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Training and Resources to Support Research Use: A BC Needs Assessment

As BC’s provincial health research support agency, the Michael Smith Foundation for Health Research supports a strong research enterprise that’s recognized worldwide for innovative discoveries that improve health and save lives.

September 2012

Training and Resources to Support Research Use: A Provincial Needs Assessment | i

Survey Highlights

Executive Summary 1

1. Introduction 4

2. Methodology 5

2.1 MSFHR’s KT approach

2.2 Survey design

2.3 Recruitment

2.4 Data analysis

3. Results 8

3.1 Who participated 8

3.2 Perceptions of KT 11

3.3 Building KT skills 12

3.3.1 Interest overall

3.3.2 Common and unique interests

3.4 KT support 17

3.4.1 Existing KT resources

3.4.2 Interest in training

3.4.3 Support for KT workshop training

3.5 Beyond training: applying KT skills in work 23

3.5.1 Barriers to doing KT

3.5.2 Facilitators

4. Summary and Implications 26

5. Next Steps for MSFHR 30

Table of Contents

BC Knowledge Translation Needs Assessment: Highlights

The assessment involved an online survey asking a broad range of health care providers, administrators and researchers about their interest in KT, their capacity for KT training, and barriers to engaging in KT.

The survey was distributed through health research and health care organizations across British Columbia and targeted at individuals who produce or use health research evidence in their work. Survey participants included people from every region of the province. More than 1,200 people repsonded to the survey.

Results

While there is considerable interest in learning more about KT, existing training and resources are insufficient. In addition, time and cost constraints are a barrier to delivering training to those who are interested.

Highlights

• Nearly 80% of respondents are interested in developing more KT skills. Research producers have higher interest in disseminating research findings and general KT skills, while research users are more interested in the application of research findings and working with researchers during the research process.

• About half of respondents require beginner-level training in KT skills, while another quarter need advanced training. Higher numbers of researchers, clinician-scientists and knowledge brokers (intermediaries between researcher producers and users) require advanced-level training, while health care providers tend to need beginner-level training.

• Although more than 70% of respondents agree that existing KT support (e.g. training, resources) is relevant and of high quality, fewer (56%) agree that it is accessible, affordable (52%) and sufficient (42%).

• Time and cost constraints are the biggest barriers to participating in KT training. More than half of respondents (55%) have no financial support for travel and 45% lack support for course registration fees. Clinician-scientists, health care providers and people in rural and remote settings were more likely to report lack of support for KT training.

• Time is the biggest challenge to integrating KT into work, as mentioned by 75% of respondents. Health care providers and administrators rated barriers to KT higher than did other groups.

Next steps for MSFHR• Mapping existing and potential training and

resources to identified needs.

• Meeting with partner organizations to discuss results and how to work together to meet the needs.

• Identifying local KT trainers interested in sharing their expertise.

What is KT? MSFHR uses the Canadian Institutes of Health Research definition:

“a dynamic and iterative process that includes synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.”

In spring 2012 the Michael Smith Foundation for Health Research (MSFHR) conducted a province-wide knowledge translation (KT) needs assessment. The results of this assessment will help guide new programs in BC aimed at building KT skills and at providing KT resources for people who produce or use evidence for health care decision-making.

Training and Resources to Support Research Use: A Provincial Needs Assessment | 1

Executive Summary

IntroductionThe Michael Smith Foundation for Health Research (MSFHR) is committed to promoting the use of health research evidence to improve health outcomes for British Columbians and health system sustainability. In support of that commitment, in spring 2012 we conducted a province-wide assessment to identify knowledge translation (KT) resources and training needs in British Columbia (BC), Canada. The purpose was to understand KT needs and interests of communities that produce or use health research evidence. Information from the assessment will help guide our programs aimed at building KT skills and providing resources to support increased use of health research evidence in decision making. The assessment involved an online survey asking respondents about interest in KT skills, capacity to participate in training, and barriers to KT.

MethodologyThe Canadian Institutes of Health Research (CIHR) defines KT as “a dynamic and iterative process that includes synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.”1

For the benefit of survey recipients, we further defined the four aspects of KT: dissemination, synthesis, exchange and application (see page 5).

Our target recipient group for the survey was people who produce and use health research evidence as part of their work and — due to the complex nature of the subject — who are already familiar with KT. The survey included questions about interest in learning more about KT, the level of KT support in their organizations, and barriers and facilitators to engaging in KT.

Of the 1,206 survey responses we received, 1,071 met the criteria for inclusion in our analysis. We used SPSS to analyze quantitative results. Overall frequencies provided us with initial findings, and based on demographic information about respondents, we further broke down data to reveal patterns related to the primary role of respondents, their geographic region, and work setting. We analyzed qualitative results in NVivo.

Results and implications

Who participated Of the 1,071 survey respondents included in the analysis, just under half (48%) are health care providers and administrators who primarily work in health authorities, while 30% are researchers, research trainees and clinician-scientists primarily from universities or research institutes. Although 83% of respondents are located in urban centres, there is representation from every region of the province.

Results include a good balance between respondents who are research producers and research users. However, we need to further understand KT training needs of groups that were not as well represented in our survey (not-for-profit, government and private sectors).

1 www.cihr-irsc.gc.ca/e/39033.html; accessed July 19, 2012.


Perceptions of KTRespondents indicated all four aspects of KT have fairly high importance in their work — dissemination and application are rated at 3.4 on a scale where four equals “very important,” exchange is rated at 3.3, and synthesis is rated at 2.9. Research producers consider dissemination the most important aspect of KT to their work, while research users consider application of most importance.

These findings suggest we must consider all aspects of KT in developing resources and training opportunities, while taking into account the different interests of research producers and users.

Building KT skillsAbout 80% of respondents are interested in learning more about each KT skill listed in the survey, and nearly half (47%) require beginner-level training in those skills. Only in four specific areas did about a third of respondents indicate a need for advanced-level training. More than half (63%) of health care providers responding to the survey require KT training at the beginner level.

These results suggest the importance of designing training programs to meet specific needs for particular types of skills and for the levels of training required. Of note is that respondents rate the importance of KT to their work as high, yet the highest demand for training is at the beginner level; barriers to learning more about KT may account for the lower skill levels.

KT supportAbout half of respondents indicated there is insufficient KT support in their work environment. Regarding learning formats, most respondents (72%) prefer small group training sessions, while self-guided study is the second most preferred option. A significant number of respondents said they have no support for travel and course registration fees (55.4% and 44.6%), and over half said cost and time commitment would prevent their participation.

The results suggest that KT training and resources may be difficult for people to obtain and use — and that some groups are less aware of them. MSFHR can play a role in making people more aware of and providing access to KT resources. In developing new KT resources, we must consider the different learning preferences among target groups.

Barriers and facilitators to doing KTTime and competing priorities are the biggest barriers for respondents to doing KT, followed by KT funding and access to resources. Clinician-scientists and health care providers/administrators were more likely to report barriers for all KT categories than other respondents.

Differences in perceived barriers across roles must be considered when developing KT supports. MSFHR could also play a role in increasing organizational awareness of, commitment to and understanding of KT.


Next steps for MSFHR• Map existing and potential training and resources to identified needs.

• Meet with our partners to discuss needs assessment results, get feedback on our mapping exercise and discuss how we can work together to meet identified needs.

• Identify local KT trainers interested in sharing their knowledge and skills.

• Raise awareness of the importance of KT provincially, and of the need to overcome barriers related to time and access to resources.

• Develop mechanisms to better understand groups not represented or under-represented in the survey.


1. Introduction

Named after Nobel Laureate Dr. Michael Smith, the Michael Smith Foundation for Health Research (MSFHR) is British Columbia’s (BC’s) provincial health research support agency. MSFHR’s mandate is to strengthen BC’s health research enterprise, which in turn improves the health of British Columbians, their health system and their economy.

As part of our commitment to increasing knowledge translation (KT) — which we define as the use of health research evidence to inform practice and policy — MSFHR launched a province-wide survey to assess KT resource and training needs in BC. Our objectives were to:

1. Determine current KT needs of communities that produce and use health research evidence.

2. Identify interest in KT training opportunities and resources.

3. Understand barriers to KT.

The results of the assessment, provided in this report, will inform new MSFHR programs aimed at building KT skills and offering resources across the province.

