Bowen, S. J. & Graham, I. D. (2013). From knowledge translation to engaged scholarship: Promoting research relevance and utilization. Archives of Physical Medicine and Rehabilitation, 94(1 Suppl 1), S3-8. doi:10.1016/j.apmr.2012.04.037
It is now accepted within health care that clinicians and managers should base their practice and decision making on evidence. One would think that this would be quite a simple undertaking—if good research is available and well communicated, people will act on it. But most of our efforts to date, which have focused largely on research transfer, have had modest success. This has created a need to reexamine the evidence—and the assumptions—on which our current knowledge-to-action activities are based. This article will summarize what is known about what works in promoting evidence-informed action, tracing the evolution from a linear focus on research transfer to complex strategies for user engagement. Using concrete examples, it will illustrate the strengths and limitations of various approaches and implications for rehabilitation medicine.
I enjoyed this paper because it focuses the Knowledge to Action (KTA) gap from one of knowledge transfer/diffusion to one of knowledge production. This is a very important re-framing which has implications for anyone seeking to maximize the impacts of research on end users.
The KTA gap is commonly defined as a knowledge transfer problem. In other words, it is proposed that the reason knowledge is not moved into action is because there has been a failure to transfer it effectively to the intended audience…Within the field of health, there has been increasing recognition that researchers cannot, however, rely on diffusion: new knowledge will not, without active dissemination and implementation efforts, necessarily make its way to the intended user—or result in action.
I would go further (as the authors do, below) to say that even active dissemination isn’t enough. We need implementation efforts, which ask us to think about how we create the conditions to enable our downstream implementation partners to take up research evidence and implement it into products, policies and services that will have an impact on end beneficiaries. And how do researchers do this when they are not working in the companies that produce the products, with government Ministries who are making the policies or with community agencies who are delivering the services?
A critical factor predicting research use is the engagement of knowledge users in prioritization, definition, interpretation, and application of research. It makes more sense to bring the end user partners into the research process upstream and practice integrated knowledge translation (iKT). This turns the KTA Gap into one of knowledge co-production (iKT) and not one of knowledge dissemination (end of grant KT). Research goes unused not because of a simple failure in dissemination, but because researchers fail to address the most important problems facing clinicians, managers, and decision-makers.
Table 1 in the article identifies the differences between end of grant dissemination (knowledge transfer paradigm) and integrated KT (engagement paradigm).
And then the authors use the term engaged scholarship (=iKT) to describe this form of collaboration. Engaged scholarship (defined as a form of collaborative inquiry between academics and practitioners that leverages their different perspectives to generate useful knowledge) is based on the belief that higher-quality, more relevant research results from true collaboration and from integrating the diverse perspectives of multiple stakeholders.
This paper also recognizes the role of organizations as knowledge brokers. Recognition of the importance of organizational context has resulted in a shift from focusing on individuals who broker knowledge between specific individuals to the concept of knowledge brokering as an organizational process. This requires changing the way organizations do business (set priorities, allocate resources, and plan, implement, and evaluate programs). Changes to organizational structure and processes are needed to support this new way of doing business. This requires us to think about not just who we hire but how we create organizational structures that facilitate engaged scholarship.
However researchers and knowledge users report barriers to engaged scholarship. The authors recognize that this type of collaboration won’t happen without support for both sides. We must collectively find ways to provide incentives to both researchers and knowledge users to work together in identifying pressing research questions and conducting solutions-focused research to address these questions in a timely manner.
This is another example of good Canadian KT scholarship. We have many leaders in the scholarship and practice of KT/KMb in Canada. We can trace this back to the early days of CHSRF (now CFHI) in the 1990s and the creation of CIHR in 2000 with its legislated mandate to “excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system”.
Questions for brokers
- Is engaged scholarship enough? What about “engaged implementation” where researchers work with end users to support the implementation of research evidence into products, policies and services.
- What incentives do researches and knowledge users need to work together?
- Why is Canada a leader in KT research and practice? Hint, check an old blog I wrote for a suggestion.
ResearchImpact is producing this journal club series as a way to make the evidence on KMb more accessible to knowledge brokers and to create on line discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read the article. Then come back to this post and join the journal club by posting your comments.