Background
Methods
Context
Outcomes (operationalization)
Study design
Quantitative phase
Step 1: document review
Step 2: survey
Data analysis
Qualitative phase
Methodology
Participants and recruitment
Procedure and data collection
Data analysis
Results
Document review
Survey
N = 37
| n | |
---|---|---|
Project Status | Completed | 29 |
In progress | 8 | |
Study Design | Qualitative | 17 |
Quantitative | 11 | |
Other | 9 | |
Mixed Methods | 8 | |
Study Setting | Rehabilitation | 16 |
Other (community-based (5), university (3), national or international network of clinicians (3), communities of practice and school district) | 13 | |
Acute care | 7 | |
N/A | 5 | |
Tertiary care | 3 | |
Target population | Health care providers | 22 |
Adults (18–65) | 12 | |
Other professionals (managers (2), administrative staff (2), educators in rehab ethics, students, faculty, elementary school teachers) | 8 | |
Older adults (65+) | 5 | |
Parents or caregivers | 4 | |
Other (researchers, university students, decision makers) | 4 | |
School-aged children (4–12) | 3 | |
Adolescents (13–17) | 2 | |
Community/NGOs/grassroots | 1 | |
N/A (scoping review) | 1 | |
Infant/toddler (0–3) | 0 | |
Health condition of study population | No specific condition/mixed | 10 |
N/A (health care providers (4), scoping review)) | 5 | |
Chronic pain | 4 | |
General mental health | 4 | |
Stroke | 3 | |
Back pain (including neck) | 3 | |
Cerebral Palsy | 2 | |
Rheumatoid arthritis/Osteoarthritis | 2 | |
Hip fracture | 1 | |
Autism Spectrum Disorder | 1 | |
Spina Bifida | 1 | |
Multiple Sclerosis | 1 | |
Osteogenesis Imperfecta | 1 | |
Burn survivors | 1 | |
Stakeholders involved in the project | Health system/care practitioners | 28 |
Health System/Care Managers | 15 | |
Patients/consumers of health system/care | 14 | |
Families/caregivers | 7 | |
Health System/Care Administration | 7 | |
Students | 6 | |
Health System/Care Professional Organizations | 4 | |
Federal/Provincial Representatives | 2 | |
Community/Municipal Organizations | 2 | |
Consumer Groups/Charitable Organizations | 2 | |
Others (professors, teachers) | 2 | |
Media | 1 | |
Industry/Corporation | 0 | |
Use of a KT framework | Yes | 28 |
No | 9 | |
Name of framework or conceptual model used (N = 28) | KTA cycle | 22 |
Theoretical Domains Framework | 2 | |
KTA cycle + Technology Acceptance Model | 1 | |
KTA cycle + Consolidated Framework for Implementation Research | 1 | |
Ottawa Model of Research Use | 1 | |
Transtheoretical model of health behavior change | 1 |
N = 37 | n | |
---|---|---|
What is the primary outcome measured? | Clinician practice behaviors | 19 |
Clinician knowledge | 17 | |
Clinician attitude towards evidence | 14 | |
Process evaluation | 10 | |
Knowledge dissemination | 8 | |
Stakeholder engagement | 7 | |
Patient outcomes evaluation | 4 | |
N/A | 4 | |
Community attitude towards evidence | 4 | |
Patient knowledge | 3 | |
Other practice change | 2 | |
Other | 2 | |
Patient attitude towards evidence | 1 | |
Informing policy | 1 | |
How was the primary outcome measured? | Questionnaire | 22 |
Focus group | 12 | |
Semi-structured interviews | 12 | |
Other | 9 | |
Standardized Outcome Measure | 3 | |
Concept mapping | 0 |
N = 37 | n | % | |
---|---|---|---|
Level of satisfaction with the actual impact of your project | Very satisfied | 7 | 19 |
Satisfied | 11 | 30 | |
Somewhat satisfied | 6 | 16 | |
Neutral | 5 | 14 | |
Not satisfied | 1 | 3 | |
Did not answer
|
7
|
19
| |
How were the results of the project disseminated? | Scholarly conference | 24 | |
Publication | 18 | ||
In-service workshop in your clinical setting | 7 | ||
Further funding | 6 | ||
Graduate course | 5 | ||
In-service/workshop in another clinical setting | 4 | ||
In-service/workshop in your research setting | 3 | ||
Web-based resource | 2 | ||
Material | 1 | ||
Non-peer-reviewed paper | 1 | ||
Did not answer
|
6
| ||
Level of agreement with the statement: I am very satisfied with the partnership I formed with the clinical site | Strongly agree | 16 | 43 |
Agree | 9 | 24 | |
Somewhat agree | 3 | 8 | |
Neutral | 7 | 19 | |
Somewhat disagree | 0 | 0 | |
Disagree | 1 | 3 | |
Strongly Disagree | 0 | 0 | |
Did not answer
|
1
|
3
|
Focus group with principal investigators
Overarching themes | Nested categories | Excerpts |
---|---|---|
Individual projects are framed within a broad vision of research | A project is a piece of a larger research project | Research is on the 5 to 10-year plan, so [projects] are just pieces of bigger programs for which the funding was extremely useful Well they are taking a piece of a larger project With one year projects, if you don’t continue on, there is no way to have any long-term or very extensive evaluation of impacts |
KT framework as essential | It needs to be framed within a larger project where this creation of knowledge will serve to be implemented You need to word it in a knowledge translation framework […] You need to frame it in terms of knowledge translation | |
Planning ahead for sustainability | I would take that end part of the grant application where you look at future directions very seriously, as opposed to saying a couple publications here. Consider whether a publication is really the end point of this. If you don’t know where you’re going with your project, you’re not going to get there. So, you have to design the project from the end and sort of say where do I want to go and what piece is this. We already know that we have to think about sustainability right from the beginning or at least where its going to lead in the future. It basically died after the funding period ended […] So, sustainability is a real issue. | |
