Ch 9

Question 1

Research transfer

Answer 1

◦Despite the need for research transfer, the best methods for doing it still remain a mystery for many who embrace evidence-based practice (EBP).
◦Traditionally, “transfers of health care information” took place through the undiscriminating distribution of print media (bulletin/journal article) or large group seminars.
◦Either the information was not reaching those who needed it, it wasn’t convenient for the practitioners who wanted to learn, or the format of the material alienated the participants.

Question 2

Models of knowledge transfer

Answer 2

Some research theories about how to transfer knowledge into practice have centered on changing the behavior of individual practitioners while others have centered on changing the organizations in which practitioners work.

Question 3

Readiness to Change
(The Transtheoretical Model)

Answer 3

◦How clinicians respond to new knowledge depends on their readiness to make changes at the time the information is provided

◦Focus is on the individual

Question 4

Stages of change and process of change

Answer 4

Precontemplation Consciousness Raising
Contemplation Emotional Arousal
Preparation Commitment
Action Reward
Maintenance Environmental- Reevaluation

Question 5

“the process by which an innovation is communicated through certain channels over time among members of a social system.”

Answer 5

Innovation

Question 6

Stages of innovation decision process model

Answer 6

1. Knowledge (learning about a new idea)
   2.Persuasion (forming an opinion about the idea)
   3.Decision (deciding to use the idea or not)
   4.Implementation (trying out the new idea)
   5.Confirmation (evaluating the implementation of the idea)

Question 7

Recent research about knowledge transfer and diffusion of innovations indicates:

Answer 7

◦Use of mass media channels in health care such as peer-reviewed journals, newsletters, TV/radio, presentations, and short information bulletins are effective to increase knowledge and awareness.

◦Interpersonal transfer strategies (e.g., using opinion leaders, face to face communications) are most effective in ensuring actual implementation of innovations and are most effective during the persuasion and decision stages of Roger’s Model

Question 8

Methods of Knowledge Transfer

Answer 8

◦Continuing education courses (interactive or didactic)
◦Expert opinion
◦Journal articles/educational materials
◦Research summaries/abstracts
◦Audit and feedback
◦Reminders
◦Educational outreach (academic detailing)
◦Influential educational leaders/opinion leaders
◦Clinical guidelines
◦Patient-mediated interventions

Question 9

Toolkit on Knowledge Exchange
(Provincial Centre of Excellence for Child and Youth Mental Health, 2006)

Five Key Strategies for KT:

Answer 9

1.Cultural approach (artifacts, symbols, storytelling, socializing to affect tacit knowledge)
2.Multi-sector partnerships (bring different strengths together)
3.Conferences and conference leverage (push out or pull in knowledge)
4.Research summaries (tailored specifically; wide range of audiences)
5.Supportive infrastructures

Question 10

Technology Enabled Knowledge Transfer, Information and communication technologies that push out evidence:

Answer 10

◦Handheld PDAs give physicians immediate access to knowledge
◦Likely the way of the future (few/no innovations currently in rehab)

◦Assist practitioners with info access and uptake
◦Improve speed of uptake of research in policy making
◦Facilitate transfer of public data to policy makers
◦Support communities of practice–shared knowledge

Question 11

Evidence-Based Policy

Answer 11

◦Inherently political
◦Not always a logical process, but based on the considerations of health care policy research and the consensus of a group who may not be experts.
◦Processes that work in EBP don’t necessarily translate into EB policy.
◦Researchers see evidence in policy as a fundamentally linear and rational process; decision makers see more variety and are less likely to act on a single piece of evidence.

Question 12

Knowledge-driven model

Answer 12

1.Research
2.Technological Development
3.Use (adoption of technology
4.Quality of implemented actions
5.Outcome

•Requires “perfect knowledge”

Question 13

Problem-driven model

Answer 13

1.Definition of a problem
2.Identification of missing knowledge
3.Acquisition of knowledge, various possible channels
4.Interpretation for the problem situation
5.Use (adoption of technology)

Question 14

Research transfer model as three-pronged mechanism:

Answer 14

Input
Throughput
Output

Question 15

Emphasis on preparing practitioners to gather and assimilate new information.

Answer 15

Input

Question 16

Interpreting knowledge to be useful for individuals, preparing to teach others the knowledge.

Answer 16

Throughput

Question 17

Reflection on research process and improvements; feedback loop.

Answer 17

Output

Question 18

True/False: Effective research transfer dissemination strategies conform to personal learning needs of the researcher and utilize at least two different strategies simultaneously.

Answer 18

True

Question 19

Requires “perfect knowledge” and assumes knowledge will be adopted without impediment; unrealistic.

Answer 19

Knowledge-driven model

Question 20

Alternative approach; begins with a problem rather than research. Acknowledges that evidence distribution is not always perfect and that policy makers tend to draw upon previously available information.

Answer 20

Problem-driven model

Question 21

Consist of series of clinical recommendations that have been assembled from the best possible evidence.

Answer 21

Practice guideline’s

Question 22

True/False: Researchers see evidence in policy as a fundamentally linear and rational process; decision makers see more variety and are less likely to act on a single piece of evidence.

Answer 22

True