The Conceptual Structure
of Research Utilization
Carole A. Estabrooks*
University of Alberta, Faculty of Nursing, 3rd Floor Clinical Sciences Building,
Edmonton, Alberta, Canada, T6G 2G3
Received 24 February 1998; accepted 17 November 1998
Abstract: Despite the fact that the nursing literature is replete with calls to make the practice of
nursing research based, little is known about the structure and function of research utilization.
The purpose of this study was to explore the conceptual structure of research utilization. Data
were collected from a randomly selected sample of 600 registered nurses practicing in western
Canada. Using the techniques of structural equation modeling (with LISREL), competing models
representing conceptual structures of research utilization were developed and evaluated. In the
first model, a simplex style of model, the investigator proposed that a nurse’s early responses
would influence subsequent responses to the question measuring research utilization, implying
a time ordered causal sequence. In the second style of model, a common cause (or factor-like)
model, the investigator proposed a stable underlying concept, research utilization, that was rel-
atively insensitive to prompting and time ordering. The simplex style of model failed to reach ac-
ceptable indices of fit. The common cause model fit the data well, suggesting that instrumental,
conceptual, and persuasive research utilization exist and that a global measure of research uti-
lization may be defensible. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22:203 – 216, 1999
Keywords: research utilization; structural equation modeling; Lisrel
Research in Nursing & Health, 1999, 22, 203–216
© 1999 John Wiley & Sons, Inc. CCC 0160-6891/99/030203-14 203
For some 25 years nurses have been writing
about and reporting on studies of research utiliza-
tion. This work dates from the first studies in
North America (Ketefian, 1975; Shore, 1972), and
notably from the work of the Conduct and Uti-
lization of Research in Nursing (CURN) project of
the 1970s (Horsley, Crane, & Bingle, 1978; Hors-
ley, Crane, Crabtree, & Wood, 1983). However,
the central question implicit in this literature re-
mains largely unanswered—how do we get
knowledge, for the most part a particular kind of
knowledge, into the hands of, and used by the clin-
ician in a timely manner? This research utilization
(or theory practice) problem can be defined as the
gap that exists between what nurses know (re-
search) and what nurses do (practice). The nursing
literature is replete with calls to make the practice
of nursing research based. Nurse leaders have
called for the profession to bridge the gap between
research and practice at least since Abdellah
(1970) addressed the issue nearly 30 years ago.
Today it is often heard as a call for evidence-based
practice (Hayes, 1997; Kitson, 1997; Naish, 1997;
Pearson, 1997; Shorten & Wallace, 1997; Simp-
son, 1996; Stetler et al., 1998).
The terms research utilization and evidence-
based practice often are used interchangeably;
however the terms are not synonymous. Evidence-
The author acknowledges the substantive contribution to the study and manuscript made by
Dr. Leslie Hayduk at the University of Alberta; and thanks the following individuals for their com-
ments on earlier drafts of the paper: Dr. Phyllis Giovannetti, University of Alberta; Dr. J. Ivan
Williams, Institute for Clinical Evaluative Sciences, Toronto; Dr. Souraya Sidani, University of
Toronto; and Marilyn Hodgins, University of New Brunswick.
This research was supported in part by a National Health Canada (NHRDP) PhD Fellowship;
and a Canadian Nurses Foundation (CNF) Fellowship; and grants from the Alberta Association
of Registered Nurses and the University of Alberta’s Faculty of Nursing.
*Medical Research Council (MRC) and Alberta Heritage Foundation for Medical Research
(AHFMR) postdoctoral fellow at the Institute for Clinical Evaluative Sciences (ICES) in Toronto,
Ontario, and Assistant Professor, Faculty of Nursing, University of Alberta in Edmonton. A copy
of the survey questionnaire is available from the author.