Is Knowledge Translation In Health Too Important to Leave to Health Professionals?
Posted: April 24, 2013 Filed under: education & learning, innovation, journalism, knowledge translation | Tags: communication, health communication, health systems, journalism, knowledge exchange, knowledge integration, knowledge translation, librarians, social media, storytelling, teachers 7 Comments »
Knowledge translation — and its affiliated terms knowledge exchange, knowledge integration and knowledge mobilization — was coined to describe a process of taking what is known into what is done in health across the spectrum of science, practice, policy and the public’s health. As health issues become more complex due to the intertwining of demographics, technology, science, and cultural transformations the need to better understand evidence and its impact on health has never been higher. Questions remain: has demand met supply? How are the health professions dealing with this equation?
Translating knowledge
The Canadian Institutes of Health Research (CIHR), one of the earliest champions of the concept of knowledge translation in research, define it as:
a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians (sic), provide more effective health services and products and strengthen the health care system.
These ideas are expanded below:
Synthesis – Synthesis, in this context, means the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods. It could take the form of a systematic review, follow the methods developed by the Cochrane Collaboration, result from a consensus conference or expert panel or synthesize qualitative or quantitative results. Realist syntheses, narrative syntheses, meta-analyses, meta-syntheses and practice guidelines are all forms of synthesis. Resources related to synthesis are available.
Dissemination – Dissemination involves identifying the appropriate audience and tailoring the message and medium to the audience. Dissemination activities can include such things as summaries for / briefings to stakeholders, educational sessions with patients, practitioners and/or policy makers, engaging knowledge users in developing and executing dissemination/implementation plan, tools creation, and media engagement.
Exchange – The exchange of knowledge refers to the interaction between the knowledge user and the researcher, resulting in mutual learning. According to the Canadian Health Services Research Foundation (CHSRF), the definition of knowledge exchange is “collaborative problem-solving between researchers and decision makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between knowledge users and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decision-making.”
Ethically-sound application of knowledge – Ethically-sound KT activities for improved health are those that are consistent with ethical principles and norms, social values, as well as legal and other regulatory frameworks – while keeping in mind that principles, values and laws can compete among and between each other at any given point in time. The term application is used to refer to the iterative process by which knowledge is put into practice.
In short, knowledge translation is about taking what we learn and know from evidence, sharing that knowledge with others and assisting them to make useful health choices in practice and policy through KT.
This often involves communicating across contexts, disciplines, and roles between and from scientists, clinicians, policy makers and to the public alike. In a health environment that is increasingly becoming complex, the ability to communicate across boundaries is no longer an advantage, it’s an essential skill. While we may not always have the right language, we can translate meaning through stories.
But if stories are to be effective they need to be valued.
The value of storytelling
I’ve seen health professionals — scientists and clinicians — roll their eyes when you mention storytelling in a work context. It is as if the only legitimate role for stories is to communicate with children (which University of Alberta researchers are exploring as a tool for sharing health knowledge with parents). Yet, it is through stories that most people share what they know in every other context; why would it be different in health?
Perhaps it is the connotation that stories are ‘made up’ like children’s bedtime tales, but one need only look to journalism to find that we’ve been making ‘stories’ a central part of our life every day. We listen to drive-time radio for stories about the traffic conditions, we watch, download and listen to news stories filed by professional journalists and citizen bloggers alike on mainstream media, Twitter, YouTube, Facebook along with myriad sources across the web. Last week we were glued to various sources to learn stories — some of them false — and create stories about the events of the Boston Marathon bombings.
Stories are what conveys multiple information threads and puts it in a coherent context.
Stories are coherence engines.
Valuing knowledge translation
If knowledge translation is important then it should be reflected in research priorities and evidence for its impact on the system across different disciplines. Dr Shannon Scott and her U of A team recently conducted a systematic review of knowledge translation strategies in the allied health professions and found that the field was full of low quality studies that made it impossible to make firm statements on which methods were best among them . That team has recently proposed a systematic review looking at how the arts and visual methods can further contribute to KT in practice, although it likely the same issue with methodological quality might come into play here, too.
What she and her team are doing is looking at the process of sharing stories and, from a research perspective, sharing stories appears to not have been worth investing in scientifically. At least, not enough to generate a lot of studies and good evidence.
One could argue that knowledge translation is still new and that it takes time to generate such evidence. That is partly true, but it is also an easy prop for those who want to avoid the messiness that comes with communication (and its problematic research context), learning from others, and creating more equitable information spaces, which is what knowledge translation ultimately does. Knowledge translation has also been in use for almost 20 years so in that time — even with the most dismal assessment of the length of time it takes to put knowledge into practice — we should be seeing some decent research published.
KT is fundamentally about sharing. Journalists’ are rewarded for sharing — the more they share and the more people who they share with (as measured by readers, listeners, viewers etc..) the more successful they are in their work. Teachers are rewarded for sharing because that means that they are teaching people. Librarians are rewarded for sharing because that means people are checking out books and using the resources in their library.
We don’t apply the same standard to academic research, even though we have some crude metrics to measure reach and impact, and there is roughly no metric for the degree to which clinicians share among themselves. Maybe this needs to change.
