A summary: Knowledge into Action

July 30, 2013

After one week’s interactive teaching and learning, here is my summary of what’s important in moving knowledge into action…

 Knowledge is a multi-faceted concept: it is a combination of research evidence, experience and expectation that can be both explicit and tacit; and it can be used for  understanding,  engagement and for behaviour change. Everywhere we look, there seem to be problems in synthesising and organising knowledge for use. We know that the latest research evidence is not routinely implemented and that at times, we don’t change practice to prevent harm. Within organisations, we have difficulty managing knowledge and there are often challenges transferring the tacit know-how for new staff.

When we think about why this happens, it usually comes down to an individual reticence to change, until we recognise the shared benefits. Rather than assume all individuals are resistant to change and that it therefore needs to legislated, financially renumerated or just shouted louder, an understanding of human behaviour may be insightful. There are useful theories about why individuals and groups change. Essentially, we are social creatures and we like to discuss the research and experiential evidence with colleagues we trust and respect. Often, it is important to review the best summaries of evidence, often presented as clinical guidelines, with peers in a constructively critical environment, where we can debate how to generalise the knowledge in our own local context. When we design practical clinical pathways that work, it can actually make everyday practice more relevant. However, we are often too impatient and just want to solve the problem with the most obvious solution for the person in the most powerful position.

In these cases, we don’t take the time to understand the real root causes and evaluate the options for the best outcome. We forget that the process of engaging people in defining the problem, also engages them in finding a shared solution. We may not bother identifying key stakeholders who have interest and influence in the proposed change. These people will assist in identifying key barriers and ultimately design the most appropriate way to implement the change that is tailored to meet individual needs. With regular monitoring of the change, small adjustments can be made. Regular feedback and formal evaluation will clarify the issues that will determine whether the change can be sustained.

So I would like to reiterate that common sense is a crucial mediator. Art and Science are important. Lastly, I wonder if the rigour and transparency of science can offer some insights into ways that we can evaluate and summarise the contributions of the art of practice, so that we can share the essence of new learning with current and future generations…

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