Moving intention to practice change: through massive open online courses (MOOCs)

Knowledge into Action 

Feasibility of integrating evidence-based behaviour change techniques within a massive open online course (MOOC) to influence practice change


What we know

There is some evidence to support the use of educational interventions (including e-learning) to raise awareness of, or promote confidence in, delivering care. Many such interventions can lead to good intentions, however, it has been shown that intentions do not always lead to desired actions and that providing education-based content alone does not always result in behaviour change, which is fundamental to the implementation of evidence-based practice.

Study Aim

To understand whether and how behaviour change can be supported by providing learners with evidence-based behaviour change techniques (BCTs), actions and tools delivered through a MOOC.

What this research explored

The Scottish Improvement Science Collaborating Centre had previously designed and delivered, on the FutureLearn platform, a Massive Open Online Course (MOOC) “Compassionate Care: Getting it Right”. This research worked with stakeholders from multiple sectors involved in the delivery of care (for example, NHS, private and public care home providers, practitioners, and managers) to identify appropriate BCTs and co-produce relevant content for inclusion within the MOOC. A behaviour change toolkit was developed to provide access to resources around five mechanisms for successful behaviour change: Pre- and post MOOC participation interviews, forum data and questionnaires were used to collect data on individual practice change.

What this study adds 

Findings suggested that participants found the learning useful and reported intentions to incorporate what they had learnt in their practice. From the forum data, most learners were able to give examples of how their behaviour at work had changed as a result of participating in the course. Questionnaire data identified a self-reported increase in person-centredness, improved communication skills and active listening. Increased confidence and motivation were also reported. Comparing pre and post-questionnaire data identified that following participation in the course, learners were more likely to agree that they had regular discussions with their colleagues about compassionate score, more likely to agree that they felt competent in applying a compassionate approach in their workplace and more likely to agree that they felt competent in applying a compassionate approach in their personal life.  In addition, they were less likely to agree that some people are more deserving of compassion than others and less likely to agree that health and social care practitioners do not always have time to be compassionate. However, it was unclear to what extent the MOOC impacted upon practice change.


This project was led by the SISCC team based at the School of Health Sciences, University of Dundee, in conjunction with colleagues from the University of the West of Scotland, Edinburgh Napier University and NHS Education for Scotland (NES).   


Zubala A, Lyszkiewicz K, Lee E, Underwood LL, Renfrew MJ, Gray NM Large-scale online education programmes and their potential to effect change in behaviour and practice of health and social care professionals: a rapid systematic reviewInteractive Learning Environments, 27:5-6, 797-812, doi: 10.1080/10494820.2018.1465438

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Behaviour Change Wheel