Between evidence and experience: a sociocultural analysis of learning and practice in anterior cruciate ligament rehabilitation

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BACKGROUND: Evidence-based practice is a core principle of contemporary health professions education. However, the translation of evidence into routine clinical practice remains uneven, particularly in complex rehabilitation contexts. Previous research suggests that professional practice is shaped not only by individual knowledge but also by social, educational, and organisational factors. Anterior cruciate ligament rehabilitation provides a relevant empirical setting to examine how healthcare professionals learn, interpret, and implement evidence-based principles in practice. METHODS: A qualitative study design was adopted using semi-structured interviews. Nine healthcare professionals involved in postoperative anterior cruciate ligament rehabilitation participated, including clinicians (n = 5), researchers (n = 2), and educators or trainers (n = 2), with professional experience ranging from 2 to 32 years. Interviews were conducted online between March and September 2024, audio-recorded, transcribed verbatim, and anonymised. Data were analysed using a thematic approach combining deductive and inductive coding. The analysis was informed by sociocultural theories of professional learning and implementation science frameworks. The trustworthiness of the study was supported through reflexive practices, independent coding of a subset of transcripts, and triangulation with existing literature. RESULTS: Participants described a clear evolution from time-based rehabilitation protocols toward decision making guided by objective criteria. However, clinical practice was shaped by a range of organisational, educational, and contextual factors, while the implementation of evidence-based principles remained constrained by barriers such as limited time, restricted access to resources, and challenges in interprofessional communication. Knowledge use was rarely described as a direct application of research findings; instead, it emerged as experiential, socially negotiated, and shaped by local norms and professional interactions. Variations in practice reflected differences in learning environments and workplace cultures rather than a lack of awareness of evidence. CONCLUSIONS: This study highlights evidence-based practice as a socially situated and context-dependent process. The findings emphasise the importance of professional learning cultures, organisational conditions, and collective sense-making in shaping practice. Educational and implementation strategies that account for these sociocultural dimensions may better support the sustainable integration of evidence into healthcare practice. TRIAL REGISTRATION: Not applicable.

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