Report outlineThis report provides a detailed analysis of the findings from our provincial survey.2 Section 2 discusses our methodology, including MSFHR’s approach to KT, the survey design, participant recruitment, and data analysis. Section 3 presents the results of the survey as follows:

• Participant demographics, including proportions of respondents by their primary professional roles, geographic locations and workplace settings.

• Perceived importance of the four aspects of KT: dissemination, synthesis, exchange and application.

• Levels of interest in learning more about KT skills.

• Perspectives on existing and potential KT support.

• Barriers and facilitators to doing KT.

Section 4 follows with a summary of findings and implications, and the report concludes with next steps.

2 Companion reports exploring high level provincial findings and regional aggregate data specific to BC health authority geographic regions can be found at www.msfhr.org/reports/msfhr_reports.


2. Methodology

2.1 MSFHR’s KT approachWe adopted the Canadian Institutes of Health Research (CIHR) term and definition for KT, as it is widely known and used by the health and research communities in BC and nationally: KT is “a dynamic and iterative process that includes synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.”3 However, given our commitment to plain language, our external communications describe our KT activities broadly as “using health research evidence to improve health.”

For the purposes of the survey4 we define the four aspects of KT as follows:

Dissemination: Identifying the appropriate audience and tailoring the message and medium to the audience.

Synthesis: The contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic.

Exchange: Interactions between evidence users and researchers at any or all stages of the research process.

Application: The process by which health research evidence is put into practice through new or existing programs, policies or practices.

We base our KT work on the following assumptions:

• There is general understanding in BC of what KT is, and its importance.

• There is a need to increase both the practice and science of KT.

• There is a need for dedicated resources and expertise to facilitate evidence use in BC.

• MSFHR needs to partner to have a meaningful impact on KT.

For more information on KT at MSFHR, see Appendix A or visit our website at www.msfhr.org/about/KT.

3 www.cihr-irsc.gc.ca/e/39033.html; accessed July 19, 2012.4 See Appendix B for more details.

DEF

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2.2 Survey designWe determined that an online survey was the most appropriate mechanism to begin to understand KT training and resource needs in BC, as it would enable collection of a large amount of data, across the province, within a short period of time. Our intended audience was people who produce and/or use health research evidence as part of their work and — due to the complex nature of the subject — who are already familiar with KT.5

We developed the survey based upon the KT approach described above and pilot tested it with a group of KT professionals. The final survey included 24 multiple choice, multiple answer, and open-ended questions:6

• The survey began with demographic questions, including primary professional role, geographic region, and workplace setting.

• Part one focused on respondents’ interest in various KT skills in categories of general KT, dissemination, synthesis, exchange and application.

• Part two focused on KT support such as learning resources, training activities, and funding, with questions related to the current level of KT support available in work environments, the likelihood of respondents’ participation in various KT activities, and the capacity of respondents to participate in KT training workshops.

• The final section focused on barriers and facilitators to doing KT.

2.3 RecruitmentA recruitment strategy was critical to ensure our intended audiences knew about the survey and understood the importance of their participation. We developed a two-pronged strategy — targeted and general — as follows:

Emails with the survey link were sent to three groups:

1. For endorsement: Key stakeholders at our partner organizations (e.g. universities, research institutes, health authorities, government, other health-related organizations) were asked to forward the survey under their own signature to potential respondents.

2. For participation: Individuals with close ties to MSFHR were asked to complete the survey and forward to contacts as appropriate. These included MSFHR award holders, people who registered for our KT workshops, and BC KT Community of Practice (CoP) members.

3. For information only: We shared the survey with a number of people, including our board of directors, grant facilitators, health research leaders, and KT stakeholders across Canada.

For general recruitment, we publicized the survey on our website and in our newsletter and through social media, initially at launch and throughout the data collection period.

Our expectations for response numbers were initially modest, as we did not know if the community would recognize the value of participating. By working with our partners, our final response number — 1,206 — far surpassed our expectations.

5 We acknowledge there are many people who produce and use health research evidence who are not familiar with KT concepts, but who would benefit from and appreciate access to training and resources. Given the more in-depth discussions that would be necessary with this group, an online survey would not be adequate to understand their needs. Our future work includes working with our partner organizations to design more appropriate engagement mechanisms.

6 To see the survey content, including definitions, questions and response options, please see Appendix B.


2.4 Data analysisOf the 1,206 survey responses received, 1,071 cases met the criteria for inclusion7 in our analysis. We used SPSS to analyze quantitative results. Overall frequencies provided us with initial findings, and based on demographic information, we further broke down data to understand different patterns by primary role, geographic region, and setting. We analyzed qualitative results, including “other” responses and additional comments, in NVivo.

Overall findings represent all respondents who meet the criteria for inclusion. When analyzing the data by respondents’ primary professional roles, we explored results in various ways:

• To understand differences between roles, we compared seven unique groups — researchers, clinician-scientists, research trainees, health care providers, health care administrators, public servants and knowledge brokers — but left out “other” respondents.

• To understand differences between those who more generally produce research and those who use it, we regrouped professional roles by categories of research producers (researchers, clinician-scientists and research trainees) and research users (health care providers and administrators, public servants and knowledge brokers).

• We considered knowledge brokers (intermediaries between producers and users of research) a unique group because of their hands-on role in KT so in some instances separated them.

• We combined researchers and research trainees together for analysis by health research pillar.

As mentioned previously, when reviewing the results of this assessment it is important to keep in mind that we targeted individuals with at least a basic understanding of KT. As we did not reach many individuals unfamiliar with the concept of KT — but who are involved in the production and use of health research evidence — additional efforts will be required to understand the KT training and resource needs of this group. Also note that low proportions of responses from certain professional roles or regions means data are not necessarily representative of some groups.

7 Cases were removed if respondents included minimal responses, such as providing only demographic information, or if respondents were from outside of BC.


3. Results

This section presents the provincial needs assessment results as follows:

• Who participated: The demographic information of respondents

• Perceptions of KT: The perceived importance of KT

• Building KT skills: Interest in building skills and the level of training required

• KT support: Existing resources, interest in training activities, and workshop training support

• Barriers and facilitators to doing KT

We present overall results and then break down the data by role, region and setting where significant.

3.1 Who participated

» Almost one in every two respondents is a health care provider or administrator (48.1%).

» Approximately one in three respondents is a research producer — researchers, clinician- scientists and research trainees (30%).

» Most respondents from Interior Health and Northern Health geographic regions are health care providers and administrators (over 75%), while there are more respondents who are researchers and research trainees from Vancouver Coastal Health and Vancouver Island Health Authority geographic regions (~40%) than other areas.

Primary professional role

We asked survey respondents to identify their primary professional roles, as our aim was to reach individuals across sectors. Of the 1,071 cases, almost half are health care providers or administrators (32.1% and 16.0% respectively); approximately a third are researchers (17.4%), research trainees (7.5%) and clinician-scientists (5.1%); and the remainder are knowledge brokers (7.6%), public servants (2.9%) and individuals in other roles (11.5%) including clinical educators, research administrators and other support functions (e.g. IT services, office administration, library services) (Graph 1). Respondents primarily work in a health authority (60.6%), a university or college (20.3%) or a research institute (11.3%). The remaining 7.8% work in not-for-profit organizations, government, the private sector or other work environments.

HIG

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Researcher

Clinician-scientist

Research trainee

Health care provider

Health care administrator

Public servant

Knowledge broker

Other

Health research pillars

We were also interested in understanding the unique KT needs of researchers and trainees8 in the four health research pillars.9 Researchers and trainees are from disciplines across the four pillars: 28.9% are involved in biomedical research, 24.7% are in health services research, 24.0% are in population health research, 15.6% are in clinical research, and the remaining 6.8% are in other or multiple pillars. The researchers alone (without trainees) are more evenly distributed across pillars, with a small number (9.3%) involved in other or multiple pillars. There is a larger proportion of trainees (43.8%) involved in biomedical research. This larger group of biomedical trainees is more consistent with MSFHR personnel funding: at the time of the survey, 54.4% of MSFHR-funded researchers and trainees were in biomedical research, compared to 20.5% clinical, 13.5% population health, and 11.6% health services researchers and trainees.

