In October-November 2016, the Collaborative Healthcare Improvement Partnerships Thematic Group (CHIPS) of The Canadian Association for Health Services and Policy Research (CAHSPR) ran a competition inviting trainees to share their experiences using an integrated knowledge translation (IKT) approach in their work. With several submissions received from across the nation, Christine Cassidy from the east coast and Erin Coates from the west coast won the case competition for their IKT experiences!
I interviewed the two winners, Christine and Erin, to learn more about what they do; their career track and interest in IKT; and of course their winning cases. Here is what they both had to say:
Tell us about yourself.
Christine: I am a registered nurse and I am originally from Prince Edward Island. I graduated with my Bachelors of Science in Nursing from the University of Prince Edward Island in 2013. I am now a PhD candidate in my third year of the PhD Nursing Program at Dalhousie University in Halifax. I am doing my PhD full-time and I am also working in a part-time role as a Nursing Research Coordinator on the Medical, Surgical, and Neurosciences Unit (MSNU) at the IWK Health Centre, which is the children’s and women’s health hospital in Halifax.
Erin: I am a second year medical student in the Island Medical Program, a distributed site of the University of British Columbia MD Undergraduate Program (MDUP). Prior to medicine, I worked as an ER Registered Nurse in the Fraser Health Authority for five years. I am passionate about health equity in both global and local settings.
What does IKT mean to you?
Christine: I view IKT as a true team approach for health research and advancing both practice and policy; using those established partnerships and relationships from the very outset, from the very start; making sure that we are asking relevant questions and that those questions are yielding useful findings; and then taking those findings to put them directly in the hands of the knowledge users – clinicians, patients, administrators, policy makers and so on.
Erin: I got involved in IKT as a Research Volunteer with Vancouver Island Health Authority (VIHA) Research and Capacity Building. To me, IKT represents a means by which academics, clinicians, and community leaders can be both connected and empowered in creating positive change in health care. It represents a structure by which these players can come together to discuss an identified issue and create concrete next steps to address that problem.
What made you study/practice/research IKT?
Christine: So going back to you mentioning having different hats on, that is kind of how I see my own work as well. I have the registered nurse hat and also the graduate student/aspiring scholar hat. In both those areas, I have noticed really firsthand the different values that are placed on research evidence and ensuring that we are using best practice evidence in our own nursing practice. So I wanted to help bridge that divide and again make sure that we are asking those relevant questions of nursing practice and helping nurses and other healthcare providers to make sense and make use of those findings. It’s one thing to just give people the best evidence, but it’s another thing to actually help them make use of it.
Erin: I was introduced to the concept of IKT through being a Research Volunteer with VIHA Research and Capacity Building (RCB). I was able to pursue Research Volunteering through the Flexible and Enhanced Learning Program, a course in the UBC MDUP. This group hosts multiple IKT events during their annual Knowledge to Action month in November. I was able to get involved in the planning and facilitation of two Knowledge to Action events as well as writing the summary reports for these events. It was one of these events, related to Older Adults and Malnutrition, which I wrote about in my CAHSPR Case Competition submission.
What IKT strategies, techniques or methods have you used (or use) in your work?
Christine: Something that really stands out in my work is working on teams with diverse perspectives. It is really easy to be on a team where everyone thinks the same way, where everyone has the same background and so you always go down one path. But, when you bring in different disciplines, different backgrounds, immediately there are different perspectives. So I find that is a very useful IKT strategy. I have also had training in some of the different KT theories and frameworks that I have used to guide my own work and some of the work that I do in my supervisor’s research lab here. For instance, the knowledge-to-action cycle by Dr. Ian Graham is one that we often use in our own work. We also often engage in knowledge syntheses, conducting barriers and enablers assessment, and a really helpful IKT strategy is connecting with the key stakeholders in order to design KT interventions and other strategies. So these are probably some of the common things that I use in my own work that are related to IKT.
Erin: We worked to increase awareness of local research findings and to facilitate change in the community and health authority related to these findings. We engaged leaders from a variety of backgrounds who had a vested interested in the impact of malnutrition on the health of older adults. I then wrote a summary report that will be disseminated to workshop leaders as part of Next Steps.
Please share with us your recent IKT experience that won you the CAHSPR Case Competition.
