Important conceptual and measurement issues with regard to research utilization could be better addressed if research in the area were undertaken longitudinally by multi-disciplinary teams of researchers.

Several studies have been published listing sources of practice knowledge used by nurses. However, the authors located no studies that asked clinicians to describe comprehensively and categorize the kinds of knowledge needed to practice or in which the researchers attempted to understand how clinicians privilege various knowledge sources. In this article, the authors report findings from two large ethnographic case studies in which sources of practice knowledge was a subsidiary theme. They draw on data from individual and card sort interviews, as well as participant observations, to identify nurses' sources of practice knowledge. Their findings demonstrate that nurses categorize their sources of practice knowledge into four broad groupings: social interactions, experiential knowledge, documents, and a priori knowledge. The insights gained add new understanding about sources of knowledge used by nurses and challenge the disproportionate weight that proponents of the evidence-based movement ascribe to research knowledge.

Nurses are more likely to value interpersonal contact, and prefer to use personal experience and communication with colleagues and patients rather than on-line and traditional sources of practice knowledge. In order for an information source to be seen as valuable in the clinical setting, contextually relevant information needs to be accessed quickly and efficiently. Energies should be focused on constructing information systems that address the particular needs of nurses.

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We still do not really know enough about the management of change. What level do we go in? Top? Bottom? Up and down? Sides to middle? Is it better to work through the practitioners or to impose practice edicts from above? Does reading research, exposure to research appreciation courses, attending research skills courses, doing 'hands-on' research produce a quasi-researcher or a research-based practitioner? Should we use quality circles as a major method of managing change? Dutch experience would suggest that we should.What is clear is that the whole process is found to be more complex and difficult than any of us imagine when we blithely talk about a wholesale change to research-based practice. We can only strive to make the labourers worthy of their hire and hope that the fruits justify their labours.