What use is research and the latest clinical evidence if it isn’t being used on the front lines of patient care? Researchers are now turning to an interaction-based view of knowledge translation, a broader contextualization of knowledge beyond just empirical evidence, in order to boost implementation and adoption rates of clinical software and technology.
HARNESSING “REAL WORLD” EXPERIENCE
Knowledge-in-practice, better known as tacit knowledge, is developed from direct, practical experience. It’s highly pragmatic and situationally specific, meaning that at times, this kind of knowledge can be difficult to articulate in a formal manner, and is often disseminated through interactive conversation and shared experience.
Much of technical knowledge and clinical evidence must be coupled with the tacit knowledge of clinicians who have worked in their fields of specialty in order to develop tools and solutions that make practical and tangible sense in clinical settings. Contextualizing explicit knowledge, or empirical evidence and research, and integrating it with previously held experiential knowledge of clinicians is a critical step towards ensuring that the evidence will actually be implemented and adopted in the realities of clinical practice.
VARYING CONTEXTS AND PREFERENCES
There is a growing awareness of the different preferences for various types of knowledge in particular contexts. One study surveyed tertiary-level hospitals in Alberta and Ontario and found that nurses in those organizations actually preferred social interactions and experiential knowledge to more traditional, formal sources, such as books and journals.
Additionally, integrating a tacit knowledge approach to traditional evidence is critical to accommodating different environments in which public health is practiced, such as some public schools for example. This creates an interesting challenge if one is only considering empirical evidence as a guiding tool. Knowledge translation must be examined in situ and within a team-based context, as health care is trending more and more towards a multi-disciplinary, collaborative, team-based approach.
MULTI-DISCIPLINARY TEAM OF KNOWLEDGE TRANSLATORS
Combining both explicit knowledge and socially contextualized, experiential knowledge will be the key to improving clinical knowledge translation. The most effective way of ensuring that both empirical and practical objectives are being met requires knowledge translation specialists to work in a team-based environment that leverages the collective tacit knowledge, and varying expertise of different members of the team.
Knowledge translation teams should also be comprised of individuals who have practiced in different clinical settings and capacities, such as large, tertiary-level hospitals, to long-term care facilities, and primary care groups. The hands-on knowledge that a nurse brings will differ widely from a clinical pharmacist, or an acute care clinician. Having a diverse, multi-disciplinary team helps direct clinical evidence to a more patient-centric focus.
Estabrooks, C., Scott-Findlay S., Rutakumwa, W., Duan, Q., Rozanova, J. The Determinants of Research Utilization in Acute Care: Pain Management in Adult and Paediatric Settings. Faculty of Nursing, University of Alberta. Edmonton, Alberta. December 2004.