Definitions of Knowledge Translation, Implementation, Related Terms

Knowledge Translation

Understanding the scope of KT requires greater clarity relative to terms and definitions. Definitions express the essential nature and enable a common understanding of a word or subject (Whitfield, 2012). For over two decades, the term “knowledge translation” has generated much discussion and confusion stemming from its more than 100 different definitions (McKibbon et al., 2013).

According to Azimi, Fattahi, and Asadi-Lari (2015, p. 96), the most commonly cited and adopted definition of knowledge translation is:

[The] exchange, synthesis and ethically-sound application of knowledge—within a complex system of interactions among researchers and users—to accelerate the capture of benefits of research for Canadians, through improved health, more effective services and products, and a strengthened health care system. (Canadian Institutes of Health Research [CIHR], 2015)

This CIHR definition of KT focuses more narrowly on the instrumental use of research evidence and its application in health care settings. In this report, we conceptualize KT more broadly: that is, beginning with the processes and strategies that ensure research evidence is accessible to a range of KUs such that they can understand and benefit from evidence in some way, and ending with the implementation of evidence that is ready for application. Inherent in our definition are three key elements: (1) accessing evidence, (2) understanding that evidence, and (3) benefitting from the evidence. The benefits users may derive from research evidence are related to the type of research discovery (e.g., a new concept, an intervention, a new technology, improved knowledge), level or quality of evidence (see Figure 1), and stage of discovery on the research continuum. In medical research, those stages can range from the “bench” of basic science research (i.e., preclinical studies and animal research) through the “bedside” activities of clinical research with humans, until findings are put into clinical practice (Westfall, Mold, & Fagnan, 2007).

Benefits capture the results of research evidence (Amara, Ouimet, & Landry, 2004) and are categorized as instrumental, conceptual, or symbolic. Instrumental use applies research results in concrete, specific, and direct actions, now largely considered the realm of IS, a KT sub-specialty. Conceptual use involves general enlightenment or improved knowledge, where research may influence actions but more indirectly and less specifically than in instrumental use. Symbolic use involves using research evidence to legitimate and sustain predetermined positions (Amara et al., 2004).

In light of the prominence that is often given to instrumental research use (particularly in health care, where the focus is on practice and behavior change), it is important to keep in mind the extent to which certain benefits reportedly occur. Researchers report estimates of instrumental research use that fall somewhere between 40% (Caplan, Morrison, Stambaugh, & University of Michigan, 1975) and 12%, with 22% reporting conceptual use, and 16% claiming symbolic use (Amara et al., 2004). Being realistic with respect to what we might achieve with KT efforts is important.

The central aim of KT is to accelerate the benefits emerging from research; these benefits may be related to knowledge, attitudes, behaviors, practices, or policies. The research continuum discussed previously focuses on when KT occurs rather than its purpose. The level of research evidence (see Figure 1) informs the purpose behind the KT goal (see Figure 2). For instance, practice and policy change must be based on strong evidence, but any level of evidence can be disseminated to build knowledge and to inform. The purpose or KT goal may be to share what we know—as when evidence emerges from a single study; to build awareness and knowledge; to inform research, decision-making or policy; to facilitate change in practice, policy, or behavior based on a body of high-quality, rigorous evidence; or to transfer technology via a commercialization pathway.

KT may involve exchange (diffusion, dissemination), data management, synthesis, or application (implementation) of knowledge within a complex system of interactions among researchers and users. The past decade has resulted in a variety of KT classifications that warrant greater distinction. We review several of the terms we believe fall under the KT umbrella.

Diffusion/Dissemination

Diffusion and dissemination capture the collaborative problem-solving that unfolds both passive and active linkage and exchange between researchers and KUs. “Whereas diffusion is the natural spread of ideas, dissemination is the conscious effort to spread new knowledge, policies, and practices to target audiences or the public at large” (Green, Ottoson, García, Hiatt, & Roditis, 2014, p. 3).

Commercialization and Technology Transfer

Commercialization usually refers to processes, products, and inventions making their debut in the market or private sector. Technology transfer and commercialization may involve the assignment of technological intellectual property that is developed and generated in one place to another entity through legal means such as technology licensing or franchising. It is the process of converting scientific and technological advances into products, processes, applications, materials, or marketable goods or services.

Knowledge Brokering

Knowledge brokering forges new partnerships that facilitate interaction between researchers and KUs. Serving as both a role and a process, knowledge brokering promotes better understanding of one another’s goals and professional cultures, influence on one another’s work, and benefits from research-based evidence (Bornbaum, Kornas, Peirson, & Rosella, 2015).

Knowledge Management

Knowledge management (KM) was established as a discipline in 1991 within the information and KM literature. KM captures the systematic management of an organization’s knowledge assets to create value and meet tactical and strategic requirements. It consists of initiatives, processes, strategies, and systems that sustain and enhance the storage, assessment, refinement, and creation of knowledge. The Japanese organizational theorist, Ikujiro Nonaka (1991), made the early connection between tacit (experiential) knowledge and explicit (articulated, codified, and stored) knowledge and knowledge conversion—the interaction of these two forms of knowledge—to enhance an organization’s efficiency, productivity, and profitability. KM places strong emphasis on organizational knowledge culture. It involves the strategic use of information and knowledge resources within an organization and includes the creation, management, sharing, and flow of knowledge within organizations and across systems. Since some managed knowledge emerges from research or quality assurance activities (e.g., surveillance monitoring of cancer incidence rates), we include it in the spectrum of KT.

Knowledge Mobilization

Knowledge mobilization is a common synonym for KT and refers to getting the “right information” to the “right people” in the “right format” at the “right time.” Knowledge mobilization was introduced in Canada in 2001–2002 by the Social Sciences and Humanities Research Council of Canada (SSHRC) and was based on the French term la mobilization, which means making ready for service or action (SSHRC, 2019).

Translational Research

Translational research is the process of applying discoveries generated in basic, preclinical studies to the development of trials and studies in humans. Translational research describes efforts to move scientific knowledge “from bench to bedside,” building on basic research advances such as studies of biological processes using cell cultures or animal models and using them to develop new therapies or medical procedures. The term ”translational research” appeared as early as 1993, yet few references to it were documented in the medical literature during the 1990s, and most were in reference to cancer research (Rubio et al., 2010). At the time, the literature on cancer tended to use the term translational research to refer to work covering different types of research (e.g., immunology studies including basic and clinical research) or work spanning disciplines within a particular type of research (e.g., bench research involving molecular genetics and immunology).

Implementation and Implementation Science

Implementation refers to the use of methods and strategies to facilitate the adoption of evidence-based interventions and change practice patterns within specific settings. Relatedly, implementation science is the systematic study of the processes, factors, and mechanisms necessary for successful adoption of an evidence-based intervention or innovation that results in widespread use, the uptake of new practices, or broad-scale reach and penetration through dissemination and implementation efforts, marketing, laws and regulations, and/or systems research and policies (Bauer, Damschroder, Hagedorn, Smith, & Kilbourne, 2015).

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