Christine: This all started in May 2015. There was a team of nurses at the Medical, Surgical, and Neurosciences Unit (MSNU) at the IWK Health Centre in Halifax. We attended a 4-part knowledge translation workshop series. This workshop series was designed to help strengthen both clinicians’ and administrators’ research skills to help them design practice and policy change. I was involved in that workshop, which was lead by my supervisor Dr. Janet Curran, as a junior KT mentor. Just to give a little background, MSNU is a pediatric inpatient unit that cares for close to 2000 pediatric patients a year. Many of the MSNU patients are of high acuity and they often require more nursing resources than the unit is able to provide. So the MSNU team came to this workshop because they wanted to implement a new model of care that could address this issue, and that model of care was known as the high-dependency care (HDC) model. But the MSNU team required some additional skills to ensure a successful implementation. Basically they had an idea, but they wanted to enhance their research skills in order to implement it. So that really started our collaborative partnership that has continued to evolve over the past 20 months now. Myself and my supervisor started to work with the MSNU team and we guided them through a systematic KT research process that included so far a scoping literature review and a barriers assessment, which I spoke about in my submission to the CAHSPR Case Competition. Based on our findings from that exploratory work, we are now conducting an implementation and an evaluation study of this new model of care introduced in the MSNU.
Erin: Like I noted above, I got involved in organizing, facilitating, and writing the summaries for two IKT events through my role as a Research Volunteer with VIHA RCB. The first event I was involved in was organized based on research findings indicating a high rate of malnutrition in older adults who had been admitted to Nanaimo Regional General Hospital. I, along with a team of passionate people from Island Health, organized speakers from Island Health, community organizations, and from the Nanaimo municipality.
Who made the biggest impact on your winning IKT experience?
Christine: It really was a team; starting off with my supervisor, Dr. Janet Curran, who first introduced me to knowledge translation and KT science and she has really supported me in every opportunity to advance my KT research training. But also my teammates on MSNU: the manager Shauna Best, the clinical leader Laura Foley and clinical leader of development Mary-Beth Rowe. They helped to really prioritize the research question for their care area, they were supported in the research process, but they challenged me to make sure that every step of the research process always aligned back with the needs of the MSNU. So I would have to say those four.
Erin: VIHA Research and Capacity Building, especially Wendy Young (Research Facilitator and Knowledge Translation Coordinator), created the space for me to take on a leadership role in this IKT event. They also provided me with an incredible amount of support as I navigated this new role. Dr. Hasselback (Central Island Medical Health Officer, VIHA) was very supportive of my role and an important leader at this event.
Were you surprised when you won? How did it feel?
Christine: Yes! I was very surprised. Like I mentioned earlier, there are so many innovative IKT initiatives that are taking place across the country. So I was really proud to see that our partnership and the work being done in Nova Scotia is recognized at the national level.
Erin: I was incredibly surprised when I won. I felt as though I’m just getting my feet wet in the area of IKT, and I didn’t expect my involvement in these IKT events to become nationally recognized. It has been an empowering experience to see the changes that IKT can facilitate, as well as the national interest in IKT activities.
What are your career goals? How do you plan on being involved in IKT in the future?
Christine: I want to continue to use my clinical nursing hat and my nursing research hat in the clinician-scientist role to strengthen the partnership between both academics and nursing administrators and clinicians. Based on the work that I described earlier with MSNU, I have recently been hired in a part-time embedded nursing research coordinator position to provide the sustained research support to the team. It has given me an opportunity to continue with these IKT initiatives and being right there with the frontline staff and the administration team.
Erin: I am interested in family practice, with a focus on working with vulnerable populations in resource-limited settings. I am passionate about the issue of health equity both locally and globally. I am excited to use IKT in the future to address important issues within health care as they arise and create sustainable change by empowering leaders from relevant groups to come together and build momentum.
What are three practical tips that you would like to give our readers who are interested in studying and/or practicing IKT?
Christine: #1: Work to establish those meaningful relationships that bring the diverse perspectives to the table. Like I mentioned before, people can bring different backgrounds, perspectives, ideas and strengths into the relationships and into the partnerships.
#2: I find it very useful for the research question to come from the frontline, so whoever or wherever that is in your area of work – whether it is the clinician or administrator or teacher for instance. By having the research question come from the frontline, everything else just seems to align quite well after that and you make sure that the findings are useful for the knowledge users.
#3: Discuss timeline and priorities early on. Coming from an academic perspective and then coming from a clinical perspective, there are definitely different priorities and having those discussions at the beginning is very important.
Erin: #1: Find knowledgeable, passionate mentors that can guide you in navigating the IKT process.
#2: It’s okay to feel a bit overwhelmed when you first start getting involved in planning IKT activities. You will learn so much as you go; embrace the whirlwind of new experiences and relationships—it’s all part of the IKT process!
#3: Celebrate the diverse backgrounds and knowledge bases of the members of your IKT team. You have so much to learn from each other!
Anything else you would like to share with us?
Christine: Again, I just want to mention that I am so honoured to receive this award and I am looking forward to continuing to enhance the value of nursing research here at the IWK Health Centre and making some new partnerships along the way.
Erin: I think that’s about it!
Way to go, Christine and Erin! We wish you the very best in all your IKT endeavours.
To the rest of you, what has your IKT experience been like? Share away!
P.S. Here is the link if you are interested to learn more about the CHIPS/CAHSPR Student Competition: http://www.cahspr.ca/web/en/community/news/580b842a37dee8ac303e6e00