ABSTRACTBackgroundKnowledge translation (KT) refers to the process of moving evidence into health... more ABSTRACTBackgroundKnowledge translation (KT) refers to the process of moving evidence into healthcare policy and practice. Understanding the experiences and perspectives of individuals who develop careers in KT is important for designing training programs and opportunities to enhance capacity in KT research and practice. To date, however, limited research has explored the challenges that trainees encounter as they develop their careers in KT.AimsThe purpose of this study is to identify the challenges that KT trainees face in their KT research or practice.MethodsAn online survey was conducted with a sample of trainees associated with the Knowledge Translation Trainee Collaborative or the KT Canada Summer Institutes, with written responses thematically analyzed.FindingsA total of 35 individual responses were analyzed, resulting in the identification of six interrelated themes, listed in descending order of prevalence: limited availability of KT‐specific resources (54%), difficulty inherent in investigating KT (34%), KT not recognized as a distinct field (23%), colleagues’ limited knowledge and understanding of KT (20%), competing priorities and limited time (20%), and difficulties in relation to collaboration (14%).DiscussionKT trainees experience specific challenges in their work: limited understanding of KT in other stakeholder groups; limited structures or infrastructure to support those who do KT; the inherently interdisciplinary and applied nature of KT; and the resultant complexities of scientific inquiry in this field, such as designing and testing multifaceted, multilevel implementation strategies and accounting for contextual factors.Linking Evidence to ActionKT training and capacity‐building efforts are needed to better position health systems to routinely adopt knowledge into healthcare policy and practice.
Advances in Health Sciences Education, Jan 3, 2021
Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, ... more Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.
Background: Substantial gains could be made in reducing the cancer burden if current scientific e... more Background: Substantial gains could be made in reducing the cancer burden if current scientific evidence was applied in practice. The World Health Organization estimates that, worldwide, one-third of cancer cases could be prevented and another one-third cured if evidence was consistently implemented and sustained in cancer care. However, moving evidence-based interventions into care has proven a significant challenge. Even when interventions are put into practice, they often fail to become integrated into the long-term routines of organizations. This poor sustainability means many patients do not benefit from the best care possible. There is little empirical data on the factors that influence the sustainability of interventions in clinical settings. Aim: To identify the determinants of, and explore the processes that facilitate, sustainability of interventions in cancer care survivorship. Sustainability was defined as the continued use of an intervention and its associated components and/or the continued achievement of the intended benefits after the initial funding or support period. Methods: We first conducted an environmental scan to identify interventions in cancer survivorship care implemented in Canada. This was followed by a literature review to ascertain the evidence base for each intervention and identify those meeting the US National Cancer…
Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned... more Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned in the first year
Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, ... more Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case comple...
Background To date there has been relatively little published about how research priorities are s... more Background To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation. Methods The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthe...
ObjectivesMoving innovations into healthcare organisations to increase positive health outcomes r... more ObjectivesMoving innovations into healthcare organisations to increase positive health outcomes remains a significant challenge. Even when knowledge and tools are adopted, they often fail to become integrated into the long-term routines of organisations. The objective of this study was to identify factors and processes influencing the sustainability of innovations in cancer survivorship care.DesignQualitative study using semistructured, in-depth interviews, informed by grounded theory. Data were collected and analysed concurrently using constant comparative analysis.Setting25 cancer survivorship innovations based in six Canadian provinces.ParticipantsTwenty-seven implementation leaders and relevant staff from across Canada involved in the implementation of innovations in cancer survivorship.ResultsThe findings were categorised according to determinants, processes and implementation outcomes, and whether a factor was necessary to sustainability, or important but not necessary. Seven ...
Background One of the key conceptual challenges in advancing our understanding of how to more eff... more Background One of the key conceptual challenges in advancing our understanding of how to more effectively sustain innovations in health care is the lack of clarity and agreement on what sustainability actually means. Several reviews have helped synthesize and clarify how researchers conceptualize and operationalize sustainability. In this study, we sought to identify how individuals who implement and/or sustain evidence-informed innovations in health care define sustainability. Methods We conducted in-depth, semi-structured interviews with implementation leaders and relevant staff involved in the implementation of evidence-based innovations relevant to cancer survivorship care (n = 27). An inductive approach, using constant comparative analysis, was used for analysis of interview transcripts and field notes. Results Participants described sustainability as an ongoing and dynamic process that incorporates three key concepts and four important conditions. The key concepts were: (1) co...
Journal of health organization and management, Jan 20, 2016
Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assi... more Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for ratio...
Journal of health organization and management, Jan 21, 2016
Purpose - The questions addressed by this review are: first, what are the guiding principles unde... more Purpose - The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. Design/methodology/approach - The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Findings - Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed l...