Geographic regions

We asked respondents to identify the location of their workplaces based on the geographic areas of BC’s health authorities10 to understand differences in KT needs by region. Thirty-five percent of respondents are primarily based in Vancouver Coastal Health (VCH) geographic region, 21.4% are in Northern Health (NH) geographic region, 16.6% are in Vancouver Island Health Authority (VIHA) geographic region, 14.5% are in Fraser Health (FH) geographic region, and 12.4% are in Interior Health (IH) geographic region.

Of importance to note is that over 75% of respondents from IH and NH geographic regions are health care providers and administrators (77.9% and 75.1%) compared to 54.4% in FH geographic region, and under 30% in VCH and VIHA geographic regions (29.7% and 24.3%). Conversely, there are more respondents who are researchers and research trainees from VIHA (41.3%) and VCH (40.4%) than FH (19.8%), IH and NH (both at 3.1%) (Graph 2). Smaller proportions of respondents involved in research professions in IH and NH are not unexpected, as there are fewer research institutes and academic institutions in these areas.

8 We did not include clinician-scientists in analysis by pillar: data indicates they are primarily involved in clinical research, in addition to being uniquely involved in both research and practice.

9 The health research pillars are biomedical, clinical, health services and population health research.10 While regional results are categorized by health authority, findings include all respondents located in each health authority’s geographic boundaries, not

only respondents who work for the particular health authority.

Graph 1: Respondents by primary professional role (%)


0%

20%

40%

60%

80%

100%

IH NH FH VCH VIHA

Health care provider or administrator

Researcher or research trainee

Clinician-scientist

Knowledge broker

Public servant

Other

Workplace settings

We also asked participants to identify their workplace settings, assuming that some KT needs differ depending on whether individuals work in urban centres versus rural or remote settings. Overall, 82.9% of respondents are located in an urban centre, with the remaining 17.1% located in a rural or remote setting. The large majority of respondents from VCH, FH and VIHA geographic regions work in urban settings (98.9%, 95.5% and 93.8% respectively), while over half of respondents from NH geographic region (54.1%) and over a quarter from IH geographic region (27.5%) primarily work in a rural or remote setting.

[ What do the findings suggest? ]• Results include a good balance of respondents who are research producers and research users —

primarily researchers and trainees from universities, colleges and research institutes, and health care providers and administrators from health authorities. Audience-specific KT skills training and resources may need to be considered where findings indicate significant differences.

• The higher proportion of respondents who are health care practitioners and administrators in IH and NH geographic regions means that those regional results will likely correspond to results by professional role.

• More will need to be done to understand KT training needs for groups with low representation (i.e. not-for-profit, government, and private sectors).

Graph 2: Breakdown of professional roles by geographic region


3.2 Perceptions of KT

» Overall, respondents indicate all four aspects of KT — dissemination, application, exchange and synthesis — have fairly high importance to their work. Of all aspects, synthesis is rated of least importance.

» Research producers consider dissemination to be the most important aspect of KT to their work, while research users consider application to be of most importance.

We asked survey respondents to rate the importance of the four aspects of KT — dissemination, synthesis, exchange and application — to their work on a scale of four, where one equals “not important” and four equals “very important”. Overall, dissemination and application are rated of highest importance, both at an average of 3.36 out of four, followed by exchange at 3.27 and synthesis at 2.94. The highest percentages of respondents also indicate dissemination and application are “very important” to their work (60.0% and 59.4%). The greatest differences are in the importance of synthesis, where there are slightly more respondents who indicate it is “not important” or “somewhat important” to their work, and fewer who say it is “very important” (Graph 3).

0%

20%

40%

60%

80%

100%

Very important

Moderately important

Somewhat important

Not important

Importance by role and region

When comparing how respondents in various roles rated the importance of KT aspects, most noteworthy is how research producers (researchers, research trainees and clinician-scientists) rated the aspects compared to research users (health care providers and administrators, and public servants11). Knowledge producers rated

11 Knowledge brokers were considered a separate group in this analysis because of the high ratings of importance across all KT aspects.

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Graph 3: Overall rated importance of KT aspects (%)


dissemination as the most important aspect of KT to their work — clinician-scientists rated it as 3.69 out of four, research trainees at 3.42 and researchers at 3.38 — and dissemination is consistently the highest rated aspect across the four research pillars. Application is rated the most important aspect by health care providers and administrators (3.41 out of four) and public servants (3.36). Results likely reflect research producers’ roles as creators of evidence that should be ideally shared; and research users’ roles in the delivery of health care, where that evidence is ideally applied to improve health.

While various professional groups rated the KT aspects differently, there is little variation in the results by role, which suggests respondents across professions consider all of the KT aspects important to their work. Including knowledge brokers, who rated three of the four KT aspects highest overall, results for each aspect across the various roles differ from 0.28 (application) to 0.61 (dissemination) on the scale of four. Without knowledge brokers, the differences in results by role range from 0.22 (exchange) to 0.49 (dissemination).

Regional results of the importance of KT to work likely reflect differences in roles. Dissemination is rated highest in VIHA and VCH (3.57 and 3.45), where there are more respondents who are researchers and trainees. FH, IH and NH geographic regions rated application with the highest importance (3.52, 3.41 and 3.23), where respondents are largely health care providers and administrators.

[ What do the findings suggest? ]• Respondents consider all aspects of KT important to their work, so we must consider all aspects of KT in

developing resources and training opportunities.

• There are some differences in the perceived importance of KT aspects between research producers and users, indicating we must also address those differences.

3.3 Building KT skills

» There is high interest in learning more about KT: on average four out of five respondents are interested in learning more about each of the KT skills listed in the survey. Approximately 20% of respondents are not at all interested in learning more about synthesis.

» More respondents require beginner-level training in KT, although there are some topics where about a third of respondents require advanced-level training.

» Knowledge brokers have the highest levels of interest in learning more about KT skills, and are more likely to require advanced-level training than the overall results.

» Research producers have higher levels of interest in dissemination as well as general KT skills, while users are more interested in application and exchange skills.

» More health care providers require training at the beginner level for all KT skills than the overall results. H

IGH

LIG

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A major piece of the assessment was exploring what KT skills people are interested in developing. We listed 28 KT skills and asked respondents about which they want to learn more, and what level of training they require. To provide structure, we categorized the KT skills in five areas — general KT and the four aspects of KT — although we recognize they are not usually separated in practice.

3.3.1 Interest overallThere is generally high interest in learning more about KT: across all skills, an average of 79.9% of respondents are interested in learning more. Of the top 10 skills identified, all are of interest to over 85% of the respondents (Table 1). By area, there is highest overall interest in skills related to knowledge exchange (82.3%), followed by skills related to dissemination (81.8%), application (80.5%), general KT (78.5%) and synthesis (72.0%). Less than 10% of respondents are not at all interested12 in an area except in the case of synthesis, where approximately 20% of respondents are not at all interested.

There is most need for training at the beginner level for all skills. Of those respondents who said they are interested in learning more, 46.5% indicated they require beginner-level training. By area, an average of 54.6% of respondents indicated they require beginner-level training in general KT skills, 50.1% in synthesis skills, 44.3% in exchange, 43.1% in dissemination, and 42.6% in application. In only one skill area — communicating using plain language (written and verbal) — is there below 35% of respondents who indicated interest at the beginner level. This is likely because some media and writing training is already offered, but also because the difficulty of communicating to different audiences is often underestimated.

On average, 22.5% of respondents require training in KT skills at the advanced level, and there are less than 30% of respondents (between 16 to 28%) who need training at the advanced level when looking broadly at KT areas. However, in certain skills there are over 30% of respondents interested at the advanced level:

• Developing evidence-informed practices and programs (31.1%).

• Implementing evidence-informed practices and programs (31.0%).

• Working with researchers (31.0%).

• Sustaining evidence-informed practices and programs (30.6%).

12 Not at all interested means “not interested” was chosen as a response for all skills in an area, or was chosen for the majority of responses with the remaining missing (i.e. “interested” was not chosen).


