Disseminated learning from clinician-scientists : A multiple case study in physiotherapeutic care

Clinician-Scientists are considered to be important for continuous improvement of patient care, because they are ideally positioned to bridge the gap between scientific research and clinical care. However, limited empirical evidence is available about how they connect these two realms. So far research has mainly focused on their direct role in bridging the gap. This study investigates an additional mechanism; that is whether clinician-scientists also connect science and care indirectly through disseminated learning. During this type of learning, clinical colleagues learn by working with clinician-scientists. Disseminated learning was studied in five physiotherapeutic care settings in the Netherlands with clinician-scientists (N = 5) and their clinical colleagues (N = 14). Semi-structured interviews were conducted between March and May of 2016. Interviews were transcribed verbatim and analyzed using thematic analysis. Clinicians and clinician-scientists in all settings reported clinicians learning informally. They learned by being informed about (evidence for) new tests and treatments, through increased understanding of the research process and research results, and through awareness of an academic reflective approach to care. Learning took place primarily through knowledge sharing, and to a lesser extent through role modeling or joint implementation. Interpersonal and organizational conditions, such as overlapping clinical expertise and organizational policy and culture, seemed to facilitate or hinder learning. This study highlights disseminated learning as a mechanism of how clinician-scientists may connect science and care. Furthermore, it provides insight into how disseminated learning may take place and the conditions that may facilitate or restrict learning.