Change Driven by Peer Comparison and Reflection

Interesting article in the Times!

Instructional designers have to be aware of change management because it’s pointless to put a lot of effort into creating beautiful instruction only to have learners just go back to doing things how they’ve always done them. Or, maybe worse, spending time designing instruction to tell learners things they already know (i.e., not a training problem).

As noted in the Times article, antibiotics are a classic example. Doctors overprescribe antibiotics despite training efforts to help them understand the significant negative ramifications of doing so.

I’m aware of research suggesting that people are motivated to change when they think that others have already made the change or they think they are being compared to others, which the article above suggests is effective for doctors and drives down overprescriptions of antibiotics by over 80%. The article points to another interesting angle, though–that setting up a “speed bump” asking physicians to write out a justification for prescribing antibiotics is almost as effective. I find appealing the idea that reflection, albeit forced, can lead us to do the right thing instead of choosing the easy thing. Maybe something to take advantage of in instructional design.


One thought on “Change Driven by Peer Comparison and Reflection

  1. Rob Foshay

    Good to see the principles of HPT apply here, too: it’s not a training problem, and more training won’t fix it. Pay incentives don’t work either, as Pink reminds us. What does work is changes in the work environment, such as the EPSS (really a job aid), and peer interaction.


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