Identifying priorities in knowledge translation from the perspective of trainees: results from an online survey

We obtained a response rate of 62 % (44/77), and the respondents completed 91 % of
the questions. The respondents self-identified as Masters or PhD students (60 %) or
faculty (14 %), with the remainder (26 %) identifying as practitioners, clinician
scientists, and fellows. Many respondents reported being involved in both KT research
and practice (45 %) or solely KT research (41 %), with the remainder involved in KT
practice or other (14 %).

The data were categorized into seven main themes related to KT priorities. Many of
these priorities relate to one another, as depicted in Additional file 1.

Determining the effectiveness of KT strategies

The most frequently mentioned KT priority concerned developing generalizable knowledge
about the effectiveness of KT strategies in various contexts. The respondents spoke
to the need for more empirical testing of KT strategies (“I believe that there needs
to be a greater number of good quality, theory-based KT interventional studies conducted
to improve our understanding of uptake and spread of knowledge”) [respondent D]. Many
suggested testing whether tailored KT strategies are more effective than generic,
one-size-fits-all strategies. The respondents emphasized the importance of adapting
existing strategies from behavior change research (“many people do not benefit from
this [the theoretical and empirical work related to behavior change] wisdom.”) [respondent
N].

Use of technology

The respondents frequently reported the need to capitalize on technologies such as
the Web, mobile phone applications, health informatics, and social media in KT research
and practice. One respondent wrote: “KT is about communication and the new technologies
provide opportunities to test and understand the dilemma of the knowledge to practice
gap differently” [respondent E]. The respondents highlighted the potential benefits
and importance of sharing data through technology and online: “Online sharing is very
easy, but the ‘open source’ mentality is far from the norm in … health research. On
a positive note, KT researchers are very open in general, since they value collaboration
and interdisciplinarity” [respondent N].

Increased involvement of key stakeholders

The respondents noted the importance of more stakeholder involvement in various aspects
of KT. This included developing partnerships with key stakeholders, such as commissioning
bodies and a broad range of end users (e.g., policy makers, health-care providers,
and patients) as well as across countries. One respondent stated, “it is not always
clear either to practitioners that their particular local/lay knowledge is always
welcome in academic research” [respondent AA]. Similarly, as another stated, “we often
forget our main partner, the patient…there is a world that we need to explore there”
[respondent K]. Lastly, the respondents acknowledged that stakeholder participation
is limited by academic culture, which does not reward academic researchers for participating
in KT practice. As one respondent [F] stated:

Academia creates incentives for publication, which we know is not an adequate strategy
for effective KT. Creating solid partnerships takes a lot of time and resources, but
those efforts are not valued and recognized in academia.

Importance of context

The respondents prioritized assessing contextual elements in two ways. First, the
respondents suggested that research is needed to clarify contextual constructs and
develop methods for collecting, analyzing, and acting on data about contexts. For
instance, the respondents prioritized pre-implementation assessments, implementation
barriers, and feasibility of implementation. Second, many respondents suggested that
specific contexts (or settings) require more KT research, such as dementia care, primary
care, nutrition, chronic care, health-care organizations, rural settings, and low-resourced
settings. For example, one respondent [F] challenged the KT research community to
pay more attention to the needs of Indigenous peoples:

I believe the CIHR model for KT does not go far enough in recognizing and valuing
different cultural (and other) factors that are necessary for effective KT with our
Indigenous people—a true ethical problem in a time when health problems are dire for
many Indigenous communities.

Finally, the respondents recommended that more attention be given to how evidence
can be adapted to local contexts.

Importance of theory

Several respondents’ priorities related to the use of theory in KT research and practice,
stating that using theory is a prerequisite for quality KT research. They expressed
their belief that using theories from diverse disciplines and perspectives is important
and also suggested using “theoretical frameworks to identify the ‘key components’
or drivers in knowledge exchange” [respondent AJ]. While some respondents suggested
specific theories (e.g., complexity theory), others referred more generally to the
importance of integrating theory and practice.

Sixteen of the 44 respondents responded that there needs to be less emphasis on developing
new KT frameworks/models and more emphasis on testing, refining, and improving those
that already exist.

Expand our ways of inquiry

Many respondents identified research priorities related to expanding our ways of inquiry. One respondent felt “we need to explore other modes of inquiry that are more finely
attuned to the particular that shed light on specific relationships between actual
people” [respondent X]. In addition, many suggested embracing a broader array of research
methodologies and approaches underutilized in KT research, such as social network
analysis, economic evaluation, mixed methods, and qualitative research. As one respondent
[AL] noted,

KT is predominantly supported from a more traditional research perspective yet continuously,
research indicates that the most critical component to the success or failure of a
KT project or strategy is contextual. Qualitative research can more effectively get
at context.

The respondents also prioritized development of valid and reliable outcome measures,
including those for contextual elements (e.g., organizational readiness for change),
complex interventions, service-system outcomes (e.g., timeliness), implementation
outcomes (e.g., sustainability), and downstream effects of KT efforts on end users
and health-care teams. They also expressed the importance of using evaluation frameworks
and of routinely conducting evaluations of KT efforts.

Finally, the respondents prioritized improved descriptions of KT processes and research
through development of reporting guidelines specific to KT. Reporting guidelines were
suggested in response to a perceived problem in the literature: “limitations of syntheses
are often related to intervention reporting” [respondent M].

Sustainability

The respondents indicated that sustainability is a top priority at the design phase
of any KT research or practice initiative. Many mentioned measuring sustainability
of KT efforts as a priority. One respondent acknowledged, “We don’t know if it is
our efforts are sustainable, or even if they should be” [respondent K]. Other respondents
noted the need for the development and testing of specific KT strategies to enhance
sustainability.