I have scientific colleagues who are fierce in the face of their most strident academic critics and have delivered keynotes to auditoriums filled with researchers that are nearly paralyzed in the face of speaking to the public. This is not fear of public speaking, its fear of speaking to the public.
Should they be? I don’t think speaking to the public should be expected to be enjoyable for everyone, but neither are doing statistical calculations, completing ethics applications, or presenting posters at conferences, but we still expect scientists to do that. We still expect nurses, doctors, psychologists, medical technicians and social workers to traverse complex social problems to talk to their patients in an open and honest way.
Why is it when scientists are speaking to policy makers, clinicians to scientists, policy makers to the public, or any professional to another from another discipline, speciality or division we decide its not critical for them to make the effort?
Why don’t we do the research to support it?
Why is it OK not to do KT because its uncomfortable, awkward, difficult or confusing?
Declining interest, rising demand
It is perhaps for reasons like this that knowledge translation is so poorly understood and taken up as a focus for research. Looking at Google NGram data (which tracks mention of specific topics in books and publications) we see a steady rise in citations until about 2003 followed by a levelling off. Keep in mind that the leveling begins before social media became known. In the years after Twitter, Facebook and YouTube — arguably the most powerful communications media we have for doing knowledge translation widely (but perhaps not deeply) — there is roughly no sharp increase.
Below are the citations for the terms knowledge translation, knowledge exchange, and knowledge integration from 1996 (when the Web first started gaining wide use beyond academia and the military) and 2008, the latest year for which there is available data. Note that the numbers reflect general mentions as a percentage of overall terms, so they are relative, not absolute values.
Figure 1: Google NGram Data for KT, KE & KI: 1996-2008
Is there so much other stuff to talk about in 2013 that the relative importance of knowledge translation is diminished?
A look at Google Trend data using the same terms finds that not only are these concepts not growing, their mention is actually shrinking.
Looking at the three terms we see that all three concepts have declined over time. During these years — 2004-2013 — we saw not only the birth of social media, but the rise of Internet-enabled handheld devices to allow knowledge to be shared anywhere there is a data signal. We now have apps and nearly all of the Internets resources in our pockets and we are seeing a decline in the use of these terms.
Figure 2: Google Trend Data for KT, KE & KI: 1996-2013
Where to?
So to review: We have a body of evidence in KT that is problematic and incomplete at the same time we have a decrease in use of the terms, while at the very same time we have a sharp rise in available tools and technologies to share information quickly and a continued, steady demand for more information to make decisions for health providers, patients, policy makers and insurers.
Yes, the data presented here are not perfect. But does it not make sense that there should at least be some trend upward if knowledge translation is valued? Should we not see some shift to more research, better research evidence, and greater interest given the tools and scope of communications we have through social media?
This begs the question: is knowledge translation in health too important to leave to health professionals?
In future posts this question will be looked at in greater depth. Stay tuned.
* Blog has been updated since original post
Too Much Social Media, Not Enough Social Message
Posted: July 30, 2012 Filed under: business, marketing, social media | Tags: Cluetrain manifesto, communication, complexity, Edmund Snow Carpenter, emergence, Facebook, idea markets, knowledge integration, knowledge translation, learning, markets, Marshall McLuhan, media ecology, social media, Twitter, Web 2.0, YouTube 1 Comment »
Social media is any networked information technology, tool or platform that derives its content and principal value from user engagement and permits those users to interact with that content. But last time I checked (in), the content stream being produced through my media stream was becoming a lot less social (Web 2.0) and more of a throwback to the media of old (Web 1.0); the implications could be considerable for those wishing to reach new audiences or create them in the first place.
It’s been a rough ride for social media companies. On Friday Facebook’s shares were at a record low since their IPO a couple months ago. Last month, Twitter provoked much concern after dropping its partnership with LinkedIn as part of its desire to have greater control over its messaging, prompting concern that Twitter might end up closing itself off to 3rd party applications like EchoFon, HootSuite and Tweetbot to ensure quality. This desire for tailoring and control of messages and trends has prompted some to suggest that Twitter may be ruining itself in the process.
The issue is not just one of control, but of a disrespect for the complexity and conversation that makes social media attractive to its users. In short: it’s about the social, not the media.
Social media, non social content
Scanning through my Facebook page its easy to see why their stock is dropping and will continue to do so. In their quest to justify their valuation, Facebook needs to find ways to make money from what people post and pictures of people’s kids, quips about daily hassles and joys, sharing cat videos, and posting check-ins at a local restaurant aren’t enough to justify a $100bn valuation. To do this, they need advertising dollars and deals with game makers and app developers to drive revenue up. Aside from the possibility of games, there is little social about advertising, no matter what kind of spin is offered.
Within a year my Facebook page has gone from a loose collection of social miscellany from friends and family to a steady stream of non-social junk with advertisements in the form of page updates, news stories that require me to accept an app that sends me more ads, and a litany of non-essential information.
The signal to noise ratio has officially flipped from more noise and less signal.
