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Knowvember: knowledge mobilisation

By david.charles.green, on 25 November 2022

Introduction

The NHS continues to improve ways to share knowhow and spread best practice. Resources available through Health Education England (HEE), help staff to do this, including the Knowledge Mobilization Framework (KMF). This comprises a set of tools and techniques, which emphasize learning either before, during or after a piece of work. In terms of help with ‘learning after’, KMF allows you reflect on a piece of work, and to preserve corporate knowledge (knowledge harvesting). The technique of knowledge harvesting is described at the end of this posting, as well as further resources on knowledge mobilisation. Let’s begin with knowledge mobilisation, however.

(The following eight paragraphs are adapted from the transcript of a NIHRtv webinar, broadcast on 22 Jan. 2022.)

What is Knowledge Mobilisation (KMb)?

The term ‘knowledge mobilisation’ came from disciplines of business, education and science, and consequently there is a lot of jargon surrounding it. Defined as:

“…the sharing of knowledge between communities to catalyze change” (NIHRtv, 2022).

Alternative terms in use, include: knowledge transformation, knowledge exchange, knowledge transfer, or ‘pathway to impact’. In health and social care, the term knowledge mobilisation (KMb) is commonly used.

What does that mean?

Generally speaking, it is giving people access to knowledge, and being able to both understand and use it. At the organisational level, it is using evidence and expertise in a meaningful way, to guide research policy and practice, in order to improve outcomes. As well as research, it is employing practice-based evidence, making use of expertise from practitioners as well as the experience of people and families. It is more than disseminating information (one-way form of communication); it’s about end-users both engaging and participating, and distinct from impact (the demonstrable contribution made by research to society and the economy). Impact is regarded as the outcome of dissemination and knowledge mobilization. Hence, ‘pathway to impact’ is sometimes used to label KMb.

Why do KMb?

The presenters’ transcript from the NIHRtv webinar, perhaps sums up the ‘why’:

“It helps empower people to use information in strategic ways, to address real-life problems. Can help you make the case for support from funders and donors. Helps raise awareness, prompts change, brings people together, and puts what we know into active use” (NIHRtv, 2022).

What is the problem?

Although evidence-based practice and policy are now central to the way healthcare services work, they are not always adhered to. Sometimes, this leads to sub-standard practices. The research process takes time to complete; it can take up to 17 years to get evidence embedded into practice, and only 14% of health research becomes standard of care. Even if development of practice guidelines is completed in a timely manner, it doesn’t mean recommendations are implemented.

How to introduce KMb approaches in a useful way?

It can be introduced at all stages of the research cycle, although the earlier, the better, and the easier and more beneficial it can be to practitioners, policy makers and users. KMb can assist shaping research to the needs of users. One way is through a mid-dissemination meeting, in which stakeholders discuss what they feel the key questions of findings should be. There is opportunity to build relationships. Eight to ten people is effective, as is one-to-one.

New approaches

New approaches based on KMb and ‘mindlines’. Mindlines (Gabbay & Le May, 2004): ‘guidelines in the head’ reframe the KMb problem, from how can we improve uptake of scientific evidence, to what type(s) of evidence are needed for effective healthcare, and how is it learned, modified and transmitted. A practical example is based around a play. A play is devised to represent stories about an issue which needs to change. (Protagonists’ outcomes are poor.) The play is performed in front of stakeholders who previously contributed the stories. The expectation is to stimulate debates and knowledge sharing. The play is then re-performed, but this time audience members are invited to step in, to try out new solutions. The remaining theatre players improvise the impact of this intervention, and any unforeseen consequences.

How to plan for KMb?

Planning should involve three stages:

  1. Identify who the researchers are or the communities which are going to use research.
  2. What are the ‘contextual influencers’ that may affect use of research?
  3. What tools do you need to share knowledge?

It is important that you have diversity in the stakeholder group; key stakeholders have high interest and high influence.

Prioritise to use your time and energy and avoid wasting others’ time. You need to answer two questions: 1. who could or should be interested in your research, and 2. how much influence do they have? This can change over time. Mapping answers to questions can focus your efforts.

Remember, influence and interest can change over time, often due to change of context. (Context = set of characteristics or circumstances surrounding your research.) It’s a good idea to use a PESTLE chart, to think through different contexts. Additionally, use SWOT to consider what may influence these aspects.

How best to communicate to your priority audience?

There are many channels of communication – they all have their pros and cons. You might approach stakeholders directly; might choose an intermediary (colleague or knowledge broker); or go through a ‘community’.

All formats (e.g. presentation, poster, etc.) provide good ideas to get stakeholders on board, to get buy-in. With an academic audience, have a ‘punchline’ at the end, but switch the format for different audiences.

Another thing to consider is reciprocity (exchange) and trust; you have to think what you are bringing to help those colleagues in practice. Help them to think though opportunities and challenges.

(Challenges – resources available: time, finances and skills. Consider at outset.)

Knowledge harvesting: leavers toolkit:

HEE’s Knowledge Mobilisation Framework (KMF) comprises a set of tools and techniques, which emphasize learning either before, during or after a piece of work. Help with ‘learning after’, allows you to reflect on a piece of work; also, to preserve corporate memory.

Screenshot of help page for choosing the right Knowledge Mobilisation technique. The final option in the screenshot has been highlighted.

(efLH, 2022)

Use knowledge harvesting to capture unique and valuable knowledge from people so it can be shared and re-used, when somebody moves to a new role. It can be planned in the same way as KMb from research. This can involve an interview with the leaver, or use of a self-harvest tool.

A leavers toolkit can include the following documents in an electronic folder (with file path added in the footer), and /or printed copies of all docs, to include:

  • Collated vital emails
  • Key contact lists
  • Table of activities/ events that take place during a standard year
  • Organise files to be transferred to a shared drive (in folder bearing post name)
  • Draft a position statement for ‘work in-hand’ pieces of work
  • Useful resources
  • Handover guides – ‘how to’ /’best practice’
  • My FAQs – questions you are repeatedly asked
  • 1:1 with line manager to draw out ‘tacit knowledge’ (use prompt questions template)
  • Q & A with team

Use these together with the knowledge prioritisation matrix and prompt questions (efLH, 2022).

Further resources:

References:

  • elearning for healthcare (2022). Knowledge Mobilization Framework module [online]. Available at: https://www.e-lfh.org.uk/programmes/knowledge-mobilisation-framework/. (Accessed: 23 Nov. 2022.)
  • Gabbay, J & Le May, A. (2004) Evidence based guidelines or collectively constructed “mindlines?” Ethnographic study of knowledge management in primary care. BMJ 329 (7473).
  • Gabbay, J (2011) Practice-based evidence for healthcare: Clinical Mindlines. Oxford: Routledge
  • Le May, A (2009) Communities of practice in health and social care. Chichester: Wiley-Blackwell
  • NIHRtv (2022) An introduction to knowledge mobilisatiion for researchers [webinar]. Available from: https://www.youtube.com/watch?v=2l1R0sdSark (Accessed 18 Nov. 2022).

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