Elsevier

Social Science & Medicine

Volume 74, Issue 3, February 2012, Pages 297-304
Social Science & Medicine

Exploring knowledge exchange: A useful framework for practice and policy

https://doi.org/10.1016/j.socscimed.2011.09.021Get rights and content

Abstract

Knowledge translation is underpinned by a dynamic and social knowledge exchange process but there are few descriptions of how this unfolds in practice settings. This has hampered attempts to produce realistic and useful models to help policymakers and researchers understand how knowledge exchange works. This paper reports the results of research which investigated the nature of knowledge exchange. We aimed to understand whether dynamic and fluid definitions of knowledge exchange are valid and to produce a realistic, descriptive framework of knowledge exchange.

Our research was informed by a realist approach. We embedded a knowledge broker within three service delivery teams across a mental health organisation in the UK, each of whom was grappling with specific challenges. The knowledge broker participated in the team’s problem-solving process and collected observational fieldnotes. We also interviewed the team members. Observational and interview data were analysed quantitatively and qualitatively in order to determine and describe the nature of the knowledge exchange process in more detail. This enabled us to refine our conceptual framework of knowledge exchange.

We found that knowledge exchange can be understood as a dynamic and fluid process which incorporates distinct forms of knowledge from multiple sources. Quantitative analysis illustrated that five broadly-defined components of knowledge exchange (problem, context, knowledge, activities, use) can all be in play at any one time and do not occur in a set order. Qualitative analysis revealed a number of distinct themes which better described the nature of knowledge exchange.

By shedding light on the nature of knowledge exchange, our findings problematise some of the linear, technicist approaches to knowledge translation. The revised model of knowledge exchange which we propose here could therefore help to reorient thinking about knowledge exchange and act as a starting point for further exploration and evaluation of the knowledge exchange process.

Highlights

▸ Using empirical data gathered from UK healthcare teams we problematise linear approaches to knowledge translation. ▸ Our findings show that knowledge exchange is a dynamic and fluid process which incorporates knowledge from multiple sources. ▸ We contribute a clear description of the nature of knowledge exchange and a model which can help to reorient thinking. ▸ We propose that the model can act as a starting point for further exploration and evaluation.

Section snippets

Context

Finding ways of translating research-based knowledge into healthcare policy and practice has become one of the most pressing concerns over the last decade or more (Nutley, Walter, & Davies, 2007). This intense interest has been prompted by a range of well-rehearsed arguments about the social and economic damage caused by failures to put research evidence to good use (Berwick, 2003, Darzi, 2008, World Health Organization, 2004). In the wake of the current economic crisis arguments about wasted

Methods

Our research is an example of a small-N study which was designed to capture situational specificity within a framework of theoretical reasoning (Tsoukas, 2009). As such, it was informed by a realist approach because we were particularly interested in developing, refining and extending a theoretical understanding of knowledge exchange by investigating how the process unfolded in specific circumstances (Pawson and Sridharan, 2009, Pawson and Tilley, 1997). The research had three phases. First, we

Key components of knowledge exchange

Using an iterative process we defined the five components of our conceptual framework more tightly and applied these definitions to the data from each narrative. We found that all five components occurred on multiple occasions with each team and only identified 5 instances of data from the narratives which did not fit into one of the components. These came from the personal reflections of the knowledge broker herself and were found to particularly relate to the challenges associated with

Discussion

Having illuminated the nature of knowledge exchange across the three teams with whom we worked, we now return to the literature to consider the contribution of our findings and suggest how they can be used to reorient thinking about knowledge translation and exchange.

We found problem definition to be a crucial aspect of the knowledge exchange process but observed how this was open to continuous revision and evolution over time. This compares favourably with the concepts of knowledge exchange

Conclusion and implications

In this paper we have described how knowledge exchange occurred across three teams within a healthcare organisation and used this to develop a realistic and informative framework which illustrates the nature of knowledge exchange. Our assumption throughout has been that the gap between knowledge and action is a knowledge exchange problem and that understanding how this process is enacted in particular contexts can inform the development of more suitable approaches to knowledge translation. We

Acknowledgements

This study was funded by the Medical Research Council (grant no. G0601172). The authors would like to thank Dr Peter Trigwell and Professor Justin Keen who acted in an advisory capacity during the research. Final thanks go to all of our study participants and to the reviewers and colleagues who commented on this paper.

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