Bit by bit, Facebook is choking its users to death with ephemera and it would not surprise me if in two years we refer to it as we do MySpace today. YouTube is also running perilously close to offering too much media with not enough message as users increasingly have to sit through advertisements or click on banner ads before accessing content. News sites like the Globe and Mail will run a 30 second advertisement before allowing you to see a 20 second news clip, a 150% advertisement to content ratio on some stories.
I remember a few years ago when my email took the same turn. Now, probably 75 per cent of my received (non-spam!) email goes unread and is immediately deleted on sight. This isn’t necessarily spam, much of it is bacn, the kind of updates that I might have subscribed to voluntarily or I receive as part of a professional membership or affiliation. However, it’s severely disabled email’s potential and is now a ‘necessary evil’ instead of a useful tool I welcomed having in my toolkit.
Speaking to colleagues, it is not unreasonable to hear of people receiving messages in the hundreds each day and spending more than 3 hours per day just managing that content alone. How is this helping us communicate better? To learn?
This is one gigantic distraction and is not proving useful to improving our communications or helping us integrate the knowledge we receive and already have. Some claim that the era of big data will allow advertisers to target their ads with such exceptional focus and appropriateness that they will be serving us as much as we are needed to service them. I somehow doubt that.
From Web 2.0 back to 1.0
Consider the definition of what social media is on Wikipedia (as Web 2.0):
Web 2.0 is a concept that takes the network as a platform for information sharing, interoperability, user-centered design,[1] and collaboration on the World Wide Web. A Web 2.0 site allows users to interact and collaborate with each other in a social media dialogue as creators (prosumers) of user-generated content in a virtual community, in contrast to websites where users (consumers) are limited to the passive viewing of content that was created for them. Examples of Web 2.0 include social networking sites, blogs, wikis, video sharing sites, hosted services, web applications, mashups and folksonomies.
When my social media stream is filled with promoted tweets, sponsored posts, ‘like’ requests on advertisements or updates from projects, I lose the social and just end up with media.
Social media is at its best when it is a conversation. Sometimes the conversation involves a lot of talking on one side, but there is a genuine back-and-forth, an unpredictability to it, and a non-linear dynamic that makes it interesting. Straight-to-viewer messages that offer no ways to engage except to watch, click off or ‘like’ don’t make for a conversation.
Imposing Structure and Losing Complexity
In trying to turn a setting where complexity, emergence and non-linearity come alive and work to create conversation, social media property managers are stifling the very thing that makes their tools and platforms so attractive. Creativity is born from serendipity and diverse connections. In imposing structures that remove or highly limit this potential for discovery by adding unnecessary noise, we are a risk of losing some of the best tools for idea testing, discussion, and knowledge translation we have ever known by reducing the opportunities for serendipity.
It is the commercial drive that contributed to bringing these tools in the first place, however that drive can lead to blindness creating an Internet ivory tower rather than a true marketplace of ideas as advocated in the Cluetrain Manifesto, which looked at how markets operate as innovation hubs by promoting conversations.
From markets to artists, the messages that are created by media are related to the media itself. Marshall McLuhan knew that and so did his peer, Edmund Snow Carpenter. Mathematician-artist a Youtube video maker vihart knows this too and spoke to Carpenter’s thesis in a terrific short video below.
In critiquing the push for standard ‘best practices’ in social media, vihart (and Carpenter, by posthumous extension) point to the ways in which the traditional media formats that advertisers desperately wish to use to contain your attention (and limit your feedback) is exactly the opposite of the new media.
Taken from the forward of Carpenter’s book, They Became What They Beheld, (and explicated beautifully by vihart) come some rules of communication commonly pursued by traditionalists and reasons why we shouldn’t pay attention. These rules as noted by Carpenter are:
1. Know your audience and address yourself directly to it
2. Know what you want to say and say it clearly and fully
3. Reach the maximum audience by using existing channels
Whatever sense this may have made in world of print, it makes no sense today. In fact, the reverse of each rule applies.
If you address yourself to an audience, you accept at the outset the basic premises that unite the audience. You put on the audience, repeating cliches familiar to it. But artists don’t address themselves to audiences; they create audiences. The artist talks to himself out lout. If what he has to say is significant, others hear & are affected.
The trouble with knowing what to say and saying it clearly and fully, is that clear speaking is generally obsolete thinking. Clear statement is like an art object: it is the afterlife of the process which called it into being. The process itself is the significant step and, especially at the beginning, is often incomplete and uncertain.
The problem with full statement is that it doesn’t involve: it leaves no room for participation; it’s address to consumer, not co-producer.
One is left watching this video with the question: what happens when social media has too much media, not enough message?
Knowledge Translation Lip (Sync) Service
Posted: September 29, 2011 Filed under: knowledge translation, public health, research, social media | Tags: arts, cancer, communication, design, health communication, knowledge translation, social media, video, YouTube 1 Comment »
Dancing for a Cure
Researchers and policy makers wring their hands and wrack their brains at ways to get people to take up the knowledge generated through scientific research and use it for social good and further invention. Some, stop doing this and just make it happen and YouTube and the Internet are showing us how.
