Knowledge Science:Empirical Measures in Knowledge Utilization

Paul J GrahamResearch Associate & LibrarianDepartment of SociologyUniversity of SaskatchewanDecember 2008

Presentation Contents

Part I: What is Knowledge Science?– State of the Art

Theory, Methods, Models, Concepts

Part II: Knowledge Science Today– Nursing Research

Research Examples

Part III: Problem Based Learning– How do we study a real life Problem?

Part I: Knowledge Science:State of the Art

State of the Art: Terminological Tangle

Terminology Tangle– Knowledge Management, Transfer, Translation,

Utilization, Research Transfer, Implementation Research…the list goes on

Two Approaches to Knowledge Studies– Broad Approach (comprehensive)

Searching any possibility, any combination

– Narrow Approach (Focused) Searching specific terminology, Knowledge Translation

State of the Art:Broad Approach (Comprehensive)

Over 1800 publications

USA (32%) and Canada (26%) are top producers

English articles makes up 94%

Top Author: Carole Estabrooks from Nursing

State of the Art:Broad Approach (Comprehensive)

1 Management -- R&D, Human resources, Technology networks, Multi-national corporations, cost of information, including information science.

372

2 Nursing – Building Social Capital, Barriers to research utilization, translation to practice, overlapping into evidence based medicine

218

3 Business – Time management, international business, customer knowledge transfer, vertical alliances, absorptive capacity

198

4 Public, Environmental Health – Health technology assessment, teen pregnancy, cancer management

108

5 Operations Research and Management Science – Technology performance, network size and organizational culture, product development process

101

State of the Art:Narrow Approach (Focused)

Over 500 Articles

Canada (39%) and US (39%)

99% in English and 1% in German

Estabrooks is Top author

1 Nursing -- Building Social Capital, Barriers to research utilization, translation to practice, overlapping into evidence based medicine

188

2 Public, Environmental Health - Health technology assessment, teen pregnancy, cancer management

60

3 Health Care Sciences – Mentorship strategy, Research Based Theatre, health care policy making

47

4 Emergency Medicine – Knowledge Translation, adult asthma guidelines, Knowledge Translation systems

33

5 Education, Scientific Disciplines – Stroke rehabilitation programme, Guides to KT, improving performance & evaluation

23

State of the Art:Narrow Approach (Focused)

State of the Art:Components to Study

Subjects– Health, Business, Governance, Social Sciences

Roles (as intermediaries)– Knowledge Brokering, Funding agencies, Implementation Units, Librarians,

Database Technicians

Approaches or Theory– Specific Approaches (Roger’s Diffusion of Innovation model)– General Approaches (Social Engineering, Mode 2, Triple Helix)

Models– Instrumental (Rational)– Educational/Enlightenment (Conceptual)– Symbolic (Aesthetic)– Interactive (Collaborative)

State of the Art:Components to Study

Environments to Analyze– Policy, Administration, Politics– Clinical Application & Technology– Theory/Research/Academic (educational)

Levels to Analyze– Individual (psychological)– Group (sociological)– Organizational (culture and structure)

Methods (General)– Bibliometrics; Factor Analysis; Structured Equation Modeling – General Surveys, qualitative and quantitative methods

Methods (Specific)– Devising Special models and ways to interpret Knowledge Science

activities.

State of the Art:General Models

Information Utilization Scale Stage of Concern Scale Levels of Use Scale Research Utilization Index Overall Policy Impact Scale Diffusion of Innovations AHRQ Knowledge Transfer

Framework

State of the Art:Knowledge System for Clarification

Holzner & Marx (1979) Knowledge Application: The Knowledge System in Society

– The Knowledge System represents the different, but sometimes overlapping, processes in society:

Production Management (Organization, Storage & Retrieval) Transfer (or Translation) Application Implementation Evaluation Mobilization (inter-systematic)

Part II: Knowledge Science Today:Nursing Research

Nursing Research:Setting the Foundation

Undergraduate Research Programmes– Research Mentorship

Evidence Based Literacy – Number needed to treat; risk assessment; interpreting

context of research problem Information Literacy

– You can’t analyze what you can’t find!– Consult with librarians; enroll in skills development

Communication Skills & Diplomacy– Don’t take your skill set for granted– You might consider a Critical Thinking course

Literacy is the Key

The basis of Knowledge Science is the basis of academic activity: critical reading skills, database skills, systematic thinking and synthesis of concepts.

