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Nindra U, Shivasabesan G, Mellor R, Chua W, Ng W, Karikios D, Richards B, Liu J. Evaluating Systemic Burnout in Medical Oncology Through a National Oncology Mentorship Program. JCO Oncol Pract 2024; 20:549-557. [PMID: 38290086 DOI: 10.1200/op.23.00469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/14/2023] [Accepted: 12/01/2023] [Indexed: 02/01/2024] Open
Abstract
PURPOSE Mentorship has a positive influence on trainee skills and well-being. A 2022 Pilot Mentorship Program in New South Wales involving 40 participants revealed high burnout rates in Medical Oncology trainees. As part of an Australia-wide inaugural National Oncology Mentorship Program in 2023 (NOMP23), a national survey was undertaken to assess the prevalence of burnout, anxiety, depression, professional fulfilment, and drivers of distress in the Australian medical oncology workforce. METHODS NOMP23 is a 1-year prospective cohort study that recruited medical oncology trainees and consultants using e-mail correspondence between February and March 2023. Each participant completed a baseline survey which included the Maslach Burnout Index (MBI), Stanford Professional Fulfilment Index, and Patient Health Questionnaire-4 for anxiety and depression. RESULTS One hundred and twelve participants (56 mentors, 56 mentees) were enrolled in NOMP23, of which 86 (77%) completed the baseline survey. MBI results at baseline demonstrated that 77% of consultants and 82% of trainees experienced burnout in the past 12 months. Professional fulfilment was noted to be <5% in our cohort. Screening rates of anxiety and depression in trainees were 32% and 16%, respectively, compared with 7% and 2% for consultants. When assessing reasons for workplace stress, two thirds stated that heavy patient load contributed to stress, while almost three quarters attributed a heavy administrative load. Lack of supervision was a key stressor for trainees (39%), as was lack of support from the training college (58%). CONCLUSION Trainees and consultant medical oncologists demonstrate high rates of burnout and low professional fulfilment. The NOMP23 program has identified a number of key stress factors driving burnout and demonstrated concerning levels of anxiety and depression. Ongoing mentorship and other well-being initiatives are needed to address these issues.
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Affiliation(s)
- Udit Nindra
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Gowri Shivasabesan
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia
| | - Rhiannon Mellor
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
- Garvan Institute of Applied Medical Research, Sydney, Australia
- School of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Wei Chua
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Weng Ng
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Deme Karikios
- School of Medicine, University of Sydney, Sydney, Australia
- Department of Medical Oncology, Nepean Hospital, Sydney, Australia
| | - Bethan Richards
- Department of Rheumatology, Royal Prince Alfred Hospital, Sydney, Australia
- Institute of Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Jia Liu
- Garvan Institute of Applied Medical Research, Sydney, Australia
- School of Medicine, University of Sydney, Sydney, Australia
- The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney Australia
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Shelby-James T, Rattray M, Raymond G, Reed R. Capacity building for mental health services: methodology and lessons learned from the Partners in Recovery initiative. Aust J Prim Health 2024; 30:NULL. [PMID: 37697656 DOI: 10.1071/py23003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND The Partners in Recovery (PIR) program was implemented by the Australian Government Department of Health. Its overriding aim was to improve the coordination of services for people with severe and persistent mental illness, and who have complex needs that are not being met. The PIR capacity-building project (CBP) was funded to provide capacity building activities to the nationwide network of consortia that were set up in 2013 to deliver PIR over a 3-year period. The purpose of this paper is to describe the design and findings from an evaluation of the PIR CBP. METHODS The evaluation involved collecting feedback from consenting PIR staff via an online survey and follow-up semi-structured interviews. CBP activities included: state and national meetings; a web portal; teleconferences; webinars; a support facilitator mentor program; and tailored support from the CBP team. RESULTS The CBP made a positive contribution to the implementation and delivery of PIR. Staff highly valued activities that employed face-to-face interaction or provided informative knowledge exchange, and were appreciative of CBP staff being responsive and adaptable to their needs. CONCLUSIONS From this evaluation, we recommend the following: identify relevant functions (e.g. prioritise networking), select the right mode of delivery (e.g. establish an online presence) and abide by key principles (e.g. be responsive to staff needs). This information is informing the mental health workforce capacity building activities that our team is currently undertaking.
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Affiliation(s)
- Tania Shelby-James
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Megan Rattray
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Garry Raymond
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Richard Reed
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
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Thijsen A, Masser B, Davison TE, Williamson A. Researchers' views on and practices of knowledge translation: an international survey of transfusion medicine researchers. Implement Sci Commun 2024; 5:9. [PMID: 38217052 PMCID: PMC10787432 DOI: 10.1186/s43058-024-00546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Health research is often driven by the desire to improve the care and health of the community; however, the translation of research evidence into policy and practice is not guaranteed. Knowledge translation (KT) activities, such as dissemination and end-user engagement by researchers, are important to achieving this goal. This study examined researchers' views on and practices of KT in the field of transfusion medicine. METHODS An anonymous, cross-sectional survey was distributed to transfusion medicine researchers in May 2022 by emailing corresponding authors of papers in four major blood journals, emailing grant recipients, posting on social media, and through international blood operator networks. Comparative analyses were conducted for career stage, work setting, research type, and KT training. RESULTS The final sample included 117 researchers from 33 countries. Most participants reported that research translation was important (86%) and felt it was their responsibility (69%). Fewer than half felt they had the skills to translate their research (45%) or knew which strategies to employ (45%). When examining how research findings are shared, most reported using diffusion activities (86%), including publishing in peer-reviewed journals (74%), or presenting at academic conferences (72%). Fewer used dissemination methods (60%), such as developing educational materials (29%) or writing plain language summaries (30%). Greater use of tailored dissemination strategies was seen among researchers with KT training, whilst traditional diffusion strategies were used more by those working in an academic setting. Most participants had engaged end-users in their research (72%), primarily to consult on a research component (47%) or to involve them in the research process (45%). End-user engagement was greater among researchers with established careers, working in both academic and applied settings, and with KT training. CONCLUSIONS Whilst participating researchers acknowledged the importance of KT, they typically focused on traditional diffusion strategies. This is despite well-established knowledge of the limited impact of these strategies in achieving KT. Those with KT training were more likely to use tailored dissemination strategies and engage end-users in their research. This demonstrates the value of sharing knowledge from the KT field with health researchers to facilitate KT.
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Affiliation(s)
- Amanda Thijsen
- School of Public Health, The University of Sydney, Sydney, Australia.
- Research & Development, Australian Red Cross Lifeblood, Sydney, Australia.
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Australia
- Research & Development, Australian Red Cross Lifeblood, Brisbane, Australia
| | - Tanya Ellen Davison
- Research & Innovation, Silver Chain, Melbourne, Australia
- Monash Art, Design and Architecture, Monash University, Melbourne, Australia
| | - Anna Williamson
- School of Public Health, The University of Sydney, Sydney, Australia
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Kennedy F, Steiner A, Tucker JD, Kaba M, Abdissa A, Fongwen N, Kpokiri EE. Development of a research mentorship guide and consensus statement for low- and middle-income countries: Results of a modified Delphi process. PLoS One 2023; 18:e0291816. [PMID: 37878609 PMCID: PMC10599585 DOI: 10.1371/journal.pone.0291816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/29/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Institutional research mentorship is a form of mentorship whereby institutions foster mentor-mentee relationships. Research mentorship improves research effectiveness and supports relationships. However, resources are needed in order to institutionalize research mentorship tailored to low- and middle- income countries (LMICs). The aim of this study was to develop a consensus document on institutionalizing research mentorship through a modified Delphi process as part of the practical guide development process. METHODS This study used a two-round modified Delphi process, which is an iterative, structured approach of consensus decision making. Each participant was asked about a series of items related to research mentorship using Likert scale questions. Agreement for each item was pre-defined as ≥80% of participants rating the item as "agree" or "strongly agree." The items that reached agreement, were then discussed during round two at an in-person conference in Ethiopia. A separate group of individuals only participated virtually. For the final consensus survey, response rates and commenting rates (participants who wrote two or more comments) were compared among conference and non-conference participants. RESULTS The Delphi process led to the inception of three main themes in terms of developing research mentorship: leveraging existing resources, measuring and evaluating institutional mentorship, and encouraging a research mentorship life cycle. During the virtual first round, 59% (36/61) participants who were emailed completed the survey. In the second round, conference participants had a response rate of 79% (11/14) compared to non-conference participants with a response rate of 45% (21/47). Conference participants had a 100% (11/11) commenting rate whereas non-conference participants had a 38% (8/21) commenting rate. This study achieved consensus in both survey rounds for all 35 items on the consensus document. CONCLUSIONS The data suggest that an in-person conference may increase participant engagement. The consensus developed through a modified Delphi method directly informed a practical guide on institutionalizing research mentorship in LMICs.
