Effective knowledge mobilisation methods – Cochrane reviews
The following Cochrane and systematic reviews provide research evidence about the effectiveness of different knowledge mobilisation methods. Please note that although for many the effects are ‘small to moderate’, this is unsurprising given the heterogeneity of approaches.
Passive dissemination is the production of reports and other written documents that are usually distributed without targeting or tailoring for specific audiences. These documents may be held electronically on websites or in paper format. Bero and colleague’s overview of systematic reviews suggests that this passive dissemination makes little difference. Since Bero’s review, studies over the past 20 years have confirmed this.
Bero L, Grilli R, Grimshaw J, Harvey E, Oxman A, Thomson M, et al. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ. 1998;317(7156):465-8. https://www.bmj.com/content/317/7156/465.extract
Collaborations and personal relationships
Personal relationships and collaborations appear to be particularly effective when influencing policymakers such as Parliamentarians, civil servants, health and care commissioners etc, as concluded by this systematic review of systematic reviews.
Oliver et al. A systematic review of barriers to and facilitators of the use of evidence by policymakers
BMC Health Services Research 2014, 14:2 http://www.biomedcentral.com/1472-6963/14/2
Educational outreach visits
Educational outreach visits are when trained personnel visit clinicians in face-to-face meetings to provide information about how to change practice. This Cochrane review found that these visits led to small changes in prescribing and small to moderate changes for other types of professional practice such as screening.
O'Brien MA, Rogers, S., Jamtvedt, G., Oxman, A.D., Odgaard-Jensen, J., Kristoffersen, D.T., Forsetlund, L., Bainbridge, D., Freemantle, N., Davis, D. and Haynes, R.B.,. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of systematic reviews. 2007;4. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000409.pub2/abstract
Audit and feedback
In audit and feedback, practitioners’ professional practice is measured and then compared to standards. The results are then fed back. This Cochrane review looked at audit and feedback for doctors and nurses in a variety of specialities. Overall, the effect ranges from little to no effect to substantial effect. The reviewers state that audit and feedback may be most effective when:
- The health professionals are not performing well to start out with
- The person responsible for the audit and feedback is a supervisor or colleague
- It is provided more than once
- It is given both verbally and in writing
- It includes clear targets and an action plan
Ivers N, Jamtvedt G, Flottorp S, Young J, Odgaard-Jensen J, French S, et al. Audit and feedback:effects on professional practice and healthcare outcomes Cochrane Database of Systematic Reviews 2012;6.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000259.pub3/abstract
Continuing education meetings and workshops
Educational meetings include courses, conferences, lectures, workshops, seminars, and symposia. This Cochrane review found that educational meetings alone or combined with other interventions can improve professional practice and the achievement of treatment goals. The effects on professional practice was small and variable and the effect on patient outcomes was less. Effects were greater when:
- Attendance at meetings was high.
- Interactive and didactive education were combined rather than either on its own.
- The intended outcomes were less serious.
- The behaviours were less complex.
Forsetlund L, Bjørndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf FM, et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane database of systematic reviews. 2009;2. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003030.pub2/full
Tailored interventions are strategies used to change professional practice that take into account factors that currently affect professional practice and possible reasons for resisting change. These may differ substantially between professional groups, healthcare settings and clinical tasks. This updated Cochrane Review found that tailored interventions have a small to moderate effect on changing professional practice. The most effective approaches to tailoring are not known.
Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, et al. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes Cochrane Database of Systematic Reviews,. 2015;3. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005470.pub3/abstract