Nursing Research:Bibliometrics

Estabrooks et al. (2004) “Mapping the Field” Purpose

– Map the characteristics of “research utilization” in the nursing research field.

Methodology– Searching bibliographic databases resulting in 630 articles on research

utilization between 1972 and 2001– Used available bibliographic software (freeware from Internet) to organize

results

Results & Conclusions – Models important to Nursing (Iowa Model of Research in Practice,

Multidimensional framework, Ottawa Model of Research Use)– Top Journals (Journal of Advanced Nursing, Nursing Standard)– Important Authors (Cheryl Stetler, Jo-Anne Horsley, Carole Estabrooks)

Empirical Analysis

This is a library science assessment that requires understanding databases; Information Science Skills (Boolean Searching); Content Analysis; Citation Analysis; co-authoring with Librarians.

Nursing Research:Systematic Reviews

Estabrooks et al. (2003) Individual Determinants of research utilization Purpose

– Review studies that examine individual characteristics & determinants

Method– Advanced searching of relevant databases– Using an inclusion criteria for systematically reviewing specific content– Employed a validity Score

Results & Conclusions– Research was organized into: beliefs and Attitudes, involvement in research

activities, information seeking, professional characteristics, education, socio-economic status.

– Support for a positive association between individual beliefs and attitudes and increased research utilization.

– Development of a strong interdisciplinary body of work, relevant to nursing is important

Empirical Analysis

Although using Bibliometrics and Information literacy as the basis, it extends on this basis by needing the nursing knowledge identify specific content for systematic review.

Nursing Research:Nursing Models

Conduct and Utilization of Research in Nursing

Iowa Model of Research in Practice Collaborative research utilization

model Stetler/Marram Model for application

of research findings in practice Framework for dissemination and

utilization of research for healthcare policy and practice

Multidimensional Framework BARRIERS to Research Utilization

Scale Research Factor Questionnaire

Important Contribution

Recommend the creation of a database/website to track, organize and discuss Nursing models in Knowledge Science.

Nursing Research:Utilizing a Nursing Model

McCloskey (2008) Nurses’ Perceptions of Research Utilization in a Corporate Health Care System

Purpose– Investigate selected characteristics of nurses based on educational level, years

of experience, hospital position that might affect Research Utilization

Methods– Nurses in five hospitals were surveyed using Research Utilization

Questionnaire – ANOVA was used to analyze data

Results & Conclusion– Significant differences (p <.001) were found in perceived use of research,

attitude toward research, availability of research resources, or perceived support for research activities based on education and organizational position.

Does the Instrument Fit?

The question to ask yourself when you read what instrument is being used is “Does this fit”? Will the model actually measure what the authors want it to measure?

Nursing Research:Validating a Nursing Model

Tolson et al. (2008) “Achieving evidence-based nursing practice”

Purpose– Determine the impact of the Caledonian Development Model (version 2),

designed to promote evidence based practice– Participants engage in Communities of Practice, focus on a specific goal, and

learn how to use and participate in a “virtual college”

Method– 24 nurses and 18 practice sites formed 3 Communities of Practice.– Pre- and post intervention Revised Nursing Work Index; focus groups – SPSS and Nvivo used for analysis

Results– The model performed well as an agent of knowledge translation supporting the

implementation of values-based evidence-based care guidance within the context of nursing older people.

Reflect on Knowledge Process

Communities of Practice are important to this model; it is a concept that is overlapping with a large “Knowledge Management” literature, another important part of Knowledge Science.

Nursing Research:Evaluation or Testing

Estabrooks (1999) Modeling the Individual Determinants of Research Utilization Purpose

– This study’s objectives were to develop and test a series of structural equation models that included individual factors believed to influence research utilization

Method– Using Instrumental, Conceptual & Persuasive research utilization– Using a 1996 Nurses Survey– Model fit was assessed by examining chi-square, the adjusted goodness of fit

index– Scaling and reliability in LISREL

Results– Some individual factors: Activism, Affiliation, attitude, Autonomy, Awareness of

policy, Belief suspension, Cosmopoliteness, Dogmatism, Educational level, Problem solving ability, Theoretical orientation, Time spent reading professional journals, Trust

Empirical Analysis

We are still interested in the individual determinants, but we are building on our previous examples: you need to know more quantitative analysis, structural equal modeling & LISREL

Nursing ResearchClinical Realm

Oh, E.G. (2008) Research activities and perceptions of barriers to research utilization among critical care nurses in Korea

Purpose– Analyze data from Nurses and Nurse Managers working in critical care units to

describe research activities and to identify barriers

Method– Data from 63 critical care nurses describing research activity such as reading

journals / week, additional nursing courses, etc.– Barriers to Research Utilization Scale (Funk, 1991) used.

