What Is Implementation Science and What Forces Are Driving a Change in Medical Education?

Abstract

Evidence-based interventions to improve health care and medical education face multiple complex barriers to adoption and success. Implementation science focuses on the period following research dissemination, which is necessary but insufficient to address important gaps in clinician performance and patient outcomes. This article describes the forces on health care institutions, medical schools, physician clinicians, and trainees that have created the imperative to design educational interventions to address the gap between evidence and practice. These forces include accreditation, certification, licensure, and regulatory and research funding initiatives focused on improving the quality of health professions education and clinical practice. Medical educators must expand their focus on "what to change" to include "how to change" in order to prepare health care professionals and institutions to effectively adopt new evidence-based practices to improve patient, and ultimately population, outcomes.

Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial

“…The actions resulting from a positive screen may be inadequate, poorly timed, or incorrectly targeted to effect change in individuals at risk of delirium. Optimal methods to embed evidence‐based practice into routine clinical care are the subject of scrutiny through implementation science . In basic terms, this study used the common “diffusion of innovation” approach to implementing delirium screening and actions on the basis of a positive screen .…”

“…Optimal methods to embed evidence-based practice into routine clinical care are the subject of scrutiny through implementation science. 23,24 In basic terms, this study used the common "diffusion of innovation" approach to implementing delirium screening and actions on the basis of a positive screen. 25 The disappointing findings in this study could represent inadequate attention to knowledge transfer.…”

Tensions and critical aspects of the implementation of school climate policies, in Chile

“…El marco conceptual que guía esta investigación es el de las ciencias de la implementación. Las ciencias de la implementación (implementation sciences) han sido popularizadas en el ámbito científico durante los últimos 10 años y se refieren al estudio de métodos necesarios para llevar la evidencia y conocimiento científico a la práctica (Eccles & Mittman, 2006;Smith & Polaha, 2017;Thomas et al, 2016). Es por lo anterior que las ciencias de la implementación también han adquirido relevancia en otras disciplinas tales como la psicología, el marketing y las ciencias políticas (Foy et al, 2015;Rabin et al, 2012).…”

“…Puntualmente, las ciencias de la implementación ofrecen un método sistemático que puede contribuir a la instalación y evaluación del éxito o fracaso de planes, programas y políticas públicas (Tabak, Khoong, Chambers & Brownson, 2012;Thomas et al, 2016). Lo anterior, con el objetivo de mejorar la calidad, eficiencia (en tiempo y recursos) y efectividad de ellos (Eccles & Mittman, 2006;Smith & Polaha, 2017).…”

The Need and Curricula for Health Professions Education Graduate Programs

“…Students are being prepared for a system that no longer exists, and the report emphasizes that education should be structured to produce lifelong learners across the continuum of health professionals’ practice (National Academies of Sciences and Medicine, 2016). Nevertheless, there exists a tremendous amount of experimentation and examples of reform related to interprofessional education (Lutifyya, Brandt, & Cerra, 2016), social determinants of health (Lypson, Woolliscroft, Roll, & Spahlinger, 2016), evidence‐based practice (Thomas et al., 2016), continuing professional development (Balmer, 2012), and lifelong learning (Mylopoulos, Bridges, Woods, Manzome, & Schwartz, 2016).…”