Skip to main content

Advertisement

SpringerLink
Log in

Leveraging knowledge translation and implementation science in the pursuit of evidence informed health professions education

  • Reflections
  • Published:
Advances in Health Sciences Education Aims and scope Submit manuscript

Abstract

Evidence informed approaches to health professions education can ensure accountability to learners and society in providing meaningful and effective education and helping resource strained systems via streamlined and cost-efficient practices. Knowledge translation and implementation science are two areas of study originally developed in clinical medicine in response to concerns that health care practices were incongruent with the scientific evidence. Two decades of research have led to important advances in our understanding of the nature and magnitude of research-practice gaps, the factors that support or impede adoption of evidence in clinical decision-making, and in the design and evaluation of theory driven interventions to reduce gaps. This paper borrows concepts from knowledge translation and implementation science to further our thinking about how health professions education can ‘truly’ be evidence informed. The article is organised in four sections: a discussion of the impetus for the evidence informed health professions education movement; a description of the origins of knowledge translation and implementation science; a discussion on how knowledge translation and implementation science can be leveraged to advance the evidence informed health professions education agenda; and suggestions for future discussion and research. An example is used to illustrate the application of the underpinning principles of knowledge translation and implementation science. The authors suggest a theory driven, staged and systematic approach that integrates knowledge translation principles and processes and involves key stakeholders interested in promoting the application of educational research of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ajzen, I., & Fishbein, M. (2000). Attitudes and the attitude-behavior relation: Reasoned and automatic processes. European Review of Social Psychology, 11, 1–33.

    Article  Google Scholar 

  • Albert, M., Hodges, B., & Regehr, G. (2007). Research in medical education: Balancing service and science. Advances in health sciences education : theory and practice, 12, 103–115.

    Article  Google Scholar 

  • Anaby, D. K.-B. N., Steven, E., Tremblay, S., Snider, L, Avery, L., & Law, M. (2017). Current rehabilitation practices for children with cerebral palsy: Focus and gaps. Physical & Occupational Therapy in Pediatrics 37.

  • Atkins, L., Francis, J., Islam, R., O’Connor, D., Patey, A., Ivers, N., et al. (2017). A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implementation Science, 12, 77.

    Article  Google Scholar 

  • Bauer, M. S., Damschroder, L., Hagedorn, H., Smith, J., & Kilbourne, A. M. (2015). An introduction to implementation science for the non-specialist. BMC Psychology, 3, 32.

    Article  Google Scholar 

  • Birken, S. A., Powell, B. J., Shea, C. M., Haines, E. R., Alexis Kirk, M., Leeman, J., et al. (2017). Criteria for selecting implementation science theories and frameworks: results from an international survey. Implementation Science, 12, 124.

  • Birken, S. A., Rohweder, C. L., Powell, B. J., Shea, C. M., Scott, J., & Leeman, J., et al. (2018). T-CaST: An implementation theory comparison and selection tool. Implementation Science, 13, 143.

  • Bonham, C. A., Sommerfeld, D., Willging, C., & Aarons, G. A. (2014). Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies. Psychiatry Journal, 2014, 802983–802983.

    Article  Google Scholar 

  • Bowen, S. J., & Graham, I. D. (2013). From knowledge translation to engaged scholarship: promoting research relevance and utilization. Archives of Physical Medicine and Rehabilitation, 94, S3-8.

    Article  Google Scholar 

  • Bragge, P., Grimshaw, J., Lokker, C., & Colquhoun, H. (2017). Aimd: A validated, simplified framework of interventions to promote and integrate evidence into health practices, systems (p. 17). Bmc Medical Research Methodology: And Policies.

  • Brehaut, J. C., Colquhoun, H. L., Eva, K. W., Carroll, K., Sales, A., & Michie, S., et al. (2016). Practice feedback interventions: 15 suggestions for optimizing effectiveness. Annals of Internal Medicine, 164, 435–441.

    Article  Google Scholar 

  • Brehaut, J. C., & Eva, K. W. (2012). Building theories of knowledge translation interventions: Use the entire menu of constructs. Implementation Science, 7, 114.

    Article  Google Scholar 

  • Broekkamp, H., & Van Hout-Wolters, B. (2007). The gap between educational research and practice: A literature review, symposium, and questionnaire. Educational Research and Evaluation, 13, 203.

    Article  Google Scholar 

  • Brown, C. H., Curran, G., Palinkas, L. A., Aarons, G. A., Wells, K. B., Jones, L., et al. (2017). An overview of research and evaluation designs for dissemination and implementation. Annual Review of Public Health, 38, 1–22.

