Knowledge acquisition is achieved by contracting out, or by finding co-sponsors, a process now extending outside the university. For 2000 and beyond, Lomas suggested the model may be partnering, that is, joint efforts based on linkages and co-sponsorship. Lomas recommended the decision makers should be involved in ongoing research relevant to their areas enabling both the research and the decision maker better to understand each other. Saskatchewan-based Steven Lewis had a fascinating take on why evidence plays a smaller role in decision making than many would like. Behaviours respond to incentives.
Most systems pay for both kinds of behaviour.
Experience trumps probability. Avoiding adverse events is more important to a practitioner than consistency with research evidence, and in any case, statistical conclusions will always be subordinate to the particular cases. Methodological purity breeds suspicion. A randomized, controlled trial is an abstraction from real world messiness. Publication is not the same thing as communication.