Designer, strategist and broadcaster Debbie Millman, host of the Design Matters podcast, signs off each episode with a great quote:
We can talk about making a difference, we can make a difference, or we can do both
It seems when talking about knowledge translation, there is a lot of talk about how to do it better and then there are some who just do it better. McGill University and some of the researchers associated with the Goodman Cancer Research Centre have partnered up with filmmakers, volunteers and a medical supply company to ‘dance for cancer’ as a means of promoting their work and raising funds for cancer research. (The company, Medicom, has offered to donate per click so if you’re interested in donating and being entertained, click the link below).
Besides being catchy (Taio Cruz‘s club hit, Dynamite, is the song that these researchers and cast are dancing to) and well-produced, the video unscores the potential that video and some creative use of the arts can offer the scientific community in showing the world what it does and how it does it. The video shows what life is like (in a singing-and-dancing way) in a lab and showcases some of the people who do it, making them real humans rather than some mysterious “scientists off in the lab”.
They are designing a knowledge translation opportunity that (so far) has been viewed nearly 30,000 times as of this writing. I suspect that number will triple in the coming weeks. When some of the best, most cited research articles in the world are read (viewed) by maybe hundreds of people, the attention of thousands in such a short time should give pause.
Further, of the thousands that view the video, it is safe to say that most are non-scientists. For many, but certainly not all, of the studies we do in public and population health, the audience for this video is almost the same as ours — or at least includes many of the same people. Not all studies or research projects will yield the kind of data that are video-worthy or inspire photosharing, but some are. Many more than we acknowledge. And if we want the public engaged in science, if we want to reach practitioners and inspire policy makers and researchers alike to pay attention to the evidence being generated, this video might offer some suggestions for a way forward.
While you think of that, enjoy the choreography and lip sync skill of McGill’s brave super-translators and support a good cause in the process:
Creating Campires For Innovation and Knowledge Translation
Posted: June 21, 2011 Filed under: complexity, environment, innovation, knowledge translation | Tags: campfire, collaboration, communication, complexity, design, intimacy, knowledge translation, meditation, storytelling Comments Off
Gather round
A campire has been a beacon for human life for centuries and may provide the ideal analogy and literal tool to engaging people in creating new things. The opportunities for it to shape our thinking and actions is enormous.
The campfire is a place where we go for warmth, intimacy, safety, light, food and inspiration. As camping season comes upon us in the Northern part of the Americas, it seems fitting to consider the ways that the campfire might be used to stoke the sparks of imagination and flames of passion (pun firmly intended).
Metaphors and analogies are commonly used in systems thinking and complexity science to illustrate concepts that are, on their own, relatively complex and awkward to describe literally. A campfire provides both a metaphor for bringing people together, but also a literal tool that could be used more effectively in work with groups struggling to innovate, collaborate and contemplate together. From a design perspective, campfires and the social system that they create around them provide an opportunity to enhance intimacy quickly, allowing for the potential to explore issues in ways that are more difficult to do in other settings.
Consider some of the following properties of the campfire.
Lighting has been found to have a strong environmental effect on many behaviours and moods, and the type of inconsistent light that is thrown by a campfire is similar to that which induces relaxation and intimacy (PDF).
It can be argued that storytelling has been our most powerful vehicle for sharing what we know throughout human history. Research on narrative effectiveness has found that emulating the environments created by a campfire (PDF), the close-in, small-group, open dialogue sharing kinds of spaces, leads to more effective communication in business contexts.
The sensory richness of a campfire — the smell of wood and smoke, the crackle, the sight of sparks and flame, the feeling of heat — all create an environment that differs from much of what we are used to, provoking psychophysiological stimulation that has been associated with learning outcomes. Research linking environmental design and architecture has explored the phenomenon of sensory richness and how modern designed environments reduce this and (potentially) limit learning. (See program example here).
Another quality of a campfire is that it creates space for meditative inquiry. Anthropologists and psychologists have speculated that it was the campfire and the meditative rituals that it created that led modern humans to separate from Neanderthals. The focus on something like a fire draws attention away from the chaos of the world and channels into a circle that is generated through the campfire.
One of the benefits of a campfire is the circle that it creates. Leadership scholar Meg Wheatley, Christina Baldwin and Ann Linnea reflected on their use of the circle and how it has been used historically as a means of creating a common space where participants are on more equal footing with one another as a means of leadership promotion. In a circle, everyone can (usually) see everyone else and no position is held as more important than others, which privileges all participants and not just some.
Lastly, the campfire creates not just internal peace, but social intimacy as well. Indeed,modern social media has been compared to the campfire (PDF) in its ability to potentially replicate the focused, shared space that a campfire occupied for much of human life. For the reasons listed above, the social media effect is likely limited, but nonetheless the metaphor may partly hold in light of a lack of alternatives.
In practice, lighting a chord of wood in the middle of an urban setting might be problematic, but it is worth considering for those of us looking to create those social spaces where people can gather. Taking a break and leaving town might be worth doing as well. Failing that, what are the campfire-like spaces that we can create with what we have.
Designers, health promoters or anyone seeking to bring together ideas while working in complex spaces may wish to give this more thought — or meditate on it, which might (as it has done before) spark a new evolutionary shift attributed to the campfire.
