title: Dealing with a shifting paradigm.
abstract: In 1970, T. S. Kuhn, in The Structure of Scientific Revolutions argued that scientists work by creating a comprehensive model--a model he called "a paradigm." A paradigm, Kuhn said, is an encompassing world view that tells us what facts to pay attention to and what to ignore. He contended that, although we may think that we consider all the facts and ask all the questions, there is always some ordering and selection going on, and we must first be prepared by our paradigm to make sense of what we see. He stated that one of the first signs that a paradigm is shifting is the discovery of facts that seem significant and indisputably true but cannot be explained by the current model. The essential elements, according to Kuhn, that are required for a paradigm to shift are a strong stimulus, a rapidly changing environment, and the realization that whether the change is good or bad is essentially of no significance. The parties most closely involved are frequently the last to appreciate that the shift has occurred.
mesh_terms: D004469:Economics, Hospital / Q000639:trends*; D006739:Hospital Administration / Q000379:methods*; D010934:Planning Techniques; D014481:United States