*13

Area KT Skills Top 10 Skills of Interest

Require Beginner-Level Training

Require Advanced-Level Training

General KT

Developing a KT plan

Implementing a KT plan 10

Evaluating a KT plan

KT models and theories

KT research (i.e. dissemination and implementation research)

Teaching KT

Dissemination

Developing a dissemination plan

Implementing a dissemination plan

Evaluating a dissemination plan

Developing key messages 8

Communicating using plain language (written and verbal) 4

Targeting communication to specific audiences 3

Social marketing

Working with the media

Synthesis13

Conducting evidence syntheses

Communicating evidence syntheses

Finding and appraising evidence syntheses

Exchange

Working with decision makers 2

Working with researchers

Working with industry

How decisions are made in health care environments 1

How decisions are made in government environments

Using social media or web-based tools for knowledge exchange

Application

Developing evidence-informed practices and programs 5

Implementing evidence-informed practices and programs 6

Sustaining evidence-informed practices and programs 7

Evaluating the implementation of evidence-informed practices and programs 9

KT related to the commercialization of products or services

10-19%

20-29%

30-39%

40-49%

50-59%

13 For the purposes of the survey, skills related to using evidence from syntheses or dissemination activities were included under application.

Table 1: Overall interest and level of training required


[ What do the findings suggest? ]• There is generally high interest in developing skills in KT: on average, four in five respondents are

interested in learning more about each of the 28 KT skills, indicating there is demand for activities and resources that support KT skill development in BC.

• Even in the area of synthesis, which is the lowest rated in importance and has the highest percentage of people not interested in learning more, four in five respondents did express interest in learning about at least one of the synthesis-related skills. This again suggests we should consider all aspects of KT when developing resources and training opportunities.

• In general, there is highest demand for training in KT skills at the beginner level, although there are particular skills where a larger group requires training at the advanced level. We need to ensure activities and resources are developed to adequately support audiences’ levels of expertise in various KT skills.

3.3.2 Common and unique interestsKnowledge brokers

Comparing the KT interests of the various professional roles, knowledge brokers indicated the most interest in learning more about KT across all skills, which is understandable as their role facilitates the production and use of evidence. There is over 90% interest from knowledge brokers in approximately two-thirds of the skills, and over 80% interest in all but two of the 28 — interest in teaching KT (79.2%) and KT related to the commercialization of products or services (67.6%). On average, 90.0% of knowledge brokers are interested in learning more across all KT skills, which is 10.1% higher than the overall average.

Other research producers and users

Of the remaining roles, there is generally high interest (over 80%) from both research producers and users in nine specific KT skills, most of which coincide with the top 10 skills overall. In addition, research producers have higher levels of interest in general KT and dissemination skills, while research users have higher levels of interest in exchange and application skills. KT skills with generally lower interest across all roles (i.e. most groups with average interest under 70%) are teaching KT, working with industry, and KT related to the commercialization of products or services (Table 2).

A noteworthy finding is that, in addition to knowledge brokers, research trainees and public servants have consistently higher interest in those skills of generally lower interest overall. For example, while less than 70% of most groups are interested in learning more about working with industry, 90.3% of research trainees and 77.8% of public servants indicated interest in this topic. Similarly, while interest in teaching KT and KT related to the commercialization of products or services is generally lower across the roles, interest from trainees and public servants is over 10% higher than others.


Area KT Skills Research Producer a Interest

Research User b Interest

Gen

eral

KT

Developing a KT plan

Implementing a KT plan

Evaluating a KT plan

KT models and theories

KT research (i.e. dissemination and implementation research)

Teaching KT

Dis

sem

inati

on

Developing a dissemination plan

Implementing a dissemination plan

Evaluating a dissemination plan

Developing key messages

Communicating using plain language (written and verbal)

Targeting communication to specific audiences

Social marketing

Working with the media

Synt

hesi

s Conducting evidence syntheses

Communicating evidence syntheses

Finding and appraising evidence syntheses

Exch

ange

Working with decision makers

Working with researchers

Working with industry

How decisions are made in health care environments

How decisions are made in government environments

Using social media or web-based tools for knowledge exchange

App

licati

on

Developing evidence-informed practices and programs

Implementing evidence-informed practices and programs

Sustaining evidence-informed practices and programs

Evaluating the implementation of evidence-informed practices and programs


a Includes researchers, clinician-scientists and research traineesb Includes health care providers and administrators, and public servants. For analysis on levels of interest, knowledge brokers were considered separately because of consistently high interest.

80% interest and over

70-79% interest

Below 70%

Varying results

Table 2: Level of interest by research producer and user


Levels of training required

Respondents generally require beginner-level training, but the percentage of health care providers who require training at that level is consistently higher than the overall results for all of the KT skills. On average, 63.0% of health care providers require beginner-level training in KT skills, compared to the overall average of 46.5%. Even in the area of application, which is rated of most importance to research users, the percentage of health care providers who need beginner-level training is higher than all other roles. On the other hand, fewer health care administrators require beginner-level training in application skills related to evidence-informed practices and programs, and have higher need for advanced-level training in these skills than the average.

While fewer respondents require advanced-level training in the various KT skills, there are consistently more researchers, clinician-scientists and knowledge brokers who require this level of training. Compared to 22.5% overall, 44.9% of clinician-scientists, 35.2% of knowledge brokers and 30.0% of researchers require KT skills training at the advanced level in the various KT skills.

[ What do the findings suggest? ]• It is important to design training programs to meet specific audiences’ needs for particular types of skills

and the levels of training required.

• Knowledge brokers — those who work as intermediaries between research producers and users — have the highest interest in teaching KT; this is important to meeting the high demand for KT training identified in the assessment.

• While some KT skills are of generally lower interest across roles, there are some professional groups with consistently higher interest in learning more, so it will be important not to discount them. These include working with industry, teaching KT and KT related to the commercialization of products or services for knowledge brokers, research trainees and public servants.

• Of note is that respondents rate the importance of KT to their work as fairly high, yet the highest demand for training is at the beginner level. If KT is important to respondents’ work, why do many not, at minimum, already have beginner level skills? Barriers to learning more about KT, which are discussed below, are likely involved.

3.4 KT support

» While there is high interest in learning more about KT, about half of respondents do not agree that KT support in their work environments is of sufficient amount, affordable or accessible.

» To learn in general, most respondents prefer small group sessions, followed by self- guided study. Specific to learning about KT, results are comparable, as respondents are most likely to access online resources, attend a workshop or take web-based training to learn more about KT.

» Cost and time constraints are training barriers: more individuals have no support for travel and registration fees, and say cost and multi-day commitment would prevent their participation. H

IGH

LIG

HTS


3.4.1 Existing KT resourcesWe asked respondents to rate their level of agreement about KT support available in their work environments: if it is accessible, affordable, relevant, interesting, of high quality, and of sufficient amount. Overall, there is a high level of agreement that KT support is interesting (76.4%), relevant (74.7%) and of high quality (70.5%); agreement from about half that KT support is accessible (55.6%) and affordable (52.0%); and less agreement that KT support is of sufficient amount (41.8%) (Graph 4).

0% 25% 50% 75% 100%

Interesting

Relevant

Of high quality

Accessible

Affordable

Of sufficient amount

Strongly disagree

Disagree

Somewhat disagree

Somewhat agree

Agree

Strongly agree

Respondents’ regions and settings (i.e. urban or rural and remote) do not affect their perceptions of KT resources and training. However, there is variation between respondents’ roles and the level of agreement about the accessibility of KT support. Compared to the overall average of 55.6%, public servants and researchers have the highest level of agreement that KT support in their work environments is accessible (68.0% and 61.7%), while approximately half of research trainees and health care providers and administrators agree, and a low 46.5% of clinician-scientists.

[ What do the findings suggest? ]• Generally high agreement that KT support in work environments is interesting, relevant and of high

quality suggests that there are useful resources and training in existence.

• Less agreement that KT support is accessible, affordable and of sufficient amount indicates that it can be difficult for people to obtain and use those resources and training activities, or that some groups are less aware of the resources that exist and how to access them.

• There is a role for MSFHR in making people aware of existing KT resources through linking to or bringing them to BC.

Graph 4: Agreement about KT support in work environments (%)


We asked respondents to list (a) KT skills trainers based in western Canada who they would recommend to lead a KT workshop, and (b) the most useful KT resources and activities.

Respondents shared the names of 63 individuals in BC and Alberta. Of those, two were mentioned more than 10 times and one was named seven times. Along with KT trainers from eastern Canada who are already working with MSFHR, a core group of KT trainers in western Canada is critical to building and sustaining KT within the BC health research community.

