Knowledge does not equal action—bridging the chasm between research evidence and its application

AO Spine Knowledge Translation Task Force

The science of knowledge translation

Academics have been scientifically investigating the concept of knowledge translation for several decades and have developed various frameworks over the years. Among the most prominent are the Knowledge-To-Action Cycle from the Canadian Institutes of Health Research (CIHR), the Promoting Action on Research Implementation in Health Services (PARIHS) framework, and the Knowledge Exchange Model. In summary, the following elements should be at the core of any knowledge translation effort:

Determining the innovation: what concrete product, procedure, treatment, or service with the potential to enhance health outcomes will be translated into clinical practice?
Specifying the actors and actions: which individuals or groups will either affect or be affected by the innovation, and who needs to do what differently? These stakeholders include medical professionals and patients, but also administrators, policymakers, regulators, industry representatives, research funders, and researchers themselves.
Identifying the best agents of change: who is best placed to inform medical practitioners about— and motivate them to adopt—new innovations? Often, these agents will be peers or organizations with high credibility.
Designing and implementing a knowledge translation plan: which strategies are most likely to promote behavioral change regarding the innovation at hand, and what barriers must be overcome? Research shows that educational outreach on specific clinical research outcomes, written reminders, and interactive educational meetings and workshops are among the most successful strategies.
Evaluating the outcomes: how well has the plan worked? Formal evaluation frameworks are available to verify the success of knowledge translation activities and to determine their reach, effectiveness, implementation, and other aspects.

The AO—a knowledge translation superpower?

More than most organizations, the AO Foundation has great potential to turn itself into a knowledge translation superpower in the future. Not only is it very active in terms of generating its own research, for example through its own ARI research institute and its clinical divisions such as AO Spine and its Knowledge Forums, AO Trauma, and AO CMF. Thanks to its strong footing in training and education, the AO is also in the unique position of being able to use its own research results right away to inform efforts like the AO courses and the numerous other educational events it organizes around the world every year.

“From a patient care standpoint, a 17-year gap is unacceptable, “ Bransford says. “We have the opportunity and obligation to place the new knowledge we generate front and center and push implementation for the betterment of our patients and our society. There are no excuses, we can do better!”

The sustained effort the AO puts into the development of its international community of physicians, researchers, academics, and other stakeholders is another valuable asset in this regard. This is especially important when it comes to the local adaptation of research outcomes to various geographical regions. For instance, does it make sense to adapt a certain research result from Europe to a region like Latin America, where there are big differences in terms of patient population and healthcare standards? The AO's vast international network can be of great advantage in terms of answering questions such as these and accelerating research outcome uptake by its the global community.