use the approach)
• “and calls for help” – this is a behaviour, the nurse has called for help.
• “after washing their hands”
• “a junior…doesn’t mention it” – this is a behaviour too.  In this case, this is NOT doing a beneficial behaviour.

Check your understanding

Are the following examples changes in behaviour?