    Article  Google Scholar 

  • Bryant, J., Boyes, A., Jones, K., Sanson-Fisher, R., Carey, M., & Fry, R. (2014). Examining and addressing evidence-practice gaps in cancer care: A systematic review. Implementation Science, 9, 37.

    Article  Google Scholar 

  • Cane, J., O’Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7, 37.

    Article  Google Scholar 

  • Caplan, N. (1975). The use of social science knowledge in policy decisions at the national level: A report to respondents.

  • Colquhoun, L., Hetts, J. L., Law, C. L., Macdermid, C. J., & Missiuna, A. C. (2010). Canadian Journal of Occupational Therapy, 77, 270–279.

    Article  Google Scholar 

  • Cook, D. A., & Beckman, T. J. (2010). Reflections on experimental research in medical education. Advances in health sciences education, 15, 455–464.

    Article  Google Scholar 

  • Corish, B. (2018). Medical knowledge doubles every few months: How can clinicians keep up?

  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A. & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4.

  • Dauphinee, W. D., & Wood-Dauphinee, S. (2004). The need for evidence in medical education: the development of best evidence medical education as an opportunity to inform, guide, and sustain medical education research. Academic Medicine: journal of the Association of American Medical Colleges, 79, 925–930.

    Article  Google Scholar 

  • Davies, P., Walker, A. E. & Grimshaw, J. (2010). A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. Implementation Science, 5.

  • Duncombe, D. C. (2018). A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice. Journal of Clinical Nursing, 27, 1216–1226.

  • Durning, S., Dolmans, D., Cleland, J., Mennin, S., Amin, Z., & Gibbs, T. J. (2012). The AMEE Research Committee: Initiatives to stimulate research and practice. Medical Teacher, 34, 458–461.

    Article  Google Scholar 

  • Gale, B., & Schaffer, M.A. (2009). Organizational readiness for evidence-based practice. The Journal of Nursing Administration, 39, 91–97.

  • Godin, G., Belanger-Gravel, A., Eccles, M., & Grimshaw, J. (2008). Healthcare professionals’ intentions and behaviours: A systematic review of studies based on social cognitive theories. Implementation Science, 3, 36.

    Article  Google Scholar 

  • Graham, I. D. (2012). RE: Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches.

  • Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., & Caswell, W. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26, 13–24.

    Article  Google Scholar 

  • Green, L., & Kreuter, M. (2005). Health program planning: An educational and ecological approach. New York: McGraw-Hill.

    Google Scholar 

  • Greenhalgh, T., & Russell, J. (2006). Promoting the skills of knowledge translation in an online master of science course in primary health care. Journal of Continuing Education in the Health Professions, 26, 100–108.

    Article  Google Scholar 

  • Gupta, D. M., Boland, R. J., & Aron, D. C. (2017). The physician’s experience of changing clinical practice: A struggle to unlearn. Implementation Science, 12, 28.

    Article  Google Scholar 

  • Hammersley, M. (2004). Some questions about evidence-based practice in education. In E.-B. Education (Ed.), Thomas R & Pring, P. Maidenhead: Open University Press.

    Google Scholar 

  • Harden, R. M., Grant, J., Buckley, G., & Hart, I. R. (2000). Best evidence medical education. Advances in Health Sciences Education: Theory and Practice, 5, 71–90.

    Article  Google Scholar 

  • Hayward, D. V., & Phillips, L. M. (2009). Considering research quality and applicability through the eyes of stakeholders. Quality Research In Literacy And Science Education: Springer.

  • Hull, L., Goulding, L., Khadjesari, Z., Davis, R., Healey, A., Bakolis, I., & Sevdalis, N. (2019). Designing high-quality implementation research: Development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide. Implementation Science, 14, 80.

    Article  Google Scholar 

  • Institute of Medicine Committee on Quality of Health Care In, A. (2001). Crossing The Quality Chasm: A New Health System For The 21st Century. Washington (Dc): National Academies Press (Us). Copyright 2001 By The National Academy Of Sciences. All Rights Reserved.

  • Institute of Medicine Committee on the Health Professions Education, S. (2003). In: Greiner, A. C. & Knebel, E. (Eds.) Health Professions Education: A Bridge To Quality. Washington (Dc): National Academies Press (Us). Copyright 2003 by The National Academy Of Sciences. All Rights Reserved.

  • Irby, D. M., Cooke, M., & O’Brien, B. C. (2010). Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Academic Medicine, 85, 220–227.

    Article  Google Scholar 

  • Jacobs, S. R., Weiner, B. J., & Bunger, A. C. (2014). Context matters: measuring implementation climate among individuals and groups. Implementation Science, 9, 46.

