Role Domains of Knowledge Brokering: A Model for the Health Care Setting Glegg, S. M and Hoens, A. (2016). Role domains of knowledge brokering: A model for the health care setting. J Neurol Phys Ther, 40(2), 115-23. doi: 10.1097/NPT.0000000000000122. Abstract Knowledge brokering is a strategy to support collaborations and partnerships within and across clinical, research, and policy worlds to improve the generation and use of research knowledge. Knowledge brokers function in multiple roles to facilitate the use of evidence by leveraging the power of these partnerships. The application of theory can provide clarity in understanding the processes, influences, expected mechanisms of action, and desired outcomes of knowledge brokering. Viewing knowledge brokering from the perspective of its role domains can provide a means of organizing these elements to advance our understanding of knowledge brokering. The objectives of this special interest article are (1) to describe the context for knowledge brokering in health care, (2) to provide an overview of knowledge translation theories applied to knowledge brokering, and (3) to propose a model outlining the role domains assumed in knowledge brokering. The Role Model for Knowledge Brokering is composed of 5 role domains, including information manager, linking agent, capacity builder, facilitator, and evaluator. We provide examples from the literature and our real-world experience to demonstrate the application of the model. This model can be used to inform the practice of knowledge brokering as well as professional development and evaluation strategies. In addition, it may be used to inform theory-driven research examining the effectiveness of knowledge brokering on knowledge generation and translation outcomes in the health care field, as well as on patient health outcomes. Cool thing about this paper is there is a video abstract. First time I have seen a video summary of a paper published alongside the actual abstract. Check it out at https://youtu.be/udp8JNu_tL4. This paper describes a model of knowledge brokering synthesizing five domains of knowledge broker functions from five different models all describing various aspects of knowledge brokering. In this sense the paper described a model of models or a meta-model. Models. Don’t we have enough models? Do we need a model of models? Models are important especially when helping to make sense of complex processes or systems. As the authors state, “A model provides a way of thinking about something complex—it delivers a simplified description of a phenomenon that is designed to support our understanding of it.” This references an interesting paper on models: Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implement Science, 10(53). doi:10.1186/s13012-015-0242-0. Check it out if you have not yet had your fill of models. Back to the question – do we need a model of models? We need systematic reviews that synthesize messages across bodies of literature so a meta-model brings together the best of many models and synthesizes into a single take home model. At least that’s the intent. Full disclosure – I am guilty of making my own model called the co-produced pathway to impact (soon to be published). Since models are inherently simplifications of complex processes I think we all want to make a model that fills the gap in the existing models. Or we are hoping that our model is better than everyone else’s and will be our legacy. Peer review might guard against bias but doesn’t guard against ego. Rant about models over…back to the paper. This article uses a very relationship based definition of knowledge brokering. Excellent. While connecting to codified knowledge (end of grant KT) is important it is not as robust as integrated KT where stakeholders are engaged throughout the process from research to impact. “KBs move among groups fostering collaborative processes, with the aim of generating new “brokered” knowledge that is more robust and readily applicable within its intended local context.” The paper brings together KB related theories and frameworks including Knowledge to Action Cycle (see my earlier journal club post about this framework that is often cited but rarely implemented…time for a new paradigm if you ask me) PARiHS framework (see earlier journal club post) a foundational framework describing the three elements of implementation: evidence, context, facilitation. This has subsequently been expanded to the CFIR which makes this manageable construct far more robust and far less manageable. The focus on facilitation makes this a good framework for relationship based knowledge brokering. A model from 1994 called the Fernandez and Gould model – a model that explicitly addresses power in relationships. Diffusion of innovation – which isn’t a model or framework but a theory. The K* spectrum that described knowledge brokering functions from information intermediary to innovation broker These five come together in the Role Model for Knowledge Brokering in health care describing the following five domains Information Manager Linking Agent Capacity Builder Facilitator Evaluator Each of these roles is described by their functions. 5 roles. 16 functions (and not an exhaustive list of functions). Does this make our jobs as brokers complex. Yes. But as I have said previously, get over it. That’s what also makes our jobs exciting. Interestingly the role of capacity builder doesn’t appear in any of the five models/theories reviewed (Table 1) so the authors have included it as an additional role as it is an important function of our work. One observation about this paper is that it is research(er) centric. Everything is focused on the research(er) connecting to practice (especially evident on page 120). Knowledge brokers can facilitate end user engagement in research – but no mention of researcher engagement in end use. Knowledge brokers can provide education and mentoring about research to the clinical setting – but nothing about providing education and mentoring about the clinical setting to researchers. “KBs guide and support knowledge users to find ways to integrate knowledge about research, as well as context and experience into decision making about practice or research processes”. This research(er) centric view continues to privilege academic research over other forms of knowledge (i.e. clinical practice, lived experience, indigenous knowledge) and reinforces power differentials in relationships. In my practice I spend a lot of time working with researchers to socialize them to the skills, expertise and context of knowledge use in community. Brokers need to spend as much time training and educating researchers as we do knowledge user partners. Questions for brokers The paper develops the Role Model for Knowledge Brokering in health care. Why just health care? If a model describes knowledge brokering shouldn’t it be robust enough to apply to education, environment etc. What is missing from the five role domains? Where is the role of impact manager? Should this be included as an additional function under evaluator more than just “and outcomes”? After all, isn’t that why we do this work? Are you research(er) centric or use(er) centric? What is the balance of effort between the two in your practice? ResearchImpact-RéseauImpactRecherche (RIR) 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. If you’re a community member seek a colleague at your local university to obtain this article for you. Or use the version attached to this post. Then come back to this post and join the journal club by posting your comments.