Just do it / Faites le!

David Phipps, RIR-York
David Phipps has taken a break to read some journal articles that have been piling up. Reading about the science of knowledge mobilization is good. Getting out and actually mobilizing knowledge is better.
David Phipps a pris une pause pour lire quelques articles de journaux qui s’étaient empilés. Lire sur la science de la mobilisation des connaissances, c’est bien. Sortir et vraiment mobiliser les connaissances, c’est mieux.
I had some time to sit back and read some recent issues of Evidence and Policy and came across the following article- Adrian Cherney and Brian Head (2011) Supporting the knowledge-to-action process: a systems-thinking approach. Evidence and Policy. 7(4): 471-488.
Cherny and Head developed a holistic model supporting the knowledge-to-action (KTA) process based on systems thinking. It is based on 9 C’s: communication, capacity, competency, compatibility, committment, collaboration, creativity, compliance, champions (see figure). Like the Promoting Action on Research Implementation in Health Services (PARiHS) framework (see below), this is another model that helps practitioners think about our practie but it is not a practice per se. Cherny and Head say, “We have purposely focused on the principle and processes that should underpin a support system for enhancing the KTA process.  While infrastructure is central to the delivery of such support it is important to specify principles rather than physical activities because we want to highlight the building blocks for an effective support system relevant across a range of contexts.” Cherny and Head are explicitly saying that they chose to focus on thinking about it rather doing it.
It reminded me of a recent article in Implementation Science- Cheryl B Stetler, Laura J Damschroder, Christian D Helfrich and Hildi J Hagedorn (2011) A guide for applying a revised version of the PARIHS framework for implementation. Implementation Science. 6(99).
The PARiHS framework was developed to help understand those elements that contribute to successful implementation of evidence into practice in health care settings. The PARiHS framework is a function of the interplay of three core elements: 1) the level and nature of the evidence; 2) the context or environment into which the evidence is to be placed; and 3) the method or way in which the process is facilitated. By 2010 there had been 32 papers published on the PARiHS framework, but according to Stetler et al (2011), “No published studies were identified that used the framework comprehensively and prospectively to develop an implementation project. The ability to fully evaluate its usefulness thus has been limited.” The authors mean that this framework is a way of thinking about practice, not a practice per se. For more on the PARiHS framework see the KMb Journal club post.
It must be nice to be able to think about something and never have to do it.
But then that’s the role of researchers in many fields. Researchers think about things and study things without actually doing the things they study. Then there’s the role of practitioners.  We do things without having incentives or rewards (ie the time) to sit back and think about and reflect upon what we do.
I wrote about this on February 1, 2012 when I wrote that we were all knowledge hypocrites. We need more mobilization of knowledge about knowledge mobilization. Researchers need to move beyond thinking about frameworks to working with practitioners who are putting those frameworks into practice. Practitioners likewise need to embed researchers in their practice. At York we are starting a conversation among our engaged scholars and knowledge mobilization projects and their embedded knowledge brokers. Our goal is to inform our practice by working directly with our researchers. That’s also what the Canadian Knowledge Mobilization Forum will start to address. By mixing knowledge mobilization researchers and practitioners it will sow the seeds of mutually beneficial researcher-practitioner relationships. Join many of your knowledge mobilization colleagues in Ottawa on June 19-20.

I have also written that what we do as knowledge brokers isn’t rocket science (see point #2 in a recent journal club).  Knowledge brokering is as much common sense as it is implementation of frameworks. But these frameworks are the opposite, presenting complicated inter-relations of elements, stages and components all designed to maximize the impact of research and evidence on decision making without ever having been evaluated to see if the outcomes support that design. If I had to think of all the elements and sub elements of the PARiHS framework and all 9 C’s of the systems thinking model before addressing any knowledge mobilization opportunity I would be paralyzed, unable to figure what to do first.
I read the literature.  I engage with researchers.  That is important, for sure. And then I just do it.