Forty-four resources were mentioned ranging from online manuals, journals and databases to organizations, forums and workshops/seminars. Some are new to us and will be reviewed as part of our next steps.

3.4.2 Interest in trainingLearning preferences

We asked respondents how they generally prefer to learn about a topic so we understand what types of formats are most effective for training. Respondents could pick up to two options. By far, the most preferred learning format is small group sessions, chosen by 72.3% of respondents. Self-guided study is the second most preferred format (47.2%), followed by teleconferences and webinars (34.4%), large group sessions (29.1%), and one-on-one formats (11.5%).

Respondents’ professional roles impact their preferences to learn only in regards to teleconferences and webinars. Compared to the overall average (34.4%), more health care administrators (42.4%), public servants (37.0%) and health care providers (36.7%) prefer to learn with teleconferences and webinars, while fewer clinician-scientists (18.4%), research trainees (25.9%), researchers (28.4%) and knowledge brokers (33.8%) indicated this is a preference. These differences may point to varying time constraints or work responsibilities that make certain formats more preferable to various groups. By region, respondents’ learning preferences differ significantly only in regards to small group sessions, but regional results vary only from 68.1% to 76.5%.

KT activities

We asked participants what the likelihood is that they would engage in a selection of KT activities, on a scale of six from “very unlikely” to “very likely.” Overall, the highest percentage of respondents said they would be somewhat to very likely to access online resources (86.0%), attend a workshop (83.9%) and take brief, free web-based KT training with local and international mentors and peers (83.5%). To a lesser extent, respondents indicated they would likely take brief, free web-based KT training for a certificate (72.0%), seek KT advice (68.6%), work with a KT mentor (67.7%), join a KT CoP (63.0%), and apply for KT funding (61.5%).

Respondents’ roles impact their likelihood of engaging in all activities except in regards to working with a KT mentor and seeking KT advice. Across the activities where respondents’ roles are significant, knowledge brokers and research trainees are consistently more likely to engage than the overall average. KT training is directly related to knowledge brokers’ professional development, and it is likely that trainees are still new to their careers

RES

OU

RCE

S


and open to trying various activities to support their development. Researchers and clinician-scientists are consistently less likely to engage in the various KT activities, with results below the overall average in all areas except with regards to applying for KT funding — the one activity where research producers and knowledge brokers fall above the average and research users are below. Applying for grant funding is a common part of research work, so it is understandable that more research producers are open to this activity (Table 3).

Attend a KT workshop

Web-based training a

Web-based training for certificate b

Access online

resources

Join a KT CoP

Work with a KT mentor

Seek KT advice

Apply for KT funding

Overall 83.9 83.5 72.0 86.0 63.0 67.7 68.6 61.5

Researcher 80.2 74.2 57.9 80.3 54.4 75.7

Clinician-scientist

68.7 71.4 52.0 80.0 59.6 72.2

Research trainee

91.5 88.1 79.6 89.8 74.6 73.3


85.4 86.0 76.2 84.7 60.9 52.3


83.7 86.1 71.2 88.9 59.7 52.7

Public servant 88.8 81.4 77.0 88.0 68.0 40.0

Knowledge broker

92.1 90.7 86.5 97.4 86.3 70.5

a Take brief, free web-based KT training with local and international mentors and peersb Take free web-based KT training with local and international mentors and peers that would lead to a certificate.

Overall average

Statistically significant and below the average

Not statistically significant

Statistically significant and above the average

Differences across geographic regions are less significant, with region affecting only the likelihood of attending a workshop, participating in web-based training for a certificate, and applying for KT funding. Respondents in VIHA geographic region are consistently more likely to participate in all three activities than the overall results, while the other regions fall both above and below the average results for the various activities (Table 4). Most noteworthy is the difference between respondents’ likelihood of applying for KT funding: respondents in NH and IH are far less likely to apply for KT funding (50.0% and 44.4%) than the other three regions (64.3% and above). This likely reflects the higher proportion of respondents in NH and IH geographic regions who are health care providers and administrators, as respondents in those roles indicated they are less likely to apply for funding.

Table 3: Respondents rating somewhat to very likely, by role (%)


Attend a workshop

Web-based training for a certificate a

Apply for KT funding

Overall 83.9 72.0 61.5 Overall average

NH 79.6 76.4 50.0 Statistically significant and below the average

VCH 84.6 67.3 69.1 Statistically significant and above the average

FH 79.1 74.1 64.3

VIHA 90.7 72.2 68.1

IH 85.9 76.4 44.4

a Take free web-based KT training with local and international mentors and peers that would lead to a certificate.

[ What do the findings suggest? ]• In general, both learning preferences and interest in training activities suggest that initiatives such as

training workshops and providing online resources are important to supporting KT in the province.

• Differences between roles indicate that there is need to ensure initiatives are developed in consideration of the target group, not only to ensure that the topics in which they are most interested are available, but to ensure the format in which training and resources are offered meets their needs.

3.4.3 Support for KT workshop trainingIn order to understand individuals’ capacity to participate in KT training initiatives, we asked respondents about the level of support they receive at work to attend a KT workshop, what barriers they experience to participating, and what level of registration fees they are able to afford.

Support at work

We asked what levels of encouragement, time, registration fees and travel costs respondents receive at their workplaces to attend a KT workshop. The highest percentages of respondents indicated that they have no support for travel costs (55.4%) and registration fees (44.6%), while more respondents have some support in regards to encouragement (41.4%) and time (42.0%) (Graph 5).

Individuals’ primary roles affect the level of KT workshop support they receive at work. Most noteworthy is that the percentages of clinician-scientists and health care providers — those most directly involved in health care delivery — who said they have no support to participate are consistently higher than the overall results. Knowledge brokers who indicated they receive no support, on the other hand, are consistently below the average (Table 5). Respondents’ settings also affect the levels of encouragement, time and registration fees they receive, with higher percentages of respondents in rural and remote locations reporting no support.

Table 4: Respondents rating somewhat to very likely, by region (%)


25.431.7

44.655.4

41.442.0

40.633.5

33.226.4

14.9 11.1

0%

20%

40%

60%

80%

100%

Encouragement Time Registration fees Travel costs

Full support

Some support

No support

Encouragement Time Registration fees

Travel costs

Overall 25.4 31.7 44.6 55.4 Overall average

Researcher 22.6 27.9 50.0 62.8 Statistically significant and below the average

Clinician-scientist 26.8 48.8 52.6 58.3 Statistically significant and above the average

Research trainee 27.5 30.6 50.0 56.8

Health care provider 34.6 42.1 49.4 65.3

Health care administrator 27.8 35.7 42.3 50.5

Public servant 35.0 23.8 21.1 26.3

Knowledge broker 11.3 12.7 33.9 40.7

Barriers to workshop training

To further understand individuals’ capacity to participate in workshops, we also asked respondents to identify what would prevent their participation in a KT training workshop. Only 5.4% of respondents indicated that nothing would prevent them from participating. Of the barriers, the lowest percentage of respondents indicated that lack of commitment from an employer would prevent them from participating (34.3%), but all other barriers are comparable: travel costs (64.1%), multi-day time commitment (58.9%), location (58.7%) and registration fees (57.0%).

Primary professional roles impact the way individuals responded to some of the barriers. Higher percentages of health care providers (53.3%) and public servants (48.1%) indicated that lack of commitment from an employer would prevent their participation; more clinician-scientists (72.0%) identified a multi-day commitment as a barrier; and a higher percentage of research trainees (76.3%) said registration fees would prevent them from participating. In addition, more respondents from rural and remote settings said location and a multi-day commitment are barriers than respondents from urban centres.

Graph 5: Respondents receiving support to participate in a KT workshop (%)

Table 5: Respondents receiving no support to participate in a KT workshop, by role (%)


Registration fees

Generally most respondents said they would attend a training workshop only if it was free, or would be willing to pay up to $200. More people are also interested in workshop training over a shorter period of time: 5.1% would not attend a one-day training workshop, while 28.8% would not attend a workshop over three days.

[ What do the findings suggest? ]• There is varying support at workplaces for participation in KT training workshops, with time and money

being bigger issues than encouragement or commitment from an employer.

• While we need to be conscious of the various elements that may prevent individuals from attending a workshop, and work with partners to overcome time and cost constraints when providing training, we also need to raise awareness of the importance of KT training with leaders of organizations involved in health care and health research.

