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Forging the future: is the injury prevention community a learning organisation?
  1. Roderick J McClure
  1. School of Rural Medicine, University of New England, Armidale, NSW 2351, Australia
  1. Correspondence to Dr Roderick J McClure, School of Rural Medicine, University of New England, Armidale, NSW 2351, Australia; rmcclure{at}

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It is 70 years since John Gordon wrote ‘The epidemiology of accidents’ in the American Journal of Public Health 1 and 55 years since Haddon W Jr and colleagues edited the text book ‘Accident Research: Methods and Approaches’ published by Harper and Row.2 Thirty years ago, the First World Conference on Accident and Injury Prevention was held in Stockholm. Twenty-five years ago, Injury Prevention published our first issue. In the modern form, injury prevention is no longer new. Does the field of injury prevention yet have the level of self-confidence required to step forward with purpose into the future?

I was at an international meeting recently where there was much reference to ‘the injury prevention community’. At this same meeting, there was also much discussion about how the injury prevention community needs to be more effective in influencing governments, institutions, industry, funders and members of the public to better support our community’s activities and goals. “If other people listened to us more and took our advice, the world would be a safer place.”

Is there a cancer prevention community? A cardiovascular disease prevention community? A kidney disease prevention community? If not, what does this say about our collective identity as injury preventers, and about the way we see our contribution? Should we being distinguishing ourselves as a community apart from the world we try to influence, or should we function as component parts of the totally integrated communities within which we exist.

Let us suppose for a moment there is value in people, who have an interest in the injury prevention, conferencing as a self-identifying community for creative support. How successful have we been in optimising value from these conference events?

Here is a test. What are the 20 questions we should ask, that if answered in sequence would solve the public health problem of injury? I don’t believe the field knows what these 20 questions are. I don’t believe the field is searching for this list of 20 questions, let alone searching for the answers to them. I don’t believe our conferences are structured this way.

Perhaps this is a poor test. The injury prevention field is diffused across such a broad territory. What possible contribution could the answers to just 20 questions make to the advancement of knowledge in the fragmented field that is injury prevention? A substantial contribution I think. Injury prevention covers a diverse terrain, yes, with variation in people affected, settings, mechanisms, locations, breakdown factors and injury types—but if we are a single injury prevention community, then diversity should not equal fragmentation. We need to be able to internalise our diversity and make it a strength. We must sharpen our purpose, and accelerate our maturation as a field.

We tend to spend our time at conferences either in big rooms talking at each other or in multiple small rooms talking in parallel conversations. Is it any surprise that the conversations are still about Gordon and Haddon and the size of the problem? Perhaps we should shift gear and hold consensus meetings, with agendas, goals, objectives and reports that summarise progress made since the previous meeting. These consensus conferences could define frameworks, set courses of action and hold us all accountable against defined performance standards, but I am not sure this is the answer. Does good research and practice come from committee planning or is it better driven by individual brilliance and passionate champions?

No. The real question of reflective important we need to ask is how does the injury community perform as ‘a learning organisation’?3 As an injury prevention community, do we have: a common vision of our goals, a holistic appreciation of the inter-relationships between our component parts, continual effective communication of the mental models that underpin our work, advanced collaborative dynamics that drive adaptive changes in our personal and collective underpinning values? If our injury prevention community had those attributes, our conferences would be structured to support our continually self-transforming inquiry.

I began by arguing the injury community away suggesting it was more important that we become indistinguishable from the society of which we are part. I then argued it back as a self-help group to provide opportunities for ‘collaborative double loop learning’.3 I conclude by arguing the need for injury preventers to be both. People wholly integrated in the interstitial structures of society and yet also engaged with injury prevention colleagues in a process of collective learning.

Are we up to the challenge of working in the world beyond our support base as integral parts of other people’s systems? Do we want to develop a conference series that defines frameworks, set courses of action and holds the injury prevention community self-accountable for global injury outcomes? Does anyone want to play the 20 questions game?



  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.