Why You Need a Knowledge Broker

By Joanne Wincentak

We’ve written quite a bit about knowledge brokers in the past — including a firsthand account of moving from student to knowledge broker; a post about the Role Domains of knowledge brokering; and a ‘thought experiment’ on how reported tasks of knowledge brokers fit into the role domains theoretical framework.

In this post, Joanne Wincentak, Knowledge Broker at Holland Bloorview Kids Rehabilitation Hospital shares similar information about what knowledge brokers do — but in a more user-friendly and easily digestible format — an infographic!

Joanne’s team often uses this infographic to help stakeholders such as clinicians and decision makers better understand how a knowledge broker can help close the know-do gap in their own work, whether it be research, programs, or policy.

Jacks/Jills/Jos of All Trades, Masters of KT

Knowledge brokers (KBs) are the human component of knowledge translation (KT). They connect clinicians, families, and other stakeholders with the research they need to improve health research, care, and services [1]. But what does this actually mean? If you were to look at two different job postings for a KB, you would likely get two entirely different pictures of what a KB does:

That’s because there’s a plethora of activities and competencies needed to make KT happen. The role of a KB depends on the mission of the organization, stakeholder needs, and KT goals [1]. What a KB does not only differs from one organization to the next, but also from one project to the next, and the skillset each KB individually possesses. In Trish’s post, she highlights the complexity of the role from an over-arching theoretical perspective. Needless to say, there’s a lot that goes into the ‘human component of KT’.

When Do You Need a Knowledge Broker?

The long and short of it is that KBs can be brought in at any stage of the work for KT-related activities (from designing a project or program to implementation). The purpose of this infographic is for stakeholders to quickly and easily identify where there is a fit between their project and what a KB does.

Can You Give Me Examples?

You bet we can. Here are some tangible ways a KB can support each of the six activities listed in the infographic:

1. Evidence Synthesis

KBs can turn broad clinical questions into searchable ones. For example, a KB uses tools like PICO (population; intervention; comparison; outcome) for systematic reviews and PCC (population; concept; context) for scoping reviews to move you from:

“Is arts-based therapy effective?”
to “Is arts-based therapy for children and youth with spinal cord injury more effective than usual care for increasing mental well-being?”

and

“How should infant care be delivered?”
to “What are the characteristics of infant care models in rehabilitation settings?”

KBs can also use rapid review methods to extract, synthesize, and draw implications to inform decision making [2].

2. Implementation

We’ve all heard about the 17-year research gap for integration of research evidence into clinical practice. However, studies show that with the help of dedicated implementation ‘doers’, that gap is closing [1, 3]. KBs can be those ‘doers’. Guided by theories, models, and frameworks like the Knowledge-to-Action Cycle and the Theoretical Domains Framework, KBs can:

• Identify an evidence-based practice that addresses a prioritized clinical need (e.g. a consultation guideline for physicians to reduce unnecessary testing);
• Assess barriers and facilitators to implementation of evidence-based practice (e.g. assess barriers/facilitators for doing KT in health research in Manitoba);
• Determine and develop appropriate implementation strategies (e.g. developing a multi-pronged intervention to improve uptake of physiotherapy guidelines); and,
• Implement strategies and monitor needs for supporting evidence-based practice (e.g. in facilitating the use of measurement tools in physiotherapy practice; KBs as an intervention strategy).

3. Dissemination

KBs are experts in dissemination, which is all about sharing information purposefully. There are different goals for dissemination, such as:

• Increasing awareness and understanding of research;
• Priming for implementation (i.e. facilitating the use of research findings); and,
• Informing future research.

KT products — tools that present evidence in a clearly organized, visually appealing and user-friendly format — are an evidence-informed strategy often used by KBs for dissemination [4,5,6].

For example, KBs at Holland Bloorview Kids Rehabilitation Hospital have co-opted research evidence with clinician and family input to create KT products such as:

• Handbooks: School first — Enabling successful return-to-school for Canadian youth following a concussion;
• Toolkits: The chronic pain assessment toolbox for children with disabilities;
• Pathways: Hip surveillance pathway; and
• Infographics: Topics like concussion, aspiration, and biofeedback:

4. KT Planning

KBs create plans using KT approaches to make sure that research projects and programs achieve their intended impact.

