NUR 699: are literature gaps a help or hindrance to change?
A discussion posed as a binary that is not one — the answer depends on which kind of gap you found, and the rubric pays for synthesis rather than for picking a side.
Editorial process
Last reviewed · August 8, 2026
Why 'help or hindrance' is the wrong shape of question
The question is posed as a binary and it is not one, which is the first thing to notice and the easiest mark to collect. *Help or hindrance* invites a side to be picked; the defensible answer is that it depends entirely on what kind of gap you have found, and that distinction is what the post should be organised around. A gap because nobody has studied your population is a different object from a gap because six studies disagree, and both differ again from a gap because the studies are small, unblinded, and all from one setting. The first is an opportunity, the second is a warning, the third is a reason to look harder before changing anything. Open by naming the types of gap you will distinguish, then answer the question separately for each. That structure alone lifts a post out of the pile of one-paragraph opinions the rubric is designed to separate.
Take the *help* side seriously and make it specific to the change process rather than to research in general. A gap tells you where the boundary of the evidence sits, and knowing that boundary is what lets you scope a change proposal honestly: it decides how far the intervention can be generalised, which outcomes you can promise and which you can only monitor, and where you will need local data because published data does not exist. A gap also produces the PICOT question — the whole point of the literature review step in this course is to arrive at one — and a well-specified gap converts directly into a measurable aim. Frame gaps as the thing that makes a proposal *precise*, and the argument stops sounding like consolation and starts sounding like method. The test of this paragraph is whether a reader could name one decision in your own change project that a gap in the literature has already settled for you.
The *hindrance* side needs the same discipline, because the real hindrance is not that the evidence is thin — it is what a thin evidence base does to the people whose behaviour you are trying to change. Colleagues asked to alter a routine will reasonably ask what the evidence shows, and "there is a gap here" is a much weaker warrant than a strong trial. That affects stakeholder buy-in, the ethics of pilot design, and how far you can hold anyone accountable to an outcome that has never been demonstrated. It also raises a real risk: filling a gap with expert opinion, or with your own reasoning, and then presenting the result as evidence-based. Naming that risk explicitly is the single most clinically mature thing this post can do, because it is the failure mode the course is trying to train out of you rather than an abstract caution.
Once both sides are on the table, the post needs somewhere to land, and the honest landing is procedural rather than rhetorical. Practice change does not wait for the evidence to be complete, because it never is; what changes is how much certainty you claim and how tightly you monitor. Structured approaches exist for exactly this problem — GRADE separates the strength of a recommendation from the certainty of the evidence behind it, which is precisely the distinction the question is circling, and implementation models like the Iowa Model build a pilot-and-evaluate step in for the case where evidence is insufficient. Cite one and use its language. It converts an opinion into a defensible position, which is what the rubric means by critical analysis and synthesis rather than reflection. Say what you would monitor, and say what result would make you stop, because a change proposal without a stopping rule is not a proposal.
Two things about the rubric are worth reading before writing, because they carry nearly half the marks between them. The main posting is scored on reflection *with critical analysis and synthesis*, drawn from the module readings and current credible sources — synthesis meaning the sources talk to each other rather than appearing in sequence, so a post citing three studies that never meet earns less than one citing two that disagree and explaining why. And the response posts are separately scored, including for whether faculty questions are answered, so budget effort for them instead of treating them as an afterthought. Meeting the credible-sources expectation means current peer-reviewed work, not the textbook alone, and the citation belongs with the specific claim it supports rather than gathered at the end. Two sources used precisely will always score better here than five listed, which is worth knowing before you start reading.
Type of gap | What it actually tells you | Help or hindrance |
|---|---|---|
Nobody studied this population | The evidence boundary sits before your setting | Help — it defines the PICOT question |
Studies disagree | The effect may be real but context-dependent | Both — a reason to pilot, not to adopt |
Studies are small or weak | Certainty is low even where a direction exists | Hindrance — weak warrant for asking others to change |
Outcome never measured | You cannot promise what has not been demonstrated | Hindrance — limits the aim you can commit to |
No implementation evidence | The intervention works; nobody has embedded it | Help — the gap IS the project |
Evidence is old | Practice, technology or population may have moved | Both — grounds for local data collection |
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Distinguish kinds of evidence gap rather than treating 'a gap' as one thing.
- 02Connect the boundary of an evidence base to the scope of a change proposal.
- 03Separate strength of recommendation from certainty of evidence.
- 04Recognise where expert opinion is being presented as evidence.
Read the full question
Review every instruction before using the planning guidance that follows.
