Mind the Gap: Bridging the Knowledge-to-Practice Gap in Nursing

This dissertation explores the persistent gap between knowledge acquired during training and its application in nursing practice—commonly referred to as the knowledge-to-practice or knowledge-to-action gap. Using the Dynamic Transfer Model as a theoretical framework, the research investigates how personal, contextual, and training-related factors influence the transfer of training in nursing practice.

The study highlights that continuing professional development (CPD) is essential for maintaining high-quality nursing care, especially in the face of increasing healthcare complexity and workforce shortages. However, CPD efforts often fail to translate into behavioral change due to misalignment between training content, workplace conditions, and individual nurse needs.

Six studies were conducted, including qualitative research, a scoping review, a case study, and the development and validation of a new measurement tool: the Integrated Measure for Training Transfer in Nursing Practice (IMTT-NP). This instrument combines adapted versions of the Learning Transfer System Inventory (LTSI) and the Learning Climate Questionnaire (LCQ), and was validated among over 1,500 nurses in Dutch teaching hospitals. It enables assessment of nurses’ perceptions regarding training transfer across personal, contextual, and training-related domains.

Key findings include:

Collaboration is critical: Training transfer fails when nurses, managers, and educators do not align their strategies or support each other. Organizational culture and leadership play a pivotal role in enabling learning to be applied.

Different nursing groups have different needs: Newly graduated nurses, experienced nurses, and those aspiring to advanced roles face distinct barriers and facilitators in CPD. Tailored strategies are required to support each group effectively.

Use the IMTT-NP to assess influencing factors of training transfer in nursing practice.

The dissertation concludes that an integrative approach is necessary to bridge the knowledge-to-practice gap. This includes methodological tools like the IMTT-NP, recognition of diverse nursing profiles, and structural collaboration between stakeholders. Investing in nurses’ professional development is not only vital for retention and satisfaction but also for ensuring sustainable, high-quality patient care.