A "practice gap" refers to a problem that exists in practice or an opportunity for improvement in at least one of the following areas:
Practice gaps are the "building blocks" of an educational activity, in that they form the foundation to its justification, design, implementation, and assessment. These can be clinically based, professional (for example, leadership skills), patient care problems, or any similar areas in which learner improvement is necessary.
Conducting a gap analysis helps to identify the necessity for the educational activity, which frames the resulting learning objectives, selection of the appropriate teaching methods, format to achieve these objectives, and implementation of evaluation/assessment methods to measure the effectiveness of the educational activity.
Identifying gaps in practice for learners is essential in planning and developing Continuing Medical Education (CME) activities and helps to address the underlying educational needs (in knowledge, competence, and/or performance) that will close those identified gaps. Practice gaps are often phrased as deficits in a given area. Some examples of practice gaps include:
Practice gaps can be identified through the process of a gap analysis. Performing a gap analysis helps to identify the necessity for the educational activity, frame learning objectives, select the appropriate teaching methods and format to achieve these objectives, and implement the most appropriate evaluation/assessment methods to measure the effectiveness of the educational activity.
Practice problems or gaps can be defined as the difference between what a learner currently knows and is doing (current practice) and what he or she should know and do (best practice). Therefore, the first step in a gap analysis is to define each component:
The space between the best practice (the answer to the question "What should be happening?") and the current practice (the answer to the question "What is currently happening?") reveals the gap (the answer to the question "What is the difference between what is and should be happening?").
Another way to approach a gap analysis is by answering the following questions:
Below are common methods used to determine best practices and resulting practice gaps:
The first three questions on the ACS CME Application section "Educational Activity Details" pertain to practice gaps and underlying educational needs that must be addressed when planning and developing a CME activity:
When identifying practice gaps and the underlying educational needs, consider how an educational activity that addresses both should be designed. The resulting educational intervention must relate to increasing learner knowledge, competence, and/or performance (ACCME "Designed to Change" Requirement).
With at least one of these areas in mind, develop corresponding learning objectives.
Learning objectives clearly state what the learner will be able to do upon completion of a CME activity. Keeping the intended outcomes in mind when developing an educational activity helps to guide its structure and design, including the selection of educational formats and content that promote the achievement of these goals. Answering the question "What is the best format for teaching and learning the concepts to be presented?" may help in selecting the most effective educational format. Examples include:
The ACS CME Application contains questions related to each of these areas in order to prompt thoughtful consideration during the planning of the educational activity. In addition, learning objectives inform which evaluation and assessment tools should be utilized after an educational intervention, which help measure to which extent the intended goals were met. Refer to more information regarding writing effective learning objectives.
ACCME. Addressing Practice Gaps. July 5, 2016. Available at: https://www.accme.org/resources/video-resources/accreditation-requirements/addressing-practice-gaps. Accessed May 2020. Wittich CM, Chutka DS, Mauck KF, Berger RA, Litin SC, Beckman TJ. Perspective:
A practical approach to defining professional practice gaps for continuing medical education. Acad Med. 2012;87(5):582‐585. doi:10.1097/ACM.0b013e31824d4d5f