We can’t measure everything | Lessons learned by researchers | This is research, not everything is going to work out, but if you don’t try, and the lessons learned, with all due respect, you learn those lessons even if you apply those in 5 years […] You learned how to engage a group, the continuity is in you, that is where the continuity is. There are learning lessons also that come from, at least from one of the projects where it was very challenging to recruit. They help plan future projects that we want to take. It is part of a larger project, so these are actually very useful for us to learn and improve on what we are doing |
Project leader as an agent of change | What is not really measured is the change in attitude and their engagement. I think it is very significant and I’m quite sure would have significant and important impact in their respective practice with their colleagues [Clinicians] feel more empowered to changing. | |
The unknown impact of dissemination strategies | There are a lot of outcomes that may not be so tangible that we may not continue to measure and we don’t know whether things have changed, attitudes or practices that have been implemented in different ways. A lot of what I’ve learned in these projects has informed students in my teaching. | |
Ambiguity around defining success | Success | That may be actually an important aspect in terms of judging the success of the project, as where the intended impact is expected to happen. I mentioned I was involved in a current project the goal was to produce a meta-analysis. There I would say, publication of that data would be a successful project because the goal is not to impact a specific group of clinicians at a specific centre, but to distribute a certain better analyzed knowledge wide It’s not necessarily a project that gets finished but a project that leads to something more. So I think it was successful in the sense it was published and we understand, we moved forward. But not yet successful in the way that we really changed practice. It was just the beginning. So successful, ‘yeah, we published and understood’. But not yet, ‘yeah I’m happy I’m done, we are just starting’. If a project has an ending, I’m not sure it’s a successful knowledge translation project. |
Failures | I thought it wasn’t successful because the student did not finish and did not produce publications The project I was involved in was not necessarily successfully even if we reached all the goals we had set out, simply because there was no follow-up to those goals. There is no such thing as failure. Because...The whole [research program] is not going to fall apart because of your one study | |
Building partnerships with clinicians and clinical program directors | Clinical context as a significant driver | Right now, the current funding, the way things are, you don’t have time for research. […] you just see so many patients a day and that’s the reality. [clinicians] can have ideas, but you know they are not going to have the time free to do it. The system just doesn’t allow it. These higher level structural organizational kinds of things do make a big difference and can really help get clinicians on board. We used to have a salary award by foundation, this has been suspended for two years now. But the salary award program was very successful. |
Understanding clinician motivation | Engaging with clinicians, engaging with other partners, I think that as a group, we need to think about what’s in it for them. Like what are the people going to get out of it that’s going to make it sustainable, and you know, participation, and you know, that sort of thing, and making it clear on that. This is called motivation, it is the effort against the outcome. So maybe the outcome was not high enough for the effort. I think we have to kind of think of that. In terms of how much effort are we asking our people to do and what is the outcome for them. | |
Feasibility of projects co-led by clinicians | The questions that are being raised by clinicians are pretty unviable. And you know the methodology that you need to ask them is like impossible, like beyond the scope. They tend to be asking impossible questions, like questions that are very high level […] almost policy level questions. That’s part of the disconnect between what they want to get out of it and the reality of what they can achieve. |
Theme 1: Individual projects are framed within a broad vision of research
Theme 2: We can’t measure everything
Theme 3: Ambiguity around defining success
Theme 4: Building partnerships with clinicians and clinical program directors
Interviews with project leaders
Overarching themes | Nested categories | Excerpts |
---|---|---|
Project Deliverables | Scientific contribution | Two articles, I did 4–5 oral presentations and an international conference, a poster presentation. There was something produced now that is available on YouTube and Internet site that physios, OTs and the general population can see. |
