Lost in Translation: Just Lost or Beginning to Find Our Way?
2009; Elsevier BV; Volume: 54; Issue: 2 Linguagem: Inglês
10.1016/j.annemergmed.2009.02.021
ISSN1097-6760
AutoresIan D. Graham, Jacqueline Tetroe, Michelle Gagnon,
Tópico(s)Health Sciences Research and Education
ResumoWe have been reading with interest the dialogue about knowledge translation. The refinement of the discussion through the explanations and responses provide a great example of knowledge translation in action. As the Canadian Institutes of Health Research is responsible for coining the term knowledge translation, we thought it appropriate to participate in the discussion. When the Canadian Institutes of Health Research was created in 2000, knowledge translation was a unique aspect of our parliamentary mandate. We define knowledge translation as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.”1Canadian Institutes of Health ResearchAbout Knowledge Translation.http://www.cihr-irsc.gc.ca/e/29418.htmlGoogle Scholar A key element of the definition is knowledge exchange which encompasses the need for 2-way interaction between researchers and knowledge-users. We further divide knowledge translation into 2 main categories: end of grant and integrated knowledge translation.1Canadian Institutes of Health ResearchAbout Knowledge Translation.http://www.cihr-irsc.gc.ca/e/29418.htmlGoogle Scholar, 2Graham I.D. Tetroe J. How to translate health research knowledge into effective healthcare action.Healthcare Quarterly. 2007; 10: 20-22Crossref PubMed Google Scholar In the former, researchers develop and implement a plan to ensure that the appropriate individuals/organizations are aware of the research findings. This is the more conventional approach often referred to as diffusion and dissemination of research findings. However, as Dr. Sargeant and colleagues note,3Sargeant J. Hurley K.F. Duffy J. et al.Lost in translation or just lost?.Ann Emerg Med. 2008; 52: 575-576Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar integrated knowledge translation is a different way of doing research that meaningfully engages knowledge-users in the research process, from determining the research question, deciding on the methodology, being involved in data collection or tools development, interpreting the findings, and helping disseminate the research results. This approach, also known by such terms as mode 2 knowledge production, collaborative research, action-oriented research, and co-production of knowledge, is intended to produce research findings that are more likely to be relevant to and used by the end-users and hopefully avoid some of the concerns about knowledge production raised by Dr. Wears.4Wears R.L. Lost in translation.Ann Emerg Med. 2008; 51: 78-79Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar, 5Wears R.L. Reply to Lost in translation or just lost?.Ann Emerg Med. 2008; 52: 576Abstract Full Text Full Text PDF Scopus (1) Google Scholar We have a number of funding opportunities designed specifically to promote integrated knowledge translation which require knowledge-users (who may be practicing clinicians, health system managers, or policymakers, for example) to be co-investigators or co-principal investigators on the grant. Some of these funding opportunities also require the entire research team, including the knowledge-users, to come together to interpret the findings as they become available to ensure that the knowledge-user's perspective on the findings are discussed. Furthermore, these grants are reviewed by peer-review panels comprised of roughly equal numbers of both researchers and knowledge-users who must evaluate both the scientific merit of the application as well as its relevance and potential impact (both criteria are weighed equally). Only applications scoring high on both criteria can be funded. Although a relative new concept for Canadian Institutes of Health Research, researchers and knowledge-users have taken to it, if application pressure is any indication. We agree that knowledge translation is a messy business that needs to be responsive and tailored to the context in which it is taking place. We also agree that the gap between research and practice exists due to circumstances arising from both the knowledge-producers and the knowledge-users. Integrated knowledge translation, however, is a potential means to close the gap through the mutual contributions and learnings of these 2 communities. In replyAnnals of Emergency MedicineVol. 52Issue 5PreviewHurley et al have contributed thoughtfully to this discussion in their letter,1 and I think our areas of agreement are greater than our differences. We certainly agree on the goals and role of knowledge translation, and also on the value of qualitative, ethnographic, or cognitive engineering approaches to the problem. (Just imagine what knowledge translation would be like if it were dominated by ethnographers and cognitive engineers, rather than by epidemiologists and MPHs). And, we agree that to the extent knowledge translation helps clinicians reduce the gap between global evidence and their local realities, it does good. Full-Text PDF In replyAnnals of Emergency MedicineVol. 54Issue 2PreviewGraham et al's efforts at developing “integrated knowledge translation” are clearly moving in the right direction, and I strongly support them, particularly if they lead to improved understandings of what constitutes scientific activity.1 Of course, the devil is in the details–it would be very easy to wind up with new “integrated” icing on the old knowledge translation cake, if for example the knowledge-users tend, as seems likely, to defer to knowledge-producers on research design and execution issues. Full-Text PDF
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