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Affiliation(s)
- Fiona Kennedy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Annabel Steiner
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Joseph D. Tucker
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Noah Fongwen
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Eneyi E. Kpokiri
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Roberts NA, Young AM, Duff J. Using Implementation Science in Nursing Research. Semin Oncol Nurs 2023; 39:151399. [PMID: 36894448 DOI: 10.1016/j.soncn.2023.151399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES Clinical research continues to build knowledge that can potentially improve clinical and health service outcomes; however, integrating evidence into routine care is challenging, resulting in a knowledge practice gap. The field of implementation science is a resource available for nurses to translate evidence into their practice. This article aims to provide nurses with an overview of implementation science, illustrate its value integrating evidence into practice, and show how it can be applied with high rigor in nursing research practice. DATA SOURCES A narrative synthesis of the implementation science literature was conducted. A series of case studies were purposively selected to demonstrate the application of commonly used implementation theories, models, and frameworks across health care settings relevant to nursing. These case studies demonstrate how the theoretical framework was applied and how the outcomes of the work reduced the knowledge practice gap. CONCLUSION Implementation science theoretical approaches have been used by nurses and multidisciplinary teams to better understand the gap between knowledge and practice for better informed implementation. These can be used to understand the processes involved, identify the determinants at play, and undertake an effective evaluation. IMPLICATIONS FOR NURSING PRACTICE By using implementation science research practice, nurses can also build a strong foundation of evidence about nursing clinical practice. As an approach, implementation science is practical and can optimize the valuable nursing resource.
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Affiliation(s)
- Natasha A Roberts
- University of Queensland, Metro North Health, Herston, QLD, Australia; University of Queensland, Brisbane, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia.
| | - Adrienne M Young
- University of Queensland, Metro North Health, Herston, QLD, Australia; University of Queensland, Brisbane, QLD, Australia
| | - Jed Duff
- University of Queensland, Metro North Health, Herston, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia
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Howlett O, O’Brien C, Gardner M, Neilson C. The use of mentoring for knowledge translation by allied health: a scoping review. INT J EVID-BASED HEA 2022; 20:250-261. [DOI: 10.1097/xeb.0000000000000334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Flenady T, Dwyer T, Kahl J, Sobolewska A, Reid-Searl K, Signal T. Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians' engagement in the research process. Health Res Policy Syst 2022; 20:45. [PMID: 35477479 PMCID: PMC9044663 DOI: 10.1186/s12961-022-00849-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians’ engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme. Methods This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed. Results The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators’ skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey. Conclusion This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians’ engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians’ increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.
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Affiliation(s)
- Tracy Flenady
- School of Nursing & Midwifery, Central Queensland University, Building 18, Bruce Highway, Rockhampton, 4702, Australia.
| | - Trudy Dwyer
- School of Nursing & Midwifery, Central Queensland University, Building 18, Bruce Highway, Rockhampton, 4702, Australia
| | - Julie Kahl
- Central Queensland Hospital and Health Services, Canning Street, Rockhampton, 4701, Australia
| | - Agnieszka Sobolewska
- School of Nursing & Midwifery, Central Queensland University, Building 18, Bruce Highway, Rockhampton, 4702, Australia
| | - Kerry Reid-Searl
- School of Nursing & Midwifery, Central Queensland University, Building 18, Bruce Highway, Rockhampton, 4702, Australia
| | - Tania Signal
- School of Health, Medical & Applied Sciences, Central Queensland University, Building 6, Bruce Highway, Rockhampton, 4701, Australia
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Imani B, Bahadori H, Amiri M. The effects of task-based learning and mentorship on the perceived surgical competency and clinical education condition of surgical technology students. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_136_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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‘It seems like common sense now’. JBI Evid Implement 2021; 20:189-198. [DOI: 10.1097/xeb.0000000000000297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Young AM, Hickman I, Campbell K, Wilkinson SA. Implementation science for dietitians: The 'what, why and how' using multiple case studies. Nutr Diet 2021; 78:276-285. [PMID: 34184377 DOI: 10.1111/1747-0080.12677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Abstract
AIM Implementation science theories, models and frameworks help to address evidence-practice gaps, which have increasing importance for dietetic practice. This paper aims to provide dietitians with insight into how implementation science can be applied to practice, using multiple 'real-life' case studies. METHODS Three case studies were purposively selected across areas of dietetics practice to demonstrate application of commonly-used implementation theories, models and frameworks. Reflections from the authors were provided in response to a structured set of questions outlining how the theoretical approach was selected and used, and considerations for future application. Within and cross-case analysis was undertaken. RESULTS Dietitians used diverse implementation theories, models and frameworks to identify barriers and enablers, to plan for implementation, and to guide the selection of implementation strategies. Implementation theory was used to evaluate the implementation process in one case study. Cross-case analysis identified that mentoring by those with implementation expertise, multidisciplinary implementation teams, and leadership and investment in research and translation at an organisational and departmental level as key enablers. CONCLUSIONS This paper offers dietitians insight into how implementation science can be applied to improve the uptake of evidence-based practices within nutrition and dietetics, and suggests that there needs to be investment in implementation science as a foundation science within nutrition and dietetics, including education, training and mentoring for dietitians.
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Affiliation(s)
- Adrienne M Young
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Ingrid Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Katrina Campbell
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Shelley A Wilkinson
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Implementing Implementation Research: Teaching Implementation Research to HIV Researchers. Curr HIV/AIDS Rep 2021; 18:186-197. [PMID: 33709323 DOI: 10.1007/s11904-021-00551-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Given the growth in HIV-related implementation research, there is a need to expand the workforce and rigor through implementation science (IS) training and mentorship. Our objective is to review IS training opportunities for HIV-focused researchers and describe the approach and lessons learned from a recent HIV-related implementation research training initiative. RECENT FINDINGS IS training opportunities range from degree programs to short- and longer-term professional development institutes and community-focused institutional trainings. Until recently, there have not been extensive dedicated opportunities for implementation research training for HIV-focused investigators. To meet this gap, an inter-Center for AIDS Research IS Fellowship for early-stage investigators was launched in 2019, building on lessons learned from dissemination and implementation training programs. Key components of the HIV-focused IS fellowship include didactic training, mentorship, grant-writing, and development of HIV-IS collaborative networks. Fellows to-date were two-thirds junior faculty and one-third post-doctoral fellows, the majority (69%) with prior public health training. Perceived value of the program was high, with a median rating of 9 [IQR 8-9] on a 10-point scale. Overall, 22/27 (81%) Fellows from the first cohort submitted IS-related grants within 12 months of Fellowship completion, and by 1 year 13 grants had been funded among 10 investigators, 37% overall among Fellows. Mentors identified framing of IS questions as the top-ranked training priority for HIV-investigators. Increasing knowledge of the utility of IS may support more grants focused on optimal implementation of HIV treatment and prevention strategies. Experiences from mentors and trainees engaged in an IS-focused fellowship for HIV investigators demonstrate the demand and value of a dedicated training program and reinforce the importance of mentorship.
