Unlearning and Learning: Health vs. Other Forms of Training
This approach mirrors how individuals learn complex skills. Clinical visits provide (opportunity for) practice, while everyday environments provide practice. Consistent reinforcement enables habits to develop over time. Extending care into these environments allows health systems to support the moments that truly shape outcomes in real time. Ratio of Practice to Performance or Instruction to Practice Practice consistently outweighs performance or instruction time across disciplines. Skill development happens in the repetition, preparation, and daily commitment behind the scenes. + Piano: 30 minutes of instruction to 4 hours of daily practice + Football: 32:1 practice-to-game ratio + Acting: 1 to 8 hours of daily rehearsal over extended periods
Behavior change in healthcare follows the same principles as learning any complex skill: instruction alone is not enough. A clinical visit provides guidance, but lasting change is shaped by repeated practice in everyday life. Just as musicians, athletes, and performers build skill through routine and repetition, individuals must repeatedly apply health guidance in real- world moments for it to become a habit. The environments where people live and work become the true training ground for change. This is where routines are formed, behaviors are reinforced, and outcomes are ultimately determined. Extending care into these daily moments allows health systems to support the repeated actions that drive lasting results. Reality Check People do not deviate from care plans during a brief medical appointment. They disconnect from adherence at home, at work, and under stress, which is when intervention and support are crucial.
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