Role Domains of Knowledge Brokering: A Model for the Health .. : Journal of Neurologic Physical Therapy

My training and socialization is vastly different from that of architects, designers, and engineers that I work with. This aligns with discussions and theories on workplace ethnology and the concept of participant observer that is popular in anthropological literature. “There is a great deal of ‘credibility work’ to be put into establishing and maintaining credibility and this is a big part of a knowledge broker’s role.” CB and KK reviewed records for compliance with inclusion criteria; LR resolved any classification disagreements and oversaw methodological considerations.

• Recognising science policy boundaries at multiple levels are not set in stone means there can be transparent discussions about what is in and out of scope and negotiations can take place about where the boundary is to be drawn.
• These KBs draw on evidence syntheses about treatment effectiveness, frameworks to guide clinical decision making and other resources, including an online EIP toolkit,41 to support and streamline the varied steps involved in identifying evidence, assessing its value, and implementing it where appropriate.
• Integration was identified as an important aspect of translation and was required to populate the assessment framework.
• Second, while we aimed to be inclusive in our characterization of KB activities and tasks, we did not contact study authors or the KBs who performed the reported interventions.

This means that much of the evidence which is currently available remains anecdotal and inconclusive (Conklin, Hallsworth et al. 2008). Reasons for this lack of evidence include a general lack of agreement about the key functions and skills of brokers, the multiplicity of brokering models and the practice of combining aspects of different models within one brokering intervention. In addition, knowledge transfer and knowledge brokering can be conceptualised as complex social activities which are difficult to evaluate (Ward, House et al. 2009). Key questions are what type of brokering outcomes can and should be measured (i.e. increased evidence use, relationships and interactions between researchers and users, increases in capacity to use evidence) and how can they be adequately captured (i.e. via survey, interview, documentary analysis)?

“if [knowledge brokers] are judged strictly by the rules of one world or the other they will always come up short.” This paper defines the work of the knowledge broker in a significantly different way and uses the term ‘knowledge translation’ to describe the ninth archetype of knowledge brokerage, the Knowledge Translator. The most common definition of a knowledge broker, are the individuals that act as links between the different groups and individuals in an organization that would not normally have a relationship with one another and that the core part of that role is the connecting of people.

The Experimental Kitchen: Thoughts on Corporate University Structures and Maturity Models

This leads to less than informed decisions and many unintended consequences that impact health adversely (Culley & Highey, 2008). At SHHC, the physiotherapy KB engaged physiotherapists to refine content for and to co-facilitate a case-based conference workshop46 in collaboration with therapists from the community and the local children’s hospital, on the topic of best practices in the management of cerebral palsy. This endeavor fostered awareness and learning of current evidence and strengthened knowledge exchange and relationships with community partners, while enhancing relevance of and receptiveness to content for workshop participants. In addition, as exemplified by the BC Physical Therapy KB position, the KB may catalyze the formation of research teams by providing a mechanism to enable collaboration. The creation of an online registry47 has enabled the expedient creation of multiple teams of clinicians, researchers, and decision makers to identify each other when opportunities to collaborate in specific areas of shared interest and expertise were available.

• At SHHC, the physiotherapy KB engaged physiotherapists to refine content for and to co-facilitate a case-based conference workshop46 in collaboration with therapists from the community and the local children’s hospital, on the topic of best practices in the management of cerebral palsy.
• We find that teams frequently experience “aha” moments when brokers challenge them to rethink familiar problems in new contexts.
• In contrast, the Sunny Hill Health Centre for Children (SHHC) KB initiative, supported by the onsite Child Development and Rehabilitation Evidence Centre, engages clinicians as KBs within a pediatric health center to support EIP within their interprofessional teams or discipline groups.
• However, owing to methodological limitations, we cannot conclude that the KB interventions performed by Ward et al. [43], Lyons et al. [42], Waqa et al. [32], and Yost et al. [48, 49] were responsible for the reported changes to participants’ knowledge (Additional file 4).
• This article introduces the importance and nature of the role of the nurse scientist as a knowledge broker.

A growing body of research on knowledge brokers has emerged over recent years in response to on-going calls to close the ‘know-do gap’ (Bennett and Jessani, 2011, p. 3) and foster sustainability science utilisation (or remedy the lack thereof) (Cash et al., 2003; Cash et al., 2006; Leith et al., 2017; Van Kerkoff and Pilbeam, 2017). Knowledge brokers establish strong social networks between scientists and decision-makers
Over the 12-month period that formed the basis of our study, the knowledge broker’s network grew to include 192 actors (see Figure 1). These individuals spanned over 30 national and international organisations, including government agencies, natural resource management groups, universities and research institutions, community groups, and industry representatives. Furthermore, only 46% of individuals were internal to the knowledge broker’s home institution, demonstrating the dominant end-user focus of these roles. To the extent that such calls have been answered, the focus has been on the consequences for knowledge brokers themselves, as pioneering members of a new occupational group facing unique stresses and an uncertain career pathway (Chew et al, 2013; Knight and Lightowler, 2010; Kislov et al, 2017). Less attention has been devoted to the consequences for knowledge-brokering work of contextual conditions that often remain oriented towards the maintenance of existing institutional boundaries.

Conceptualizing how KBs operate in practice

We thank two anonymous peer reviewers for comments that were helpful in sharpening our argument. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This study was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Leicestershire, Northamptonshire and Rutland. Graham Martin is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute. The Healthcare Improvement Studies Institute is supported by the Health Foundation, an independent charity committed to bringing about better health and healthcare for people in the UK. Natalie Armstrong is supported by a Health Foundation Improvement Science Fellowship and by the NIHR Applied Research Collaboration East Midlands (ARC EM).