Results– Critical care nurses share a strong sense of value for the contribution that

research makes to improving their practice, bus also perceived barriers in the lack of administrative support

Reflect on Types of Models

The author calls the work a “description” of research activities, similar to the Educational or Conceptual Model of Knowledge

Utilization

Nursing Research:Nursing Culture

Watson et al. (2005) Exploratory Factor Analysis of the research and development culture index among qualified Nurses

Purpose– Factor analysis of a rating instrument for assessing the strength of

organizational Research and Development (R&D) Culture

Methods– Qualitative research is the basis for creating the formal index– R&D Culture Index used as means of appraising R&D culture

Results– Both Individual and Organizational Factors are important and distinctive. – Three components must be developed: Skill base of practitioners, infrastructure of

organizations, and reflective development nature of the immediate work environment

Mixed Methods

We can note the role of qualitative data as the preliminary stage in forming Knowledge Utilization

theory or method.

Nursing Research:Organizational Measures

Fink, Thompson, Bonnes (2005) Overcoming Barriers and Promoting the Use of Research in Practice

Purpose– Identify Nurses changes in attitudes toward research utilization and the organization’s

environment pre-implementation and post-implementation.

Method– Descriptive, cross-sectional, pre-survey, post-survey design to identify inpatient nurses’ personal

and professional characteristics, perceptions of organizational culture and the effectiveness of organizational strategies.

Results & Conclusion– Research activities most participated: Shared research findings with peers (70%), attended

conference (67%) Evidence based council meetings (55%); participant in data collection (n = 123), attending Journal club (n = 105)

– Barriers to Research included: Nurse had no authority to change practice, aware of research, administration not allowing implementation, nurse is isolated from colleagues, access to research, no time on the job to read research.

Organizational Readiness

The Canadian Health Services Research Foundation developed a “readiness” assessment guide for analyzing the organization’s

preparedness

Nursing Research:Qualitative Analysis

Thompson et al (2008) The relationship between busyness and research utilization

Purpose– Explore the concept of busyness in nursing and to understand the relationship

between busyness and nurses’ research utilization better

Method– Conducted a secondary analysis of data collected in a large ethnographic

multiple case study examining the use of research by Canadian nurses in the context of adult and pediatric pain management

Results & Conclusions– Lack of time or busyness refers to the mental time and energy required to use

research and the culture of busyness in nursing rather than physical time required to perform routine tasks.

Using Qualitative Software

Nvivo 7/8 is now available at the university; you can seek out training from the Qualitative Research Centre. The author provides Nvivo sessions.

Nursing Research: Research Environment

Ax, Susanne (2001). Nursing Students’ Perceptions of Research: Usefulness, Implementation and Training

Purpose Investigate Nursing Research perceptions of usefulness, implementation,

interest and personal involvement Investigate Nursing Training in structure and design of classes, reading

materials, personal study and stress

Methodology One to one Interviews of 13 Nursing Students

Findings Improving Practice by testing assumptions of current practice Many students voiced difficulties voicing suggestions for change Feeling of a lack of understanding, a disconnect to application

The Reality of Implementation

The need for education and attitudinal changes are real; you will need to know how to communicate new ideas, changes and be able to argue for their implementation.

Part III: Problem Based Learning Plan your own Knowledge Science Project

Let’s Apply what we’ve learned…

Possible Scenario:Descriptive Assessment

Knowledge Management– Identify Knowledge Brokers (800 million rural poor)

Professionals Local Authorities Trusted persons

Cultural Component/Indexes Mapping the flow of knowledge

– Diffusion of Innovation Conceptual/Educational Model

– Learning about the System Level of Analysis

– Policy AND Practice level (Government)