A recent systematic review of 145 studies concluded that key barriers for getting research into practice are limited availability and access to research and a lack of relevant, reliable and clear research findings. Another recent review of 16 systematic reviews has confirmed that education using evidence-based health care (EBHC) principles improves participants’ knowledge, critical appraisal skills and their ability to integrate research into decisions. So we can confirm that multifaceted, clinically integrated education helps clinicians learn to find, critically appraise and interpret research for their own use.
However, the process of using research to improve clinical practice requires a broader understanding of individual and organisational behaviours, and an ability to integrate the research evidence with existing tacit and organisational knowledge. There is a growing evidence base to support this process, focused around the areas of knowledge translation and implementation science.
An Evidence-Based Health Care Fellows programme has been introduced as part of Oxford Academic Health Science Network‘s Continuous Learning programme. This will sponsor fellows to complete an MSc in Evidence-Based Health Care while focusing their learning on a specific local service challenge. There may be local practices that have not yet been able to integrate new research evidence; clinicians may be confused by conflicting research evidence, or there may be instances of increasing adverse events or poor adherence.
Each fellow will be supported by organisational mentorship and academic supervision to investigate their own clinical challenge more deeply, so they can understand how research evidence is or is not being used in daily practice. Through the development of local learning networks, fellows will share knowledge about identifying and managing the local barriers and facilitators for implementing change. Fellows will also develop measurement and monitoring systems so their implementation plans can be responsive to local needs. A series of seminars are planned to share lessons learned for each step of this complex implementation process. It is expected that fellows will learn a lot about their own organisational cultures from each other and become more able to lead these required changes.
After three years of intensive engagement, the successes of each local project will be communicated clearly, to capture the learning and to share this with other similar projects. It is expected that while each fellow has used evidence to improve a local service, they will also have learned more about facilitating change in other parts of their service, so they can integrate more evidence-based clinical practices in the future.
Ultimately, this project will contribute more knowledge about the practical challenges of using research evidence to improve local practice.