Training and development | It demystified what research was and made it more accessible. I feel more confident answering patients’ questions. I feel more confident in my abilities to go get the information. Being an agent of change in terms of pushing the team here, we all know there’s a positive to doing it, but now I have the back-up, the information to back it up. It’s also the people that you meet and you’re growing your network. So, I think that helped my career. I don’t know if it’s a career, but it did help my academic CV to improve. | |
Increased awareness of best practices | Now there’s more formal kind of processes in place to incorporate the knowledge and the expertise of the patients into decision-making. It had an impact on the psychologists and physicians I work with, […] the overall care of the team, I like to say, has changed. We didn’t change the world, but maybe it started to bring ideas or reminded physios that this was a hot topic and something to think about. Awareness increase, that could be my outcome. The awareness of clinicians was a bit greater after the project. Clinical outcomes are hard… for the clinical side, I have to say, it didn’t change much. | |
Step in a larger effort | Getting the pilot, like a small part of the project started, so after you can have some data to show to bigger grants, so, a first step, a good first step. I feel like I just did one piece on a big puzzle that is way too big to handle by myself. | |
Difficulty measuring clinical changes | It’s hard to say sometimes, because you never know, people what they’re gonna take with them and how they’re going to apply that in their clinical practice. I brought the results of our scoping review and shared our results with the participants. Did they integrate that knowledge? Did it lead to a change in their practice? I don’t know for sure. Change does not happen within three months, only within a year, two years, and we don’t have any way to capture that. You don’t have time to grow with the project. | |
Exploration of partnership dynamics | Shared leadership | I think it was a good partnership because I brought my reflection, my mind, my reflexivity from clinical practice. And they were willing to help me out with the research background, to make sure my research was well-thought and would be strong research proposal. Power issues were related to hierarchies that emerged based on perceived education, knowledge, status of different stakeholder. |
Researcher as the leader | So when you don’t know the process, you need somebody to guide you and that’s what the mentor was there for, for me. Guidance. Every step of the way. Everything was discussed with me, but I didn’t coordinate what was going on […] I didn’t have to worry about… all the questions about feasibility and reliability. Everything was dealt with by the research department, with the researcher. | |
Clinician as the leader | I was technically the leader, so as soon as she suggested the idea, I was definitely on board and I was always referring to her as a consultant. It was kind of a tacit agreement that I was responsible for the project and I was to approach them with questions. | |
Ideal partnership | If you can use their expertise, that’s going to motivate them. […] And just knowing that the researchers will be there to support them in what is not their area of expertise. A straight goal from the start, like everyone knew what we were doing. […] what are the goals? What are the resources? What are barriers? What are the actual facilitators? And the timeline of the project. So everyone knew exactly, where we were going, and I tried to detail their contribution individually, from the start, to make sure that everyone knew their role in the project. An ideal partnership is one where […] people are excited about doing it. It’s meaningful to them. | |
Facilitators of effective IKT | Being motivated to participate in research | [The PI] was the head of that committee at the time. So I just go to her and say, well this interests me if you have anything that comes up in the future. I wanted to offer the best services possible, I wanted to develop something that would be useful to somebody. “What makes me all excited is the tangible outcome that is at the end [...] to take that and then to apply that into clinical practice.” I was also interested in the research part and that was my incentive to be so invested in the project. If you’re not really interested in the research world, […] I can see why it would be challenging. |
Institutional support | I think the motivation of clinicians is there, but the structure of the environment, the working environment doesn’t allow them to get involved in research. So, if you have, if the institution allows for research and allows time and facilitates this for clinicians, then it’s a win-win situation. | |
The proximity of researchers | To have researchers on the premises, [...] around you, around your environment, for me was a big positive, was a motivation. Having a researcher right next to your office is gold […] closeness is a key. | |
Previous research experience | I think clinicians need to get used to research for it to be interesting, and not to be too much intimidating. [previous research experience] gave me the motivation, the bug for research. After that, it was like, oh okay let’s do more research |