Bridging the Chasm: Challenges, Opportunities, and Resources for Integrating a Dissemination and Implementation Science Curriculum into Medical Education

Abstract

Background:Physicians are charged with implementing evidence-based medicine, yet few are trained in the science of Dissemination and Implementation (D&I). In view of the potential of evidence-based training in D&I to help close the gap between research and practice, the goal of this review is to examine the importance of D&I training in medical education, describe challenges to implementing such training, and provide strategies and resources for building D&I capacity.Methods:We conducted (1) a systematic review to identify US-based D&I training efforts and (2) a critical review of additional literature to inform our evaluation of the challenges and opportunities of integrating D&I training in medical education.Results:Out of 269 unique articles reviewed, 11 described US-based D&I training. Although vibrant and diverse training opportunities exist, their capacity is limited, and they are not designed to meet physicians’ needs. Synthesis of relevant literature using a critical review approach identified challenges inherent to changing medical education, as well as challenges related to D&I science. Finally, selected strategies and resources are available for facilitating incorporation of D&I training into medical education and overcoming existing challenges.Conclusions:Integrating D&I training in the medical education curriculum, and particularly in residency and fellowship training, holds promise for bridging the chasm between scientific discoveries and improved patient care and outcomes. However, unique challenges should be addressed, including the need for greater evidence.

What hinders and helps academics to conduct Dissemination and Implementation (D&I) research in the field of nutrition and physical activity? An international perspective

“…This is potentially unsurprising given the number of training schemes available to support D&I research in the USA compared to other countries, and a long history of USA funding schemes to support research translation through the National Institutes of Health (NIH) [19]. Nonetheless, consistent with this study, the importance of, and need for, increased expertise and training in D&I science, and research-practice translation more broadly across the health disciplines, has been well-documented [10,[19][20][21]. Skill and knowledge development is an integral part of capacity building in D&I research, in particular among junior and pre-doctoral students.…”

Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives

“…In the same year, an expert assessment on training opportunities in D&I was documented [ 59 ] together with a content analysis of D&I resources using public, web-based information [ 60 ]. More recently (in 2018–2019), studies have identified D&I training initiatives to help inform medical education [ 61 ], training needs in public health [ 62 ] and mental health [ 16 ], and a review of online D&I resources was performed [ 63 ]. Taking this evidence collectively, the value of D&I CBIs in developing and harnessing skills in implementation research and evidence translation can be seen.…”

“…Taking this evidence collectively, the value of D&I CBIs in developing and harnessing skills in implementation research and evidence translation can be seen. Taking the evidence individually, however, most of the research is geographically restrictive, focussing only on D&I CBIs in the USA [ 59 ] or the USA and/or Canada [ 16 , 55 , 61 , 63 ]. While one paper considered D&I training efforts on a global level [ 62 ], this was not the main aim of the work, and thus, information on the characteristics of the CBIs and gaps in training needs were understandably limited.…”

Building the Next Generation of Implementation Science Careers to Advance Health Equity

“…Implementation science research that addresses health equity must include collaborations across stakeholders (ie, researchers, practitioners, patients, organizations, and communities) that address diversity and the needs of the population including women, ethnic minorities, residents in rural areas, children, the elderly, and persons with disabilities. 21 Federal agencies and organizations with implementation research programs have supported a range of training and training resources including conferences, short-term learning institutes, mentoring and research training awards incorporating health disparities and health equity strategies that emphasize stakeholder and community-based collaborations. 22,23 NIH has partnered with many funders and stakeholders to advance the implementation science field 24,25 Current implementation science activities across NIH, federal agencies, and other organizations have steadily increased and include research and research training opportunities where health equity can be enhanced.…”