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Table 1 Barriers to change identified in the literature

From: The changing landscape of professional practice in podiatry, lessons to be learned from other professions about the barriers to change – a narrative review

Barriers to change Themes to discuss barriers to change
• Poor practice organisation (time constraints/ environment/ clinical setting/ finances).
• Support (Failure to provide access to appropriate information or time for innovation and training).
• Failure of previous change initiatives.
The Organisation
(The existing structures, operations, culture and context of the change environment)
• Individual practice, habits, tradition and personal preferences.
• Knowledge (Unaware of current evidence based practice (EBP), obsolete clinical knowledge/ skills/ inappropriate professional development (CPD)).
• Aware guidance has changed but unaware of how to adopt change or how to access new evidence.
• Fear (clinical uncertainty/ loss of professional identity/ autonomy/ inability to perform as well in the new situation.
• Inadequate training, communication and preparation for the change effort.
• Lack of incentives to participate in effective educational activities or change processes.
The Professional
(Awareness, knowledge and attitudes)
• Demands for care.
• Media influence.
• Perceptions and beliefs about appropriate care.
• Compliance with clinical guidance.
3 – The patient
(As a consumer and a co-producer of care)