Tag: social media

eHealthinnovationpublic healthsocial innovationsocial media

Seeing the lights in research with our heads in the clouds

Lights in the clouds

Lights in the clouds

Some fields stagnate because they fail to take the bold steps into the unknown by taking chances and proposing new ideas because the research isn’t there to guide it while social innovation has a different twist on the problem: it has plenty of ideas, but little research to support those ideas. Unless the ideas and research match up it is unlikely that either area will develop.

 

Social innovation is a space that doesn’t lack for dreamers and big ideas. That is a refreshing change of pace from the world of public policy and public health that are well-populated by those who feel chained down to what’s been done as the entry to doing something new (which is oxymoronic when you think about it).

Fields like public health and medicine are well-served by looking to the evidence for guidance on many issues, but an over-reliance on using past-practice and known facts as the means to guide present action seriously limits the capacity to innovate in spaces where evidence doesn’t exist and may not be forthcoming.

The example of eHealth, social media and healthcare

A good example of this is in the area of eHealth. While social media has been part of the online communication landscape for nearly a decade (or longer, depending on your definition of the term), there has been sparse use of these tools and approaches within the health domain by professionals until recently. Even today, the presence of professional voices on health matters is small within the larger discourse on health and wellbeing online.

One big reason for this — and there are many — is that health systems are not prepared for the complexity that social media introduces.  Julia Belluz’s series on social media and healthcare at Macleans provides among the best examples of the gaps that social media exposes and widens within the overlapping domains of health, medicine, media and the public good. Yet, such problems with social media do not change the fact that it is here, used by billions worldwide, and increasingly becoming a vehicle for discussing health matters from heart disease to weight management to smoking cessation.

Social innovation and research

Social innovation has the opposite problem. Vision, ideas, excitement and energy for new ideas abound within this world, yet the evidence generation to support it, improve upon it and foster further design innovations is notably absent (or invisible). Evaluation is not a word that is used much within this sphere nor is the term research applied — at least with the rigour we see in the health field.

In late May I participated in a one-day event in Vancouver on social innovation research in Vancouver organized by the folks at Simon Fraser University’s Public Square program and Nesta as part of the Social Innovation Week Canada events.Part of the rationale for the event can be explained by Nesta on its website promoting an earlier Social Frontiers event in the UK:

Despite thriving practitioner networks and a real commitment from policymakers and foundations to support social innovation, empirical and theoretical knowledge of social innovation remains uneven.

Not only is this research base uneven, it’s largely invisible. I choose to use the word invisible because it’s unclear how much research there is as it simply isn’t made visible. Part of the problem, clearly evident at the Vancouver event, is that social innovation appears to be still at a place where it’s busy showing people it exists. This is certainly an important first step, but as this was an event devoted to social innovation research it struck me that most attendees ought to have already been convinced of that.

Missing was language around t-scores, inter-relater reliability, theoretical saturation, cost-benefit analysis, systematic reviews and confidence intervals – the kind of terms you’d expect to hear at a research conference. Instead, words like “impact” and “scale” were thrown out with little data to back them up.

Bring us down to earth to better appreciate the stars

It seems that social innovation is a field that is still in the clouds with possibility and hasn’t turned the lights on bright enough to bring it back down to earth. That’s the unfortunate part of research: it can be a real buzz-kill. Research and evaluation can confirm what it means for something to ‘work’ and forces us to be clear on terms like ‘scale’ and ‘impact’ and this very often will mean that many of the high-profile, well-intentioned initiatives will prove to be less impactful than we hope for.

Yet, this attention to detail and increase in the quality and scope of research will also raise the overall profile of the field and the quality and scope of the social innovations themselves. That is real impact.

By bringing us down to earth with better quality and more sophisticated research presented and discussed in public and with each other we offer the best opportunity for social innovation to truly innovate and, in doing so, reach beyond the clouds and into the stars.

