Knowledge Transfer in Health Care
© Law, M., Kertoy, M., Teplicky, R., Russell, D., King, S., Plews, N., Hanna, S., Missiuna, C., Fysh, A. & Rosenbaum, P., 2004
CanChild Centre for Childhood Disability Research
Why is Knowledge Transfer Important?
In health care, there has been increasing recognition of the need to facilitate the transfer of research evidence into clinical practice and policy development. To meet this need, health care researchers and granting agencies have begun to place more importance on the processes used to communicate knowledge from research studies and to promote knowledge uptake by appropriate audiences (e.g., service providers, managers, and policy makers). This Keeping Current brings together ideas from the literature and from organizations that are dedicated to improving knowledge transfer practices. It is intended to help researchers develop knowledge transfer strategies that are specific to their area of research and target audiences.
What Is Knowledge Transfer?
The Program in Policy Decision-Making at McMaster University defines knowledge transfer as
a process by which relevant research information is made available and accessible for practice, planning, and policy-making through interactive engagement with audiences. Knowledge transfer is supported by user-friendly materials and a communication strategy that enhances the credibility of the organization. Where relevant, knowledge transfer reinforces key messages from the research."1
There are many terms that are used to describe this knowledge transfer process. These terms include: research transfer, knowledge exchange, knowledge translation, knowledge mobilization, research uptake, research/knowledge utilization, and dissemination. Although these terms are similar and are sometimes used interchangeably, each one has a slightly different meaning. In this Keeping Current, we will use the term "knowledge transfer".
How Can Knowledge Transfer Be Accomplished?
There are many different techniques that are available to share knowledge. These techniques range from traditional approaches, such as distribution of education materials and conference presentations, to more recently popular approaches, such as the use of knowledge brokers2 and communities of practice3. The Institute for Work and Health provides definitions and examples of many of these techniques in their knowledge transfer and exchange workbook.4
With so many possible techniques, how do you decide which ones to use? The literature suggests a number of principles that are important to consider when planning knowledge transfer activities. The Program in Policy Decision-Making has incorporated these principles into five questions to help researchers develop a "systematic approach to knowledge transfer". These questions are presented in the following table and provide a framework for presenting concepts and tips from the literature (as referenced) and from the experience of CanChild researchers. The concepts and tips are not all-inclusive, but provide key ideas that will be helpful as you develop or improve upon your knowledge transfer strategies.
Ideas For Developing A Knowledge Transfer Strategy
Questions to Consider1
1. To whom should the message be delivered?
• Identify your target group(s).
• Learn about their needs, beliefs, current practices, and readiness for change.7,8
• Engage your target group in the knowledge transfer process.
• Take time to figure out who will benefit from hearing your message and who will be able to put the message into action.
• Involve your target group from the beginning of the knowledge transfer process. Often their needs will differ from what you consider to be a priority. You can
• Ask representatives of the target group to identify the most relevant aspects of the knowledge you wish to transfer.
• Ask them to identify if there are established ways of communicating within their group (e.g., some consumer organizations have newsletters that are well-distributed and read by their members).7
• Have members of your target group review draft versions of your knowledge transfer material.7 Be prepared to revise your material based on their feedback.
2. What message do you want to transfer?
• Develop a message that is:
• clear and compelling1
• relevant to your target group7
• Involving your target audience when developing your knowledge transfer strategy will help ensure the relevance and clarity of your message.
• For all target groups, use language that is easy to understand. Avoid technical terms, jargon, and acronyms.
• Within your message, identify specific things that your target group can do to put your ideas into practice and the potential implications for making these changes.8
• In situations where you would like to influence changes in practice, it can be useful to emphasize the ways in which your message is compatible with your target group's beliefs and then show how modifications to practice would preserve these beliefs, but improve their outcomes. When your message is counter to your target group's beliefs, it is particularly important to demonstrate how the changes will benefit them or be an advantage over current practice.
3. By whom should the message be delivered?
• The organization or person delivering the message should be considered to be credible by the target group.1
• The messenger should also be recognized as having expertise in the area.7
• If your target group is not familiar with you or your organization, develop a partnership with someone whom they consider to be credible.7
• Work with the credible individual or organization to facilitate communication with your target group. For example, parents of children who have had a brain injury may not be familiar with your research team; however, they will likely recognize the Brain Injury Association in your region. These parents may pay more attention to messages communicated by this credible association and at the same time will become familiar with your research team.
4. How should the message be delivered?
• Use the evidence about knowledge transfer to determine the best techniques to meet your desired outcome.
• Use an approach that meets the needs of your target group (e.g., format, level of information, accessibility).7
• Ensure that the knowledge transfer techniques you select are feasible within your budget, time and personnel constraints.
• Grimshaw and colleagues5 provide an overview of systematic reviews of interventions that are aimed at changing the behaviour of service providers. Their findings suggest that you:
• Use passive dissemination (such as distribution of educational material) when you want to increase your target group's awareness and knowledge.
• Use active, interpersonal approaches (such as educational outreach, an approach in which a trained individual provides information to service providers at their workplace4) when you want to influence changes in practice.
• Incorporate more than one technique into your knowledge transfer strategy. If you do so, consider the rationale for each technique rather than just including everything with the hope that something will work.