What If Research Was Like the Restaurant Industry?
Posted: April 25, 2011 Filed under: design thinking, research | Tags: communication, knowledge translation, marketing, research, restaurant, universities 6 Comments »
A model for research?
Spend some time engaging with the service industry reveals a stark gap between what they do to deliver a product that satisfies and what research does and maybe there are lessons to learned for those of us in the scientific world.
I’ve recently had the privilege to spend a week in the Sonoma and Napa Valley areas of Northern California. If there ever was a place devoted to food and drink, it is this part of the world.
Spending time sampling wine and exotic locally produced, handcrafted foods, beyond being enjoyable, also raises awareness of the craftsmanship that goes into a good drink or meal. From the way a food is grown or raised, prepared, delivered and consumed, it is hard not to appreciate the amount of effort that goes into making that meal a good one. Add in the restaurant, its ambiance, design, and the people there to serve the food to you and soon you are prepared to say “thanks” before every meal whether you are religious or not.
Sitting at a table looking at all that was around me, I couldn’t help but notice the finer details of my experience and wonder about why we have no equivalent in research. Whether it was the texture of the linen table cloth, the arrangement of flowers on the table across from me, the blown-glass lantern and flickering light it produced on my table, to the smell of the food, its temperature, its presentation and, of course, the taste. What about the cadence of the service? How about the way that the server introduced the menu and commented on the options for pairing a wine with each course? Restauranteurs create experiences and products and work to make sure that they are matched to what I want and how I want it now.
In research, we spend at least as much time thinking about how to produce a product that is worthwhile as farmers, ranchers, and vintners do, yet once created we do comparatively little to further develop a worthwhile experience for our end user — if we think about them at all. When was the last time a researcher — or knowledge producer (it could be a clinican sharing their knowledge — helped you to gain a deep appreciation of what they had to offer by working with where you were and what you kind of experience you were looking for?
I can say confidently that this has never happened to me. And why shouldn’t it have? Or better yet: why haven’t I done it for my audiences?
Anticipating some answers that others might give, I offer a back and forth / Q & A:
1. Position: That is not a researcher’s job. We are trained to do research, not sell ideas.
Response: Times change. I can’t think of another role, job or position that doesn’t have to adapt to changing times and where there is no accountability for the outcomes of that job to someone else. I am not suggesting that a researcher, particularly those doing more basic/foundational research, will, can or should know the myriad possible applications of that research, but the idea that they ought not have thought of some possible, eventual application is problematic. I have heard time and again that such applied thinking undermines discovery, but there is no evidence that this is the case, nor does it seem reasonable when those who pay the bills are the public. Even a discovery that makes it easier to make further discoveries is an application of translational thinking and it is time to change.
2. Position: Others don’t understand my research; it’s too complicated to explain.
Response: Any service organization that is unable to explain its purpose goes out of business. There are a lot of ideas that seemed complicated at first, but became easier to grasp once those offering such services reached out. Investing and mutual funds are two examples of complicated business models that have gained widespread purchase. Nearly every concept can be broken into pieces that can be understood by someone else. For a great example, look at the Academic Minute program on WAMC Radio where academics take one minute to share their research with the world. It can be done.
3. Position: The time I spend selling my ideas takes away from generating knowledge. I will be far less effective if I have to do one more thing.
Response: This might be true, but that is only if a researcher does all her or his own knowledge translation and communication. The service industry uses many models. Great chefs aren’t always out on the street wearing a sandwich board trying to convince you to eat at their restaurant, or romancing a dish at your table, there are specific roles that do that. But a great chef is always prepared to play that role if needed and at many great restaurants, the manager or chef surveys what is going on in the front and back of the house to make sure things are going well. In research, we don’t do this much at all. We produce knowledge and maybe share it with other producers, spending little time with other audiences and even less wondering whether we produced the right kind of research for the. There are some models that are promising, like the knowledge broker , who can play the role of the sommelier for research , but like restaurants that have a role like this for wine, they only work when the system is in place to use those talents well. The analogy here is that there needs to be the right stock of research, the right options for using it, and a mechanism to connect the knowledge broker to the audience.
4. Position: Selling research cheapens it and makes it like a commodity and it is so much more than that.
Response: If you don’t think that there isn’t some commodification of knowledge, then maybe you need to consider what is happening to academia and the trends in research, education and publishing. Louis Menand‘s great historical review of the North American university views the battle for ideas as a marketplace shows that this isn’t even a new phenomenon, rather its just looking different than it did before. He has gone further to discuss the problem with PhD’s, echoing recent work published in the Economist on the disposable academic, pointing to the commodification and professionalization of academia. Researchers may like to imagine that their ideas and work are pure, but the reason we get funding is that someone is interested in what we do for reasons that go beyond reason and science and into passion and some acknowledgement that something will be better because we ask the question. Yes, knowledge is greater than just its application, but we must acknowledge than we compete for attention and that when people pay attention to what we do, we have greater impact than if they don’t.