Photo credit: Lightbulb Clouds by MyCatkins used under Creative Commons License. Thanks Mike for sharing!

behaviour changecomplexitypublic healthsocial systemssystems thinking

The New Zombie

Zombie stare

They are among us and hungry for brains

Zombies are attacking us; not for brains, but for attention. The consequences of this is that they are everywhere and sucking the intelligence out of human systems. 

Forget orange, zombie is the new black.

Zombies are hot. TV shows, books and films about zombies are more popular than ever, and this time of year the public’s attention to the undead is at its nadir. The CDC in the United States even got into the act by using zombies as a health promotion vehicle to support emergency preparedness. From zombie walks to art shows, the staggering brain-eating, brain-less are everywhere.

Yet, there is a new breed being formed that doesn’t eat brains and has them, but may not be using them well and they are all around us everywhere.

They walk among us

Look around and what do you see? People online, on the phone, texting and walking and driving, being everywhere except where they are. Examples of people walking into fountains or falling into a sinkhole while on the phone are often seen as comi-tragic, yet they belie a remarkably powerful trend towards disengagement from the world around them. Charlene deGuzman and Miles Crawford‘s beautiful and disheartening short film I Forgot My Phone plays this for further comic and sad effect as they portray a day in the life of someone paying attention to those not paying attention to anything away from their screen. The film highlights the modern paradox of being more connected than ever, yet overwhelmingly alone.

Emerging research is showing remarkable spikes in risks associated with mobile phone use and injury and mortality. We might laugh at people falling into holes or bumping into things, but only when it hurts the ego and not the body. This is serious stuff. Keep in mind that we don’t see non-reported injuries (e.g., someone bruising their head) and the many near misses between person and object — including cars, which have their own epidemic of problems with texting and attention.

Indeed, zombies embody paradox: a brainless being that is undead seeks brains to stay unalive. Whether they are alive or dead depends on where you stand and that is what makes them a complex character despite their surface-level simplicity.

Brains…need…more…(use of science) brains….

Zombie Science

Zombie Science?

While it might be easy to point to those on phones, zombie behaviour occurs elsewhere in places where the effects are far less comic and just as dangerous. The latest issue of The Economist features a cover story on the problems science is having with it credibility and quality control. Some of this is due to what I would call zombie-like behaviour: mindless attention in a manner that restricts awareness and appreciation of one’s immediate context and the larger system to which that behaviour occurs.

The recent expose by science journalist John Bohannon published in the journal Science exposes zombie-like thinking in how open-access science journals accept and reject papers. Bohannon’s inquiry was prompted by questions about the way fees were charged for open access journals (which is how they can remain open to the public) and the peer review require to advance publication. Presumably, an article has to pass review from peer professional scientists before it is accepted and then the fee is paid. No acceptance, no fee (except for perhaps a small application processing charge).

As profiled in an interview with the CBC radio show The Current

Bohannon wanted to find out whether fee-charging open access journals were actually keeping their promise to do peer review — a process in which scientists with some knowledge of a paper’s topic volunteer to check it for scientific flaws…

…In the end, what he concluded was that “a huge proportion” of the journals were not ensuring their papers were peer reviewed.

Even in cases where peer review happened, it didn’t always function correctly. For example, the Ottawa-based International Journal of Herbs and Medicinal Plants clearly sent the paper out to be reviewed by real scientists, who pointed out some flaws, Bohannon recalled. Even so, when Bohannon submitted a revised version of the paper without correcting any of the flaws, it was accepted.

Bohannon’s approach and findings are not without some problems of their own, but they don’t much change the conclusion that there are deep problems within the scientific enterprise.

Much of what Bohannon found can be attributed to greed, but a great deal of it is due to bad scientific practice. As a consultant who is also a publishing researcher and ‘recovering’ academic I know the enormous amount of energy that goes into publishing an academic article in a scholarly journal. As one who is sent between 4 to 5 manuscripts to review from legitimate journals per month I know the demands that are placed on reviews. We also publish far too much for the system to handle. Writing in the Chronicle of Higher EducationMark Bauerlein and colleagues look closely at the ‘avalanche’ of publishing and shed light on many reasons why the problems that the Economist and Science occur (Note: I’d strongly encourage you to read through the comments as it is as instructive as the article itself).

