This learning module is designed to achieve the following objectives:
- Define Knowledge Translation
- Understand the impact of knowledge translation on practice
- Describe at least one knowledge translation action process
- Reflect on how you can contribute to knowledge translation in your practice in educational settings
The number of high quality research studies addressing the efficacy of interventions within the scope of occupational and physical therapy and speech language pathology practice and the outcomes of interest to practitioners working in early intervention and school settings has grown exponentially over the past several decades. Despite the increasing availability of relevant research, there continues to be a significant gap between research and practice and it is widely understood that it can take up to two decades for scientific research recommendations to be accepted and implemented. Dr. Ray Kent, Professor Emeritus at in the Communication Sciences and Disorders Department at the University of Wisconsin-Madison highlight this gap in his presentation at a recent ASHA conference. Listen to his presentation here on the perspectives of a basic science researcher on closing the knowledge to practice gap.
The gap between what is known, how it is disseminated and absorbed, and what is done in practice impacts service delivery outcomes and practitioners are at risk for adopting or overusing interventions that lack sufficient evidence, providing unnecessary or contra-indicated interventions, and missing opportunities to introduce interventions that can effectively and efficiently improve client function and participation. Outcomes improved when practitioners systematically synthesize and apply research using a process known as knowledge translation.
Knowledge translation (KT) is defined by the Canadian Institutes of Health Research as a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system. Though the exact definition changes from setting to setting, the primary focus of KT is to move us away from a model that does not apply the knowledge to practice.
While this model supports the dissemination of research knowledge to those in practice it does not provided enough support on its own to ensure the use of knowledge in decision-making. Implementation is harder than most people think! The ways in which the knowledge to practice gap is closed is described in the literature in a number of theoretical and pragmatic ways. Read the following three papers that highlight different approaches and models to KT.
- Lemire, S., Christie, C. A., & Inkelas, M. (2017). The methods and tools of improvement science. In C. A. Christie, M. Inkelas & S. Lemire (Eds.), Improvement Science in Evaluation: Methods and Uses. New Directions for Evaluation, 153, 23–33.
- Straus, S., Tetroe, J., & Graham, I. (2009). Defining knowledge translation. Canadian Medical Association journal, 181(3-4), 165-168.
As you read in these summaries, effective KT requires a diverse array of competencies to include: 1) research literacy (e.g., skills in research and evidence based practice processes, resources and dissemination methods); 2) understanding data synthesis and application across varying settings and populations (e.g., empirical research, annual, technical, and project reports, white papers, organizational documents), and 3) a lifelong commitment to collaboratively share knowledge and foster innovation in one’s unique practice context.
Many researchers suggest, however, that the development of competencies alone may not be sufficient to close the knowledge to practice gap. Barriers to the effective synthesis, dissemination, exchange and ethically sound application of knowledge in educational settings may include:
- Availability and access to relevant research
- Difficulty in applying available research to the specific practice settings
- Practitioners may become entrenched in particular practice patterns
- Specific practices are embedded in inter-disciplinary and multi-disciplinary practice contexts that may be resistant to practice change
- Assumptions that practice is supported by the evidence
Organizational structures may help educational teams consider the application of evidence in their settings and make specific evidence informed decisions with and on behalf of the children and youth that they serve. Organizational structures may effectively structure KT practices in a way that accelerates the uptake and application of knowledge in practice. There is emerging evidence that suggests that using organizational structures to enhance KT practice may improve prognostication and lead to increased predictable client outcomes, improve client satisfaction, and eliminate ineffective service delivery. An organizational structure that has been shown to have utility in pediatric settings including early intervention and schools involves the following steps:
One additional consideration to note is that educators may not have developed KT competencies in the same way that related service personnel have. In fact, many describe evidence based practice and knowledge translation in a different way. Many educators describe evidence-based practices (or evidence based instruction in their language) as best practices, and these practices have been generally made available to them through district wide knowledge distillation activities and dissemination centers (Explore the array of centers that offer information on evidence based instruction here.). Best practices for many educators come in the form of either high leverage practices, or those practices that show promise in the evidence for producing the best educational outcomes for learners, or they come pre-packaged as evidence based interventions or program that educators implement with fidelity in their classrooms. (Check out the array of evidence based reading intervention/programs here).
To deepen your understanding check out the evidence based practice tools and resources on your professional organizations’ website:
- AOTA: https://www.aota.org/Practice/Researchers.aspx
- APTA: http://www.apta.org/EvidenceResearch/
- ASHA: https://www.asha.org/Research/EBP/
1) Now that you are familiar with these 3 models, identify similarities and differences between the models and how they differ from the model above.
2) What are some of the barriers limiting knowledge transfer to clinical practice?
3) What strategies could you use to resolve some of the barriers you and your colleagues posted?