END-OF-GRANT KNOWLEDGE TRANSLATION
This approach is closely tied to dissemination. To make sure research doesn’t just ‘sit on a shelf’ after it’s completed, KBs create and carry out plans for dissemination, taking into consideration the:

• Dissemination goal (e.g. informing future studies, changing policy);
• Target audience who would benefit from the research findings (e.g. other researchers, patients, decision makers);
• Key messages (i.e. if your audience only takes away one thing from your work, what is it?);
• KT strategy (e.g. the type of KT product and how it will be shared — such as an infographic promoted by a disease-specific advocacy group on social media); and
• Resources (cost, time, and skilled personnel — like a graphic designer).

INTEGRATED KNOWLEDGE TRANSLATION
Using this approach, KBs can identify and engage stakeholders throughout the entire research process — such as clinicians and patients — which has been shown to facilitate better use of research [7]. A KB can work with stakeholders to:

• Identify gaps in clinical practice or care, based on their own lived experience with health and the healthcare system;
• Inform consent scripts and advise on risk management strategies;
• Provide insight into which data collection methods would work best and resonate with research participants;
• Inform survey or interview guide content and language; and,
• Contribute to data interpretation, based on their contextual knowledge.

KBs may also partner with decision makers in an organization for program development, where they can use program logic models to plan for implementation.

5. Stakeholder Engagement

As in integrated KT, stakeholders are often involved in projects because of their expertise and lived experience of the context in which research findings are often applied. Navigating engagement is tricky — KBs bring structure and organization to the process.

For example, KBs may use consensus methods like Delphi processes and workshops to prioritize research questions, or select recommendations for practice guideline implementation. In creating KT products, KBs can facilitate participatory editing with stakeholders through tools like Google Docs. Check out NeuroDevNet’s Stakeholder Guide of Guides for stakeholder engagement techniques. For a more hands-on look at some of these methods, check out CHI’s Guide to Methods in Patient and Public Engagement in the resources section of their website.

6. Evaluation

A lot of money and resources go into research, project, and KT activities. It’s important to monitor and evaluate what’s working well, what isn’t, and whether the intended impact is being achieved at various stages of the process. KBs have the know-how and tools to monitor and evaluate your efforts, at both the process and outcome levels.

For example, let’s say you’re working on an evidence synthesis to inform clinical practice at your organization. As part of the process, several clinicians were engaged in identifying the research question, data extraction, and interpreting the findings. A KB can examine and evaluate:

Process Elements, such as:

• Who was involved;
• The number of meetings held and attendance; and
• How engaged clinicians felt.

Outcome Elements, such as:

• Perceived benefits of engagement;
• Whether there has been a change in clinical practice since producing the evidence synthesis.

Looking for a knowledge broker to help with planning for KT or engagement?

• In Manitoba, complete an intake form to book a free one-hour consult with a member of the Knowledge Translation team at CHI.
• In other provinces, contact your local SPOR SUPPORT Unit for more info.

References

1. Bornbaum CC, Kornas K, Peirson L & Rosella LC. Exploring the function and effectiveness of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci, 2015;10(162).
2. Tricco A, Langlois E & Straus S. Rapid reviews to strengthen health policy and systems: a practical guide. Geneva: WHO. 2017.
3. National Implementation Research Network & State Implementation and Scaling-up of Evidence-Based Practices Centre. Why are implementation teams important?
4. Martin L et al. Exploring the role of infographics for summarizing medical literature. Health Prof Educ, 2019;5(1).
5. Provvidenza C, et al. Does a picture speak louder than words? The role of infographics as a concussion education strategy. J Vis Comm Med, 2019.
6. Yamada et al. The effectiveness of toolkits as knowledge translation strategies for integrating evidence into clinical care: a systematic review. BMJ Open, 2015;5.
7. Kothari A & Wathen N. Integrated knowledge translation: digging deeper, moving forward. J Epidemiol Community Health, 2017;71(6).

About the Author

Joanne Wincentak is a knowledge broker on the knowledge translation team (Evidence to Care) at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Ontario, Canada. She is passionate about identifying research evidence to support clinical practice and has recently gained interest in information design. Find her on Twitter as @jwincentak.