They are everywhere

To add to the examples of zombie culture I need only look to my own daily life outside of science and  mobile phones. Just the other day I witnessed the following example at a community meeting that was organized in part to discuss the expenditure of funds to make a better living area for people in a building:

Presenter: “…and I am pleased to conclude that the new furniture for the outdoor spaces is going to be made by a company that created the same products at [place] out of recycled materials. We will expect to have the new furniture here in 6 to 8 weeks. Any questions?”

First question: “I love the work you’ve done. Can you tell me when the furniture will be here?”

Sadly, I have many other stories that show that many people are not paying attention. They are sitting through workshops and not picking up basic concepts (even after having asked for it and having been given it multiple times over), asking for materials that were already shared on multiple occasions, suggesting ideas that were already discussed and agreed upon over because that person didn’t engage in the discussion and so on. This happens not because people are stupid, but because they are disengaged.

A simple search through statistics compilations finds enormous material on what kind of inputs we expose ourselves to and its impact on attention. There is more coming at us in quantity and context and that is undoubtedly influencing quality of processing and engagement. I can speak of this personally and through observation. The amount of times I find people not hearing what is said, processing it effectively, or even remembering something said is staggering.

It’s not surprising. We are alerted everywhere: a text message, a phone call, a Facebook message, an email, an app alert, someone coming by the office, external noise outside, and visual noise everywhere. The explicit and ambient signals we are exposed to in a day is staggering. Clay Shirky suggests it’s not that we have too much information, it’s that our filters are failing. I think it’s now both and one reinforces the other.

Coming back…a look at systems

While individuals are distracted, they are products of distracted systems. To look at one part of the science zombie situation, professors are now asked to publish more than ever, get grants from a dwindling pool, teach more students than ever and in more crowded conditions and with greater social needs, and to find ways to make their research more accessible to different audiences while engaging more with the communities of interest affected by that research. All of this takes time. Add to that the probability that the professor her/himself has to raise their own salary and that the only way to do this is to be very successful at the above-mentioned tasks and you get someone who is stressed and overtaxed.

Mindfulness-based approaches do not change any of that, but they can help strengthen the filter. By being more individually mindful, but more importantly create mindful organizations. Building resilient tribes of social innovators and the leadership communities to steward them is another. Granting ourselves the time to reflect, sensemake and listen to the systems we work in is also key. By listening better, we are better able to design systems that are innovative, responsive and humane by building them to human scale.

All well and good you might say, but how? That’s what’s to come in some future posts as we look at designing better systems and making them more attractive so people stay engaged.

Stay tuned….and watch out for zombies.

Photo credit: Zombie Walk 2012 SP by Gianluca Ramalho Misiti used under Creative Commons License

complexityemergencejournalismknowledge translationsocial media

Shaking the System of Knowledge Translation and Journalism

Media covering the media talking about the media #riptide #media #harvard #journalism

Leveraging systems change comes when you are willing to examine the system itself, not just the component parts. News media is struggling to remain financially viable in a time when readership / viewership is high and revenues low by considering ways to adapt to an online world and the way it thinks about the problem will go a long way to whether it can solve it.  

Last night The Joan Shorenstein Center  at Harvard University hosted an event launching the public face of an initiative called Riptide, which sought to create an oral history of journalism as it transmophizes from independent media like paper, television and radio into what I would say is transmedia and social mediaThe Riptide Project has already been criticized for its lack of diversity of its subject matter to the point of being called “The History of Internet News, as Told by Rich, White Men” , although for its many faults it does bring together individuals who have shaped the landscape of the English-language news. That story is still worth listening to and learning from.

The event was organized around a panel featuring AOL Chairman Tim Armstrong, Caroline Little – head of the Newspaper Association of America, and New York Times publisher Arthur Sulzberger Jr. The one hour event featured some wide-ranging discussion on how mainstream media has responded to digital challenges and is seeking to promote quality journalism amidst all these threats (A summary of key points are summarized in a Storify  (click link)).  Among the points that stood out was one NOT discussed and that was around the news systems themselves. While AOL, local newspapers and international publishers like the NY Times were exploring different media vehicles for news — such as AOL’s Huffington Post and recently scaled back local news network Patch — the way journalism was to be done was basically the same, except for journalists this means more work.

