Continuing Education and Professional Development Practice Gap & Educational Need Guide

Purpose

Accredited continuing education activities should be designed to address an identified professional practice gap. Before developing content, planners should determine:

• What is happening now?
• What should be happening?
• Why does the gap exist?
• What do learners need to improve?

The answers to these questions help establish the educational need and guide the development of learning objectives, educational strategies, and outcomes.

What Makes a Good Professional Practice Gap?

A professional practice gap should represent a difference between current and desired practice that affects:

• Professional performance
• Team performance
• Patient care
• Safety
• Quality
• Healthcare delivery
• Patient, family, or population health outcomes

A gap should be supported by evidence, data, observations, or documented needs and should be appropriate for educational intervention.

The identified gap should have a measurable or observable impact on patient outcomes, patient experience, caregiver experience, healthcare quality, safety, population health, or healthcare delivery.

Step 1: Identify the Professional Practice Gap

A professional practice gap is the difference between current practice and the desired state of practice.

Current Practice → Desired Practice → Gap

Example

Ask

• What is happening now?
• What should be happening?
• Is there evidence that a gap exists?

Supporting Data

Whenever possible, identify:

• Current performance level
• Desired performance level
• Data source
• Relevant benchmark, guideline, or standard

Topic vs. Professional Practice Gap

A topic alone does not identify a professional practice gap.

Tip: A topic identifies the subject. A professional practice gap identifies the problem that needs to be addressed.

Step 2: Describe Current Practice

Document what is currently occurring in practice.

Possible Sources

• Chart audits
• Quality improvement data
• Safety reports
• Learner surveys
• Peer review findings
• Benchmarking data
• Regulatory findings
• Literature reviews

Examples:

• Sepsis screening is completed inconsistently across inpatient units.
• Central line maintenance documentation varies across departments.
• Medication reconciliation is not consistently completed at discharge.
• Asthma education provided to patients and families varies among care teams.
• Screening and referral for social determinants of health occurs inconsistently across clinics.

Step 3: Describe Desired or Evidence-Based Practice

Describe the desired state based on:

• Clinical guidelines
• Standards of care
• Regulatory requirements
• Evidence-based practices
• Quality benchmarks

Example

National guidelines recommend routine developmental screening for all eligible children during specified well-child visits.

Step 4: Identify Why the Gap Exists

Understanding the root cause helps determine whether education is the appropriate intervention.

Common Causes of Practice Gaps:

Knowledge

Learners do not know or understand the information.

• Examples:
  • Nurses are unfamiliar with updated central line maintenance recommendations.
  • Physicians are unaware of recent sepsis guideline changes.
  • Pharmacists are unfamiliar with revised antimicrobial stewardship recommendations.

Competence

Learners know the information but are uncertain how to apply it.

• Examples:
  • Physician Assistants understand sepsis criteria but lack confidence in escalating care.  
  • Social workers are uncertain how to integrate screening results into referral workflows.
  • Pharmacists need support applying evidence-based prescribing recommendations.

Skill

Learners require technical or procedural training.

• Examples:
  • Nurses require hands-on practice performing ultrasound-guided vascular access care.
  • Respiratory therapists need training on new ventilator equipment.
  • Physicians require practice using point-of-care ultrasound techniques.

Performance

Learners know what to do and how to do it but are not consistently applying it in practice.

• Examples:
  • Medication reconciliation is not consistently completed at discharge.
  • Sepsis huddles are not initiated according to protocol.
  • Standardized pain assessments are not routinely documented.

Team Performance

Challenges exist within communication, collaboration, or care coordination.

• Examples:
  • Communication between inpatient and outpatient teams is inconsistent during transitions of care.
  • Care teams do not consistently follow escalation pathways for deteriorating patients.
  • Interprofessional rounding practices vary across departments.

Patient Outcomes

The gap contributes to less-than-optimal patient, family, or population health outcomes.

• Examples:

• Delayed recognition of clinical deterioration contributes to increased ICU transfers.
• Inconsistent asthma education contributes to increased emergency department utilization.
• Variability in discharge education contributes to higher readmission rates.

System Factors

Workflow, technology, staffing, policies, resources, or organizational barriers contribute to the gap.

• Examples:
  • Required documentation fields are missing from the electronic health record.
  • Staffing limitations affect compliance with care protocols.
  • Referral workflows are unclear or inconsistent.

Interprofessional Consideration: When multiple professions contribute to the identified gap, planners should consider whether an interprofessional education approach may improve collaborative practice, team performance, and patient outcomes.

Important Consideration

Education is not always the sole solution to a professional practice gap.