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Kim T, Sharma M, Teerawattananon Y, Oh C, Ong L, Hangoma P, Adhikari D, Pempa P, Kairu A, Orangi S, Dabak SV. Addressing Challenges in Health Technology Assessment Institutionalization for Furtherance of Universal Health Coverage Through South-South Knowledge Exchange: Lessons From Bhutan, Kenya, Thailand, and Zambia. Value Health Reg Issues 2021; 24:187-192. [PMID: 33838558 PMCID: PMC8163602 DOI: 10.1016/j.vhri.2020.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/19/2020] [Accepted: 12/06/2020] [Indexed: 12/03/2022]
Abstract
Health Technology Assessment (HTA), a tool for priority setting, has emerged as a means of ensuring the sustainability of a Universal Health Coverage (UHC) system. However, setting up an effective HTA system poses multiple challenges and knowledge exchange can play a crucial role in helping countries achieve their UHC targets. This article reports the results of the discussion during a preconference session at the 2019 HTAsiaLink Conference, an annual gathering of HTA agencies in Asia, which supports knowledge transfer and exchange among HTA practitioners. As part of this discourse, 3 main HTA challenges were identified based on experiences of selected countries in Asia and Africa, namely Bhutan, Kenya, Thailand, and Zambia: availability of funding, building technical capacity, and achieving buy-in among stakeholders for successful translation of HTA research into UHC policy. The potential solutions identified through this South-South engagement included establishing a legal mandate for HTA, building local technical capacity through partnerships and enhancing strategic communication with stakeholders to increase awareness, among others. South-South Knowledge Exchange can therefore be instrumental in sharing lessons learned from common challenges and offer potential solutions to address capacity building initiatives for HTA in LMICs.
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Affiliation(s)
- Taeyoung Kim
- Health Intervention and Technology Assessment Program, Nonthaburi, Thailand
| | - Manushi Sharma
- Health Intervention and Technology Assessment Program, Nonthaburi, Thailand
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Nonthaburi, Thailand; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Cecilia Oh
- HIV, Health and Development Team, United Nations Development Programme, Bangkok, Thailand
| | - Leslie Ong
- HIV, Health and Development Team, United Nations Development Programme, Bangkok, Thailand
| | - Peter Hangoma
- Department of Health Policy and Management, University of Zambia, Lusaka, Zambia
| | - Deepika Adhikari
- Essential Medicines and Technology Division, Department of Medical Services, Ministry of Health, Thimphu, Bhutan
| | - Pempa Pempa
- Essential Medicines and Technology Division, Department of Medical Services, Ministry of Health, Thimphu, Bhutan
| | - Angela Kairu
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Stacey Orangi
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Serruya SJ, Gómez Ponce de León R, Bahamondes MV, De Mucio B, Costa ML, Durán P, Díaz-Rosello JL, Kim C, Lavelanet AF, Artigas A, Forster TA, Cecatti JG. EviSIP: using evidence to change practice through mentorship - an innovative experience for reproductive health in the Latin American and Caribbean regions. Glob Health Action 2021; 13:1811482. [PMID: 32867629 PMCID: PMC7480421 DOI: 10.1080/16549716.2020.1811482] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Maternal mortality is unacceptably high in our region. In 2015, the Latin American Center for Perinatology and Women´s Reproductive Health (CLAP) created a regional network of institutions including 16 countries, committed to improving epidemiological surveillance and healthcare of women in a situation of abortion or near miss event, using a common platform, the Perinatal Information System (SIP). The objective of the current pilot project was to test a new method of study called EviSIP (Evidence from SIP), a method of generating information on maternal near miss and abortion for the region. We describe the implementation of this initiative in reproductive healthcare facilities using SIP. Junior researchers/clinicians from these countries were included, along with expert researchers in reproductive health from across the world. Articles were produced with data on maternal near miss and abortion gathered from the SIP of each participating sentinel center; and recommendations from experts. EviSIP was the first joint workspace to discuss patient outcomes after treatment of abortion or near miss cases, with data analysis of each Sentinel Center; discuss and analyze data among centers, at a country and regional level; discuss the main outcomes and their impact on changing procedures and policies; strengthen the operational research capacity of the centers; develop and encourage the publication of scientific articles. The EviSIP initiative also promoted training of healthcare professionals in research. EviSIP provided a unique opportunity to train for research and mentorship and was pivotal to the production of scientific knowledge of reproductive health in the region.
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Affiliation(s)
- Suzanne J Serruya
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Rodolfo Gómez Ponce de León
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Maria V Bahamondes
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Bremen De Mucio
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Maria L Costa
- University of Campinas School of Medicine and CEMICAMP (Center for Studies of Reproductive Health in Campinas) , Campinas, Brazil
| | - Pablo Durán
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - José L Díaz-Rosello
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Caron Kim
- Department of Sexual and Reproductive Health and Research, Preventing Unsafe Abortion Team. World Health Organization , Geneva, Switzerland
| | - Antonella F Lavelanet
- Department of Sexual and Reproductive Health and Research, Preventing Unsafe Abortion Team. World Health Organization , Geneva, Switzerland
| | - Ana Artigas
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - Thais A Forster
- CLAP/WR-PAHO/WHO - Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization , Montevideo, Uruguay
| | - José G Cecatti
- University of Campinas School of Medicine and CEMICAMP (Center for Studies of Reproductive Health in Campinas) , Campinas, Brazil
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Bornstein S, McMahon M, Yiu V, Haroun V, Manson H, Holyoke P, Wasylak T, Tamblyn R, Brown A. Exploring Mentorship as a Strategy to Build Capacity and Optimize the Embedded Scientist Workforce. ACTA ACUST UNITED AC 2020; 15:73-84. [PMID: 31755861 PMCID: PMC7017759 DOI: 10.12927/hcpol.2019.25978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Mentorship plays a significant role in career development in academic and applied settings, but little is documented about its role in the experiential learning of academic trainees embedded in health system organizations. The experiences of the first cohort of Canada's Health System Impact (HSI) Fellowship program can provide insights into how mentorship in this innovative type of training can work. Objectives: To understand the mentorship strategies that were used and to explore fellows' and supervisors' perspectives and experiences on the effectiveness and value of those strategies. Methods: Data from the surveys of fellows and their supervisors and a panel rooted in the lived experience of the first HSI Fellowship cohort were used. Results: Health system and academic supervisors developed a range of innovative, individualized and effective approaches for guiding their fellows, such as providing the fellow with a committee of mentors within the organization, holding regular meetings with the fellow and both the health system and the academic supervisor and leveraging their own network to expand the network and resources available to the fellow. Conclusion: The results suggest that engaging senior leadership in health system settings has provided positive experiences for both fellows and their mentors.