5. Position: There is no support for this kind of selling of research.
Response: Have you looked at the Internet? Walked into a bookstore? Perhaps turned on the TV? There is research being used all the time. Do the major grant councils pay for this? Not always. But times change (see point #1). The idea that knowledge translation should be funded by grantors is new in itself and will evolve. We need to evolve with it and, if it is not supported, do it anyway. Tweet, blog, share. There is too much information available out there to not be active in its promotion or use, otherwise our intended audiences will choose to use something else.
Restauranteurs know this. They know that no matter how good they are, there are hungry (literally!) customers and competitors who will walk down the street to another place. A Michelin star or Zagat rating this year doesn’t mean that you’ll be successful next year.
Take a moment and envision what research could look like if we handcrafted it to meet the needs of our audience, still taking the time to create art like great chefs, warm our day like a host, and treat us like royalty like a great server. What might that look like and why should we not take some queues from the diners we visit and the restaurants we visit as models for a tasty future for knowledge generation and translation.
Making our customers feel good about our product
** Photo Waitress at Il Folletto by boocal used under Creative Commons License from Flickr
** Photo Sandwich Board by zappowbang used under Creative Commons License from Flickr
Art / Design / Science / Literacy
Posted: January 22, 2011 Filed under: art & design, complexity, design thinking, public health, social systems, systems thinking | Tags: arts, communication, complexity, creativity, design, design thinking, education, health communication, learning, literacy, science, systems thinking 1 Comment »
Szonyi Istvan: Man Reading (artist's father)
Literacy has many forms and art is one of the ways in which these forms come together and present some of the best opportunities for engaging diversity in complex social systems.
The relationship between art and science has been long noted by those looking at the history of discovery, and the nature of creativity and human innovation. In theory, the idea that two creative ventures that use different methods and media as the vehicle for expression should fit together is natural. But that is where theory and practice diverge sharply.
From my perspective, art and design are not perspectives warmly embraced within the scientific community. There is much suspicion among scientists about the validity, reliability and practical utility of art and design in solving important problems. Aesthetics may be nice for culture, but science tackles serious things.
Yet, one of the more serious matters for science is the concept of literacy. Scientists have been worried about the inability of people to pick up and understand the basics of how science works and its implications for society, prompting this to become an educational priority for some.
Science literacy can be defined as:
PISA (Program for International Student Assessment) 2006 defines science literacy as an individual’s scientific knowledge and use of that knowledge to identify questions, to acquire new knowledge, to explain scientific phenomena, and to draw evidence based conclusions about science-related issues, understanding of the characteristic features of science as a form of human knowledge and enquiry, awareness of how science and technology shape our material, intellectual, and cultural environments, and willingness to engage in science-related issues, and with the ideas of science, as a reflective citizen.
This definition is highly referential to the concept of science, defined by the Oxford English Dictionary as:
science |ˈsīəns|
noun
the intellectual and practical activity encompassing the systematic study of the structure and behavior of the physical and natural world through observation and experiment : the world of science and technology.
• a particular area of this : veterinary science | the agricultural sciences.
• a systematically organized body of knowledge on a particular subject : the science of criminology.
This term is rooted in the Latin scire, which is to know . If one looks at the first definition on its own, independent of the second definition and conjunction with the most popular applications of the term science, there seems to be little room for art and design. Yet, when revisiting the definition of science itself, the idea of the systematic study of the structure and behavior of the physical and natural world through observation and experiment, a door opens up to some new possibilities.
Design is largely about the study of human situations and interacting with people, ideas, and space to create solutions that emerge within those spaces. Unlike science, which has a focus on observation and understanding, design is about taking such understanding and applying it to problem solving. Milton Glaser describes design as intervention into the flow of events and the introduction of intention into human affairs.
Art is a means of expression and for exploring the intangible and making it so. It is for such reasons that art + design go together so much.
Reading the different definitions of literacy and considering what science, design and art do, it seems to me right that we contemplate the ways in which they come together. Art and design are part of the normative scientific lexicon, but perhaps they should. As the human-centred problems that science aims to tackle become more complex, abstract and intangible — climate change, chronic disease, food security, social inclusion/exclusion and mass migration/globalization — the need to visualize the problems in new ways and create (design) solutions based on science becomes imperative.
The only way this will take place is to have greater literacy on how this can be in order to recognize the opportunities that science, design and art present and the ability to transform that into true positive intention into human affairs.
** Image used under Creative Commons Licence from Flickr Pool, by freeparking. http://www.flickr.com/photos/freeparking/2351767932/
The Social Distance of Email and ICT
Posted: July 12, 2010 Filed under: Uncategorized | Tags: communication, education, email, knowledge translation, learning, mentorship 3 Comments »I’ve been reminded a lot over the past few days about the limits to email’s power and the social distance created by electronic tools. Email, even for the most careful writer, is fraught with difficulties in communicating issues of a sensitive manner or being emotive. Outside of the most simplest forms of expression, like rage or extreme joy (think: OMG!!!!!!!), there is so little opportunity to truly convey emotion or context without going into a long story.
I find it hard to convey emotions like frustration while not appearing to be angry, love (or affection and admiration) without looking trite, and confusion without seeming to be clueless. These are all complex emotions, ones that are better conveyed through a glance, a hug, or a sigh than they ever are by printed words. And yet, we expect to achieve strong, effective communication through email all the time.