    Article  Google Scholar 

  • Kuper, A., Albert, M., & Hodges, B. D. (2010). The origins of the field of medical education research. Academic Medicine, 85, 1347–1353.

    Article  Google Scholar 

  • Lapaige, V. (2010). “Integrated knowledge translation” for globally oriented public health practitioners and scientists: Framing together a sustainable transfrontier knowledge translation vision. Journal of multidisciplinary healthcare, 3, 33–47.

    Article  Google Scholar 

  • Levin, B. (2013). To know is not enough: Research knowledge and its use. Review of Education, 1, 2–31.

    Article  Google Scholar 

  • Lizarondo, L., Grimmer-Somers, K., & Kumar, S. (2011). A systematic review of the individual determinants of research evidence use in allied health. Journal of Multidisciplinary Healthcare, 4, 261–272.

    Article  Google Scholar 

  • Lortie, D. C. (1975). Schoolteacher. Chicago: IL, University of Chicago Press.

    Google Scholar 

  • Lysenko, L. V., Abrami, P. C., Bernard, R. M., Dagenais, C., & Janosz, M. (2014). Educational research in educational practice: Predictors of use. Canadian Journal of Education/Revue canadienne de l’éducation, 37, 1–26.

    Google Scholar 

  • Maggio, L. A., Thomas, A., Chen, H. C., Ioannidis, J. P. A., Kanter, S. L., & Norton, C., et al. (2018). Examining the readiness of best evidence in medical education guides for integration into educational practice: A meta-synthesis. Perspectives on Medical Education, 7, 292–301.

    Article  Google Scholar 

  • McGlynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., Decristofaro, A., & Kerr, E. A. (2003). The quality of health care delivered to adults in the United States. The New England Journal of Medicine, 348, 2635–2645.

    Article  Google Scholar 

  • McLean, M., Cilliers, F., & van Wyk, J. (2008). Faculty development: Yesterday, today and tomorrow. Medical Teacher, 30, 555–584.

    Article  Google Scholar 

  • MICHIE, S . (2014). Implementation science: Understanding behaviour change and maintenance. BMC Health Services Research, 14, O9–O9.

    Article  Google Scholar 

  • Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., & Hardeman, W., et al. (2015). Process evaluation of complex interventions: Medical Research Council guidance. BMJ : British Medical Journal, 350, h1258.

    Article  Google Scholar 

  • Nielsen, K. J., Kines, P., Pedersen, L. M., Andersen, L. P., & Andersen, D. R. (2015a). A multi-case study of the implementation of an integrated approach to safety in small enterprises. Safety Science, 71, 142–150.

    Article  Google Scholar 

  • Nielsen, S. K., Stube, J., & Bass, G. (2015b). Bridging the gap: evaluation of a pilot project to facilitate use of psychosocial strategies across an occupational therapy curriculum. Occupational Therapy in Health Care, 29, 126–138.

    Article  Google Scholar 

  • Nilsen, P., & Bernhardsson, S. (2019). Context matters in implementation science: A scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Services Research, 19, 189.

    Article  Google Scholar 

  • NORMAN, G. . (2007). Editorial—how bad is medical education research anyway? Advances in Health Sciences Education, 12, 1–5.

    Article  Google Scholar 

  • OECD. (2012). Equity and quality in education: Supporting disadvantaged students and schools. OECD Publishing.

  • Onyura, B., Légaré, F., Baker, L., Reeves, S., Rosenfield, J., Kitto, S., et al. (2015). Affordances of knowledge translation in medical education: A qualitative exploration of empirical knowledge use among medical educators. Academic Medicine, 90, 518–524.

    Article  Google Scholar 

  • Patterson, F., Cleland, J., & Cousans, F. (2017). Selection methods in healthcare professions: Where are we now and where next? Advances in Health Sciences Education, 22, 229–242.

    Article  Google Scholar 

  • Patterson, F., Knight, A., Dowell, J., Nicholson, S., Cousans, F., & Cleland, J. (2016). How effective are selection methods in medical education? A systematic review. Medical Education, 50, 36–60.

    Article  Google Scholar 

  • Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 38, 65–76.

    Article  Google Scholar 

  • Reed, D. A., Beckman, T. J., & Wright, S. M. (2009). An assessment of the methodologic quality of medical education research studies published in <em>. The American Journal of Surgery, 198, 442–444.

    Article  Google Scholar 

  • Schuster, M. A., McGlynn, E. A., & Brook, R. H. (1998). How good is the quality of health care in the United States? The Milbank quarterly, 76(517–63), 509.