ABSTRACTBackgroundKnowledge translation (KT) refers to the process of moving evidence into health... more ABSTRACTBackgroundKnowledge translation (KT) refers to the process of moving evidence into healthcare policy and practice. Understanding the experiences and perspectives of individuals who develop careers in KT is important for designing training programs and opportunities to enhance capacity in KT research and practice. To date, however, limited research has explored the challenges that trainees encounter as they develop their careers in KT.AimsThe purpose of this study is to identify the challenges that KT trainees face in their KT research or practice.MethodsAn online survey was conducted with a sample of trainees associated with the Knowledge Translation Trainee Collaborative or the KT Canada Summer Institutes, with written responses thematically analyzed.FindingsA total of 35 individual responses were analyzed, resulting in the identification of six interrelated themes, listed in descending order of prevalence: limited availability of KT‐specific resources (54%), difficulty inherent in investigating KT (34%), KT not recognized as a distinct field (23%), colleagues’ limited knowledge and understanding of KT (20%), competing priorities and limited time (20%), and difficulties in relation to collaboration (14%).DiscussionKT trainees experience specific challenges in their work: limited understanding of KT in other stakeholder groups; limited structures or infrastructure to support those who do KT; the inherently interdisciplinary and applied nature of KT; and the resultant complexities of scientific inquiry in this field, such as designing and testing multifaceted, multilevel implementation strategies and accounting for contextual factors.Linking Evidence to ActionKT training and capacity‐building efforts are needed to better position health systems to routinely adopt knowledge into healthcare policy and practice.
Advances in Health Sciences Education, Jan 3, 2021
Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, ... more Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.
Background: Substantial gains could be made in reducing the cancer burden if current scientific e... more Background: Substantial gains could be made in reducing the cancer burden if current scientific evidence was applied in practice. The World Health Organization estimates that, worldwide, one-third of cancer cases could be prevented and another one-third cured if evidence was consistently implemented and sustained in cancer care. However, moving evidence-based interventions into care has proven a significant challenge. Even when interventions are put into practice, they often fail to become integrated into the long-term routines of organizations. This poor sustainability means many patients do not benefit from the best care possible. There is little empirical data on the factors that influence the sustainability of interventions in clinical settings. Aim: To identify the determinants of, and explore the processes that facilitate, sustainability of interventions in cancer care survivorship. Sustainability was defined as the continued use of an intervention and its associated components and/or the continued achievement of the intended benefits after the initial funding or support period. Methods: We first conducted an environmental scan to identify interventions in cancer survivorship care implemented in Canada. This was followed by a literature review to ascertain the evidence base for each intervention and identify those meeting the US National Cancer…
Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned... more Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned in the first year
Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, ... more Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case comple...
Background To date there has been relatively little published about how research priorities are s... more Background To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation. Methods The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthe...
ObjectivesMoving innovations into healthcare organisations to increase positive health outcomes r... more ObjectivesMoving innovations into healthcare organisations to increase positive health outcomes remains a significant challenge. Even when knowledge and tools are adopted, they often fail to become integrated into the long-term routines of organisations. The objective of this study was to identify factors and processes influencing the sustainability of innovations in cancer survivorship care.DesignQualitative study using semistructured, in-depth interviews, informed by grounded theory. Data were collected and analysed concurrently using constant comparative analysis.Setting25 cancer survivorship innovations based in six Canadian provinces.ParticipantsTwenty-seven implementation leaders and relevant staff from across Canada involved in the implementation of innovations in cancer survivorship.ResultsThe findings were categorised according to determinants, processes and implementation outcomes, and whether a factor was necessary to sustainability, or important but not necessary. Seven ...
Background One of the key conceptual challenges in advancing our understanding of how to more eff... more Background One of the key conceptual challenges in advancing our understanding of how to more effectively sustain innovations in health care is the lack of clarity and agreement on what sustainability actually means. Several reviews have helped synthesize and clarify how researchers conceptualize and operationalize sustainability. In this study, we sought to identify how individuals who implement and/or sustain evidence-informed innovations in health care define sustainability. Methods We conducted in-depth, semi-structured interviews with implementation leaders and relevant staff involved in the implementation of evidence-based innovations relevant to cancer survivorship care (n = 27). An inductive approach, using constant comparative analysis, was used for analysis of interview transcripts and field notes. Results Participants described sustainability as an ongoing and dynamic process that incorporates three key concepts and four important conditions. The key concepts were: (1) co...
Journal of health organization and management, Jan 20, 2016
Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assi... more Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for ratio...
Journal of health organization and management, Jan 21, 2016
Purpose - The questions addressed by this review are: first, what are the guiding principles unde... more Purpose - The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. Design/methodology/approach - The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Findings - Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed l...
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Papers by Evelyn Cornelissen