Knowledge translation is about putting evidence into practice, but what about putting practices into place that support evidence creation and the people who are in charge of this? Until this missing link is addressed, our knowledge-practice gap will not shrink anytime soon.
Knowing is not enough; we must apply. Willing is not enough; we must do – Goethe
There is a widely held, mistaken belief that knowledge translation (KT) is all about knowledge. During my post doctoral work on KT and systems science I came to know just how strongly this view is held and how faulty it is in terms of practice. Spend time observing how people actually generate, share and take in knowledge and you’ll see that the actual content is a small part of the equation. Quality relationships, networks of people working together, and the right systems and environments in place to facilitate interaction of those people and ideas is what moves knowledge into action.
I was part of a review team that looked at the evidence for knowledge translation and how it fit within cancer communications and we found that much of what has been published focuses on content, not context. While good, appropriate and timely content is a necessary factor in KT, it is hardly sufficient if there are no people or environments where that knowledge can be appropriately contemplated, learned and applied. This is knowledge integration and it requires people and systems working together.
The systems part is tricky enough and has received growing attention over the past decade (see the linked paper above for a short history of knowledge-to-action research), but it is the human side that remains neglected. To make matters worse, it is our future leaders who are bearing the brunt of this lack of attention.
Consider three examples that presented themselves to me over the past week:
1. A young, bold, charismatic and clear communicator with all the skills, knowledge and enthusiasm and desire to be a knowledge broker who is working on the latest of a string of one-year contracts for different organizations. How is this person supposed to be effective at building relationships when she has to start over in a new role in a new organizational every 12 months?
2. A knowledge mobilizer who speaks highly of his team and role on an enthusiastic, dynamic project aimed at transforming academic knowledge into useful, usable, and accessible forms for policy makers and how he is going to miss it as his contract is up (because his part of the project was funded for just one year). What is going to happen to his knowledge when he leaves?
3. A knowledge generator and health promoter who brings a talent for engaging the community and building networks between disparate voices and groups contemplates what it means to be told in one breath that her work (and that of her team and their projects) is so highly valued and impactful and with the next breath that the project will not be funded again, because it is only a one-year initiative. Are those networks she helped create going to grow without someone paying attention to the whole and not just the parts?
These are not content issues, they are human resource issues and systems ones. All the wonderful research scientists do and the amazing innovations that clinicians introduce are not going to amount to anything lasting without someone to carry the torch and to pay attention to getting that knowledge into practice. The knowledge-to-action system is too complex, too fast moving, and attentional resources are too thin to expect that all this can be done on its own without some forethought and committed focus on KT.
And KT and the relationships necessary for true knowledge integration are not things that can be compartmentalized and squished into one year contracts.
What Allan Best, Bob Hiatt and the panel we worked with found (as have others) is that the content itself needs systems in place to do support its integration into practice. These are human systems and those are built on relationships, and relationships are contiguous, not arbitrary or episodic. Yet that is how we view these activities given the way we structure projects and roles for people working in KT.
We are starting to pay more attention to the way in which content is created now it is time to pay as much attention to how it is translated in real human terms and create the same kinds of supports for people that we try to do for content. Otherwise, the young leaders I profiled above will leave the system and take with them their enthusiasm, energy and, ironically, their knowledge leaving us with little more than a name (KT).
*** Photo “Thinker” by dirvish used under a Creative Commons License from Flickr
Wonderful post and couldn’t agree more that knowledge is necessary but not sufficient for knowledge transfer. The recent 1 year SSHRC Public Outreach Grants and CIHR KT Supplement Grants are enough time to establish networks but not create the trust based relationships that transcend short term push and allow for long term co-production. At ResearchImpact our 6 universities have invested in an institutional capacity to support Knowledge Mobilization. Institutional capacities span any individual researcher or decision maker and embed the KMb/KT expertise within professional brokers. We support the brokering work of our researchers and their decision making partners allowing them to excel at research and making decisions while we excel at brokering.
Its not that 1 year grants aren’t appreciated but the impact of those 1 year grants are maximized when they are added to an institutional capacity to support KMb. They are even more effective when we have been able to work with the research and KT partners throughout the research project so that any 1 year grant is addedd to a platform of successful KT.
Your post validates our work and provides further evidence of the need for institutions to support KT/KMb the way they invest in technology transfer, industry liaison and commercialization.
David, thanks for the kind words and feedback. I agree wholeheartedly that having KT funding available is an asset and something to celebrate. But only as a start. We are so much further ahead from where we were even 10 years ago in the manner that funders and policymakers support KT. At the same time, we are a very long way from creating a sustainable model of KT programming and integrated activity.
Programs like yours are good starting places and hopefully inspire more dialogue about how to make KT something beyond an experiment or boutique industry and something that is built into the health system.
I appreciate you taking the time to comment and for spreading the word on KT.
Cameron:
“…having KT funding available is an asset and something to celebrate. But only as a start. We are so much further ahead from where we were even 10 years ago in the manner that funders and policymakers support KT. At the same time, we are a very long way from creating a sustainable model of KT programming and integrated activity.”
Today, not so much a comment as a bellyache. Some perspective on what a favored situation you’re dealing with in Canada. First, as far as I know, a consortium like David’s doesn’t exist in here in the U.S.
Second, those government KT programs which do exist are siloed and don’t talk to each other; indeed, each believes what they are doing is the only real KT.
To be able to speculate, as you and David can, on how to consolidate the gains made thus far and expand them into a permanent infrastructure, well, gosh, I wouldn’t know what to do with myself.
Okay, I’ll hang up the crying towel now.