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Affiliation(s)
- Stephen Bornstein
- Professor, Division of Community Health and Humanities, Faculty of Medicine, Department of Political Science, Faculty of Arts, Memorial University; Director, Newfoundland and Labrador Centre for Applied Health Research; Co-Director, SafetyNet Centre for Occupational Health and Safety Research, St. John's, NL
| | - Meghan McMahon
- Associate Director, CIHR Institute of Health Services and Policy Research; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Verna Yiu
- President and CEO, Alberta Health Services; Professor of Pediatrics, Faculty of Medicine/Dentistry, University of Alberta, Edmonton, AB
| | - Vinita Haroun
- Director, Centre for Research and Innovation Support University of Toronto, Toronto, ON
| | - Heather Manson
- Chief, Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Paul Holyoke
- Director, SE Research Centre, SE Health, Markham, ON
| | - Tracy Wasylak
- Chief Program Officer, Strategic Clinical Networks™, Alberta Health Services; Adjunct Appointment, Faculty of Nursing, University of Calgary, Calgary, AB
| | - Robyn Tamblyn
- Professor, Department of Medicine and Department of Epidemiology, Biostatistics and Occupational Health, McGill University; Scientific Director (former), CIHR Institute of Health Services and Policy Research, Montreal, QC
| | - Adalsteinn Brown
- Dean, Professor, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Scarlett J, Forsberg BC, Biermann O, Kuchenmüller T, El-Khatib Z. Indicators to evaluate organisational knowledge brokers: a scoping review. Health Res Policy Syst 2020; 18:93. [PMID: 32831095 PMCID: PMC7444249 DOI: 10.1186/s12961-020-00607-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/23/2020] [Indexed: 01/03/2023] Open
Abstract
Background Knowledge translation (KT) is currently endorsed by global health policy actors as a means to improve outcomes by institutionalising evidence-informed policy-making. Organisational knowledge brokers, comprised of researchers, policy-makers and other stakeholders, are increasingly being used to undertake and promote KT at all levels of health policy-making, though few resources exist to guide the evaluation of these efforts. Using a scoping review methodology, we identified, synthesised and assessed indicators that have been used to evaluate KT infrastructure and capacity-building activities in a health policy context in order to inform the evaluation of organisational knowledge brokers. Methods A scoping review methodology was used. This included the search of Medline, Global Health and the WHO Library databases for studies regarding the evaluation of KT infrastructure and capacity-building activities between health research and policy, published in English from 2005 to 2016. Data on study characteristics, outputs and outcomes measured, related indicators, mode of verification, duration and/or frequency of collection, indicator methods, KT model, and targeted capacity level were extracted and charted for analysis. Results A total of 1073 unique articles were obtained and 176 articles were qualified to be screened in full-text; 32 articles were included in the analysis. Of a total 213 indicators extracted, we identified 174 (174/213; 81.7%) indicators to evaluate the KT infrastructure and capacity-building that have been developed using methods beyond expert opinion. Four validated instruments were identified. The 174 indicators are presented in 8 domains based on an adaptation of the domains of the Lavis et al. framework of linking research to action – general climate, production of research, push efforts, pull efforts, exchange efforts, integrated efforts, evaluation and capacity-building. Conclusion This review presents a total of 174 method-based indicators to evaluate KT infrastructure and capacity-building. The presented indicators can be used or adapted globally by organisational knowledge brokers and other stakeholders in their monitoring and evaluation work.
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Affiliation(s)
- Julia Scarlett
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden
| | - Birger C Forsberg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden.,Region Stockholm, Hantverkargatan 11B, 112 21, Stockholm, Sweden
| | - Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden
| | - Tanja Kuchenmüller
- World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100, Copenhagen Ø, Denmark
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden. .,World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), 445 Boulevard de l'Université, Rouyn-Noranda, QC, J9X 5E4, Canada.
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16
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Howlett O, Neilson C, O'Brien C, Gardner M. Mentoring for knowledge translation in allied health: a scoping review protocol. JBI Evid Synth 2020; 18:2171-2180. [PMID: 32813452 DOI: 10.11124/jbisrir-d-19-00260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The primary objective of this review is to identify how allied health staff have used mentoring as a knowledge translation strategy to support practice change. Secondary objectives include identifying barriers and enablers to using mentoring as a knowledge translation strategy, and the methods used to evaluate the strategy. INTRODUCTION Mentoring provides professional support and guidance while attending to the learning needs of the individual. Mentoring has been described in previous knowledge synthesis reviews as a strategy for nursing and medicine practitioners to improve capability and capacity to participate in knowledge translation to create practice change. To the authors' knowledge, a synthesis of the use of mentoring as a knowledge translation strategy by allied health staff has not been reported. INCLUSION CRITERIA This scoping review will consider all studies that describe the use of mentoring with allied health staff to support practice change as directed by research evidence. The scoping review will not investigate the use of mentoring to increase the conduct of research in a clinical setting, nor will studies be included if the majority of participants are students. METHODS A three-step search strategy will be undertaken. Two independent authors will screen articles and perform data extraction. The results will be presented in a narrative Summary of Findings, alongside a presentation of the data in diagrammatic or tabular form. The findings will inform future use of mentoring as a knowledge translation strategy in a regional health service.
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Affiliation(s)
- Owen Howlett
- Research and Innovation, Bendigo Health, Bendigo, VIC, Australia.,La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Cheryl Neilson
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Chris O'Brien
- Clinical Learning and Development, Bendigo Health, Bendigo, VIC, Australia
| | - Marcus Gardner
- Clinical Learning and Development, Bendigo Health, Bendigo, VIC, Australia
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17
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Jacob RR, Gacad A, Pfund C, Padek M, Chambers DA, Kerner JF, Sales A, Dobbins M, Kumanyika S, Brownson RC. The "secret sauce" for a mentored training program: qualitative perspectives of trainees in implementation research for cancer control. BMC MEDICAL EDUCATION 2020; 20:237. [PMID: 32723326 PMCID: PMC7385963 DOI: 10.1186/s12909-020-02153-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Mentored training approaches help build capacity for research through mentoring networks and skill building activities. Capacity for dissemination and implementation (D&I) research in cancer is needed and mentored training programs have been developed. Evaluation of mentored training programs through quantitative approaches often provides us with information on "what" improved for participants. Qualitative approaches provide a deeper understanding of "how" programs work best. METHODS Qualitative interviews were conducted with 21 fellows of the National Cancer Institute-funded Mentored Training for Dissemination and Implementation in Cancer to gain understanding of their experiences with mentoring received during the program. Fellows were selected from all 55 trained participants based upon their gain in D&I research skills (highest and lowest) and number of collaborative connections in the program network (highest and lowest) reported in previous quantitative surveys. Phone interviews were recorded with permission, transcribed verbatim, and de-identified for analysis. Codes were developed a priori to reflect interview guide concepts followed by further development and iterative coding of three common themes that emerged: 1) program and mentoring structure, 2) importance of mentor attributes, and 3) enhanced capacity: credentials, confidence, credibility and connections. RESULTS Interviews provided valuable information about program components that worked best and impacts attributed to participation in the program. Fellows reported that regular monthly check-in calls with mentors helped to keep their research moving forward and that group mentoring structures aided in their learning of basic D&I research concepts and their application. Accessible, responsive, and knowledgeable mentors were commonly mentioned by fellows as a key to their success in the program. Fellows mentioned various forms of impact that they attributed to their participation in the program including gaining credibility in the field, a network of peers and experts, and career developments (e.g., collaborative publications and grant funding). CONCLUSIONS These findings suggest that mentored training works best when mentoring is structured and coupled with applied learning and when respected and dedicated mentors are on board. Increased scientific collaborations and credibility within a recognized network are important trainee experiences that should be considered when designing, implementing, and sustaining mentored training programs.
