Case study

The case study below illustrates how engaging in social movement positively impacts health-care providers and their commitment to lead change and implement evidence-based practice changes.

Case study - Building capacity in change agents for health innovation and transformation

Case study

Junior doctors (i.e., interns) in the United Kingdom are positioned as the future leaders of health-care transformation and innovation (Carson-Steven et al., 2013). However, they often receive little training in leadership competencies at medical schools to prepare for this role; instead, they learn in clinical environments that are frequently unreceptive to change and innovation informed by best practices.

To overcome these barriers and emerge as leaders, a group of junior doctors chose to independently learn how to innovate and champion evidence-based practice by applying social movement approaches including mobilizing for change. By participating in programs, such as the Institute for Healthcare Improvement (IHI) Open Schools, they built capacity in social movement thinking and actions and used their knowledge, skills, networks and experiential learning to drive change in their clinical practice. 

The junior doctors applied social movement actions when they led a change initiative to implement the World Health Organization’s (WHO) guidelines on the use of surgical safety checklists for patient safety. Through organized and coordinated actions, the junior doctors co-created a supportive learning community to learn together and from one another, and to overcome obstacles and resistance. As emerging leaders, they engaged in collective action, including organizing a ‘teach-in’, to raise awareness for the urgent need for change and the implementation of best practices in surgical care as determined through evidence. To build a critical mass, each doctor committed to recruiting colleagues to strengthen the social movement and build momentum.

For more details, see The social movement drive: a role for junior doctors in healthcare reform - PubMed (

The above example illustrates many of the elements of the Social Movement Action (SMA) Framework:


  • Change is valued and necessary – i.e., the junior doctors’ valued quality improvement and patient safety.
  • Receptivity to change - i.e., to create health-system transformation as future leaders.
  • An awareness of examples of social movements. 

Key Characteristics:

  • An urgent need to take action.
  • The emergence of the junior doctors as informal leaders who are inspired and committed.
  • Intrinsically motivated to provide excellence in clinical care as a personal and professional expectation and standard.
  • Engaged in individual and collective action.
  • Using public visibility by holding events to create attention and gain credibility for the cause.
  • Engagement in a network to share resources and connect change agents through their participation in the IHI program.
  • A core leadership structure to guide the social movement, build a critical mass and support momentum.    


  • Goals are met and outcomes are achieved.
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