Evidence-Based Practice and Knowledge Translation

Evidence-based practice and knowledge translation is the topic concerned with how research findings are appraised, integrated with professional judgement and community context, and actually moved into routine public health and nursing practice. It joins two linked ideas: that practice should be informed by the best available evidence, and that closing the gap between what is known and what is done requires deliberate translation strategies.

Definition

Evidence-based practice is the integration of the best available research evidence with professional expertise and the values and context of the population served; knowledge translation is the set of methods by which such evidence is moved into routine practice and policy.

Scope

This topic covers the definition and steps of evidence-based practice, the special challenges of evidence in public health, and the science of knowledge translation and implementation. It introduces frameworks such as knowledge-to-action and the field of implementation science. It is educational and reference material on appraisal and translation method, not a clinical protocol.

Core questions

• What does it mean for public health practice to be evidence-based?
• Why does a gap persist between research evidence and routine practice?
• How do knowledge-translation frameworks structure the move from knowledge to action?
• How should evidence be judged when randomised trials are unavailable?

Key concepts

• Best available evidence
• Critical appraisal
• Evidence-practice gap
• Knowledge translation
• Implementation science
• Evidence-based public health
• Context and adaptation

Key theories

Knowledge-to-action framework

Graham and colleagues' model distinguishing knowledge creation from an action cycle of adapting knowledge to local context, assessing barriers, selecting and tailoring interventions, monitoring use and sustaining change, to make knowledge translation explicit.

Mechanisms

Evidence-based practice was defined by Sackett and colleagues as integrating best research evidence with clinical expertise and patient or population values, and proceeds through asking a question, acquiring evidence, appraising it, applying it and assessing the result. Knowledge translation addresses why this evidence often fails to reach practice, framing the gap as a problem to be managed through deliberate strategies; the knowledge-to-action framework maps creation and an action cycle of adaptation, barrier assessment, tailored intervention and sustainment. Implementation science studies the methods that promote uptake systematically. In public health, evidence must often be drawn from observational and theory-based sources rather than trials, requiring fit-for-purpose appraisal.

Clinical relevance

This topic explains how evidence is appraised and moved into practice and policy rather than how an individual should be treated. It is reference material on appraisal and translation method, informing how professionals use research; it is not individualised clinical guidance.

Evidence & guidelines

Sackett and colleagues' definition of evidence-based medicine anchors the field, while Graham and colleagues' knowledge-to-action framework and the launch of the journal Implementation Science (Eccles and Mittman) mark the maturation of translation and implementation as distinct sciences. Petticrew and Roberts argue that evidence hierarchies built for clinical questions fit public health questions poorly, supporting a 'horses for courses' approach to appraisal.

History

Evidence-based medicine was named and defined in the 1990s, with Sackett and colleagues' 1996 editorial a touchstone, and the idea soon extended into nursing and public health. As it became clear that good evidence often failed to change practice, knowledge translation emerged in the 2000s, with Graham and colleagues' 2006 knowledge-to-action map and the 2006 founding of Implementation Science consolidating a research field devoted to closing the evidence-practice gap.

Debates

Do clinical evidence hierarchies fit public health questions?

Ranking randomised trials above other designs suits some clinical questions but fits poorly for many public health and policy questions, where observational and theory-based evidence may be the only or most appropriate source.

Key figures

• David L. Sackett
• Ian D. Graham
• Sharon E. Straus
• Martin P. Eccles

Seminal works

• sackett-1996
• graham-2006

Frequently asked questions

What is knowledge translation?

Knowledge translation is the set of deliberate methods used to move research findings into routine practice and policy, addressing the persistent gap between what is known and what is done.

Is evidence-based practice just about randomised trials?

No. It means integrating the best available evidence with professional expertise and the population's context; in public health that evidence is often observational or theory-based rather than from trials.