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Article Title

What's in a Name

The importance of evidence based practice as an integral tool in ensuring safe and quality health care practice is now well recognized. However, there is growing research evidence which indicates ongoing difficulties in ensuring consistent implementation of research evidence into clinical practice and achieving behaviour and practice change. While there are many reasons for this, one which regularly confronts many experienced and novice health professionals is the ambiguity in terms used to describe this very process. Kerner highlights this as "the first historical challenge is one of language and meaning.”1,p73 Graham and colleagues from Canada reported on their research which focused on 33 applied research funding agencies across nine countries.2 Collectively, they identified 29 terms which were used to refer to some aspect of evidence into practice (or knowledge into action). Some commonly reported terms include knowledge transfer, knowledge translation, knowledge exchange, research utilisation, implementation, dissemination and diffusion. Lang and colleagues add to this list and include other terms such as translating research into practice, getting research into practice, knowledge use, knowledge dissemination, evidence translation, research uptake, evidence uptake, just to name a few.3

Further complicating this already murky issue is the interchangeable use of these terms to mean sometimes similar and sometimes different things. As Graham and colleagues highlight, some of these terms are used as nouns (describing the process which results in use of evidence or knowledge), while at other instances they are used as verbs (describing targeted actions or specific strategies).2 Geographical location also seems to play a role in utilization of these terms. Knowledge translation and knowledge transfer are terms commonly utilized in Canada and United States of America while Europe and Australia commonly use the term implementation (evidence implementation and implementation research). Another reason for this complexity is some of these terms are not specific to health care and are used more generically (e.g.: organisational and behvioural change). Dissemination and diffusion are such terms used to describe processes of sharing, or promulgating of, knowledge products to stakeholders and are often encountered in organisational and administrative literature.2

If we were to paraphrase Shakespeare (and our sincere apologies for that) ‘what’s in a name? That which we call evidence implementation by any other name would be equally as important,’ it is also important to achieve consensus on various terms and definitions used to denote the process underpinning bridging gaps between research evidence and clinical practice. Common nomenclature will aid in effective communication, building and expansion of ideas and knowledge, establishing collaboration and networking and creating the evidence base for the science underpinning the process of evidence into practice.2

References

  1. Kerner, J F. 2006, “Knowledge Translation Versus Knowledge Integration: A “Funder’s” Perspective”, The Journal of Continuing Education in the Health Professions, vol. 26, pp. 72-80.
  2. Graham, ID., Logan, J., Harrison, MB., Straus, SE., Tetroe, JT., Caswell, W. 2006, “Lost in Knowledge Translation: Time for a Map?”, The Journal of Continuing Education in the Health Professions, vol. 26, pp. 13-24.
  3. Lang, ES., Wyer, PC., Haynes, RB. 2007, “Knowledge Translation: Closing the Evidence-to-Practice Gap”, Annals of Emergency Medicine, vol. 49, no. 3, pp. 355-363.

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