3.5 Beyond training: applying KT skills in work

» Overall, time or competing priorities is the biggest barrier respondents experience to doing KT in their work, followed by KT funding and access to resources.

» Clinician-scientists and health care providers and administrators report barriers to doing KT at higher rates than the average in almost all categories.

» Opportunities for individuals to have more time and resources dedicated to KT rely on organizational awareness of, commitment to and understanding of KT.

3.5.1 Barriers to doing KTIn order to impact KT through training activities, resources and other initiatives, we need to recognize the barriers people experience in their work that prevent them from doing KT. We asked respondents to rate barriers to doing KT in their work, on a scale where one equals “not a barrier” and five equals “a major barrier.”

Overall, time/competing priorities is the biggest barrier to doing KT, with an overall average of 4.11 out of five, or with 75.1% of respondents choosing four or five on the scale. Of the remaining barriers, funding for KT activities and access to KT resources are the other top issues, with 68.1% and 52.4% of respondents choosing four or five on the scale.

Primary roles impact how individuals perceive the levels of barriers in all areas except time/competing priorities. Of the percentages of respondents who rated four or five on the scale, health care providers and administrators generally rate barriers higher than the overall results, with health care providers consistently above. On the other hand, researchers and public servants generally rate barriers below the overall results, with researchers consistently lower across barriers (Table 6).

HIG

HLI

GH

TS


Time/competing priorities

Funding to KT activities

Access to KT resources

KT skills of staff

Opportunities for researcher

and user interactions

Organizational culture

Formal recognition

from employer

Overall 75.1 68.1 52.4 46.5 42.1 38.6 34.8

Researcher 58.2 34.5 30.1 16.7 26.4 21.0

Clinician-scientist

72.3 68.9 54.5 35.7 46.4 41.6

Research trainee

69.2 55.7 53.3 32.7 32.0 33.3


77.2 63.3 51.2 56.1 43.3 41.9


64.2 51.6 56.2 54.3 41.8 35.3

Public servant 56.0 36.0 31.8 38.5 41.6 36.0

Knowledge broker

68.6 51.4 48.6 36.6 38.9 25.3

Overall average

Statistically significant and below the average

Not statistically significant

Statistically significant and above the average

There are some noteworthy differences in barriers experienced between the various professional roles. For example, respondents who are directly involved in health care delivery — clinician-scientists and health care providers — are more likely to rate access to KT resources as a barrier of four or five (68.9% and 63.3%) than researchers (34.5%) and public servants (36.0%). Also, there is discrepancy in the way researchers and health care providers and administrators perceive opportunities for researcher and user interactions: a small percentage of researchers rated opportunities for researcher and user interactions as a barrier of four or five (16.7%), while over half of health care providers (56.1%) and administrators (54.3%) rated a four or five. This is perhaps because researchers often have to engage with research users in their work, especially as funding agencies increasingly require this activity. Seeking out researchers may not be an acknowledged part of a health care provider’s work, so with fewer incentives to engage, it may be more difficult or considered unimportant.

There are fewer differences in barriers experienced by location. Respondents’ geographic regions impact only how individuals perceive barriers related to KT skills of staff, organizational culture and opportunities for researcher and user interactions. The percentage of respondents who rated these barriers as four or five in NH, FH and IH geographic regions are consistently higher than the overall average (Table 7). Respondents’ settings only impact opportunities for researcher and user interactions, with a higher percentage in rural and remote locations rating it as a four or five.

Table 6: Respondents rating barriers as four or five, by role (%)


KT skills of staff Organizational culture

Opportunities for researcher and

user interactionsOverall 46.5 38.6 42.1 Overall average

NH 51.2 41.3 53.1 Statistically significant and below the average

VCH 40.3 30.3 26.7 Statistically significant and above the average

FH 55.9 41.2 48.7

VIHA 41.4 42.2 43.7

IH 52.1 51.6 60.6

3.5.2 FacilitatorsTo further understand the support people need to increase their opportunities to do KT, we asked respondents what else they require in their work environments to better perform KT in their work. A small proportion of respondents (18.1%) provided comments, but there are a few common ideas worth noting.

Of those respondents who provided comments, nearly half identified resources of varying types that would increase their capacity to do KT. Some respondents indicated that additional people would help them perform KT in their work: staff dedicated to doing KT, or workload support such as patient coverage care that would allow individuals to focus some of their time on KT, or available KT expertise provided through mentors, librarians or KT units. In other cases, respondents said that tools and KT materials would support their KT activities, as would funding — for training, people and resources.

Reflecting the biggest barrier identified, approximately a quarter of respondents’ comments reiterated the need for more time. While time is clearly a big challenge and necessary to doing KT, about a quarter of the comments also focused on organizational culture as a facilitator to doing KT, and in some cases respondents drew a connection between culture and time: that without increased awareness and understanding of KT from leadership and staff, commitment to making KT a priority from management and others, and supportive structures that allow or require KT in the workflow, time will continue to be an issue.

[ What do the findings suggest? ]• Differences in perceived barriers to doing KT across professional groups must be considered when

developing KT supports in order to meet specific needs.

• MSFHR must work with our partners to increase organizational awareness and understanding of, and commitment to, KT opportunities — particularly as they relate to time and resources.

Table 7: Respondents rating barriers as four or five, by region (%)


Results of the provincial needs assessment indicate there is high interest in learning more about KT in BC, but existing training and resources may not be sufficient to meet current needs, and many groups face time and cost constraints that make training a challenge. This assessment demonstrates:

» Respondents consider KT important to their work, and have high interest in learning more about KT skills. On average, 79.9% of respondents are interested in each of the KT skills, and there is over 85% interest overall in the top ten skills provided in the survey.

» There is most need for training at the beginner level, with an average of 46.5% of respondents needing beginner-level training in KT skills and 22.5% requiring advanced-level training. However, consistently higher rates of knowledge brokers (intermediaries between research producers and users), researchers and clinician-scientists require advanced-level training than the average, while consistently higher rates of health care providers require beginner-level training.

» There are useful resources and training in existence, with over 70% of respondents agreeing that existing KT support is interesting, relevant and of high quality, but it is difficult to obtain and use: fewer respondents, especially research trainees, clinician-scientists and health care providers and administrators, agree that KT support is accessible (55.6%), affordable (52.0%) and of sufficient amount (41.8%).

» More people prefer to learn in small group sessions (72.3%) and self-guided study (47.2%), which is reflected in the higher likelihood that respondents would access online resources (86.0%), attend a workshop (83.8%) and take web-based training (83.5%). Knowledge brokers and research trainees are consistently more likely to participate in KT activities, while researchers and clinician-scientists are less likely except in the case of applying for KT funding

» Time and cost constraints are the biggest barriers to participating in KT training workshops. Higher rates of respondents receive no support for KT workshop travel costs and registration fees, with clinician-scientists, health care providers and individuals in rural and remote settings reporting that they have no support more frequently than the overall results.

» The biggest challenge to integrating KT into work is time, with 75.1% rating it as four or five on a scale where five is a major barrier. In general, health care providers and administrators rated barriers to doing KT higher than other professional groups.

4. Summary and Implications

KEY

FIN

DIN

GS


Figure 1: Key functional areas for agencies involved in KT

Implications*14

Results of the assessment indicate that KT skills training and resources that are developed to meet provincial needs must take into consideration the unique interests and circumstances of various audiences. In order to build and sustain KT capacity in BC, training and resource options must be flexible, easily accessed, and cost-effective. Local KT leaders must be encouraged and incentivized to share their knowledge and experience to address the high demand for KT skills training in the province. Findings suggest many opportunities for MSFHR and our partners to meet the KT training and resource needs of the province, and opportunities for us to work together to reduce barriers and raise awareness of the importance of KT.

High interest in KT training

Most individuals consider KT important to their work, and have a strong desire to build their capacity to engage in KT, with four out of five respondents interested in each KT skill, and generally high interest in learning more about KT broadly. These findings are consistent with our experience to date in offering general KT skills training workshops, which have been oversubscribed. To address this need, additional financial resources will need to be identified and allocated, and KT trainers identified, to increase the number and frequency of general and beginner KT training opportunities, as well as more advanced training on specific topics of interest. Further work is needed to determine advanced-level training as it relates to specific topics and audiences.