Skype or iChat, both visual media, are better, but even then it is difficult to get the warmth (or cold) from another person at a distance. I’m reminded of the work of W. Brad Johnson and Charles Ridley and their book ‘The Elements of Mentoring’ where they synthesize the vast field of mentorship and conclude that face-to-face time is critical for effective mentorship. They also observe that apprenticeship, the highest form of learning, is done through collaboration — that is, co-labour. Working together, alongside one another, is what counts. This can’t be done remotely.
I’ve been very productive with groups of people whom I’ve never met, or seen sparingly. I’ve published articles, written grants, and created entire curricula without ever being in the same room with my collaborators. But in each of these cases, while there was a product created, there was no advancement of the relationship to sustain the benefit of that product to the world. The paper was created, it was now dead. Whereas those times I did the same thing working with someone, really working with them, the products were taken in many directions I couldn’t have anticipated. This is the goal of knowledge translation: to get knowledge into practice.
So if this is true, could it be that the fundamental core of any KT plan is to get people together and find ways for them to protect interaction time? Is it possible that our efforts at creating better dissemination strategies using distance tools is not the best use of our time?
Social Media, Control and Engagement
Posted: May 30, 2010 Filed under: public health, social media | Tags: communication, dialogue, engagement, public health, social media, trust 4 Comments »
People Matter, Objects Don't (from Hugh MacLeod at Gapingvoid.com)
There’s no question that the term social media is hotter than ever with quite a future ahead. It seems you can’t go to any event that claims the term ‘innovation’ as its mandate without some reference to tools like Twitter, Facebook and Foursquare . It’s because of this that I have a love-hate relationship with social media because its popularity is also what makes it problematic, particularly for fields like public health or for academia or other types of serious matters. Why? As one who studies, uses and designs social media strategies for public health I should be thrilled that it’s taken up so widely.
It’s not that these tools are being used, but how – at least by organizations. In yesterday’s Globe and Mail, reporter Kelly Grant showcased how the Toronto mayoral candidates were using social media to advance their campaigns. The quote that stuck out for me was from candidate George Smitherman’s spokesman Stefan Baranski who said:
“What goes out on social media now is as good as a press release”
The focus is on ‘managing’ the message and “getting the word out” is, to my mind, missing the point. Social media — as its name suggests — is social. That means that it is all about relationships and that means trust. When was the last time you had a meaningful relationship that was managed? When did you last control a conversation?
Politicians, public health and health care leaders, and companies all want to engage the public and they see social media as the means to do it. But true engagement is about genuine conversation, dialogue and trust, not faux Tweets or self-promotional Facebook posts. Politicians, organizations and leaders within them might do better to treat their constituents as people rather than objects. That’s why so many distrust politicians, and why public agencies and corporations have such a difficult time using social media to convert their messages into real value.
In my field, public health (note: that first part), we often speak to people like they’re children in a patronizing manner that says “we know better, trust us”. The problem is, we don’t and they don’t . We have a lot of knowledge about how to prevent illness, keep people healthy and happy, and create stronger communities, but we don’t know it all and never will. But, we do have a lot of knowledge that is useful and can make real contributions to the betterment of society.
That is what we’re supposed to do.
Our best chance is to dialogue with the public in ways that build trust, enabling the public to learn from us and to us to learn from them just as we would at a casual conversation with a friend or colleague.
Social media gives us the tools to do this, but only if we treat it as social and not just as media.
Selling The Value of Research
Posted: April 13, 2010 Filed under: public health, research | Tags: communication, infodemiology, innovation, knowedge broker, knowledge translation, research, research funding, science, university 3 Comments »
I recently was awarded a grant from the Canadian Institutes for Health Research (CIHR), the leading funder of health research in Canada. This was one of those hard fought, peer-reviewed grants that provide the fuel for the engine of research (and look good on a CV to boot). I’ve been fortunate to have had funding from them before, but unlike the other times I’ve received a letter from them (or another funder) this time I received something extra: a pamphlet called “Communicating the Value of Health Research” .
The pamphlet provides a short outline of how as scientists we can better share what we do with not just the usual places (peer-review journals, academic presentations), but also the wider world. It fell short of advocating for science blogging, or posting results on Twitter, but went beyond the usual to discuss ways in which scientists can better explain what they do the public and why that is a good idea in the first place.
In any other venue this might not be so strange, but for CIHR — or rather, academic health research more generally — this was something of a surprise. One of the biggest problems we face as researchers is that there is an air of mystery about what we do to the public and frankly, I think most researchers are content with that. Much of what we do is unknown to the rest of the world for very good reason: we are the one’s who invented the very thing we are studying. This is pretty handy when that invention is something that has the potential to change people’s lives for the better, but much less so when that ‘thing’ is a new way of expressing something we’ve done over and over again or something that has no obvious benefit, but might a long way down the road. Sure, we like the attention that comes when people actually use our work for something, but the prevailing idea for most of the 20th century held that the work had its own merits and therefore should be valued by the public because of it.