Course-wide instructions that accompany this question
Name: Discussion Rubric Grid View List View Excellent 90–100 Good 80–89 Fair 70–79 Poor 0–69 Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. Main Posting: Writing 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Posting: Timely and full participation 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date. 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date. 7 (7%) – 7 (7%) Posts main Discussion by due date. 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date. First Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. First Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. First Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Second Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. Second Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. Second Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Total Points: 100 Name: Discussion Rubric Important information for writing discussion questions and participation Hi Class, Please read through the following information on writing a Discussion question response and participation posts. Contact me if you have any questions. Important information on Writing a Discussion Question Your response needs to be a minimum of 150 words (not including your list of references) There needs to be at least TWO references with ONE being a peer reviewed professional journal article. Include in-text citations in your response Do not include quotes—instead summarize and paraphrase the information Follow APA-7th edition Points will be deducted if the above is not followed Participation –replies to your classmates or instructor NUR 699 GC Week 6 Discussion 1 A minimum of 6 responses per week, on at least 3 days of the week. Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article Each response needs to be at least 75 words in length (does not include your list of references) Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count. Follow APA 7th edition Points will be deducted if the above is not followed Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points. Here are some helpful links Student paper example Citing Sources The Writing Center is a great resource Welcome to class Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to. I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you. Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted. If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations. Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements. Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
What the evidence-gaps discussion post must contain
- 01A discussion post answering whether literature gaps help or hinder practice change.
- 02An argument for the help side, tied to the change process.
- 03An argument for the hindrance side, tied to stakeholders and certainty.
- 04A stated position that accounts for both.
- 05Synthesis across sources rather than a sequence of summaries.
- 06Current credible sources beyond the course text.
- 07Timely responses to peers and to faculty questions.
From kinds of gap to a position on changing practice
Refusing the binary
Name the kinds of gap the post will distinguish before answering anything.
How a gap helps a change proposal
Show a gap defining scope, generalisability and the PICOT question.
How a gap hinders one
Set out the effect of low certainty on buy-in, ethics and accountability.
Deciding under incomplete evidence
Use a structured approach to say how much certainty may be claimed.
Position and implications for the change project
Land the argument on what you would do in your own proposal.
Finding gap methodology, not just studies with gaps
Recommended databases
- PubMed Central
- CINAHL
- Cochrane Library
- Implementation science and health policy journals
Search sequence
- 1.Search the methodological literature on what a research gap is and how gaps are identified, because the post's whole structure depends on gaps being more than one kind of thing.
- 2.Search for guidance on recommending practice under low-certainty evidence, which is the material that turns 'it depends' into a defensible procedure.
- 3.Search implementation and practice-change literature in nursing specifically, so the hindrance argument is about real barriers rather than about abstract uncertainty.
- 4.Find one worked example of a practice change driven by an acknowledged gap, so the post has something concrete alongside its framework.
Evidence gaps, certainty and practice-change sources
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Key stakeholders' perspectives and experiences with defining, identifying and displaying gaps in health research
BMJ Open · 2020
The source that makes the post's central move possible: it shows that 'gap' is used to mean several different things by different stakeholders, and how gaps are actually identified and displayed. Cite it when you refuse the binary and set up your categories.
- 02
Evidence to Decision framework provides a structured “roadmap” for making GRADE guidelines recommendations
Journal of Clinical Epidemiology · 2018
For the section where the post has to land. It is the formal apparatus for recommending action when the evidence is incomplete, and it keeps the strength of a recommendation separate from the certainty of the evidence behind it — exactly the distinction the question is circling without naming.
- 03
Nurses' roles in changing practice through implementing best practices: A systematic review
Health SA Gesondheid · 2022
Evidence for the hindrance argument as something that happens to people rather than to a literature. It reviews what actually blocks nurses from implementing best practice, which lets you say why a thin evidence base is a practical obstacle and not only an epistemic one.
- 04
Using Implementation Science to Implement Evidence-Based Practice: A Discursive Paper
Journal of Advanced Nursing · 2025
Current and directly on the course's own subject. Use it to show that the gap between evidence and practice is itself a studied problem with methods attached, which is the strongest version of the 'gaps are a help' claim: the implementation gap is the project.
- 05
How fast is too fast? A practice change in umbilical arterial catheter blood sampling using the Iowa model
Advances in Neonatal Care · 2008
A worked example of a unit changing practice around an acknowledged evidence gap using the Iowa Model, including its pilot step. Concrete enough to anchor the abstract argument, and it demonstrates what 'proceed while monitoring' looks like in a real clinical setting.
Before the NUR 699 discussion post goes up
Common mistakes
- Answering the binary as posed and defending one side only.
- Treating every gap as the same kind of gap.
- Arguing gaps help because 'they show where more research is needed', with no mechanism.
- Describing the literature review process instead of answering the question.
- Citing sources in sequence with no synthesis, which the rubric names explicitly.
- Relying on the textbook where the rubric asks for current credible sources.
- Ignoring how a thin evidence base affects colleagues asked to change practice.
- Missing the risk of filling a gap with opinion and calling it evidence.
- Treating the peer and faculty responses as optional; they are separately scored.
Submission checklist
- At least two distinct kinds of gap are named and treated differently.
- The help argument is specific to creating change, not to research generally.
- The hindrance argument covers stakeholders as well as certainty.
- A position is stated, not just both sides described.
- Certainty of evidence and strength of recommendation are not conflated.
- At least two sources are made to speak to each other.
- Current peer-reviewed sources appear, cited with the claims they support.
- Responses to peers are planned, and faculty questions are answered.
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Written by
Aaron Bishop
MA, Education
assignment interpretation and research-methods coaching across disciplines
Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

Reviewed by
Dr. Nathan Cole
PhD, Rhetoric & Composition
Argumentation and thesis development
Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.