Whose problem is it anyway? Confronting myths of 'problems' in health professions education

Introduction: The growing interest in knowledge translation and implementation science, both in clinical practice and in health professions education (HPE), is reflected in the number of studies that have sought to address what are believed to be evidence-practice gaps. Though this effort may be intended to ensure practice improvements are better aligned with research evidence, there is a common assumption that the problems researchers explore and the answers they generate are meaningful and applicable to practitioner needs. Methods: This Mythology paper considers the nature of problems from HPE as the focus of HPE research and the ways in which they may or may not be aligned. The authors argue that, in an applied field such as HPE, it is vital that researchers better understand how their research problems relate to practitioner needs and what the limitations on evidence uptake might be. Not only can this establish clearer paths between evidence and action, but it also requires a rethink of much of knowledge translation and implementation science thinking and practice. Results: The authors explore five myths: whether everything in HPE is a problem; whether practitioner needs involve problem solving; whether practitioner problems are resolvable with sufficient evidence; whether researchers effectively target practitioner problems; and whether studies that focus on solving practitioner problems make significant contributions to the literature. Conclusions: To advance the conversation on the connections between problems and HPE research, the authors propose ways in which knowledge translation and implementation science might be approached differently.