Your cover feature 'University challenge' (4 March) stated that teaching hospitals attract the 'lion's share of NHS research and development funding', and that medical schools have a key role in delivering the government's quality agenda. I would like to contribute some recent empirical data to this debate. It highlights the danger of making assumptions about the connection between these factors.

In a study of how policy to promote a 'knowledge-based service' had been implemented, I surveyed 700 doctors, nurses, occupational and physiotherapists in eight acute trusts, of which two were teaching hospitals. The response rate was 75 per cent.

I collected data about their involvement in research-related activities, and what they perceived to be the inhibiting and encouraging factors in their use of research evidence.

Assuming that a teaching hospital culture might be more receptive to the use of research evidence in practice than a non-teaching hospital, the analysis revealed there to be no significant statistical difference between teaching and non-teaching hospitals across the four clinician groups.

This data makes no judgement about teaching hospitals' role and contribution to generating research.

But it does call into question assumptions that teaching hospitals may better encourage the use of research evidence than non-teaching environments. If the challenge for teaching hospitals and medical schools is to 'devise ways of working together in a changing environment', focusing on improvements in knowledge management to exploit existing research evidence would seem a mutually beneficial step.

Dr Debra Humphris

Healthcare evaluation unit

St George's Hospital Medical School

London SW17