Does all knowledge need to be translated? By every researcher?

26 September 2014

Bev Holmes, MSFHR’s Vice-President, Research & Impact, was one of the speakers at the fifth annual InspireNet conference, Connect 2014, held in Vancouver on Sept. 22. The theme of this year’s conference was “Using Research to Improve Health Care – Change, Challenge and Opportunity in Knowledge Translation (KT)”.

InspireNet is an MSFHR-funded network of over 3,300 researchers, practitioners, policy-makers, educators and students working together to improve health services in British Columbia, Canada.

Organizers of this year’s InspireNet conference posed a challenging question to the closing panel as my colleagues and I wrapped up the day’s events on September 22.

With researchers Drs. Sharon Straus (Professor, University of Toronto Department of Medicine) and Anne Sales (Professor, University of Michigan School of Nursing), I was asked to reflect on:

  • How can we improve integrated and end-of-grant knowledge translation (KT) in health care?

The question is challenging for a couple of reasons: first, there’s almost no end of answers. And second, it sounds straightforward, but it’s not. From the perspective of a funder, I spoke about what this question raised for me…which was more questions!

Who is the “we” that should be improving KT? The research community? Policy-makers? British Columbians? There doesn’t seem to be enough thinking about who is responsible for what in KT. Even if “we” meant everyone in the audience that day, we all wear many hats: student, care-provider or clinician, patient, members of organizations, and more.

Does everyone have to be good at KT?  Researchers and their health care partners, for all their expertise and experience, are not necessarily the people who should be developing and implementing communications plans, talking to politicians, or taking a product to market. Nor do they have the “levers” that may be needed to change rules and regulations so their findings can be applied.

Many funders emphasize the full continuum of research-to-practice in competitions, but perhaps we’re encouraging simplistic thinking about what it takes to move evidence into practice.

As I thought about these points more, it made me question whether the distinction between end-of-grant and integrated KT always helpful.

Regardless of what KT they’re doing, research teams need to think about engaging their stakeholders audiences from the beginning. A focus on the end-of-grant KT concept may lead to overuse of resources on communications products at the study’s close – not the most strategic way to get a message across and effect change.

At the other end of the spectrum, the concept of integrated KT – working with “knowledge users” throughout the study – makes it sound like implementation is covered. Working with knowledge users makes research more relevant, but it doesn’t guarantee uptake. Perhaps a better approach is to ask “who needs to do what KT, when and how, in order for this project to meet its objectives?”

Finally, should funders be more realistic about the outcomes we expect from researchers?

Competition for funding leads to claims about how crucial a project is, and what great things it will accomplish – quickly. There’s also pressure to publicize findings widely, usually in isolation of other studies. It’s all but impossible to learn from mistakes when all everyone wants to hear about is success.

By reflecting on these issues more deeply, all of us who are involved in health research can do our part to improve integrated and end-of-grant KT in health care.