While continuing education can improve knowledge, competence, skills, performance, and team performance, some gaps are influenced by factors that extend beyond learner behavior. These factors may include workflow design, staffing, processes, technology, policies, resource availability, organizational culture, or system-level barriers.

When system factors contribute to a professional practice gap, education should be considered as one component of a broader improvement strategy. Additional interventions such as workflow redesign, policy updates, process improvement initiatives, technology enhancements, quality improvement projects, decision-support tools, or resource allocation may also be necessary to achieve the desired change in practice.

Ask: If every learner successfully completed this activity and applied what they learned, would the gap be resolved? If the answer is no, additional non-educational interventions may be needed alongside education.

Example

Effective educational planning addresses what learners need to know, do, or improve. However, sustainable practice changes often require a combination of education, quality improvement, process redesign, and organizational support. Education can close knowledge and competence gaps, but system-level barriers may require additional interventions to achieve meaningful improvements in patient care and outcomes.

Step 5: Determine the Educational Need

An educational need describes what learners need to know, do, or improve to address the underlying causes of a professional practice gap. Educational needs may involve knowledge, competence, skill, performance, team performance, or system factors.

Educational Need Statement

A strong educational need statement explains what learners need to learn, apply, or improve to help close the identified professional practice gap.

Common Formula:

Learners need to improve their ability to __________ in order to __________.

Examples

Knowledge

• Learners need increased knowledge of current pediatric sepsis recognition guidelines.
• Learners need increased knowledge of evidence-based antimicrobial stewardship principles.

Competence

• Learners need to improve their ability to apply pediatric sepsis screening criteria during patient assessment.
• Learners need to improve their ability to interpret and act on medication reconciliation findings during transitions of care.

Skill

• Learners need hands-on practice using point-of-care ultrasound to support clinical decision-making.
• Learners need to improve their ability to perform evidence-based central line maintenance procedures.

Performance

• Learners need support implementing evidence-based asthma discharge education practices consistently across outpatient settings.
• Learners need strategies to improve adherence to institutional sepsis escalation protocols.

Team Performance

• Interprofessional team members need to strengthen communication and care coordination during patient transitions.
• Healthcare teams need to improve collaboration when escalating care for deteriorating patients.

Patient Outcomes

• Learners need strategies to improve early recognition of clinical deterioration to support improved patient outcomes.
• Care teams need to improve implementation of evidence-based practices associated with reduced readmissions.

System Factors

• Learners need strategies to integrate medication reconciliation into existing workflow processes.
• Teams need approaches for utilizing electronic health record tools to support evidence-based practice.

Key Reminder

A professional practice gap identifies the problem.

A cause of the gap identifies why the problem exists.

An educational need identifies what learners need to know, do, or improve to help address the problem.

Educational needs identify what learners need to know, do, or improve to address the underlying causes of a professional practice gap. Educational needs may involve knowledge, competence, skill, performance, team performance, or system-based factors.

Connection to Outcomes

The identified educational need should align with the expected outcome of the activity.

Educational Need vs. Learning Objective

Example

Educational Need:

• Learners need to improve their ability to recognize early signs of pediatric sepsis.

Learning Objective:

• Apply evidence-based pediatric sepsis screening criteria during patient assessment.

Professional Practice Gap vs. Cause vs. Educational Need

Example: Complete Practice Gap Analysis

Current Practice

• Developmental screening is completed for approximately 65% of eligible patients during routine well-child visits.

Desired Practice

• Developmental screening should be conducted for all eligible patients according to current evidence-based guidelines.

Professional Practice Gap

• Developmental screening is not consistently performed according to current recommendations.

Cause of Gap

• Providers understand the importance of screening but lack confidence selecting and implementing screening tools.

Educational Need

• Learners need to improve their ability to apply developmental screening recommendations and integrate screening tools into routine clinical workflows.

Common Mistakes

❌ Listing a topic instead of a gap.

• Example: "Pediatric Asthma"

✅ Describe the actual gap.

• Example: Evidence-based asthma action plans are not consistently provided at discharge.

❌ Describing the educational activity.

• Example: "Staff need a lecture on infection prevention.”

✅ Describe the educational need.

• Example: Staff need to improve adherence to evidence-based infection prevention practices.

Quick Planning Checklist

Before proceeding to learning objectives, confirm that:

☐ The professional practice gap is clearly described.

☐ Current and desired practice have been identified.

☐ Evidence or data supports the gap.

☐ The root cause(s) of the gap have been identified.

☐ Educational need(s) align with the cause(s) of the gap.

☐ The educational activity is designed to help close the identified gap.

☐ Expected outcome level(s) have been identified.

☐ Interprofessional team members affected by the gap have been considered.

☐ Education can reasonably contribute to closing the identified gap.