What is knowledge translation?

Knowledge translation is a both a multidimensional concept and emerging discipline that looks at methods and mechanisms for closing the gap between what we ‘know’ from research evidence and what we ‘do’ in real world health care settings1.

Knowledge translation is formally defined as the ‘dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system’2.

Others terms for knowledge translation

  • evidence uptake
  • knowledge-to-action
  • implementation science
  • research utilisation or use
  • dissemination and diffusion
  • knowledge transfer

Why is knowledge translation important?
We know that costly research with the potential to advance healthcare quality and patient outcomes often fails to be implemented in a timely way into practice or policy. This occurs internationally, across all disciplines, and at all levels of governance3. The result of this failure for patients is inevitably suboptimal care and reduced quality of life. For a society, poor knowledge translation leads to reduced productivity overall and wasted public resources.

Characteristics of knowledge translation
Knowledge translation looks at the multiple processes that affect how evidence is generated, communicated and used as well as barriers to the transfer and uptake of this knowledge. It pays particular attention to the actual contexts in which the knowledge will be used4. By determining the specific needs and issues of potential users of knowledge, more relevant and effective ways of researching, communicating and measuring health activities can be developed5.

Knowledge translation is a more encompassing concept than evidence-based practice, continuing professional development, or even research dissemination. It encompasses multiple activities which are simultaneously ongoing, interactive, nonlinear, and impact-oriented6. This includes multidirectional engagement, rather than purely one-way communication, between researchers and a range of knowledge end-users such as policy-makers, health care providers, educators, and the general public7.

The Knowledge-Translation-Action (KTA) cycle

The KTA cycle8 can be a useful planned action approach for researchers at the outset of a research project, clinicians attempting to effect change at an individual practice or organisational culture level, and policy makers working at the level of population health.

The phases of KTA include:

  • the creation of new knowledge in response to identified gaps in the knowledge base
  • the creation of knowledge syntheses (e.g. systematic reviews) and knowledge translation tools (e.g. clinical practice guidelines and policy briefs)
  • multiple dissemination strategies based on the target group and the type of knowledge being translated
  • a process of identifying, reviewing, and selecting valid and ‘translatable’ knowledge before considering how it might be adapted for a local context
  • assessing barriers to knowledge use at the level of the individual, team, organisation, or system
  • selecting, tailoring, and implementing relevant research for the specific context
  • monitoring the ongoing application of this ‘new’ knowledge, evaluating any outcomes of its use, and implementing systems to sustain its ongoing agency.

translation_process

Used with the permission of Canadian Institutes of Health Research (CIHR).
Image from: http://www.cihr-irsc.gc.ca/e/39033.html

 

Knowledge translation in palliative and end of life care
Palliative and end-of-life care faces particular issues with regard to the translation of evidence from research to use. Its multidisciplinary nature brings different research paradigms and frameworks into play. There are challenges in defining outcomes as well as establishing outcome measures. Palliative and end-of-life care is also provided in many different settings, adding to the difficulty in developing effective communication and dissemination strategies.

Most health professionals will require some understanding and familiarity with palliative care practice. Many palliative care providers do not work only in palliative care, meaning that palliative care research competes with the findings of other fields and specialties. There may also be resistance to changing practice and a belief that reliance on evidence will undermine the care concepts that have driven the development of palliative care. By recognising these considerations, we can start to develop processes and approaches that support change and development in the field and enhance patient and family outcomes.

 

New CRE-ELC Module on Knowledge Translation

A new module on the KTA approach uses a palliative care scenario to explore knowledge translation principles Go to the module