• Some research teams prepare separate reports for different target groups. At CanChild, we typically develop only one version of a report. We use language that is easy to understand and share specific recommendations for each target group (e.g., parents and service providers). In this way, each target group is informed about how the research relates to them and to other groups with whom they work.
• Ensure that your target group can easily access your message.7 For example, posting information on a website will only be useful for those who have Internet access.
5. With what effect?
• Identify the desired impact of your message.1,4
• Set specific objectives for each target audience.1,7
• Evaluate the impact of your message and knowledge transfer strategies.1,7
• Determine what you expect to change as a result of your knowledge transfer activities. For example, are you aiming to:
• Increase awareness of your research findings?
• Increase awareness of current issues on a topic?
• Increase knowledge in a particular area?
• Change service providers' beliefs or behaviours?
• Influence a program or policy?
• For further discussion of issues related to measuring the impact of health research, including reference to measurement tools, refer to two articles by Lavis and colleagues.9,10
Resources For Developing a Knowledge Transfer Strategy Knowledge transfer and exchange: A workbook4
Organization: The Institute for Work and Health
• This workbook is designed to help users develop knowledge transfer strategies. It contains worksheets that are based on the five knowledge transfer questions presented in the previous table. The workbook is not available on the website - you must request it by contacting their organization.
Developing an effective dissemination plan7
Organization: National Centre for the Dissemination of Disability Research
• This resource presents "Ten elements of an effective dissemination plan" and provides questions related to the ten elements that are intended to guide the development of a dissemination plan. There is a particular focus on end-users of the research. This organization defines dissemination broadly and the elements relate closely to the definition of knowledge transfer presented in this Keeping Current.
Improving knowledge transfer
Organization: The Max Locke Centre
• The information, case studies, and resources are specific to urban development researchers in the United Kingdom ; however, the eight guides provide insight and recommendations that are easily transferable to other areas of research.
Resources For the Written Components of a Knowledge Transfer Strategy
Writing health information for patients and families: A guide for creating patient education materials that are easy to read, understand and use
Authors: L. Wizowski, T. Harper, & T. Hutchings (2002)
Organization: Hamilton Health Sciences
• This resource promotes the use of plain language and provides specific steps to consider when writing and designing educational materials. Although the focus is on "patient" education materials, the concepts are relevant when preparing materials for any target group.
Communication notes: Reader friendly writing - 1:3:25
Organization: Canadian Health Service Research Foundation
• This two-page reference provides tips for writing reports for decision makers. It recommends writing a one-page overview, a three-page executive summary, and a full report that is no longer than 25 pages.
Toolkit: Disseminating research online
Organization: Global Development Network
• This toolkit provides comprehensive information and practical strategies for sharing information electronically. It covers topics such as effective online communication, helping users find your research, and tips for individuals who do not have a website.
1. Program in Policy Decision-Making. (2003). Develop a systematic approach to knowledge. (accessed on June 9, 2004 from http://www.researchtopolicy.ca/ )
2. Canadian Health Services Research Foundation. (2003). The theory and practice of knowledge brokering in Canada 's health system. Ottawa , ON : Author. (This article provides an example of CHSRF's 1:3:25 approach.) Full text available at www.chsrf.ca/brokering/pdf/Theory_and_Practice_e.pdf
3. Wenger, E. (2003). Communities of practice: A brief introduction. (accessed on July 26, 2004 from http://www.ewenger.com/theory/index.htm )
4. Reardon, R., Lavis, J., & Gibson, J. (undated). Knowledge transfer & exchange: A workbook. Toronto , ON : Institute for Work and Health.
5. Grimshaw, J.M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., et al., (2001). Changing provider behavior: An overview of systematic reviews of interventions. Medical Care, 39, 8 Suppl 2:II-2-II-45.
6. Grimshaw, J.M., Thomas, R.E., MacLennan, G., Fraser, C., Ramsay, C.R., Vale, L. et al., (2004). Effectiveness and efficacy of guideline dissemination and implementation strategies. Health Technology Assessment, 8, 6, iii-iv, 1-72. (full text available at http://www.ncchta.org/execsumm/summ806.htm )
7. National Centre for the Dissemination of Disability Research. (2001). Developing an effective dissemination plan. (accessed on June 9, 2004 from http://www.ncddr.org/du/products/dissplan.html )
8. National Centre for the Dissemination of Disability Research. (1996). A review of the literature on dissemination and knowledge utilization. (accessed on June 9, 2004 from http://www.ncddr.org/du/products/review/index.html )
9. Program in Policy Decision-Making. (2003). Measure the impact of the research you fund or produce. (accessed on June 9, 2004 from http://www.researchtopolicy.ca/ )
10. Lavis, J., Ross, S., McLeod, C., & Gildiner, A. (2003). Measuring the impact of health research. Journal of Health Services Research and Policy, 8, 3, 165-170.
Want to know more about knowledge transfer? Contact:
Dianne Russell, Co-Investigator
CanChild Centre for Childhood Disability Research
Institute for Applied Health Sciences, Room 408
1400 Main St. W., Hamilton, ON L8S 1C7
Tel: 905-525-9140 x 27853 Fax: 905-524-0069