Is There a Problem With Evidence in Health Professions Education?


Rachel H. Ellaway, R.H. Ellaway is professor, Department of Community Health Sciences, and director, Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID:
Bridget C. O'Brien, B.C. O'Brien is professor, Department of Medicine, and education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California; ORCID:
Jonathan Sherbino, J. Sherbino is professor, Department of Medicine, and assistant dean of health professions education research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Lauren A. Maggio, L.A. Maggio is professor, Department of Medicine and Health Professions Education, Uniformed Services University, Bethesda, Maryland; ORCID:
Anthony R. Artino, A.R. Artino Jr is professor, Department of Health, Human Function, and Rehabilitation Sciences, and associate dean for educational research, School of Medicine and Health Sciences, George Washington University, Washington, DC; ORCID:
Laura Nimmon, L. Nimmon is scientist, Centre for Health Education Scholarship, and associate professor, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada; ORCID:
Yoon Soo Park, Y.S. Park is Ilene B. Harris Endowed Professor and head, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois; ORCID:
Meredith Young, M. Young is associate professor, Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; ORCID:
Aliki Thomas, A. Thomas is associate professor, School of Physical and Occupational Therapy and Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; ORCID:

Document Type

Journal Article

Publication Date



Academic medicine : journal of the Association of American Medical Colleges




What constitutes evidence, what value evidence has, and how the needs of knowledge producers and those who consume the knowledge produced as evidence might be better aligned are questions that continue to challenge the health sciences. In health professions education (HPE), debates on these questions have ebbed and flowed with little sense of resolution or progress. In this article, the authors explore whether there is a problem with evidence in HPE using thought experiments anchored in Argyris' learning loops framework.From a single-loop perspective ("How are we doing?"), there may be many problems with evidence in HPE, but little is known about how research evidence is being used in practice and policy. A double-loop perspective ("Could we do better?") suggests expectations of knowledge producers and knowledge consumers might be too high, which suggests more systemwide approaches to evidence-informed practice in HPE are needed. A triple-loop perspective ("Are we asking the right questions?") highlights misalignments between the dynamics of research and decision-making, such that scholarly inquiry may be better approached as a way of advancing broader conversations, rather than contributing to specific decision-making processes.The authors ask knowledge producers and consumers to be more attentive to the translation from knowledge to evidence. They also argue for more systematic tracking and audit of how research knowledge is used as evidence. Given that research does not always have to serve practical purposes or address the problems of a particular program or institution, the relationship between knowledge and evidence should be understood in terms of changing conversations, as well as influencing decisions.


Health, Human Function, and Rehabilitation Sciences