Knowledge transfer

Knowledge Transfer (KT) is concerned with the exploitation of knowledge, to speed up the translation of scientific advances into benefits for patients.

The World Report on Knowledge for Better Health (WHO 2004) has identified a large gap between what is known and what is actually being done in health systems. The so-called know-do gap. Increased communication and interaction between health systems and health research systems was called for. How do researchers achieve this? At first we may think of typical dissemination activities at the end of a study such as:

publishing research articles in high-impact peer-reviewed research journals
producing specialist press articles on the subject of (e.g. “The value of MRI in the diagnosis of X”)
producing press articles on the subject of (e.g. “How MRI can help X sufferers”)

These are valuable and valid dissemination routes, but does this get your research recognised in clinical practice? According to the WHO, not well enough. KT is about translating, synthesising, and communicating research to inform policy, practice and opinion. The three suggestions above are likely to influence these goals to some extent. KT, however, is a much more involved and active method of achieving those goals.

A KT strategy can may be considered under these headings (Lavis et al, 2003):

1. What knowledge do we want to transfer?
This involves identification of take-home messages for each audience. These messages must be immediately actionable. KT specifics must be fine-tuned for each audience for the types of decisions they face and the types of decision-making environments in which they live or work.
2. To whom is the knowledge to be transferred?
Key stakeholders must be identified (persons, groups or institutions interested in the research). These audiences are not only traditional audiences (medical and scientific to whom peer-reviewed reports are appropriate), but any audience which will influence policy, practise and opinion (or other KT goals which are identified for the study).
3. By whom is the knowledge to be transferred?
The messenger must be a credible witness in the eyes of each target audience. This has big implications in a well designed KT strategy; developing credibility throughout a research study—long before dissemination—is a highly effective component of KT.
4. How the knowledge to be transferred?
This facet may be where planned KT can differ most from traditional dissemination strategies. Effective KT requires interactive engagement with opinion leaders within each target audience. By building on existing relationships and relational networks throughout a research study, it is possible to assess how a stakeholder takes up knowledge. It is possible to assess readiness for change and interact appropriately, working around scepticism, distrust or resistance. Technological communication should not be a substitute for face-to-face engagement, by which tacit knowledge is communicated.

KT is a knowledge brokering exercise, as opposed to a “hand-off” of results.

Developing Credibility
Developing credibility must begin before the dissemination stage of a project begins; two-way dialogue / relationship / networking will engender exchange of information between those who generate and those who use knowledge. Development of credibility in this way will facilitate the use of research in practice. It is not sufficient to only transfer evidence or practices to the field in the absence of understanding what is needed to prepare organisations and practitioners to receive and implement this new knowledge. This understanding may be gathered in the relational networking throughout the project.

How can you generate interest in such networking? The recipients of your research results would be contributing their time and effort, and so developing a perceived value is critical. This can be generated by creating opportunities for stakeholders to have access to privileged information, innovation and collaborative experience through workshops, special events, newsletters / summaries of relevant information and so on. The “knowledge network’s” activities would need to be purposeful, collaborative and engaging. It would be necessary to encourage members to contribute to foster a feeling of belonging as well as privilege. For example, it may be an idea to begin to drip-feed quality resources or services to help certain stakeholders set up a disease-X imaging service such as the one used in the study.

Funding for these activities should not be overlooked; travel / access to information / ongoing communication would be costed. An added benefit would be an increase in the credibility and recognition of those involved in the KT activities. Other benefits include reduction of duplication and destructive competition, enhancement of mutual learning, increased access to new audiences and the fostering of ongoing collaboration.

A knowledge network is hard to create from scratch; it needs to be nurtured over time which is why it is necessary to start early. Existing relational foundations may be built upon, in terms of trust, respect and collaboration.

Evaluation of Success
Evaluation of the success of KT initiatives are a part of KT. Success will depend on the objective of the KT, which depends on the target audience. What did we set out to achieve? A change in behaviour? An increase of awareness? A change in policy? A change in practice? A change in culture? Introduction of an issue into a debate?

Summary
KT is a knowledge brokering exercise, and occurs throughout a research project. It includes more audiences and is wider-ranging that traditional dissemination routes. Funding organisations have begun to realise that the usual research-study-success metric (journal articles) does not necessarily address the priorities of their stakeholders, and a research organisation’s success with a particular funding source will be judged on how it meets the funders’ stakeholders’ goals. For the success of future funding applications, effective KT of a current project may prove invaluable. Thus, an effective KT network would attract participators as much for what they can put into it, as what they might take from it.

KT includes the provision of tailored, actionable messages to stakeholders. Credibility with stakeholders is developed over the course of the project. And KT requires relational, interactive engagement with target audiences, not just the golden high-impact journal article!

An introduction to Knowledge Transfer: Lavis et al, How can research organizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly, Vol. 81, No. 2, 2003.