Influences on clinical practice: the case of glue ear

A case study of clinical practice in children with glue ear is presented. T he case is part of a larger project, funded by the North Thames Research an d Development Programme, that sought to explore the part played by clinicia ns in the implementation of research and development into practice in two a reas: adult asthma and glue ear in children. What is striking about this case is the differences found in every area of the analysis. That is, diversity was found in views about diagnosis and tre atment of glue ear; the organisation of related services; and in the report ed practice of our interviewees, both between particular groupings of clini cal staff and within these groupings. The challenge inherent in the case is to go beyond describing the complexity and differences that were found, an d look for patterns in the accounts of practice and tease out why such patt erns may occur.