There was much handwringing over the threats to the system of journalism and publishing without seeing it as a system that itself requires adaptation at a fundamental level.

Seeing the system

While the event was focused on news and journalism, it could have easily been a parallel lecture in the world of health and scientific publishing and knowledge translation or knowledge mobilization. The leaders were speaking about how they were adding video, using social media and pointed to the well-known (and critiqued) ‘Snowfall‘ journalistic endeavour tried at the New York Times as an example of doing things differently. Snowfall is a multi-media story that brings video, text, and audio together under a NY Times digital umbrella and was intended to show how old and new media could work together. Yet, there are many critics who point out that the apparent success of this new multi-media, long form journalism was really just window dressing and that the numbers — 3 million visits — actually obscured a harder truth that indicated that very few of those readers went through it all. Most skimmed. Few got the whole story

The parallels with academic publishing are startling. For all the talk of high-impact scientific publications, the truth is that getting an article included in a top-flight academic journal is — if it is very well received — is likely to garner less than a few dozen citations. Yet the amount of energy and resources that go into these publications is enormous.

Academic journals are seeking to respond to this challenge by using open-access and web-based publishing, but the same fundamental challenge exists: adapting to new media while keeping the old. The publishing model is not developing, it is adapting to threats and not necessarily in a way that is resilient.

A developmental challenge

Developmental evaluation and design is about transforming the system as you move it along. It means being willing to examine or re-examine commonly held assumptions and working with changing conditions as they change, not just upon past reflection as we saw last night. It also means considering what developing a program is all about, not just improving it. Slide number 17 of the presentation below illustrates how this might look in practice. Developmental evaluation is not about program improvements, it is about developing them further to adapt and respond to changing conditions. The resulting program response might be something that is more effective at achieving goals, but that is not the primary focus.

For journalism the risk is that they will add all these additional layers to their product without questioning the assumptions behind what it means to do good journalism. Are journalist going to be videographers, photographers and web coders as well? The point was raised that the Huffington Post has a climate where journalists sit next to engineers. While creative and useful for looking at innovation, it doesn’t help if journalists, editors and publishers are still also doing all of what they used to do and now need to add on additional activities. At some point it all suffers. Yet, the panelists also argued that strong brands like the NY Times will do well when quality markers fail in the sea of low-brow content. How can this be if the resources to do good reporting aren’t there? You can’t act like a budget outfit, but claim to be bespoke.

Academics and scientists are in the same situation. They are being pushed to deliver high quality science and teaching in an age of diminishing resources, with few good metrics to assess outcome,  TED-worthy presentations, Tweet, blog and get into the community to speak to end-users. It is a lot and might even be possible if the system changed to support it. Instead, fewer resources are given, less support for excellence provided and the expectations rise.

Without quality knowledge translation — whether it be great science journalists or outstanding health scientist or clinical communicators — our entire system will collapse. There is too much information to sift through, it is too complex of a system to operate in, and there are far too many actors to navigate it well. Journalists and their institutions can provide common touch points for many across the system and the woes, challenges and systems issues they face are ones we face in health sciences. Learning from what they did and didn’t do in the realm of communication is worthy as is watching where they go as we seek to question if other areas of health communication need to follow.

Audience seeking direction on the future of #journalism by hearing from leaders of the past #riptide

art & designcomplexityjournalismscience & technologysystems science

300: Crises in Complexity, Opportunities in Design

Designing ideas

Designing ideas

In 2009 Censemaking was launched as a platform to explore issues in complexity and ways we can make sense of it to design for better futures and a sustainable world. After 300 posts it has become evident that there is much more to write as we see ever-new crises from complexity and ever-greater design opportunities to deal with it all.