Audience specific versus integrated training — a case for both

The differences in importance of, interest in and experience with KT between research producers and users likely reflects the various roles people play in the production and use of evidence. Research producers rated dissemination as the most important KT aspect, and have the highest interest in learning more about dissemination and general KT skills; research users rated application as the most important aspect, and have the highest interest in learning more about application and exchange skills. In addition, higher rates of research producers require advanced-level training than the average, while more health care providers consistently require beginner-level training.

14 www.implementationscience.com/content/7/1/39; accessed September 7, 2012.

From a funder’s perspective, we have identified building KT capacity (skills training and resources) as one of five key functional KT activities that together create an environment that facilitates effective use of evidence in practice and policy making. (Figure 1). Additional activities to support a KT program are assessment of stakeholder KT needs, evaluation of KT activities, and communication of KT activities.14


Differences in interest and skill level have implications for designing KT skills training programs to meet specific audiences’ needs. To date, the general KT workshops co-sponsored by MSFHR have included both research producers and users. These workshops will continue to be offered as we believe that training opportunities designed to bring together research producers and users are critical to building understanding of cultural and language differences, encouraging integrated and end-of-grant KT activities and partnerships, and addressing a perceived barrier by health care providers and administrators — and to a lesser extent researchers — for opportunities to interact.

However, it is also clear that additional workshops designed for specific audiences on topics identified as important and at appropriate skill levels should also be considered.

Knowledge brokers and the science of KT

Knowledge brokers are the most enthusiastic about KT and training, rating KT of highest importance across all of the professional roles, and indicating the most interest in learning more about KT by area and across skills. As expected, more knowledge brokers require advanced-level training than the overall average.

This enthusiasm complements MSFHR’s ongoing interest in better understanding the role of knowledge brokers, and is encouraging in that this group will contribute greatly to increasing KT in the province. MSFHR has offered KT broker awards in the past; new ones will be developed over the coming months to facilitate the implementation of BC-developed health research evidence, study the KT methods/tools used to better understand what KT activities are effective within specific contexts, evaluate the role of the knowledge broker, and add to the KT literature.

Addressing KT needs

While interest in developing skills is high, results suggest that there is need to offer additional resources and training that are more accessible and affordable than those existing in the province, as many do not feel the KT support available to them is sufficient. MSFHR’s current initiatives address some of the training needs identified, but we need to address gaps.

Workshop training and more flexible formats

There is most interest in small group sessions as a learning format, and more likelihood that people will attend a KT workshop over most other activities. KT workshops are offered by MSFHR and our partners that limit enrollment from 25 to 30 people and include break-out groups for discussion and KT skills development. While results confirm the value of workshops in the province, it is also apparent that cost constraints and time commitments are the biggest barriers to participating in them.

What fees to charge for KT training workshops is a question we need to answer. Some provincial and federal health research funding agencies do not charge for some of their training (e.g. Alberta Innovates – Health Solutions, CIHR), nor do some BC research institutes (e.g. Vancouver Coastal Health Research Institute). MSFHR’s practice has been to charge registration fees on a case-by-case basis, dependant on the discretion of the workshop co-sponsor, but other funding models may need to be considered if we are to reach all audiences wanting KT skills training in BC.


We also need to consider other training formats to address barriers and increase KT support with the resources available. For example, respondents indicated that, in addition to attending a workshop, they are most likely to access online resources or take a web-based course. Offering other options such as online training and resources provide more flexibility to participants, and have the potential to reduce current cost barriers.

Training is not enough

Providing KT skills training alone is not sufficient to increase the use of health research evidence among research producers and users in BC — support for doing KT in the work environment is also required. Findings indicate that time or competing priorities, followed by KT funding and access to resources, are the biggest barriers to respondents’ doing KT in their work.

While MSFHR will be able to address some organizational barriers (e.g. access to resources, opportunities for interactions between researchers and users of evidence, KT funding), results suggest the importance of our working with partner organizations to address context-specific barriers to practicing KT.


In partnership with local and national KT experts and KT-focused organizations, MSFHR is well positioned to address the opportunities and challenges that arose in our needs assessment. Our next steps include:

• Conduct a mapping exercise to:

• Determine the gaps between identified KT training and resource needs and our current KT activities and initiatives.

• Identify what existing KT resources we can link to or bring to BC, adapting them if necessary.

• Identify what new training and resources need to be developed.

• Meet with our partners to discuss needs assessment results, get feedback on our mapping exercise and discuss how MSFHR can work with them to:

• Address KT needs and barriers specific to their regions or organizations.

• Identify synergies between organizations and/or regions where partnership opportunities may exist to address similar KT training and resource needs.

• Help address organizational barriers to conducting KT (e.g. time/competing priorities, organizational structure, formal recognition from employer).

• Identify local KT trainers interested in sharing their knowledge and skills.

• Raise awareness of the importance of KT provincially and the support available.

• Develop mechanisms to better understand groups not represented (those with limited or no knowledge of the concepts of KT as described here), or under-represented in the survey (e.g. not-for-profits, government, private sector) to determine if their KT needs differ.

5. Next Steps for MSFHR

Training and Resources to Support Research Use: A Provincial Needs Assessment | A

Appendix A — MSFHR KT Program BackgrounderTo help increase the use of health research evidence to inform practice and policy, MSFHR has increased its focus on knowledge translation (KT) over the last two years. Our aim is to both improve KT activities related to our existing funding programs, and to work with partners to strengthen the province’s overall health KT enterprise. While our focus as a research funding agency is on evidence from health research studies, we recognize that many types of evidence must be drawn on to improve health care practice and policy.

Through our KT planning process, which included a review of the literature, an environmental scan and expert advice, we developed a model15 comprising five key functional areas that together create an environment towards increasing the use of health research evidence: funding KT, advocating for KT, managing KT projects, building capacity for KT, and advancing the science of KT.

We have identified three KT goals that currently focus our activities:

1. Build KT skills of BC researchers and research users

2. Bring synthesized evidence to bear on resolving BC health and health system issues

3. Maximize the impact of MSFHR-funded research

To date, we have focused on skills training workshops for researchers and research users, KT funding awards to facilitate “knowledge to action” and implementation science (i.e. the study of KT), and strengthening our internal procedures and processes related to KT.

New KT activities are in development and will be based on our experience with and evidence from our work to date (including our provincial KT needs assessment, KT workshops, demonstration KT projects), and broader internal context (organizational strategic plan, funding competitions) and external provincial and national contexts with our partners as they relate to KT.

For more information on KT at MSFHR, contact [email protected].

15 www.implementationscience.com/content/7/1/39/abstract; accessed September 7, 2012.

Training and Resources to Support Research Use: A Provincial Needs Assessment | B

Appendix B — MSFHR Provincial KT Needs Assessment SurveyPlease refer to next 11 pages.

BC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs Assessment

INTRODUCTION

As BC's provincial health research support agency, MSFHR is committed to supporting the use of health research evidence to improve practice and policy (knowledge translation, or KT). Please join your colleagues in identifying KT training and resource needs across BC. We're looking for input from both "producers" and "users" of health research evidence, recognizing that many of you play both roles. The results of this survey will help us and our partners develop KT training and resources of most interest to respondents. Please note:

l We see knowledge translation as a complex process whose components are not in practice easily or ideally separated. However, the survey asks specific questions about evidence dissemination, synthesis, exchange and application to understand needs in these specific areas as well as for KT overall.

l We also recognize that many types of evidence must be drawn on to improve health care practice and policy. The focus of this particular survey is health research evidence (or results of health research), recognizing its effective use relies on other types of evidence in context.

Thanks in advance for your input. We'll post a summary of the results on our web page this spring. Use the navigation buttons in the survey. You can leave and return to your responses at a later time using the same computer and survey link. It should take approximately 15 minutes to complete. Please note: There is no identifying information collected in this survey. For more information, visit our website.

ABOUT YOU

BC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs Assessment1. What is your primary professional role?