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Affiliation(s)
- Rebekah R Jacob
- Prevention Research Center, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA.
| | - Angeline Gacad
- Prevention Research Center, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Christine Pfund
- Center for the Improvement of Mentored Experiences in Research, Wisconsin Center for Education Research, Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, 1025 W. Johnson St., Madison, WI, 53705, USA
| | - Margaret Padek
- Prevention Research Center, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Jon F Kerner
- Canadian Partnership Against Cancer, 145 King Street West, Toronto, ON, M5H 1J8, Canada
| | - Anne Sales
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA
- Department of Learning Health Sciences, University of Michigan Medical School, 1111 E. Catherine Street, Ann Arbor, MI, 48109, USA
| | - Maureen Dobbins
- School of Nursing, National Collaborating Centre for Methods and Tools, McMaster University, 175 Longwood Road South, Hamilton, ON, L8P 0A, Canada
| | - Shiriki Kumanyika
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave. Campus Box 8100, St. Louis, MO, 63110, USA
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18
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Chong JY, Ching AH, Renganathan Y, Lim WQ, Toh YP, Mason S, Krishna LKR. Enhancing mentoring experiences through e-mentoring: a systematic scoping review of e-mentoring programs between 2000 and 2017. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:195-226. [PMID: 30830505 DOI: 10.1007/s10459-019-09883-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 02/27/2019] [Indexed: 05/17/2023]
Abstract
Mentoring is suffering from a shortage of trained mentors which compromise the efficacy of novice mentoring or mentoring between a senior clinician and a junior clinician. E-mentoring is proposed as a means of supplementing this dominant form of mentoring in medicine by providing accessible, timely and longitudinal support for mentees. However, with little is known about e-mentoring nor its role in a blended mentoring approach, a systematic scoping review is proposed to evaluate these gaps in understanding in order to better understand e-mentoring and assess the viability of employing e-mentoring practice to support novice mentoring. Using Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) approach, 5 reviewers carried out independent literature reviews of e-mentoring as an adjuvant to novice mentoring in PubMed, Embase, PsycINFO, ERIC, Cochrane Database of Systematic Reviews, Google Scholar, Scopus, GreyLit, OpenGrey, and Web of Science databases. Braun and Clarke's (Qual Res Psychol 3(2):77-101, 2006) thematic analysis approach was used to thematically analyse accounts of e-mentoring across different settings. 6557 abstracts were identified, 109 full text articles were reviewed, and 18 articles were included and thematically analysed. The themes identified include definitions, role, stages, processes, platforms, evaluation, and relationships in e-mentoring. The themes identified provide a clinically relevant definition of e-mentoring, and in highlighting the similarities in the phases of novice and e-mentoring reaffirms the validity of a blended approach as a means of addressing shortfalls in mentoring in medicine.
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Affiliation(s)
- Jia Yan Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ann Hui Ching
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yaazhini Renganathan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Qiang Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Pin Toh
- Family Medicine Residency, National University Hospital Singapore, 1E Kent Ridge Road, Singapore, S119228, Singapore.
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, North West Cancer Research Centre, Liverpool, Merseyside, UK
| | - Lalit K R Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, North West Cancer Research Centre, Liverpool, Merseyside, UK
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
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19
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Slade SC, Hay-Smith J, Mastwyk S, Morris ME, Frawley H. Attributes of physiotherapy continence clinicians: a qualitative perspective. Physiotherapy 2020; 106:119-127. [DOI: 10.1016/j.physio.2019.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 01/28/2018] [Indexed: 10/27/2022]
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20
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Young AM, Olenski S, Wilkinson SA, Campbell K, Barnes R, Cameron A, Hickman I. Knowledge Translation in Dietetics: A Survey of Dietitians' Awareness and Confidence. CAN J DIET PRACT RES 2020; 81:49-53. [PMID: 31512498 DOI: 10.3148/cjdpr-2019-027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study aimed to determine dietitians' familiarity with knowledge translation (KT), confidence in undertaking KT, and preferences for receiving KT training. An online questionnaire was designed and disseminated to all dietitians working across hospital and health services in Queensland, Australia, for completion over a 6-week period (April-May 2018). Of the 124 respondents, 69% (n = 85) reported being familiar with KT, but only 28% (n = 35) reported being confident in applying KT to their practice. Higher confidence was reported with problem identification, evidence appraisal, and adapting evidence to local context, compared with implementation, evaluation, and dissemination. Almost all respondents reported an interest in learning more about KT (n = 121, 98%), with a preference for easily accessible and short "snippets" of training aimed at beginner-intermediate level. Lack of management support, difficulty attending multi-day courses, cost, travel requirements, and lack of quarantined time were reported barriers to attending KT training. There is a high awareness and interest but low confidence in undertaking KT amongst dietitians. This highlights an opportunity for workforce development to prepare dietitians to be skilled and confident in KT. Training and support needs to be low-cost and multi-modal to meet diverse needs.
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Affiliation(s)
- Adrienne M Young
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Samantha Olenski
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Shelley A Wilkinson
- Department of Dietetics and Foodservices, Mater Group, South Brisbane, QLD, Australia.,Mater Research Institute-University of Queensland, South Brisbane, QLD, Australia
| | - Katrina Campbell
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Rhiannon Barnes
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Ashley Cameron
- Department of Speech Pathology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Ingrid Hickman
- Mater Research Institute-University of Queensland, South Brisbane, QLD, Australia.,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
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21
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Tait H, Williamson A. A literature review of knowledge translation and partnership research training programs for health researchers. Health Res Policy Syst 2019; 17:98. [PMID: 31842896 PMCID: PMC6916221 DOI: 10.1186/s12961-019-0497-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 10/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Researchers and policy-makers are increasingly working together with the goal of creating research that is focused on solving real-world problems; however, knowledge translation (KT) activities, and the partnerships they often require, can be challenging. The aim of this review is to determine the extent of the literature on training programs designed to improve researcher competency in KT and to describe existing training methods that may be used by those hoping to build capacity for partnership research. METHODS MEDLINE, EMBASE, PsycINFO and CINAHL were searched for peer review articles published between January 2000 and July 2019. Studies were eligible for inclusion in the review if they described the development of, curriculum for, or evaluation of KT and/or partnership research training programs. Data extraction included information on evaluation methods, outcomes and implications as well as the format, aims and themes of each capacity-building program. RESULTS The review identified nine published articles that met inclusion criteria - four papers described training events, two papers described participant experiences of specific learning sessions within a larger training course, two papers described part time secondments for KT capacity-building and one paper described a plan for KT training embedded within an existing research training course. All programs were delivered face-to-face, all included practical skills-building opportunities, and all employed multiple learning modalities such as seminars and small group discussions. Evaluation of the training programs was primarily conducted through qualitative interviews or feedback surveys. CONCLUSION To date, few KT training initiatives have been described in the literature and none of these have been rigorously evaluated. The present review offers insights into the planning, development and participant experiences associated with the small number of training initiatives that have been described. There is insufficient evidence available at present to identify the most effective models for training researchers in KT and partnership skills.
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Affiliation(s)
- Hannah Tait
- The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia.
| | - Anna Williamson
- The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia
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22
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Glegg SMN, Jenkins E, Kothari A. How the study of networks informs knowledge translation and implementation: a scoping review. Implement Sci 2019; 14:34. [PMID: 30917844 PMCID: PMC6437864 DOI: 10.1186/s13012-019-0879-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background To date, implementation science has focused largely on identifying the individual and organizational barriers, processes, and outcomes of knowledge translation (KT) (including implementation efforts). Social network analysis (SNA) has the potential to augment our understanding of KT success by applying a network lens that examines the influence of relationships and social structures on research use and intervention acceptability by health professionals. The purpose of this review was to comprehensively map the ways in which SNA methodologies have been applied to the study of KT with respect to health professional networks. Methods Systematic scoping review methodology involved searching five academic databases for primary research on KT that employed quantitative SNA methods, and inclusion screening using predetermined criteria. Data extraction included information on study aim, population, variables, network properties, theory use, and data collection methods. Descriptive statistics and chronology charting preceded theoretical analysis of findings. Results Twenty-seven retained articles describing 19 cross-sectional and 2 longitudinal studies reported on 28 structural properties, with degree centrality, tie characteristics (e.g., homophily, reciprocity), and whole network density being most frequent. Eleven studies examined physician-only networks, 9 focused on interprofessional networks, and 1 reported on a nurse practitioner network. Diffusion of innovation, social contagion, and social influence theories were most commonly applied. Conclusions Emerging interest in SNA for KT- and implementation-related research is evident. The included articles focused on individual level evidence-based decision-making: we recommend also applying SNA to meso- or macro-level KT activities. SNA research that expands the range of professions under study, examines network dynamics over time, extends the depth of analysis of the role of network structure on KT processes and outcomes, and employs mixed methods to triangulate findings, is needed to advance the field. SNA is a valuable approach for evaluating key network characteristics, structures and positions of relevance to KT, implementation, and evidence informed practice. Examining how network structure influences connections and the implications of those holding prominent network positions can provide insights to improve network-based KT processes.
