Clinical Practice Guidelines
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2021 ◽  
Martin Schulz ◽  
Kejia Zhu

Learning-by-connecting, the formation of connections between lessons, is a fairly common phenomenon, but how does it evolve? We argue that learning-by-connecting unfolds as the relevance of lessons to other lessons is gradually discovered over time. The process of “relevance discovery” unfolds through a dynamic interplay between lessons and their context that provides opportunities to discover the relevance of lessons to other lessons. We develop a theoretical model in which the availability of these opportunities and their sorting in time drive the formation of connections. We explore and test our model in the context of organizational rules that we conceptualize, following rule-based learning theories, as repositories of lessons learned. Our empirical context is the formation of citation ties between clinical practice guidelines (CPGs), a type of organizational rules in healthcare, in a Canadian regional healthcare organization. We find that citation tie formation intensifies when opportunities to discover relevance become available. We also find that learning-by-connecting creates rule networks in which the formation of new ties slows down due to the sorting of opportunities in time. Our findings support our assumption that learning-by-connecting is shaped by relevance discovery. Our study extends models of rule-based learning and contributes to discussions on the formation of connections in contexts of dispersed learning and knowledge.

2021 ◽  
Vol 42 (6) ◽  
pp. 413-424
Hyo-Sun You ◽  
Yu-Jin Kwon ◽  
Sunyoung Kim ◽  
Yang-Hyun Kim ◽  
Ye-seul Kim ◽  

Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.

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