Petzold, A., Korner-Bitensky, N. & Menon, A. (2010). Using the Knowledge to Action Process Model to Incite Clinical Change. Journal of Continuing Education in the Health Professions, 33(3), 167-171.

Format: Peer-reviewed article

Type: Research — Non-experimental

Experience level of reader: Fundamental

Annotation: The authors show how Graham’s Knowledge to Action Process model can be used to facilitate the translation of stroke rehabilitation research into practice.

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

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is critical to identify potential barriers that may interfere with the successful application of the new knowledge. One way to identify potential barriers is to conduct focus groups with key stakeholders.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1, KTA Step 3.C, KTA Step 6.C, KTA Step 7.C

• In cases where multiple practice guidelines have been published (e.g., at the level of the country, region and internationally), knowledge users (e.g., clinicians) may find it challenging to decide which, if any, are consistent with their needs and complimentary to their practice. There may also be instances were inter-guideline comparisons reveal inconsistencies or outright disagreements with each other, which can be confusing for the knowledge user. Guideline producers should understand their stakeholders’ needs and respond to them.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Stage 1, KTA Stage 2, KTA Stage 3, KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is critical to identify potential facilitators that may contribute to the successful application of the new knowledge. One way to identify potential facilitators is to conduct focus groups with key stakeholders.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Tip 1.1, KTA Tip 2.1, KTA Step 3.B, KTA Step 6.B, KTA Step 7.B

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one of the factors that knowledge users (e.g., clinicians) may site as an impediment is an absence of the evidence appraisal and statistical analysis skills that are required in the knowledge inquiry phase. Knowledge producers should clearly communicate, in simple terms, how knowledge users can assess the validity of the new knowledge. One solution is to provide easy-to-use synthesis, assessment, learning and application tools.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A

• One of the factors that knowledge users (e.g., clinicians) may site as an impediment to applying research-based knowledge is the absence of resources that provide a synthesis of the findings and context-specific vehicles for their application. Knowledge producers should directly link their finding to specific practitioner uses.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Stage 1, KTA Stage 2, KTA Stage 3, KTA Tip 1.1, KTA Tip 2.1

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is important to monitor how the knowledge is being used, and whether the desired practice changes are being adopted. One way to assess this is to re-administer the survey that was used in the problem identification phase.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 3.F, KTA Step 6.F, KTA Step 7.F, KTA Tip 1.5, KTA Tip 6.5

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is important to determine whether the desired practice changes have become sustainable. One way to track this is to administer a practice standards interview.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 7.G, KTA Step 3.G, KTA Step 6.G, KTA Tip 1.5, KTA Tip 6.5

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to conduct focus groups with knowledge producers (researchers) and knowledge users (clinicians) to explore why there are gaps between the availability of research evidence and its application in a clinical setting.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A, KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1, Step 1.2

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to formally survey knowledge users (clinicians) about their use of research knowledge in their practice.
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A, KTA Tip 1.2, KTA Tip 2.2, KTA Tip 3.1, Step 1.2

• When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to formally study actual cases (e.g., by conducting chart audits).
  Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
  Occurrence of finding within the model: KTA Step 3.A, KTA Step 6.A, KTA Step 7.A, Step 1.2