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Affiliation(s)
- Stephanie M N Glegg
- Rehabilitation Sciences, The University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. .,Therapy Department, Sunny Hill Health Centre for Children, 3644 Slocan Street, Vancouver, BC, V5M 3E8, Canada. .,BC Children's Hospital Research Institute, 938 West 28th Ave, Vancouver, BC, V5Z 4H4, Canada.
| | - Emily Jenkins
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Anita Kothari
- School of Health Studies, Western University, Arthur and Sonia Labatt Health Sciences Building, Room 222, London, ON, V6A 5B9, Canada
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Kingsnorth S, Orava T, Parker K, Milo-Manson G. From knowledge translation theory to practice: developing an evidence to care hub in a pediatric rehabilitation setting. Disabil Rehabil 2019; 42:869-879. [PMID: 30621521 DOI: 10.1080/09638288.2018.1514075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: Ensuring evidence-informed care happens systematically and consistently is not easy in complex health facilities. This paper describes the evolution of knowledge translation infrastructure (Evidence to Care) within a pediatric rehabilitation hospital to address barriers to evidence-informed decision-making and accelerate research uptake to influence clinical care.Methods: Development of Evidence to Care involved a series of steps integrating knowledge translation principles, best evidence and stakeholder needs. Key aspects included: recognizing health system drivers and organizational enablers; establishing organizational structures and processes; building and operationalizing a strategic vision through activities and demonstration projects; and evaluating impact.Results: By way of a fully realized working model, two large-scale demonstration projects aligned with the Knowledge-to-Action Cycle have been completed. Audit findings demonstrate tangible examples of improving healthcare quality through investment in knowledge translation resources, processes and tailored evidence products. Critical enablers of this infrastructure include strong leadership commitment and ongoing direction, a dedicated expert team, alignment with strategic priorities and situated within organizational structures to link research, clinical care and education.Conclusions: With a replicable model, Evidence to Care addresses established health system barriers related to time, resources, skill and knowledge through dedicated knowledge translation specialists and knowledge brokers to facilitate knowledge translation practice.Implications for rehabilitationDeveloping dedicated knowledge translation infrastructure is both novel and relatively new in healthcare.Sharing step by step processes helps other organizations learn from field-tested experiences of what works and what doesn't in a particular setting.Involving stakeholders at all levels of an organization is key to valuing knowledge translation and fostering an evidence-friendly culture.Co-creating tailored knowledge products and planning for dissemination and uptake fosters inter-disciplinary collaboration and joint problem-solving among clients, families and providers.
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Affiliation(s)
- Shauna Kingsnorth
- Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Taryn Orava
- Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kathryn Parker
- Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Golda Milo-Manson
- Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
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Aucoin M, Cooley K, Knee C, Tsui T, Grondin D. Naturopathy Special Interest Group Research Capacity and Needs Assessment Survey. J Altern Complement Med 2018; 25:189-195. [PMID: 30383386 PMCID: PMC6389767 DOI: 10.1089/acm.2018.0312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: Despite recent shifts in regulation and recognition of the role that naturopathy plays in health care delivery in Canada, comparatively little research has been conducted regarding individuals who conduct naturopathy-related research. A survey was undertaken to better understand the needs and capacity of these individuals to conduct more research. Design, Setting, and Subjects: The Naturopathy Special Interest Group (N-SIG) of the Interdisciplinary Network of Complementary and Alternative Medicine (INCAM) Researchers created and distributed a survey of individuals interested in naturopathy-related research to assess gaps between current and desired research activity and needs for further participation. Outcome measures: Results from a previous pilot study (2014; n = 58) were used to inform the design and distribution. This study received approval and oversight from the Research Ethics Board of the Canadian College of Naturopathic Medicine. Results: The survey was completed by 201 individuals (∼5%–10% of all naturopathic doctors and naturopathy researchers in Canada). The majority (70%) had no peer-reviewed publication experience; however, 63% reported having published in a nonpeer-reviewed medium. Respondents reported differing levels of confidence in completing various components of a research project. Frequently selected obstacles included lack of time due to professional and personal obligations, as well as insufficient training, funding, and mentorship. The greatest identified needs for participation in research were mentorship/support, access to a wider degree of scientific journals, and targeted funding opportunities for CAM research. Overall, the results of this survey suggest that there is interest in further conducting naturopathy-related research in Canada. There are individuals who are already involved and have expressed skills in the area of evidence-based medicine. Mentorship, research training, resources, and critical appraisal and writing skills may be important leverage points. Conclusion: Findings from this investigation will be used to inform an agenda for naturopathy-related research and activities of the N-SIG with respect to enhancing research capacity. Other CAM groups or geographic regions could consider using similar methodology to assess capacity and needs for research participation.
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Affiliation(s)
- Monique Aucoin
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada
| | - Kieran Cooley
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada.,2 Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, Australia.,3 Pacific College of Oriental Medicine, San Diego, California
| | | | - Teresa Tsui
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada
| | - Diane Grondin
- 5 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Urquhart R, Kendell C, Folkes A, Reiman T, Grunfeld E, Porter GA. Making It Happen: Middle Managers' Roles in Innovation Implementation in Health Care. Worldviews Evid Based Nurs 2018; 15:414-423. [PMID: 30291739 PMCID: PMC6518932 DOI: 10.1111/wvn.12324] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2018] [Indexed: 11/29/2022]
Abstract
Background Middle managers are given scant attention in the implementation literature in health care, where the focus is on senior leaders and frontline clinicians. Aims To empirically examine the role of middle managers relevant to innovation implementation and how middle managers experience the implementation process. Methods A qualitative study was conducted using the methods of grounded theory. Data were collected through semistructured interviews with middle managers (N = 15) in Nova Scotia and New Brunswick, Canada. Participants were purposively sampled, based on their involvement in implementation initiatives and to obtain variation in manager characteristics. Data were collected and analyzed concurrently, using an inductive constant comparative approach. Data collection and analysis continued until theoretical saturation was reached. Results Middle managers see themselves as being responsible for making implementation happen in their programs and services. As a result, they carry out five roles related to implementation: planner, coordinator, facilitator, motivator, and evaluator. However, the data also revealed two determinants of middle managers' role in implementation, which they must negotiate to fulfill their specific implementation roles and activities: (1) They perform many other roles and responsibilities within their organizations, both clinical and managerial in nature, and (2) they have limited decision‐making power with respect to implementation and must work within the parameters set by upper levels of the organization. Linking Evidence to Action Middle managers play an important role in translating adoption decisions into on‐the‐ground implementation. Optimizing their capacity to fulfill this role may be key to improving innovation implementation in healthcare organizations.
