Knowledge Translation: Closing the Evidence-to-Practice Gap

A model for closing the evidence-to-practice gap. This schematic demonstrates 4 stages of moving from research to practice-altering outcomes. The first stage involves getting the evidence straight, illustrated by increasingly more applicable forms of information drawn from valid and important clinical research and represented in the 4S pyramid. The evidence-to-practice pipeline, also shown, reveals the dissipation of useful conclusions from clinical research, thus failing to make it into practice. The 3 remaining disciplines of knowledge translation can facilitate evidence uptake and help close the gap between research and practice. Adapted from Glasziou and Haynes.¹⁶ EBM, Evidence-based medicine; CQI, continuous quality improvement.

Barriers to evidence uptake. Innovation and change in clinical practice at the individual, departmental, and institutional levels are contingent on 3 key sources of behavior change: knowledge, attitudes, and behavior. However, a series of complex barriers exists for each of these dimensions, some of which are illustrated here. Adapted from Cabana et al.³³