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I’ve always been uncomfortable about phrases such as ‘knowledge transfer’.  I thought that this was predominantly a question of epistemological stance – that knowledge is socially constructed, but I’ve read a couple of things in the last week that has expanded my thinking on this…

I’m going to start by quoting a huge chunk of text I’ve read in a chapter that covers the background to action science

Action science attempts to address the widening gap between social science theory/research and social science-based professional practice.  Schon (1983,1987) describes this gap as the ‘rigor vs relevance’ dilemma, in which both practitioners and researchers face the choice between remaining ‘on the high ground where they can solve relatively unimportant problems according to prevailing standards of rigor or…descend into the swamp of important problems and nonrigorous inquiry (1987:3). Schon attributed this dilemma to the dominance of the ‘technical rationality’ model, according to which pure science produces basic knowledge (theory) which applied science uses to create techniques (technology) for solving real world problems.  These two types of science make up the fundamental knowledge base of practitioners, who receive their training through professional education.

Technical rationality has worked extremely well in engineering and medicine, but not in social work, education, psychotherapy, policy, urban planning and management (Schon, 1983, 1987).  Effective practice in these fields is often attributed to intuition and personal attributes rather than the skilful application of scientific knowledge.  As a result, the gap between theory and practice is often accepted as the natural state of affairs.  According to the action science account, there is nothing natural about this gap.  Rather the problem stems from features of mainstream, or ‘positivist’, social science which renders the knowledge it produces of limited use to practitioners (Argyris et al 1985)

Friedman (2001, 132)

It felt such a relief reading this text – it was something that I’ve felt in my gut for a long-time.  And here, someone was writing it over 10 years ago drawing on texts from the 1980s.

Why then is there still such an industry in the idea of ‘Knowledge transfer’?

This takes me to the other thing I’ve read – this is a new publication which critically reviews a number of knowledge to action models with a view to considering their implications for addressing inequities.  Even before I open the document I see the words “Knowledge translation (KT) is about closing the gap between knowing and doing.  Public health has been particularly interested in finding effective models for moving research into action” this immediately evoking that technical rationality model that Schon describes.

I can understand that this technical rationality model works in the bio-medical focus of public health – I like the reassurance that any medication I take has gone through double-blind random controlled trials and then my doctor being assured that in the case of x symptoms and y diagnosis use this drug z.  But as sociology and systems sciences have helped build more sophisticated social and ecological models of public health that require a wider range of social policy practitioners – such as policy; urban planners and politicians, what Schon tells us above is that technical rationality model DON’T WORK.  (Which must therefore mean the ‘death of the expert’ which is another story)

Nevertheless, the new publication looks to assess how a number of knowledge to action models stand up to the test of being good for issues of health equity.  None of the 48 models that they find in their review scores ‘top marks’ against their set of important criteria. Whilst feeling a little frustrated to see such a focus on ‘knowledge transfer’, I do actually think this paper is a useful summary to have.  But I’d be really interested to know how social learning models or action research approaches – where knowledge is developed and enacted in the same people – would stand up to the important criteria of being useful for addressing health equity – given these approaches have an emancipatory, critical and reflective slant that can be useful for citizens and practitioners alike then I imagine they’d do pretty well.  It’s a shame that the authors of the report restricted their search criteria to terms with ‘knowledge’ in, rather than also including ‘action’.

References

Friedman, V.J. (2001) Action Science: creating communities of inquiry in communities of practice, Chapter 11 in Reason, Peter and Bradbury, Hilary (eds.) (2006) Handbook of Action Research, Concise Paperback Edition. London, Sage Publications.

Davison, C.M. & National Collaborating Centre for Determinants of Health. (2013). Critical Examination of Knowledge to Action Models and Implications for Promoting Health Equity. Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University.


One Response

  1. #1
    Helen 

    A note to self. Just found out of a talk happening in my area in the near future http://www.fuse.ac.uk/event.php?eid=2227
    The synopsis seems to pick up on this tension I am talking about.

    Speaker: Jacky Swan, Professor of Organisational Behaviour, Warwick Business School, University of Warwick

    Title: Mind the Gap: The Use of Evidence in Commissioning Decisions

    Major efforts have been made by policy-makers and practitioners to promote ‘evidenced-based’ decision making in healthcare management. Commissioning groups, in particular, are increasingly required to use evidence to make decisions regarding health service purchasing that best meet their population’s needs. Numerous studies, however, show that evidence uptake in practice is often patchy or erratic. This problem is often presented as a ‘gap’ between the evidence-base and its use by practitioners. The solution is to make more (and better) sources of information available to practitioners and/or to set targets around evidence uptake (e.g. its speed).

    This talk will report on a study that aimed to understand the reasons behind the ‘gap’ and the barriers and facilitators to the implementation of ‘evidence-based’ decision making in healthcare management. It looks at how NHS managers actually make decisions about commissioning health services and the various sorts of information, knowledge and experience they deploy. This ‘close up’ view suggests that the ‘gap’ metaphor may be the wrong place to start. Rather than seeing evidence as something that is produced and then used (or not) in practice, an alternative is to understand ‘evidence’ as (co)produced through practice. In other words, commissioning managers and other specialists, work out ‘evidence-based’ solutions to problems in their contexts by combining local intelligence with policy guidelines and information on good practice. Taking this approach, and seeing how this process happens, invites different ways of thinking about how to improve evidence-based decision-making in the NHS.

    Biography
    Jacky Swan is Professor is Organizational Behaviour at Warwick Business School, and Director of the Innovation Knowledge and Organizational Networks (IKON) research centre. Her research interests are in processes of managing knowledge to innovation and improvement. She has published in a variety of journals, including Organization Studies, Organization Science, Human Relations, Research Policy, and is co-author of ‘Managing Knowledge Work and Innovation’ (Palgrave). She has recently completed a major research project on evidence-based decision making in the NHS and is about to new research on the challenges of implementing NICE guidelines in Clinical Commissioning Groups.

    ……………………………………………
    Probably worth me looking into Jacky Swan’s writing at some point

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