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Affiliation(s)
- Robin Urquhart
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Cynthia Kendell
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amy Folkes
- Central Health Regional Health Authority, Grand Falls-Windsor, Newfoundland and Labrador, Canada
| | - Tony Reiman
- Department of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
| | - Eva Grunfeld
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Geoffery A Porter
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Cooke J, Gardois P, Booth A. Uncovering the mechanisms of research capacity development in health and social care: a realist synthesis. Health Res Policy Syst 2018; 16:93. [PMID: 30241484 PMCID: PMC6150992 DOI: 10.1186/s12961-018-0363-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 08/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research capacity development (RCD) is considered fundamental to closing the evidence-practice gap, thereby contributing to health, wealth and knowledge for practice. Numerous frameworks and models have been proposed for RCD, but there is little evidence of what works for whom and under what circumstances. There is a need to identify mechanisms by which candidate interventions or clusters of interventions might achieve RCD and contribute to societal impact, thereby proving meaningful to stakeholders. METHODS A realist synthesis was used to develop programme theories for RCD. Structured database searches were conducted across seven databases to identify papers examining RCD in a health or social care context (1998-2013). In addition, citation searches for 10 key articles (citation pearls) were conducted across Google Scholar and Web of Science. Of 214 included articles, 116 reported on specific interventions or initiatives or their evaluation. The remaining 98 articles were discussion papers or explicitly sought to make a theoretical contribution. A core set of 36 RCD theoretical and conceptual papers were selected and analysed to generate mechanisms that map across macro contexts (individual, team, organisational, network). Data were extracted by means of 'If-Then' statements into an Excel spreadsheet. Models and frameworks were deconstructed into their original elements. RESULTS Eight overarching programme theories were identified featuring mechanisms that were triggered across multiple contexts. Three of these fulfilled a symbolic role in signalling the importance of RCD (e.g. positive role models, signal importance, make a difference), whilst the remainder were more functional (e.g. liberate talents, release resource, exceed sum of parts, learning by doing and co-production of knowledge). Outcomes from one mechanism produced changes in context to stimulate mechanisms in other activities. The eight programme theories were validated with findings from 10 systematic reviews (2014-2017). CONCLUSIONS This realist synthesis is the starting point for constructing an RCD framework shaped by these programme theories. Future work is required to further test and refine these findings against empirical data from intervention studies.
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Affiliation(s)
- Jo Cooke
- NIHR CLAHRC Yorkshire & Humber, Research Capacity and Engagement Programme Management, 11 Broomfield Road, Sheffield, S10 2SE, United Kingdom
| | - Paolo Gardois
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, United Kingdom.
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Eames S, Bennett S, Whitehead M, Fleming J, Low SO, Mickan S, Caldwell E. A pre-post evaluation of a knowledge translation capacity-building intervention. Aust Occup Ther J 2018; 65:479-493. [PMID: 29851092 DOI: 10.1111/1440-1630.12483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM Knowledge translation (KT) aims to reduce research-practice gaps. Few studies have investigated methods to build clinicians' capacity for KT. To: (i) evaluate the impact of a multifaceted KT capacity-building intervention; (ii) understand barriers and enablers to clinicians' use of KT; and (iii) identify useful strategies. METHODS A pre-post study to develop KT capacity amongst occupational therapy clinicians (n = 46) in a large metropolitan hospital. A customised questionaire (baseline and 18 months) identified KT-related behaviours and barriers and enablers guided by the Theoretical Domains Framework (TDF). McNemar's tests and Wilcoxon signed rank tests were completed on matched data (n = 20). At follow-up additional items explored perceptions of change and usefulness of strategies. RESULTS At follow-up, participants had read more clinical guidelines (10 vs. 17) and more participants reported using strategies to increase the use of recommended clinical practices (P = 0.006). The main barriers at baseline were from the TDF domains of 'attention, memory and decision processes', 'knowledge' and 'environmental context and resources', while main enablers were from 'social/professional role and identity', 'reinforcement', 'social influence' and 'beliefs about consequences' domains. At follow-up, significant improvements were seen in 'knowledge' (p < 0.001), 'environmental context & resources' (P < 0.001), 'skills' (P = 0.008) 'beliefs about consequences' (P = 0.011), 'beliefs about capabilities' (P = 0.018), and 'memory, attention & decision processes' (P = 0.048) and participants agreed that KT had become part of the departments' culture. Strategies perceived most useful included working as a team, having a dedicated staff member, mentoring meetings, department leader support, learning about KT over time, and training sessions. CONCLUSIONS The KT capacity-building intervention changed one clinician-reported behaviour and perceived impact of barriers across six domains. Clinicians reported perceived improvement in understanding of - and confidence in - KT, and changes in the culture to one of engaging with KT as part of clinical practice. Further research into KT capacity building is needed.
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Affiliation(s)
- Sally Eames
- Community, Indigenous and Subacute Services (CISS), Metro North Hospital and Health Services, Brisbane, Queensland, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia, Brisbane, Queensland, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia, Brisbane, Queensland, Australia
| | - Mary Whitehead
- Department of Occupational Therapy, Metro South Hospital and Health Service, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia, Brisbane, Queensland, Australia
| | - Shanling Olivia Low
- School of Health and Rehabilitation Sciences, The University of Queensland, Therapies Annexe, St Lucia, Brisbane, Queensland, Australia
| | - Sharon Mickan
- Allied Health, Gold Coast Health, Southport, Queensland, Australia.,School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
| | - Elizabeth Caldwell
- Department of Occupational Therapy, Metro South Hospital and Health Service, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Mickan S, Wenke R, Weir K, Bialocerkowski A, Noble C. Strategies for research engagement of clinicians in allied health (STRETCH): a mixed methods research protocol. BMJ Open 2017; 7:e014876. [PMID: 28899887 PMCID: PMC5640124 DOI: 10.1136/bmjopen-2016-014876] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Allied health professionals (AHPs) report positive attitudes to using research evidence in clinical practice, yet often lack time, confidence and skills to use, participate in and conduct research. A range of multifaceted strategies including education, mentoring and guidance have been implemented to increase AHPs' use of and participation in research. Emerging evidence suggests that knowledge brokering activities have the potential to support research engagement, but it is not clear which knowledge brokering strategies are most effective and in what contexts they work best to support and maintain clinicians' research engagement. METHODS AND ANALYSIS This protocol describes an exploratory concurrent mixed methods study that is designed to understand how allied health research fellows use knowledge brokering strategies within tailored evidence-based interventions, to facilitate research engagement by allied health clinicians. Simultaneously, a realist approach will guide a systematic process evaluation of the research fellows' pattern of use of knowledge brokering strategies within each case study to build a programme theory explaining which knowledge brokering strategies work best, in what contexts and why. Learning and behavioural theories will inform this critical explanation. ETHICS AND DISSEMINATION An explanation of how locally tailored evidence-based interventions improve AHPs use of, participation in and leadership of research projects will be summarised and shared with all participating clinicians and within each case study. It is expected that local recommendations will be developed and shared with medical and nursing professionals in and beyond the health service, to facilitate building research capacity in a systematic and effective way.
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Affiliation(s)
- Sharon Mickan
- Allied Health Clinical Governance, Education and Research, Gold Coast Health, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Rachel Wenke
- Allied Health Clinical Governance, Education and Research, Gold Coast Health, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Kelly Weir
- Allied Health Clinical Governance, Education and Research, Gold Coast Health, Gold Coast, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Andrea Bialocerkowski
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Christy Noble
- Allied Health Clinical Governance, Education and Research, Gold Coast Health, Gold Coast, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
- School of Pharmacy, University of Queensland, St Lucia, Queensland, Australia
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Boscart VM, Heckman GA, Huson K, Brohman L, Harkness KI, Hirdes J, McKelvie RS, Stolee P. Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care. J Interprof Care 2017; 31:583-592. [PMID: 28876202 DOI: 10.1080/13561820.2017.1340875] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.
