70 Sustaining and developing movements, like evidence live, in medicine: lessons to be learnt when does a campaign become a movement – and how do we implement a movement into practice?

Social movements across medicine, research, and publishing, such as EBM Live, Choosing Wisely, and Reducing Research Waste are well-intentioned, but are met with varying degrees of success. We need to learn from recent successful social movements that have reached international circulation and had fundamental impact, such as #MeToo and Black Lives Matter. The EBM manifesto’s aim to reduce bias, wastage, error fraud research is driven by a small community of researchers, academics, and publishers, largely from the United Kingdom. What percentage of end users, including researchers, patients, and public, are engaged or even aware of the movement? We must move away from simply raising awareness amongst small communities to co-producing and collaborating with them. Looking at successful social movements within and outside medicine that have generated transformational change and inspired the public, the following themes emerge: Have a clear purpose and vision for the movement. This has to be simple, short, and direct rather than a complicated and detailed plan. This will hook and unify the targeted audience and break down interdisciplinary barriers. (Satell, Harvard Business Review 2016). Use a structured framework to ensure standardisation across the movement. In order to enact change locally, nationally, and internationally, there needs to be clear guidance. For example, the Knowledge–to–Action Cycle, generated by Canadian Institute of Health Research, can be used as a guiding framework to increase the relevance, applicability, and impact of research findings (Field, Implementation Science 2014). This will increase clarity and process within the movement. Training nominated champions will increase uptake of the movement. Nominated champions should undergo sponsored training which will empower them to create a shared vision amongst their teams within hospital, university, or organisation. Formal accreditation, such as the Knowledge Translation Professional Certificate™, or informal opportunities, such as workshops and summer courses run by Evidence Live are a starting point. Cementing awareness can be formalised through the National Institute for Health Research Good Clinical Practice module and local induction for all healthcare and university staff, and not just those involved in research. This will ensure everyone is involved and engaged in the movement. Continuous monitoring and evaluation are necessary for a successful movement. An iterative process will allow strategy review, monitoring of activities, and amendments to be made in line with the movement’s values. Sustaining a movement in medicine is difficult. For real change to occur, the whole community needs to be engaged. Evidence Live is an inspiring conference with an ambitious manifesto, ultimately aiming to improve patient care. Unfortunately, we are still failing to reach the majority of the medical community. To do this, we need to learn from other social movements to understand their roadmaps and how to improve ours. This will enable movements like Evidence Live to be successfully implemented into practice.