If education and persuasion of doctors cannot close the gap between
evidence and practice, other strategies are needed. We believe that knowledge
translation is an important tool. Knowledge translation includes groups other
than doctors and investigates issues more comprehensively than CME and CPD
(). Below we describe
how knowledge translation differs from CME and CPD and why it is more
effective in producing change.
Differentiating features of continuing medical education (CME), continuing
professional development (CPD), and knowledge translation
Settings and tools—
Since knowledge translation focuses on
health outcomes and changing behaviour, it is set in the site of practice and
its social, organisational, and policy environment rather than in learning
situations. Furthermore, it identifies best evidence and pathways that make it
easier for the target individual or group to follow this evidence. The
production of these aids to knowledge translation, called tools or toolkits,
of the process of knowledge translation are different
from those of CME and CPD. These two models both focus on groups of physicians
seeking to accrue credits, although CPD may permit a greater emphasis on team
and other group
Knowledge translation, however, allows attention to be given to all possible
participants in healthcare practices, including patients, consumers, and
Few models of CPD include
Content—The traditional clinical content of CME has given
way to more practice based behaviours encompassed by CPD. In turn, knowledge
translation builds on these areas, primarily by using evidence based research.
Furthermore, as knowledge translation is less learner driven than CME and CPD,
it permits a greater emphasis on initiatives to improve population health such
as screening, early diagnosis, and preventive measures.
Primary operating models—
In CME, the major driver (despite
the conscientious efforts of CME providers) remains the teacher, using 50 year
to be guided by more self directed or organisational learning principles. Both
are predicated on a simple linear model linking learning to relicensing and
recertification and only tangentially to performance or healthcare outcomes.
In contrast, knowledge translation reflects the considerations of both the
practitioner-learner and the educational or clinical policy provider or
This more holistic view makes it easier to close the gap between evidence and
practice (see below).
Interdisciplinarity—Given the multidimensional problems
inherent in closing the care gap, any studies of knowledge translation must
involve people from all relevant disciplines. Models of CME and CPD have
benefited from the expertise of educators, clinicians, social and educational
psychologists, for example. Knowledge translation can be enriched by people
with training in informatics, patient education, organisational learning,
social marketing, continuous quality improvement, and a host of others.