“…12913 The urban community generally indicates higher family income, higher education levels, better housing conditions, more public transportation and a younger population.12 The medical care system within urban communities is often characterized by more medical personnel, more referral services such as screening clinics and laboratory facilities, more emergency and triage services, more health insurance coverage, and less reliance on home health care. l 3 To determine if the context of practice alters the change and learning process for physicians, cases of change were reviewed for differences between this population and the overall population of the change study. The following variables were included: 1) forces of change, 2 ) occurrence of learning, 3) learning purposes, 4) learning methods, 5) types of learning 33 1 resources (formal or informal), 6) number of changes/physician 7) types of change.…”