Learning in practice The case for knowledge translation: shortening the journey from evidence to effect

A large gulf remains between what we know and what we practise. Eisenberg and Garzon point to widespread variation in the use of aspirin, calcium antagonists, blockers, and anti-ischaemic drugs in the United States, Europe, andCanada despite good evidence on their best use. Such variation is common not only internationally but within countries. Large gaps also exist between best evidence and practice in the implementation of guidelines. Failure to follow best evidence highlights issues of underuse, overuse, and misuse of drugs and has led to widespread interest in the safety of patients. Not surprisingly, many attempts have been made to reduce the gap between evidence and practice. These have included educational strategies to alter practitioners’ behaviour and organisational and administrative interventions. We explore three constructs: continuing medical education (CME), continuing professional development (CPD), and (the newest of the three) knowledge translation (box). Knowledge translation both subsumes and broadens the concepts of CME and CPD and has the potential to improve understanding of, and overcome the barriers to, implementing evidence based practice.