The sequence of events leading to the implementation of a change in emergency physicians' practice and the learning activities and processes undertaken are examined and described in this study. A qualitative case study design was utilized and semi-structured interviews were employed as the primary means of data collection. Thirty emergency physicians were interviewed in face-to-face or telephone interviews. One change that required learning was selected per physician for an in-depth interview. The following factors were examined: motivation to change a practice behavior, time to implementation of changes, source of awareness, barriers to change, use of learning resources, stages in the change process, and method of learning.