Implementation science made too simple: a teaching tool

Curran, G.M. (2020) Implementation science made too simple: a teaching tool. Implementation Science Communications 1:27. https://doi.org/10.1186/s43058-020-00001-z

 

Abstract

Background: The field of implementation science is growing and becoming more complex. When teaching new learners, providing a clear definition of implementation science and a description of its place among related fields can be difficult. The author developed a teaching tool using very simple language to help learners grasp key concepts in implementation science.

The teaching tool: The tool consists of a slide (visual aid) which provides simple and jargon-free definitions of implementation science, implementation strategies, and implementation outcomes, as well as a description of how implementation science relates to “effectiveness” research focusing on clinical/preventive interventions.

Conclusion: The tool could be useful to new students in the field, as well as other scholars or stakeholders in need of a brief and plain language introduction to key concepts in implementation science

 

A short journal club post for a short and simple (using the words of the author) paper. This is a lesson on clear language writing. The author (an academic director of a centre focused on implementation research) describes complex concepts in implementation science in a single slide that he calls a tool.

 

  • The intervention/practice/innovation is THE THING
  • Effectiveness research looks at whether THE THING works
  • Implementation research looks at how best to help people/places DO THE THING
  • Implementation strategies are the stuff we do to try to help people/places DO THE THING
  • Main implementation outcomes are HOW MUCH and HOW WELL they DO THE THING

 

The author uses an interesting term of “de-implementation” – I am guessing this is the stuff we have to unlearn in order to DO THE THING. But please offer your other suggestions if my guess is off base.

 

The rationale for this is the dizzying number of elements, theories, frameworks, factors that need to be considered when planning an implementation study.

 

“Tabak et al. [1] identified 61 dissemination and/or implementation theories/frameworks/models available to help craft an implementation study. Just one of those frame-works, Damschroder et al’ s [2] widely used Consolidated Framework for Implementation Research (CFIR), offers 39 implementation factors to consider. Powell et al. [3] conceptualized 73 discrete implementation strategies available for consideration when developing an implementation intervention. Proctor et al. [4] offer 17 potential outcome domains to consider for an implementation study, and the Society for Implementation Research Collaboration has compiled a repository [5] of over 400 implementation-related measures.”

 

Seriously? I know PARIHS is out of date but it has three elements to consider to get your evidence used: evidence, context, facilitation. I can keep these three things in my head. I get lost at 39 and above. Here we hit one of the differences between academic researchers and practitioners. Academic researchers describe a phenomenon in exacting detail as they learn more and more about a specific process(s). Researchers describe the gold standard or best practice. Practitioners must get the job done and sometimes being good enough is ok.

 

Don’t get me wrong, I appreciate the insight from 39 factors or 73 strategies or 400 measures (well, not 400…) but when it comes to getting down and doing it sometimes I just have to get the job done.

 

Questions for brokers

  1. “Tabak et al [1] identified 61 dissemination and/or implementation theories/frameworks/ models…” I got called out in my June journal club post for equating knowledge brokering and implementation (even though the author equated the two) with the person calling me out equating knowledge brokering with dissemination. What do you think? Does dissemination = knowledge brokering? Does knowledge brokering = implementation?
  2. Is good enough really good enough for a practitioner?

 

Research Impact Canada is producing this journal club series to make evidence on KMb more accessible to knowledge brokers and to create online discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read this open access article. Then come back to this post and join the journal club by posting your comments.

 

 

 

 

 

 

 

 

 

 

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