The KB monitored participant status across all three levels and revisited plans of action with participants half way through and at the end of the one year intervention. The KB also synthesizes local community and patient data with general and specific research knowledge to assist users in translating the evidence into locally relevant recommendations for policy and practice. An important component related to the success of this activity is the KB’s ability to tailor the key messages from research evidence to the local/regional perspective, while also ensuring the ‘language’ used is meaningful for different end users [4, 8, 29, 35, 36]. Another key component is the KB’s ability to develop a trusting and positive relationship with end users and to assist them to incorporate research evidence in their policy and practice decisions [17, 37–39], while at the same time promoting exchange of knowledge such that researchers and users become more appreciative of the context of each other’s work.

Impact Practitioners

In addition to evaluating mechanisms for linking policymakers and academics, the project provided more information about the challenges of bringing the two communities together, such as the negative perceptions of academics about policymakers and vice versa. The final report from the project recommends the use of knowledge brokers as go-betweens, linking the policy, public sector, industry and academic communities. Two case-studies of knowledge brokering interventions (Kramer and Cole 2003; Kramer, Cole et al. 2004) used a combination of active dissemination and translation strategies to introduce health and safety research evidence to workplace managers. The process included summarising a body of research into a research message, producing plain-English summaries, slides and handouts, holding one-to-one meetings with key staff members and facilitating group meetings to discuss the research. While the remaining six studies [17, 32, 33, 36, 42, 43, 48, 49, 51] reporting effectiveness data did not meet this review’s standards for methodological rigour, meaningful information about how KBs operate in practice can still be gleaned from these reports and the additional 14 studies that did not report outcome level data. In fact, every study included less tangible or more ‘subtle’ impacts of knowledge brokering such as informing policy deliberations, facilitating stakeholder communication, or identifying gaps in evidence.

Although doing traditional business offline since 1992, I fell in love with online marketing in late 2014 and have helped hundreds of brands sell more of their products and services. If you choose to follow the KBB course, you’ll receive beyond the training material, software to help you automate some parts of your business. Also, you’ll get access to tons of bonuses they offer and you’ll become a member of their community to interact with other KBB members and have your questions answered by them. He organizes, transforms, and delivers specialized knowledge in the form of products and services. A knowledge reporter collects valuable information from trusted sources to organize and transform this knowledge into products and services. We wish to thank Allison McArthur and Domna Kapetanos, Research Librarians at Public Health Ontario, for their assistance in preparing and conducting the search strategy for this protocol.

Quality assessment

That said, I am the sole ‘reviewer’ in this activity, and it is by no means scientific, but nonetheless it is important to ask these kinds of questions and think ‘outside of the box’ (or at least add some columns to the box). Hopefully this activity stimulates others to think, discuss, and perhaps even study the roles and effectiveness of knowledge brokering. The task of tailoring resources to stakeholder needs and context also requires knowledge brokers to assume the role of facilitator, by refining or delivering information in a way that is accessible, relevant, and useful. In this post, Trish summarizes a 2015 review by that looks at (1) what knowledge brokers do, and (2) the effectiveness of knowledge brokers in contributing to KT in health-related settings. While reading the article, it also struck her to try and apply what she’s learned so far as a knowledge broker to the article — which brought her to the ‘thought experiment’.

This model can be used to inform the practice of knowledge brokering as well as professional development and evaluation strategies. In addition, it may be used to inform theory-driven research examining the effectiveness of knowledge brokering on knowledge generation and translation outcomes in the health care field, as well as on patient health outcomes. Ward and colleagues [43] explored the nature of KB-facilitated knowledge exchange across three service delivery groups in mental health settings. Following the KB intervention, authors reported that one participant team broadened the scope of what they valued as ‘knowledge’ to include policy, service literature, and experiences of other service delivery teams. Additionally, Lyons and colleagues [42] reported on the Atlantic Stroke Care group’s experience with knowledge brokering to foster decision-makers’ uptake of best practices in integrated stroke care.

Knowledge brokering theory

Management and communication of unknowns is a critical element of research for policy or practice change (Bammer, 2013). This research shows that value-laden collaborative policy-making processes have implications for how uncertainty is managed. While the ZC was not shielded from the existence of uncertainty (indeed, they grappled with it continuously), neither were they exposed to all of the technical detail. In what was described by one broker as an ‘80/20 thing’, our brokers took on responsibility for the myriad uncertainties of the technical work that would otherwise have been passed direct to the ZC or left to inhibit the development of the technical work and the planning process. Conceived by our participants as sharing the burden of uncertainty, brokering involved co-ordination of the science and processes to help scientists hand over their science while being confident they had sufficiently qualified their conclusions to the broker.

Machen (2018, p. 6) also identifies translation as an active and displacing process and highlights ‘the irreconcilable tension between equivalence and difference’. In other words, in addition to the broader political and institutional landscape that influences what research is done, in conflicting situations such as water resource planning, translation cannot be value-free and brokers cannot be effective if they operate as detached actors. Wehrens (2014, p. 546) highlights how science and policy are co-produced with business broker definition boundaries emerging through discourse, practices, and material relations (see also Latour, 2004; Law, 1994; Jasanoff, 2004; Irwin and Wynne, 2003). He states, ‘the difference between what counts as a ‘scientific’ issue and what counts as a ‘policy affair’ is not something that is given in advance, but rather actively negotiated in practice’ (Wehrens, 2014, p. 545). Hence, boundaries that demarcate science and policy are seen as negotiated and emergent (Hoppe et al., 2013; Jasanoff, 2004; Leith et al., 2017).

In fact, the literature suggests that the role of a KB is complex, contextual, and certainly not cookie-cutter. Because of this, many see the profession as an opportunity for professional self-definition [2]. The KB role is a unique and challenging one, and few people currently possess the skills necessary to be effective in this position.