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Affiliation(s)
- Veronique M Boscart
- a Conestoga College Institute of Technology and Advanced Learning , Kitchener , Ontario , Canada
| | - George A Heckman
- b Research Institute for Aging and School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
| | - Kelsey Huson
- c Colleges in Seniors Care, Conestoga College Institute of Technology and Advanced Learning , School of Health & Life Sciences and Community Services , Kitchener , Ontario , Canada
| | - Lisa Brohman
- d Sunnyside Home Seniors' Services , Kitchener , Ontario , Canada
| | - Karen I Harkness
- e McMaster University , Clinical Lead, Heart Failure and Cardiovascular Chronic Disease Management, Cardiac Care Network, Hamilton Health Sciences , Hamilton , Ontario , Canada
| | - John Hirdes
- f School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
| | | | - Paul Stolee
- h School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
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Aponte J. Investing in Building Capacity Through Mentoring / Invirtiendo en fortalecer la capacidad a través de la tutoría. HISPANIC HEALTH CARE INTERNATIONAL 2016; 14:107-8. [DOI: 10.1177/1540415316665951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gagliardi AR, Dobrow MJ. Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users. BMC Health Serv Res 2016; 16:256. [PMID: 27405465 PMCID: PMC4943023 DOI: 10.1186/s12913-016-1533-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 07/08/2016] [Indexed: 11/16/2022] Open
Abstract
Background Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Methods Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Results Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. Conclusions The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for IKT. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1533-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
| | - Mark J Dobrow
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
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Langlois EV, Becerril Montekio V, Young T, Song K, Alcalde-Rabanal J, Tran N. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches. Health Res Policy Syst 2016; 14:20. [PMID: 26983405 PMCID: PMC4794922 DOI: 10.1186/s12961-016-0089-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. METHODS The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. RESULTS In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. CONCLUSIONS The collaborative evidence-to-policy approaches underline the importance of iterations and continuity in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.
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Affiliation(s)
- Etienne V. Langlois
- />Alliance for Health Policy and Systems Research, World Health Organization, 20 avenue Appia, 1211 Geneva, Switzerland
| | - Victor Becerril Montekio
- />Center for Health Systems Research, National Institute of Public Health - Instituto Nacional de Salud Pública, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera C.P., 62100 Cuernavaca, Morelos Mexico
| | - Taryn Young
- />Centre for Evidence-based Health Care, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa
- />Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Kayla Song
- />Health Systems Performance Research Network, Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6 Canada
| | - Jacqueline Alcalde-Rabanal
- />Center for Health Systems Research, National Institute of Public Health - Instituto Nacional de Salud Pública, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera C.P., 62100 Cuernavaca, Morelos Mexico
| | - Nhan Tran
- />Alliance for Health Policy and Systems Research, World Health Organization, 20 avenue Appia, 1211 Geneva, Switzerland
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Williamson HJ, Young BR, Murray N, Burton DL, Levin BL, Massey OT, Baldwin JA. Community-University Partnerships for Research and Practice: Application of an Interactive and Contextual Model of Collaboration. JOURNAL OF HIGHER EDUCATION OUTREACH AND ENGAGEMENT 2016; 20:55-84. [PMID: 28184179 PMCID: PMC5295659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Community-university partnerships are frequently used to enhance translational research efforts while benefiting the community. However, challenges remain in evaluating such efforts. This article discusses the utility of applying the contextual and interactive model of community-university collaboration to a translational research education program, the Institute for Translational Research in Adolescent Behavioral Health, to guide programmatic efforts and future evaluations. Institute stakeholders from academia and the community completed in-depth interviews querying their expectations and experiences in this collaboration. Key quotes and themes were extracted and analyzed based on the constructs within the 3 phases of the model. The findings note specific themes for future evaluations. Overall, the contextual and interactive model of community-university collaboration proved a useful framework to guide the process evaluation of the Institute. Findings suggest possible strategies for the successful development, evaluation, and sustainability of community-university partnerships.
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Straus SE, Sales A, Wensing M, Michie S, Kent B, Foy R. Education and training for implementation science: our interest in manuscripts describing education and training materials. Implement Sci 2015; 10:136. [PMID: 26416302 PMCID: PMC4585996 DOI: 10.1186/s13012-015-0326-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/18/2015] [Indexed: 11/25/2022] Open
Abstract
Alongside the growth in interest in implementation science, there has been a marked increase in training programs, educational courses, degrees, and other offerings in implementation research and practice to meet the demand for this expertise. We believe that the science of capacity building has matured but that we can advance it further by shining light on excellent work in this area and by highlighting gaps for future research. At Implementation Science, we regularly receive manuscripts that describe or evaluate training materials, competencies, and competency development in implementation curricula. We are announcing a renewed interest in manuscripts in this area, with specifications described below.
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Affiliation(s)
- Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's, University of Toronto, Toronto, Canada.
| | - Anne Sales
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Faculty of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michel Wensing
- Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Susan Michie
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Bridie Kent
- School of Nursing and Midwifery, Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Designing a knowledge translation mentorship program to support the implementation of evidence-based innovations. BMC Health Serv Res 2015; 15:198. [PMID: 25971464 PMCID: PMC4443629 DOI: 10.1186/s12913-015-0863-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 05/05/2015] [Indexed: 12/01/2022] Open
Abstract
Background Healthcare professionals require training in knowledge translation (KT) to implement evidence-based healthcare innovations. Mentorship is an effective training strategy that could be used to develop KT capacity but it has largely been used to train clinicians. The purpose of this study was to explore preferences for KT mentorship design. Methods Interviews were conducted with 54 Canadian researchers and research users who varied by profession, department, career stage and sex. Participants were asked about KT needs, views on mentorship as a strategy to develop KT capacity, and suggestions for program design. Grounded theory technique and thematic analysis were used to collect and analyse data. Results Participants uniformly expressed interest in mentorship over other forms of learning about KT because it would provide credible, tailored information when needed. A variety of options for program content, format and delivery were recommended, suggesting the need for flexibility according to KT needs. Leadership, infrastructure, culture change and incentives may also be needed to foster KT mentorship. Views were mixed on whether mentors should be KT experts or subject or clinical experts with KT experience, and embedded in, or external to organizations. Conclusions These findings can be used to develop or evaluate KT mentoring programs. Further research is needed to evaluate different models in which the mentor may be an internal or external KT expert or subject expert with experience in KT, and establish the core curriculum of a training program specific to KT and how it could best be reinforced with mentoring. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-0863-7) contains supplementary material, which is available to authorized users.
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Gagliardi AR, Marshall C, Huckson S, James R, Moore V. Developing a checklist for guideline implementation planning: review and synthesis of guideline development and implementation advice. Implement Sci 2015; 10:19. [PMID: 25884601 PMCID: PMC4329197 DOI: 10.1186/s13012-015-0205-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 01/07/2015] [Indexed: 11/15/2022] Open
Abstract
Background Developers, users and others have requested or advocated for guidance on how to plan for, and implement guidelines concurrent to their development given that existing resources are lacking such information. The purpose of this research was to develop a guideline implementation planning checklist. Methods Documents that described or evaluated the processes of planning or undertaking implementation were identified in several publications that had systematically identified such resources, and by searching medical literature databases (MEDLINE, EMBASE). Data that described implementation planning; how to develop guideline versions or tools that would support user implementation; and options and mechanisms for disseminating or implementing guidelines were independently extracted from eligible documents by the principal investigator and a trained research assistant. Data were integrated to create a unique list of guideline implementation planning processes and considerations. Results Thirty-five documents were eligible. Of these, 16 (45.7%) provided sparse information on implementation planning, 25 (71.4%) mentioned different versions or tools for implementation, and 30 (85.7%) listed options for dissemination or implementation. None provided instructions for operationalizing implementation strategies. Data were integrated into a multi-item Guideline Implementation Planning Checklist including considerations for implementation planning (12), development of implementation tools (8), types of implementation tools (12), and options for dissemination (11) and implementation (12). Conclusions Developers or users can apply the Guideline Implementation Planning Checklist to prepare for and/or undertake guideline implementation. Further development of the checklist is warranted to elaborate on all components. In ongoing research, we will consult with the international guideline community to do so. At the same time, guideline implementation is complex, so developers and users would benefit from training, and by including knowledge translation experts and brokers on implementation planning committees. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0205-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Catherine Marshall
- Guideline Adviser and Health Sector Consultant, Waipukurau, New Zealand.
| | - Sue Huckson
- Australian and New Zealand Intensive Care Society, Melbourne, Australia.
| | - Roberta James
- Scottish Intercollegiate Guidelines Network, Edinburgh, Scotland.
| | - Val Moore
- National Institute for Health and Care Excellence, London, England.
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