New theory from an old technique: the Rolma matrices.

Background:  Understanding the reasons behind non-adherence to clinical practice guidelines is a complex process. Many explanatory models have been proposed that are grounded in qualitative theory. The 2 × 2 matrix has often been used to condense this potentially complex information into a format understandable to clinicians without educational or qualitative backgrounds. Methods:  The concept of tacit knowledge and its interplay with evidence-based practice is explored and the role of matrices in demonstrating various interactions is defined. Results:  Two new matrices are proposed to describe how experience and tacit knowledge may determine the outcome of patients, regardless of the evidence base. Conclusions:  The Rolma 1 and 2 matrices can be used to demonstrate to all clinicians, regardless of their background, how their experiences effect judgements and why junior (and senior) staff may not appear to engage with best practice.