Lag time in research to practice: are we reducing or increasing the gap?

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Ours is an information age, which grows exponentially with each day, each new journal launched, and each new research project funded. Recent reports indicate that in MEDLINE alone there are 10,000 new randomized clinical trials (RCTs) included each year and 350,000 RCTs identified by the Cochrane Collaboration (Rycroft-Malone, 2006). How can any one of us, even in a defined area of research, maintain knowledge of the state of the art in our circumscribed area of expertise. Academic researchers by nature of what they do and how they spend the majority of their time are best equipped to “stay on the top of their game,” that is, to know the latest research in their content area as soon as it is published. However, awareness is only the first step, these researchers must evaluate all aspects of the research, from the theoretical to the methodological developments.

Clinicians, on the other hand, are not necessarily involved in reading the latest research as soon as it is published. In fact, nurses and health professionals are so busy with their clinical practice that they often rely on others for information on the latest knowledge. Conferences abound, focused on both the content and the process of applying research to practice, within the structures and confines of both evidence-based practice and best practice models applied to specific content areas. Yet, it remains difficult not only to distil the information but, more importantly, also to judge what should, in fact, be applied to practice. Early estimates were that it could take anywhere from 10 to 30 years for research to be implemented in clinical practice. What we do not know is whether the focus on evidence-based practice as an important model for research dissemination has reduced the gap. The diffusion of innovation model has provided support for our understandings of the necessary components of change. Informing clinicians of the research is not sufficient, but it is the recognized first step. Understanding the research is the next step. One recent initiative in support of bringing the researchers and clinicians together for dialogue was sponsored by the Robert Wood Johnson Foundation through “Author in the Room” (Robert Wood Johnson Foundation, 2007). Through this initiative, 15 monthly telephone conference calls were held between authors of recently published research articles and 3,517 health care practitioners (52% were physicians or nurses). Importantly, these practitioners reported that they would change their practice based on the discussion in the calls. This Author in the Room initiative is a demonstration of a key link in the dissemination process and a model for bridging the gap between research and practice. Now the challenge is to continue the dialogue.

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References 

1. Robert Wood Johnson Foundation . Cutting lag time in implementing findings JAMA authors discuss research with health care practitioners during conference calls. Retrieved October 6, 2007 from http://www.rwjf.org/reports/grr/050951.htm2007;
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2. Rycroft-Malone J. The politics of the evidence based practice movements: Legacies and current challenges. Journal of Research in Nursing. 2006;11:95–108
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