Knowledge Translation Series - Guest Editor, Sharon Straus
Knowledge translation is the use of knowledge in health care decision making

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Abstract

Objective

To provide an overview of the science and practice of knowledge translation.

Study Design

Narrative review outlining what knowledge translation is and a framework for its use.

Results

Knowledge translation is defined as the use of knowledge in practice and decision making by the public, patients, health care professionals, managers, and policy makers. Failures to use research evidence to inform decision making are apparent across all these key decision maker groups. There are several proposed theories and frameworks for achieving knowledge translation. A conceptual framework developed by Graham et al., termed the knowledge-to-action cycle, provides an approach that builds on the commonalities found in an assessment of planned action theories.

Conclusions

Review of the evidence base for the science and practice of knowledge translation has identified several gaps including the need to develop valid strategies for assessing the determinants of knowledge use and for evaluating sustainability of knowledge translation interventions.

Introduction

What is new?

Despite significant investment in and substantive productivity of biomedical, clinical, health services and population health research, consistent evidence shows that health systems fail to optimally use evidence with resulting inefficiencies and reduced quality of life. This has resulted in growing emphasis on knowledge translation and efforts to develop the science and practice of knowledge translation. In this article we describe a framework for knowledge translation that can be used by decision makers and researchers.

Globally, health care systems are experiencing the challenges of improving the quality of care and decreasing the risk of adverse events [1]. Health systems fail to optimally use evidence with resulting inefficiencies and reduced quantity and quality of life [2], [3]. For example, McGlynn et al. [4] found that US adults received less than 55% of recommended care. Simply providing evidence from clinical research (such as through publication in journals or presentation at scientific meetings) is necessary but not sufficient for the provision of optimal care or decision making. The science and practice of knowledge translation is needed to answer these challenges. The growing emphasis on knowledge translation (and recognition that our knowledge about how to achieve knowledge translation is incomplete) has led to the establishment of an interdisciplinary field of research. Knowledge translation research and enhanced capacity in this field are essential if we are to reap the benefits of health research, improve health and quality of life, and enhance productivity. This article provides an overview of the topic and serves as an introduction to a series of articles on the science of knowledge translation that will appear in this journal.

Section snippets

What is knowledge translation?

There have been many terms used to describe the process of putting knowledge into action [5]. In the UK and Europe, the terms implementation science or research utilization are commonly seen in this context. In the United States, the terms dissemination and diffusion, research use, knowledge transfer, and uptake are often used. In Canada, the terms knowledge transfer and exchange and knowledge translation are commonly used. In their work to create a relevant search filter, McKibbon et al. have

Why is knowledge translation important?

Failures to use research evidence to inform decision making are apparent across all key decision-maker groups, including health care providers, patients, informal carers, managers, and policy makers, in developed and developing countries, and in care provided by all disciplines. Practice audits performed in a variety of settings have revealed that high-quality evidence is not being consistently applied in practice [8]. For example, although several randomized trials have shown that statins can

What are the determinants of successful knowledge translation?

Multiple factors determine the use of research by different stakeholder groups [14], [15], [16], [17], [18]. A common challenge that all decision makers face relates to the lack of knowledge management skills and infrastructure (the huge volume of research evidence currently produced, access to research evidence, time to read and skills to appraise, understand and apply research evidence) [14], [17]. Better knowledge management is necessary, but this is insufficient to ensure effective

What is knowledge translation research?

The science of knowledge translation research is still in its infancy, and there are many gaps in the evidence base. Knowledge translation research includes work to explore measurement of gaps in decision making; improve knowledge synthesis and distillation (such as determinants of when systematic reviews and guidelines should be updated or how to enhance implementability of guidelines); enhance diagnosis and measurement of determinants of knowledge uptake; and determine effectiveness and

The knowledge-to-action framework: a model for the practice of knowledge translation

There are several proposed theories and frameworks for achieving knowledge translation that can be confusing for those responsible for it [19], [20], [21], [22], [23]. A conceptual framework developed by Graham et al., termed the knowledge-to-action cycle, provides an approach that builds on the commonalities found in an assessment of more than 30 planned action theories. It has been adopted by the CIHR as the accepted model for promoting the application of research and a framework for the

Conclusions

We must be careful to avoid the “knowledge translation imperative” that all knowledge must be translated into action. Instead, we need to ensure that there is a mature and valid evidence base before we expend substantial resources on implementation of this evidence. And, the realities of health care systems are that we have insufficient resources to do everything, and thus, we must work with stakeholders (including patients/public, clinicians, and policy makers) to establish an explicit

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