As I was reflecting on what to write for my 300th post  for Censemaking I found myself — as I often do — drawing some connections between disparate experiences as I started my daily reading and listening. Within moments of sitting at the table with materials, turning on the radio, and scanning online I found the following semi-related stories:

  • On the Stack, the Internet radio show about magazine publishing on Monocle 24, panelists were exploring the crisis of reporting that comes from citizen journalism and the generally lower quality of photography and detail that comes when professional work gets pushed out for reasons of economics and expediency;
  • This followed a profile of Ghost Lab – a hands-on architecture program that runs every summer to teach architects ways to link what founder Brian McKay-Lyons calls “the world of ideas and the world of things”  – a space that many designers are surprisingly disconnected from;
  • In the Globe and Mail newspaper (tablet edition), a column by Kathryn Borel, writes on reading both Miley Cyrus and Syria and the sanctimony that comes when we judge what is worthy reading;
  • The brilliant web comic The Oatmeal has circulated an insightful, funny and sad piece looking at what it takes to draw people’s attention to Syria’s conflict and the crises it promotes;
  • An email exchange from a group of colleagues — journalists and scientists — on how to collectively present the state of research and journalism to an audience of policymakers and peers at the upcoming Canadian Science Policy Conference;
  • Thumbing through two new magazine options that seek to bridge the gap between science, design, and public affairs by relying on quality content and publishing than advertising (The Alpine Review and Nautilus – below)
Premiere Issues of Nautilus & The Alpine Review

Premiere Issues of Nautilus & The Alpine Review

Within each of these categories is a reflection of some form of crisis — an unstable situation affecting many people — particularly the worlds of science, journalism, politics, publishing, policy, and design.

Patterns of complexity

This motley collection of tidbits loosely connects science, design, public affairs, knowledge translation and communication, and the complexity that comes when they intersect. It seems fitting that this greeted me as I sat down to write post #300.

The Censemaking name is a riff on both the name of my social innovation consultancy (CENSE Research + Design) and the term sensemaking that is a trans-disciplinary field / practice of making meaning from complex, divergent data points and experience (which is what I help my clients, collaborators and students do). It has been a vehicle that has allowed me the freedom and pleasure to explore the knotty intersections of these disparate areas of practice and scholarship that don’t fall under any particular umbrella, yet are things that are wrestled with in health promotion, industry, publishing and media, social services, policymaking, the military and social enterprise (to speak of a few).

And as I often do, I find the strangest threads are often the most useful in understanding complexity and our world.

Taking Miley Cyrus seriously

That I would even put those four words above together above might have already turned you off, but stick with me. While the Miley Cyrus reference in the above list of media notes might be the most disparate of them all, complexity science teaches us that there is often gold in looking at weak signals and Miley Cyrus might be the best example of that in this list.

In a week where the once Hannah Montana actor and singer has garnered enormous attention in the media for her moves, her behaviour and her attitude at last weekends’ MTV Video Music Awards, particularly her performance with singer Robin Thicke it seems there is little left to discuss. Or not.

Some media sources commented on Ms. Cyrus’ actions as a tasteless media ploy.

Others jumped on the fact that it was Miley Cyrus who got all the flack for the acts performed while Robin Thicke, a married father, gets away with little public condemnation despite being the main performer of a song with a deeply sexist, near misogynistic lyrics, message and related video.

The Belle Jar Blog points to how Miley’s appropriation of black culture is a racist and patriarchal act that deserved the real condemnation as much as any sexual act that it was associated with, something that only adds to the slut-shaming says the Washington Post who nevertheless seek to question the fuss.

Reading and contemplating Miley’s performance could at once be seen as juvenile, offensive, and racist, while also represent shrewd marketing, behaviour not inconsistent with previous VMA awards and its time-honoured practice of female sexualization to draw eyeballs (and commentary) , and a situation reflective of a woman growing up at a time and place where the lines between activities rooted in a particular racial, ethnic, geographic, socio-demographic heritage are — no pun intended — quite blurred and may be genuinely obscured to her.