    Google Scholar 

  • Squires, J. E., Hutchinson, A. M., Bostrom, A. M., O'rourke, H. M., Cobban, S. J. & Estabrooks, C. A. (2011). To what extent do nurses use research in clinical practice? A systematic review. Implementation Science Is, 6, 21-5908-6-21.

  • STEINERT, Y . (2000). Faculty development in the new millennium: Key challenges and future directions. Medical Teacher, 22, 44–50.

    Article  Google Scholar 

  • Steinert, Y. (2011). Commentary: Faculty development: The road less traveled. Academic Medicine, 86, 409–411.

    Article  Google Scholar 

  • Steinert, Y., Mann, K., Centeno, A., Dolmans, D., Spencer, J., Gelula, M., & Prideaux, D. (2006). A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Medical Teacher, 28, 497–526.

    Article  Google Scholar 

  • Steinert, Y., Naismith, L., & Mann, K. (2012). Faculty development initiatives designed to promote leadership in medical education. A BEME systematic review: BEME Guide No. 19. Medical Teacher, 34, 483–503.

    Article  Google Scholar 

  • Stetler, C. B. (2010). Stetler model. In J. Rycroft-Malone & T. Bucknall (Eds.), Models and frameworks for implementing evidence-based practice: Linking evidence to action (pp. 51–82). Oxford: Wiley-Blackwell.

    Google Scholar 

  • Straus, S. E., Tetroe, J. M., & Graham, I. D. (2011). Knowledge translation is the use of knowledge in health care decision making. Journal of Clinical Epidemiology, 64, 6–10.

    Article  Google Scholar 

  • Thistlethwaite, J., Davies, H., Dornan, T., Greenhalgh, T., Hammick, M., & Scalese, R. (2012). What is evidence? Reflections on the AMEE symposium, Vienna, August 2011. Medical Teacher, 34, 454–457.

    Article  Google Scholar 

  • Thomas, A., & Bussieres, A. (2016a). Knowledge translation and implementation science in health professions education: Time for clarity? Academic Medicine, 91, e20.

    Article  Google Scholar 

  • Thomas, A., & Bussieres, A. (2016b). Towards a greater understanding of implementation science in health professions education. Academic Medicine, 91, e19.

    Article  Google Scholar 

  • Thomas, A., Gruppen, L. D., Van Der Vleuten, C., Chilingaryan, G., Amari, F. & Steinert, Y. (2019). Use of evidence in health professions education: Attitudes, practices, barriers and supports. Medical Teacher.

  • Thomas, A., & Steinert, Y. (2014). Faculty development and knowledge translation. In Y. Steinert (Ed.), Faculty development in the health professions: A focus on research and practice. Dordrecht: Springer.

  • Thomas, P., Kern,De, Hughes, Mt, & Chen, By. (2016). Curriculum development for medical education: A six-step approach, United States.

  • Tractenberg, R. E., & Gordon, M. (2017). Supporting evidence-informed teaching in biomedical and health professions education through knowledge translation: An interdisciplinary literature review. Teaching and Learning in Medicine, 29, 268–279.

    Article  Google Scholar 

  • van der Vleuten, C. P. M., Dolmans, D. H. J. M., & Scherpbiera, A. J. J. A. (2000). The need for evidence in education. Medical Teacher, 22, 246–250.

    Article  Google Scholar 

  • Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, 67.

  • Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., et al. (2017). Psychometric assessment of three newly developed implementation outcome measures. Implementation Science, 12, 108.

    Article  Google Scholar 

  • Wong, G., Greenhalgh, T., Westhorp, G., & Pawson, R. (2012). Realist methods in medical education research: What are they and what can they contribute? Medical Education, 46, 89–96.

    Article  Google Scholar 

  • Yardley, S. (2014). Lost in translation: Why medical education research must embrace ‘real-world’complexities. Medical Education, 48, 225–227.

    Article  Google Scholar 

  • Yardley, S., Littlewood, S., Margolis, S. A., Scherpbier, A., Spencer, J., Ypinazar, V., & Dornan, T. (2010). What has changed in the evidence for early experience? Update of a BEME systematic review. Medical Teacher, 32, 740–746.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada

    Aliki Thomas & André Bussières

  2. Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada

    Aliki Thomas

  3. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada

    Aliki Thomas & André Bussières

  4. Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada

    André Bussières

Authors
  1. Aliki Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. André Bussières
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aliki Thomas.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thomas, A., Bussières, A. Leveraging knowledge translation and implementation science in the pursuit of evidence informed health professions education. Adv in Health Sci Educ 26, 1157–1171 (2021). https://doi.org/10.1007/s10459-020-10021-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-020-10021-y

Keywords

Search

Navigation