Metzler, M. J. & Metz, G. A. (2010). Translating Knowledge to Practice: An Occupational Therapy Perspective. Australian Occupational Therapy Journal, 57(6), 373-379.

Format: Peer-reviewed article

Type: Research — Non-experimental

Experience level of reader: Fundamental

Annotation: The authors explore the challenges and opportunities associated with applying knowledge in occupational therapy practice. They show how the Knowledge-to-Action Process model (Graham (2006, 2007), a planned action model, can facilitate knowledge translation in occupational therapy.

Setting(s) to which the reported activities/findings are relevant: University

Knowledge user(s) to whom the piece of literature may be relevant: Clinicians, Researchers

Knowledge user level addressed by the literature: Organization

This article uses the Commercial Devices and Services version of the NtK Model

• One of the factors practitioners may cite as an impediment to applying research-based knowledge is requirement for specialized skills or equipment, which may not be available.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1, KTA Step 3.C, Step 2.3

• There may be unintended consequences associated with the application of research knowledge. They may unfold with a ripple effect, affecting other processes and outcomes. Sustained monitoring of the use of the research knowledge may help to bring potential adverse consequences to light.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: Tip 6.5, KTA Step 3.E, KTA Step 6.E, KTA Step 7.E, KTA Tip 1.5, Step 2.3

• In a complex environment, determining precisely why a particular knowledge translation process failed may be challenging. Applying a systems approach may help to elucidate contributing factors.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Step 3.F, KTA Step 6.F, KTA Step 7.F, Gate 3, Step 2.3

• One of the factors that can facilitate the knowledge translation process is to explain relevant research knowledge in language that is plain language.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Step 7.B, KTA Step 3.B, KTA Step 6.B

• One of the factors that can facilitate the knowledge translation process is explaining to clients (stakeholders) how knowledge empowers them and the process.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Step 3.B, KTA Step 6.B, KTA Step 7.B

• When a practitioner is involved in a knowledge translation process, they may supplement the new (research-based) knowledge with knowledge drawn from past professional experience, training and discourse.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: Step 3.1, Step 2.2, Step 1.1

• When knowledge translation process involves collaboration with the client (stakeholder), interactions with the client can shape the knowledge translation process before research is even accessed.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A, Step 2.2, Step 1.1

• When a client (stakeholder) is involved in the knowledge translation process, the practitioner may solicit, validate and integrate client-supplied knowledge (about the client’s situation and environment) into the overall knowledge translation process.
  Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A, KTA Step 3.B, KTA Step 6.B, KTA Step 7.B, Step 2.2, Step 1.1

• One of the factors practitioners may cite as an impediment to engaging in the knowledge translation process is a discomfort with evaluating research-based knowledge (evidence). As one example, limited understanding of statistical analysis can be an impediment. (Bennett [2003]; Metcalfe [2001])
  Occurrence of finding within the model: KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• One of the factors practitioners may cite as an impediment to engaging in the knowledge translation process is a discomfort with evaluating research-based knowledge (evidence). As one example, research-based knowledge (e.g., scholarly literature) may be scattered across multiple sources and it may be challenging for the practitioner to assess its relevance and applicability (Metacalfe [2001])
  Occurrence of finding within the model: KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• Peer-reviewed journals can be challenging sources of knowledge for practitioners.One factor that can impede knowledge translation is the ability of the knowledge (evidence) to be applied in practice. (Grol [2003]; Straus [2009])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• One of the factors practitioners may cite as an impediment to engaging in the knowledge translation process is a discomfort with the perceived rigidity of some research products (e.g., clinical reviews, clinical practice guidelines, care maps and critical pathways). Practitioners may be concerned that the products will reduce their autonomy and supersede their clinical judgment. (Metacalfe [2001])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1, KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• Systematic reviews are considered to be a trustworthy means of examining the rigor of evidence and its readiness to be translated into practice. Although there are several systems developed to evaluate the strength of evidence, there is no agreement in the research and healthcare communities as to what level of evidence justifies action. One issue associated with systematic reviews is that they generally focus on the research context rather than the practicalities of implementation. In spite of these potential shortcomings, basing knowledge translation efforts on rigorous systematic reviews can help to reduce bias, increase accuracy and be time-effective. (Bannigan []997]; Straus [2009])
  Occurrence of finding within the model: KTA Tip 1.1, KTA Tip 2.1, Step 3.3

• Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is the sheer volume of available knowledge (evidence). (Grol [2003]; Bannigan [1997]; Cusick [2000])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is the practitioner’s ability to critically evaluate the available knowledge (evidence). (Grol [2003])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 1.1, KTA Tip 2.1, Step 2.3

• In a practice context that requires research knowledge to be valued above all other forms of knowledge, practitioners may rebel and apply, in substitution and without disclosure, their own experience-based (tacit) knowledge. (Whiteford [2009])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, Step 2.3

• Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is a misalignment between the knowledge (evidence) context and a specific practice context. (Cheater [2005]; Grol [2003])
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 1.1, KTA Tip 2.1, Step 2.3

Carrier: Timely incorporation of knowledge into practice is beneficial for client outcomes and responsible clinical practice. (Wyer [2007])

• New knowledge (evidence) and its translation into practice can validate, or even enhance professional integrity and values. (Kinsella [2009])
  Occurrence of finding within the model: KTA Stage 1, KTA Stage 2, KTA Stage 3

• New knowledge (evidence) should pass through a timely vetting process, which includes an assessment of implications for stakeholders and their environment. Only validated knowledge should be applied to practice. (Bannigan [1997]; Graham [2007])
  Occurrence of finding within the model: KTA Stage 1, KTA Stage 2, KTA Stage 3