Reflective Learning through Collaborative Practice Groups

In 1601, the British ship captain James Lancaster tested what was then a little known innovation in naval dietary practice when he set sail for India with a fleet of four ships. While the crew of three of his ships followed their usual diets, all of the men on the fourth were required to consume a teaspoon of lemon juice three times a day. The utility of this innovation was irrefutable. By halfway into the voyage, 40% of the 278 sailors on the first three ships had died of scurvy, while none of the sailors on the fourth had perished (Berwick, 2003). Despite the highly compelling evidence for the utility of this remedy for scurvy, thousands more sailors died during the next 146 years before the British Navy instituted a policy of including citrus in the naval diet. Once the policy was initiated, scurvy disappeared overnight.