This is a rather banal, yet clear example of the way complexity and wicked problems rise up from an interconnected, multimedia, 24/7, global culture of communication that we’ve created for ourselves. Miley is at once a perpetrator, a victim and a bystander all at the same time. She is a social construction and a real person who is accountable for what she says and does (but to whom and for what?). That is complexity in the modern age of public engagement, expression and media.

It’s one example. We are facing similar thorny, hairy issues with vaccination, big data, chronic disease, community planning, social media, journalism’s independence and viability, educational policy and the structure of learning, private-public partnerships for social benefit and beyond. There is no simple answer or simple problem. Sensemaking is a way to understand complexity and then determine what it means.

Designing compelling futures

When you know better you do better – Maya Angelou

Better knowing is the biggest step towards better doing. Sensemaking complexity means looking broadly and deeply, consulting widely and taking the time to reflect on what it means. Being mindful of our time, and its disruption, is critical.

What comes from that is the possibility not just to understand our world, but to shape it into something we deem to be better for us all. This motivation to shape is what makes us human. We are the one species that creates for enjoyment, expression, and practical need. We are makers and designers and often both at the same time.

Design is the conscious intent to shape things while design thinking is a means of engaging complexity to foster more effective designs. We cannot control complexity, but we can design for it (PDF) and work with the emergent patterns it produces. This process of design for emergence and developmental design, which brings together sensemaking, structured feedback through ongoing developmental evaluation, and foresight methods allows us to take account of complexity without letting it take hold of us. It helps us make the world we want, not just accept the world we get.

Thank you

Thank you to all of my readers — the tens of thousands of people who have come to Censemaking since it started and the many of you who come regularly and share it with the world. In a world of attention scarcity, I am deeply appreciative of you spending some of your time with my work.

I am a believer in what popular math video-blogger Vi Hart says about blogging: do it for yourself.

Create your own audiences.  I am honoured to have been able to create the audience I have; thank you for being a part of it. I hope to continue to provide you with things to contemplate and help you make sense of.

I look forward to the next 300 posts and finding new ways to navigate and contemplate complexity and design for innovation.

Image: Thinkstock used under license & Cameron Norman

public healthsocial media

Attack on Anti-vac – Toronto Public Health vs. Jenny McCarthy

Yesterday I posted on the story of Toronto Public Health tweeting a call for its followers to voice concerns to the TV show “The View” about the recent hiring of Jenny McCarthy, a prominent anti-vaccination advocate, as its new co-host. Today, Nicole Ghanie-Opondo reflects more deeply on what kind of impact such tweeting really has and the role of public health in voicing its concerns from that of an insider. What should we expect from these Tweets? What really drives change? Why is there resistance to engaging the public and how can we professionally do so in the complicated, messy work that comes with social media engagement? Huge questions to ask and the fact that people like Nicole and her blog collaborator Corey are doing it speaks to how much change potential we can expect. One of the best blog reads you’ll find on this topic.

Public Health and Social Media

I wanted to keep quiet on this issue, being the pioneer and former voice of Toronto Public Health’s Twitter for 3 years…but I think in the spirit of reflection – let’s blog on!

Cameron Norman explains the issue really well in his post ‘Public Health and Social Media: Catching Fire from Small Sparks. Here’s another opinion via Jim Garrow on why governments should have an opinion, as junk scientists do. To sum it up, Toronto Public Health tweeted at Jenny McCarthy regarding her anti-vaccine views and requested The View to change their mind about having her as a host.

2013-07-24 08.17.32 pm

My biased opinion.

I love my public health peeps and especially adored the pioneering and willing spirit Toronto Public Health had in the early days of its foray into social media. Like family, bureaucracy and public health practioners come with their own baggage. One large piece of baggage around public health messaging…

View original post 922 more words

education & learninginnovationjournalismknowledge translation

Is Knowledge Translation In Health Too Important to Leave to Health Professionals?

Storytelling

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 synthesisdisseminationexchange 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 storiessome 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

Knowledge Translation, Exchange & Integration NGram

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

Knowledge Term Trends

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