What Do We Know about Knowledge Brokers in Paediatric Rehabilitation? A Systematic Search and Narrative Summary

BackgroundImplementing research findings into practice is a complex process that is not well understood. Facilitation has been described as a key component of getting research findings into practice. The literature on facilitation as a practice innovation is growing. This review aimed to identify facilitator roles and to describe characteristics of facilitation that may be associated with successful research use by healthcare professionals.MethodsWe searched 10 electronic databases up to December 2016 and used predefined criteria to select articles. We included conceptual papers and empirical studies that described facilitator roles, facilitation processes or interventions, and that focused on healthcare professionals and research use. We used content and thematic analysis to summarise data. Rogers’ five main attributes of an innovation guided our synthesis of facilitation characteristics.ResultsOf the 38 488 articles identified from our online and manual search, we included 195 predominantly research studies. We identified nine facilitator roles: opinion leaders, coaches, champions, research facilitators, clinical/practice facilitators, outreach facilitators, linking agents, knowledge brokers and external-internal facilitators. Fifteen facilitation characteristics were associated with research use, which we grouped into five categories using Rogers’ innovation attributes: relative advantage, compatibility, complexity, trialability and observability.ConclusionsWe found a diverse and broad literature on the concept of facilitation that can expand our current thinking about facilitation as an innovation and its potential to support an integrated, collaborative approach to improving healthcare delivery.

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“…Not trained for role, 43 125 however, optimal training remains unknown 43 and training needs may vary by setting 171 …”

Section: Resultsmentioning

confidence: 99%

Facilitation roles and characteristics associated with research use by healthcare professionals: a scoping review

et al. 2017

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“…The use of an onsite knowledge broker or clinician ‘expert user’ is a KT strategy with emerging evidence of effectiveness [ 41 , 42 ]. At site 2, the on-site RA was an expert user with whom clinicians could problem-solve about technical issues.…”

Section: Discussionmentioning

confidence: 99%

A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation

Levac

Glegg

Sveistrup

et al. 2016

BMC Health Serv Res

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BackgroundDespite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills.MethodsA multi-faceted KT intervention was designed and implemented to support physical and occupational therapists in two stroke rehabilitation units in acquiring proficiency with use of the Interactive Exercise Rehabilitation System (IREX; GestureTek). The KT intervention consisted of interactive e-learning modules, hands-on workshops and experiential practice. Evaluation included the Assessing Determinants of Prospective Take Up of Virtual Reality (ADOPT-VR) Instrument and self-report confidence ratings of knowledge and skills pre- and post-study. Usability of the IREX was measured with the System Usability Scale (SUS). A focus group gathered therapist experiences. Frequency of IREX use was recorded for 6 months post-study.ResultsEleven therapists delivered a total of 107 sessions of VR-based therapy to 34 clients with stroke. On the ADOPT-VR, significant pre-post improvements in therapist perceived behavioral control (p = 0.003), self-efficacy (p = 0.005) and facilitating conditions (p =0.019) related to VR use were observed. Therapist intention to use VR did not change. Knowledge and skills improved significantly following e-learning completion (p = 0.001) and was sustained 6 months post-study. Below average perceived usability of the IREX (19th percentile) was reported. Lack of time was the most frequently reported barrier to VR use. A decrease in frequency of perceived barriers to VR use was not significant (p = 0.159). Two therapists used the IREX sparingly in the 6 months following the study. Therapists reported that client motivation to engage with VR facilitated IREX use in practice but that environmental and IREX-specific barriers limited use.ConclusionsDespite increased knowledge and skills in VR use, the KT intervention did not alter the number of perceived barriers to VR use, intention to use or actual use of VR. Poor perceived system usability had an impact on integration of this particular VR system into clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1807-6) contains supplementary material, which is available to authorized users.

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“…In contrast, KBs are defined as one of the human forces that bring people together to build relationships, uncover needs, share ideas, and evidence aiming to improve job productivity 34 . KBs link practitioners with researchers, facilitate the interactions between the two in order to better understand goals, cultures, and environmental limitations of each other's work, and help promote uptake of evidence into clinical practice 8,35‐38 …”

Section: Introductionmentioning

confidence: 99%

Determinants that influence knowledge brokers' and opinion leaders' role to close knowledge practice gaps in rehabilitation: A realist review

Gaid

Ahmed

Alhasani

et al. 2020

Evaluation Clinical Practice

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Rationale Despite the available evidence to support optimal practices in rehabilitation, significant knowledge practice gaps persist. Opinion leaders (OLs) and knowledge brokers (KBs) can enhance the success of knowledge translation (KT) interventions and improve uptake of best practices among clinicians. However, the literature on the mechanisms underpinning OLs'/KBs' activities, and guidance on the type of support needed for successful implementation of these roles in rehabilitation contexts is scarce. This research aimed to highlight the differences and similarities between OLs and KBs with respect to context, mechanism, and outcomes as well as describe the common patterns of OLs and KBs by creating a context‐mechanism‐outcomes configuration. Methods We conducted a realist review to synthesize the available evidence on OLs/KBs as active KT strategies. A search was conducted across five databases up to November 2019. Two independent reviewers extracted the data using a structured form. A context‐mechanism‐outcome configuration was used to conceptualize a cumulative portrait of the features of OLs/KBs roles. Results The search identified 3282 titles after removing duplicates. Seventeen studies (reported in 20 articles) were included in the review. Findings suggest a number of desirable features of OLs/KBs roles that may maximize the achievement of targeted outcomes namely being (a) embedded within their organization as “insiders”; (b) adequately skilled to perform their role; (c) identified as able to fulfil the role; (d) appropriately trained; and (e) able to use different KT interventions. Conclusion Findings of this realist review converge to create a context‐mechanism‐outcomes configuration with suggestions to optimally utilize OLs/KBs in rehabilitation. The configurations suggest desirable features that can lead to a greater potential to achieve targeted goals. It is preferable that OLs/KBs be embedded in the organization and that they are adequately skilful and well‐trained. Also, OLs/KBs should perform the required roles using KT interventions adapted to the local context.

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What Do We Know about Knowledge Brokers in Paediatric Rehabilitation? A Systematic Search and Narrative Summary

Cited by 19 publications

References 43 publications

Facilitation roles and characteristics associated with research use by healthcare professionals: a scoping review

Facilitation roles and characteristics associated with research use by healthcare professionals: a scoping review

A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation

Determinants that influence knowledge brokers' and opinion leaders' role to close knowledge practice gaps in rehabilitation: A realist review

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