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Knowledge gap: Most physicians are unaware that research exist in this area. They have not thought about developing an approach to this area.
Skills gap: Most physicians have not had the opportunity to practice their skills in the area.
External gap: A perception that it would take too much time to learn this skill.
Motivational gap: Physicians often react emotionally and may believe that it is simply easier to discharge the patient form care.

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Lack of readiness for clinical practice: Skills gap
Clinical sites may have different protocols/limited time for students to learn: External gap

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knowledge gap - unable to assess morbidity/long term affects of poor lifestyle habits compared to risk of dying from covid, lack of understanding how current changes in daily routine and isolation can even impact risk/ probability of poor outcome if covid is contracted, 

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knowledge gap - unable to assess morbidity/long term affects of poor lifestyle habits compared to risk of dying from covid, lack of understanding how current changes in daily routine and isolation can even impact risk/ probability of poor outcome if covid is contracted, 

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communication gap
- messaging on fear, staying apart, "doing your part", being safe, doing what is right is all focused on covid only and staying in your house, with no accompanying message that fosters an understanding that these changes should have countermeasures where individuals and families take extra efforst to maintain their health in all spheres

motivation gap
- people may be already depressed or down and cannot find the extra energy or focus to devote to healthy changes

external gap
- there are alot of barriers in place to healthy living, and nothing being done to facilitate it, rather it seems to be discouraged if anything in favour of the constant narrow message that staying home and isolating is the only thing that is going to help/save others and ourselves

JR

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Knowledge gap: clinicians not recognizing the specific skills and tools for managing these conversations. Also lack of knowledge about the significant impact on patient outcomes and resource utilization when they are done well (or done at all).

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Knowledge gap: clinicians not recognizing the specific skills and tools for managing these conversations. Also lack of knowledge about the significant impact on patient outcomes and resource utilization when they are done well (or done at all).

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Skill gap: lack of ability to identify when certain skills and tools should be implemented and actually perform them adequately.
Motivation: significant ambivalence in engaging in these conversations since they evoke emotions and difficult moments.
External issues: perceived lack of time, busy clinics

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The gap is both External and Motivational
1. COVID restrictions shut down non-essential visits which were triaged to include screening. COVID spacing of patients and cleaning of rooms lead to restricted in-person visits which put screening at a lower priority than emergent symptoms.
Patients afraid of COVID infection were reluctant to pursue asymptomatic screening in doctors' offices.
Reminder letters from CCO were put on hold so patients interpreted this as unnecessary.
2. Overwhelmed with mental health burden increases of 400% and other backlog throughout Family Medicine pushed motivation to seek screening as much lower priority. A sense of apathy in the overwhelmed, overworked environment decreased motivation to achieve this priority.

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knowledge - may/may not have been part of nursing school learning or knowledge may not have been used since (rusty!)

skill - nurses don't often use do a 'full' history and assessment in most settings as MDs/technology/supports available

motivation -  nurses are unaware of how important this baseline knowledge/skill is in low resource setting (until they arrive) so don't see value of learning

external - expectations that any nurse, with any background can learn how to do this work in 6 weeks. many competing demands/stressors (new community, far from family/supports, worries about pay, etc)

communication - nurses aren't always told before they come how they can prepare themselves, difficult to communicate the 'context' of their work in a way that translates into learning needs

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Incorrect death certificates leading to incorrect death statistics

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Incorrect death certificates leading to incorrect death statistics

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Louise McN-F
Knowledge gap in that the expectations for a well written document are not clearly outlined.
Motivation gap as not enough time with so many conflicting duties. The importance of the document is not known, and there is no feedback (positive or negative) once completed.
External/environment - "just get it done, so you can go see a patient who is still alive and needs your care". Information for completion is not available at the time you are actually completing the form. Instructions are on the back of the death certificate "in fine print"

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Knowledge gap --> lack of knowledge around exercise counseling, strategies for safe exercise in diabetes, and encouraging adherence with exercise.
Attitudinal gap --> health care providers don't believe that patients will stick with exercise; asking about and counseling about exercise takes too much time.

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Adult education skills for those doing training at social service agencies

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Adult education skills for those doing training at social service agencies

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Knowledge and Skill Gap in terms of actual “science” behind and how to apply it; but also Environmental as usually these individuals already have full time jobs and delivering “training” is an add on to their already busy schedules, so even if they were self-motivated to learn more about how to do it, they may not have been able to find the time. For similar reasons there may be Motivational issues in that if they’ve been told they have to do this training, they may not want to actually improve their skills.

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Both an educational gap and a motivational gap. Parents do not believe that toboganning is dangerous (education) and there is pressure from their kids who do not want to wear helmets if others are not. The cost is also the issue.

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Daman has skill gap not understanding that she needs three pieces of equipment
Knowledge has not completed e modele to use machine
Motivation no practice
External gap not enough ntime to comp;lete

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Gap can be both skills and knowledge. Some examples...
Knowledge: good knowledge around regulations and legal requirements in what may be a new practice location
Skills: communication skills when patient expectations and available resources don't line up, when disclosure needs to occur, or when personality issues come in to play may not yet have been acquired/practiced

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For my example, the gap is a communication gap as well as motivational since it appears people have difficulty understanding what essential travel is as well as why should they listen to the travel ban. It seems to be rare that the gap is one dimensional.

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1. Skill gap - patients need to practice using the virtual platforms
2. Knowledge gap - patients don't know how to use these platforms
3. Motivation gap - patients maybe overwhelmed by all the requirements and do not understand why phone calls are not adequate
4. external factor - patients may not have suitable devices or wifi needed to support these platforms
5. Communication gap - patients are not given any instructions on how to use these virtual platforms

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Knowledge gap: Primary care providers may not know that a diagnosis can be made clinically and treatment initiated without surgery first. They also may not feel comfortable prescribing some of the newer medications. Patients may think it's normal to have painful periods and have never heard of endometriosis

Attitude gap: Primary care providers may be busy so its easier to refer to a specialist rather then trying to manage the condition themselves

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Knowledge gap in two ways: 1) faculty don't recognize their items are not good, in part because 2) they do not know what constitutes a good MCQ or the guidelines for writing stronger MCQ.
Skill gap: even if they are aware their items are not good they do not have the experience of writing good items or getting feedback to improve their current items.
Motivation gap: may be an issue as learning a new skill takes time and there is always such a crunch for time.

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Knowledge gap - "Feel" and "Move" aspect of the MSK exam
Skill gap - unable to practice physical exam
Access gap - Pandemic restrictions

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Patient information

- Knowledge gap
- Access

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HAs not received training in the use of glucometer

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Knowledge gap wrt triage guidelines, Motivational gap - huge practice change (among many others) due to pandemic, Skill gap - may need more practice using online tool, Environmental gap - more challenging to get bedside help from a colleague due to PPE and physical distancing rules.

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Kataryna N - If you're not signed into Padlet, please remember to preface your post with your first name and last initial.