Those of you who follow me on Twitter (@alitwy) and Facebook (Alison Twycross) will know that earlier this month I attended the Specialist Knowledge Translation Training at Sick Kids, Toronto run by Melanie Barwick (@MelanieBarwick) on behalf of @KidsinPain. (See https://bit.ly/2Jbsi87 for additional details about the course.) The course is intended to develop knowledge and attitudes towards knowledge translation and improve participants’ ability in communicating their research findings.
The first thing I learnt was that implementation is not the same as knowledge translation (KT) (Box 1). This is an important distinction and something it took me a while to get my head around, particularly as in the past I have often recommended using so called KT models, such as Promoting Action on Research Implementation in Health Services (PARIHS) (Rycroft-Malone 2010), to support the implementation of evidence into practice. What these models can do is provide a framework for implementation.
Box 1: Implementation and KT are related but not synonymous
|Key point: Implementation and KT are related but not synonymous.
Knowledge translation: strategies that make research findings understandable to the knowledge user.
Implementation: the use of strategies to promote the use of evidence in practice and change practice
The distinction between knowledge translation and implementation is important. Basically, before we can implement findings into practice, we need to make them understandable to the people accessing the knowledge. Using appropriate KT strategies should increase the impact of research. As researchers we have an ethical and moral obligation to make sure our research findings are disseminated appropriately. In the UK the Research Excellence Framework (REF) assesses the impact of our research (see: https://www.ref.ac.uk/media/1092/ref-2019_01-guidance-on-submissions.pdf). Getting to grips with effective KT strategies is, therefore, important.
For more than 20 years, I have been publishing the results of my research, often concluding that current evidence is not used in practice and that this adversely impacts on patient care. Academics are expected to publish in good quality journals – indeed this is one of the factors considered in academic promotions. However, what is becoming increasingly apparent – and perhaps we have always known this deep down – is that simply publishing a paper does not change practice.
As a nurse researcher, I carry out research to improve the quality of patient care. One of the key things I learnt during SKTT was that for this to happen I need to pay more attention to KT strategies and not think that once I had published the research and maybe presented at a conference or two that this was job done and that people would automatically start using my research findings in practice. Indeed, there is increasing evidence that many academic papers are not read or cited (see: https://bit.ly/2L0UCZ3) and it is widely agreed that it takes 17 years for research findings to be implemented into practice (Morris et al. 2011).
So, what steps do we need to take to communicate our research effectively? In a relatively short Blog, there is not time to go into too much detail but my key take away messages from SKTT were, the need to:
- Write our messages in plain language, relevant to the audience. If you get this right your reader should understand the message the first time they read it. A plain language checklist is available at: https://bit.ly/2N36tZF. This suggests thinking about 1) the single most important thing (SMIT) and 2) the bottom line actionable message (BLAM).
- Think about the formatting and design of how we present the information. Things to think about include:
- use headings and/or bullet pointed lists to break up the text
- consider using visual images instead of text
- would a webinar or video get your message across more effectively
- Involve end users in developing the messages – in the same way as we involve service users in designing research studies, include them in the work developing the messages and/or to pilot test the KT strategies.
Professor Alison Twycross
Editor: Evidence Based Nursing
Independent Consultant in Nurse Education and Research
Morris, Z.S., Wooding, S. and Grant, J. (2011) The answer is 17 years, what is the question: understanding time lags in translational research, Journal of the Royal Society of Medicine, 104(12): 510-520.
Rycroft-Malone, J. (2010). Promoting Action of Research Implementation in Health Services (PARIHS). In Rycroft-Malone, J and Bucknall, T (eds.) Models and Frameworks for Implementing Evidence-Based Practice: Linking Evidence to Action, Oxford: Wiley-Blackwell, 109-136.