No more.
The dawn of the era of knowledge translation; active promotion of research and consideration for how it is presented, potentially used, and the role of the audience, participants and intended beneficiaries of research outputs is here. And CIHR is determined to ensure that we researchers promote what we do, hence the little pamphlet I received with my acceptance letter.
The concept of the socially active researcher promoting his or her research without the filter of peer review is something that scares a lot of people. Those fears are not unfounded. There is a lot of research that is not well-grounded, potentially confusing, and overtly misleading, incomplete or inaccurate. Gunther Eysenbach has pointed to some of these glaring problems in his discussion of the concept of infodemiology.
Yet, the idea of the researcher as a stand-alone generator of knowledge is outdated. It implies a system of knowledge generation that is divorced completely from its effects, which flies in the face of what we know about innovation and applied research. This is not to argue that there is no place for the “pure” scientist, focused exclusively on research, but that is only one role within a larger spectrum that ought to reflect a diversity of mixes of research and application. On the other end should be those who’s role is to exclusively translate knowledge into action, much like the Canadian Health Services Foundation’s concept of the knowledge broker (PDF).
Regardless of the position taken in this spectrum, I believe that we researchers all need to take some responsibility of arguing for reasons to do research, communicating to the world about its value (and demonstrating this), and ensuring that its application and funding is done responsibility. Otherwise, we leave its fate to a public unaware and constantly bombarded by other messages touting the value of other activities, both beneficial and banal. It is because other groups have been so good at communicating their message that science and research has been so hard hit. Last year, the federal budget for research was cut. This year, the increase barely (if at all) kept pace with inflation.
In both cases, the public outcry was non-existent. The reason, I believe, is that the public has little idea about what science means for them, why it is worth investing in, and what it would mean if it disappeared. It’s also because we researchers, programmers, and policy makers have done (collectively) a lousy job of translating what we know into what we do. As a researcher, I need to take responsibility for the part of the equation that falls within my sphere of influence and that means communication.
My message to my scientific colleagues is this: if research and its value is important to you, read the pamphlet and take action. Communication is the future of our profession.
Knowledge Translation or Just Better Marketing?
Posted: March 27, 2010 Filed under: education & learning, research, social media, social systems, systems thinking | Tags: communication, health, health communication, information, information overload, innovation, knowledge translation, marketing, research, Seth Godin, social marketing, systems thinking, tobacco industry 1 Comment »
How Much Marketing Can We Take?
This week at the CoNEKTR Lunch and Learn at the Dalla Lana School of Public Health, the focus of discussion was on knowledge translation and the theme I discussed in a previous post. It was a lively discussion and one that emphasized the limits that one hour and many great minds presents for exploring a big topic like KT.
The discussion around the room focused on the challenges of taking what it is we know and transforming it into practice, policy and research innovations that work in the everyday. While the subtext of the presentation was initially focused on systems issues, building on Russell Ackoff‘s phrase about “doing the wrong things righter”, the bulk of the conversation was on whether or not we are dealing with issues that have to do with marketing and simply being better at it.
That is, if health sciences just got better at packaging the materials they produce, delivering them more effectively (or more often) and doing so by understanding the user better, things would get done. One could view this argument as proof positive that as a field, we are so wedded to the idea of shoveling content that we no longer see that this is just doing different versions of the same thing over again. But a closer look suggests that social marketing might provide us with a middle ground between the largely content-driven approach that dominates the literature (which suggests that if we just package the best content better, people will listen to what we say because it is, after all, the best content) and a systems change approach that looks at redesigning the way we interact with knowledge and produce it in the first place.
A finer look at marketing suggests that there is something different from the traditional view. A marketing perspective is less concerned with the quality of the product (i.e., content) and more about process of how to get this content to people and get them to use it. The crassest example of this can be seen in episodes of Mad Men and how they brazenly craft messages around toxic substances like cigarettes to seduce people, fictional representations of the very real world work of the tobacco industry does to reach youth , racial minorities and women alike. But unlike the callous marketers who don’t care about their audience’s health, health professionals very much do. And so do some marketers.
By focusing on the process of getting information to the intended audience, a marketing perspective gets closer to the spirit of what knowledge translation is intended by some definitions. What it fails to do is question or even challenge the underlying structures that create the barriers to knowledge application in the first place. Emphasis on clever, creative means of getting around these barriers is a start, but just a start. The supposition here is that people are simply distracted or busy and that they are not able to attend to the messages around them due to volume. This has some merit. As anyone active in social media use, spent time in front the TV, visited a “free” website, or having visited public places like Times Square (pictured) can attest, the volume of information we get exposed to on a daily basis is enormous. It sounds good, but as any marketer can tell you, today’s effective and innovative strategy is tomorrow’s overused, ignored delivery system. Once widely adopted, a marketing strategy often loses its lustre and something new must replace it, which is why marketing is such a dynamic field.
A systems-oriented approach is also dynamic, but one that aims to transform the structure of the relationships and processes within the system rather than work around the existing ones.
Perhaps the question is less about whether social marketing is knowledge translation, but whether social marketing is enough given the information climate most health professionals and consumers exist.