2. What is your primary work environment?

3. Where is your workplace located?

Researcher

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Clinicianscientist

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Research trainee (graduate or postgraduate)

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Public servant (i.e. working in government)

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Knowledge broker (i.e. intermediary between researchers and evidence users)

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Other (please specify)

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University/college

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Research institute (within a health authority or university)

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Notforprofit organization

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Health authority (including hospital and community)

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Government

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Private sector

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A (Northern Health geographic region)

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B (Vancouver Coastal Health geographic region)

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C (Fraser Health geographic region)

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D (Vancouver Island Health Authority geographic region)

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E (Interior Health geographic region)

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Outside BC

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Other

BC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs Assessment (BC Stats, 2002)

4. In what setting is your workplace located?

5. What type of research most closely aligns with your work?

The survey is in two parts. Part I asks about your interest in learning more about KT broadly as well as specific aspects of KT. Part II asks about training experiences, preferences, and barriers to KT. For the purposes of this survey we use the definition of knowledge translation as developed by Canadian Institutes of Health Research:

A dynamic and iterative process that includes synthesis, dissemination, exchange and ethicallysound application of knowledge to improve the health of Canadians, provide more effective health services and products, and strengthen the health care system. This process takes place within a complex system of interactions between researchers and knowledge users which may vary in intensity, complexity and level of engagement depending on the nature of the research and the findings as well as the needs of the particular

Urban

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Rural or remote

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Not applicable

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Don't know

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Biomedical research

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Clinical research

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Health services research

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Population health research

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Other type of research (please specify)

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BC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs AssessmentBC Knowledge Translation Needs Assessmentknowledge user.

Other terms commonly used are knowledge transfer, knowledge exchange, research utilization, and dissemination and implementation (US).

PART I. KNOWLEDGE TRANSLATION

Identifying the appropriate audience and tailoring the message and medium to the audience. Dissemination activities can include such things as summaries for/briefings to stakeholders, educational sessions, creation of tools and media engagement.

7. How important to your work is dissemination, as defined above?

6. Indicate if you're interested in learning more about the following, and if so the level of training you need. Select all that apply.

Interested (beginner)

Interested (intermediate)

Interested (advanced)

Not interested

Developing a KT plan nmlkj nmlkj nmlkj nmlkj

Implementing a KT plan nmlkj nmlkj nmlkj nmlkj

Evaluating a KT plan nmlkj nmlkj nmlkj nmlkj

KT models and theories nmlkj nmlkj nmlkj nmlkj

KT research (also known as dissemination and implementation research)

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Teaching KT nmlkj nmlkj nmlkj nmlkj

DISSEMINATION

Other topics of interest (please specify)

Not important

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Somewhat important

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Very important

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The contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic. A synthesis must be reproducible and transparent in its methods, using quantitative and/or qualitative methods. It could take the form of a systematic review, follow the methods developed by the Cochrane Collaboration, result from a consensus conference or expert panel or synthesize qualitative or quantitative results. Realist syntheses, narrative syntheses, metaanalyses, metasyntheses and practice guidelines are all forms of synthesis.

9. How important to your work is synthesis, as defined above?





Not interested

Developing a dissemination plan nmlkj nmlkj nmlkj nmlkj

Implementing a dissemination plan nmlkj nmlkj nmlkj nmlkj

Evaluating a dissemination plan nmlkj nmlkj nmlkj nmlkj

Developing key messages nmlkj nmlkj nmlkj nmlkj

Communicating using plain language (written and verbal) nmlkj nmlkj nmlkj nmlkj

Targeting communication to specific audiences nmlkj nmlkj nmlkj nmlkj

Social marketing (i.e. the systematic application of marketing to achieve specific behavioral goals for a social good)


Working with the media nmlkj nmlkj nmlkj nmlkj

SYNTHESIS


Not important

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Somewhat important

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Very important

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Interactions between the evidence user and the researcher at any or all stages of the research process. The Canadian Health Services Research Foundation (CHSRF) says that effective knowledge exchange involves interaction between knowledge users and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decisionmaking.

11. How important to your work is knowledge exchange, as defined above?





Not interested

Conducting evidence syntheses nmlkj nmlkj nmlkj nmlkj

Communicating evidence syntheses (e.g. summaries, overviews, policy briefs)


Finding and appraising evidence syntheses nmlkj nmlkj nmlkj nmlkj

EXCHANGE





Not interested

Working with decision makers nmlkj nmlkj nmlkj nmlkj

Working with researchers nmlkj nmlkj nmlkj nmlkj

Working with industry nmlkj nmlkj nmlkj nmlkj

How decisions are made in health care environments nmlkj nmlkj nmlkj nmlkj

How decisions are made in government environments nmlkj nmlkj nmlkj nmlkj

Using social media or webbased tools for knowledge exchange (e.g. webbased forums, wikis, social networking sites)



Not important

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Somewhat important

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Very important

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The iterative process by which new or existing health research evidence is put into practice. Application can refer to both the integration of evidence into existing programs, policies or practices, or the development of new evidenceinformed programs, policies, practices, products and services.

13. How important to your work is application, as defined above?

KT support includes learning resources, advice, training activities, funding, etc.

APPLICATION





Not interested

Developing evidenceinformed practices and programs nmlkj nmlkj nmlkj nmlkj

Implementing evidenceinformed practices and programs nmlkj nmlkj nmlkj nmlkj

Sustaining evidenceinformed practices and programs nmlkj nmlkj nmlkj nmlkj

Evaluating the implementation of evidenceinformed practices and programs




PART II. KT SUPPORT

Not important

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Somewhat important

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Very important

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16. List up to five of the most useful KT resources and activities you have used or heard of.

17. List up to three KT skills trainers (based in Western Canada) you would recommend to lead a KT workshop.

18. How do you prefer to learn about a topic? Select up to two.

15. Please rate your level of agreement with the following. In my work environment, the KT support available is generally:

Strongly disagree

DisagreeSomewhat disagree

Somewhat agree

Agree Strongly agree Don't know

Accessible nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Affordable nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Relevant nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Interesting nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Of high quality nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Of a sufficient amount nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

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KT SUPPORT: PREFERENCES

Selfguided study (e.g. reading, video, etc.)

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Large group sessions (e.g. seminars, conferences, community of practice)

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Small group sessions (e.g. workshops, seminars)

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Oneonone

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Teleconferences and webinars

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21. What would prevent your participation in a KT training workshop? Select all that apply.

19. What is the likelihood that you would engage in the following?

Very unlikely UnlikelySomewhat unlikely

Somewhat likely

Likely Very likely Don't know

Attend a KT workshop nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Take brief, free webbased KT training with local and international mentors and peers

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Study for and obtain free webbased KT training with local and international mentors and peers that would lead to a certificate


Access online KT resources (e.g. KT models, tools and best practice information)


Join a KT community of practice/network nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Work with a KT mentor nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Seek KT advice (e.g. call a help desk) nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Apply for KT funding nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

20. How much of the following do you receive at your place of work to participate in a KT training workshop?

No supportSome support

Full support Not sure

Encouragement nmlkj nmlkj nmlkj nmlkj

Time nmlkj nmlkj nmlkj nmlkj

Registration fees nmlkj nmlkj nmlkj nmlkj

Travel costs nmlkj nmlkj nmlkj nmlkj


Multiday time commitment

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Registration fees

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Location

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Travel costs

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Lack of commitment from employer

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Nothing would prevent me from participating.

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24. What else do you require in your work environment to better support KT in your work?

Do you have any additional comments regarding your needs or preferences related to KT?

22. How much would you/your employer be willing to pay in registration fees so you could attend a:

$0 Only if it was free

Up to $200 Up to $600 Up to $1000 Up to $1600I would not attend

1day training workshop? nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj



5day KT professional certificate course? nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

BARRIERS

23. On a scale from one to five, how much of a barrier is each of the following to doing KT in your work?

1 = not a barrier 2 3 45 = a major

barrierNot applicable

KT skills of staff nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Time/competing priorities nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Formal recognition from employer nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Organizational culture nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Opportunities to interact with researchers and evidence users

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Funding for KT activities nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

Access to KT resources nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj

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THANK YOU

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Thank you for your input!

Please click the button below to submit your survey. For more information about this survey or MSFHR's knowledge translation activities, visit our website or contact Gayle Scarrow, Knowledge Translation Manager.

Contact: Kara Schell, Analysis & EvaluationEmail: [email protected]

200 – 1285 West BroadwayVancouver, British ColumbiaV6H 3X8 Canada

T 604 730 8322F 604 730 0524www.msfhr.org

michael smith foundation for health research | - training ......the canadian institutes of health...

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