Chapter 9

Question 1

Describe the Transtheoretical Model

Answer 1

How clinicians respond to new knowledge depends on their readiness
to make changes at the time the information is provided
Focus is on the individual

Question 2

What are the stages of change in the transtheoretical model?

Answer 2

Precontemplation: consciousness raising
Contemplation: emotional arousal
Preparation: commitment
Action: reward
Maintenance: environmental-reevaluation

Question 3

What are the stages of the Innovation Decision Process Model?

Answer 3

1. Knowledge (learning about a new idea)
2. Persuasion (forming an opinion about the idea)
3. Decision (deciding to use the idea or not)
4. Implementation (trying out the new idea)
5. Confirmation (evaluating the implementation of the idea)

Question 4

What are methods of knowledge translation?

Answer 4

◦ Continuing education courses (interactive or didactic)
◦ Expert opinion
◦ Journal articles/educational materials
◦ Research summaries/abstracts
◦ Audit and feedback
◦ Reminders
◦ Educational outreach (academic detailing)
◦ Influential educational leaders/opinion leaders
◦ Clinical guidelines
◦ Patient-mediated interventions

Question 5

What are the 5 key strategies for knowledge translation?

Answer 5

1. Cultural approach (artifacts, symbols, storytelling, socializing to affect
   tacit knowledge)
2. Multi-sector partnerships (bring different strengths together)
3. Conferences and conference leverage (push out or pull in knowledge)
4. Research summaries (tailored specifically; wide range of audiences)
5. Supportive infrastructures

Question 6

How does technology enable knowledge transfer?

Answer 6

Information and communication technologies that push out evidence
◦ Handheld PDAs give physicians immediate access to knowledge
◦ Likely the way of the future (few/no innovations currently in rehab)
◦ Assist practitioners with info access and uptake
◦ Improve speed of uptake of research in policy making
◦ Facilitate transfer of public data to policy makers
◦ Support communities of practice–shared knowledge

Question 7

What is the knowledge-driven model of evidence based policy?

Answer 7

1. Research
2. Technological development
3. Use (adoption of technology)
4. Quality of implemented actions
5. Outcomes

Requires perfect knowledge and assumes knowledge will be adopted without impediment; unrealistic

Question 8

Describe the problem-driven model of evidence-based policy.

Answer 8

1. Definition of a problem
2. ID of missing knowledge
3. Acquisition of knowledge, various possible channels
4. Interpretation for the problem situation
5. Use (adoption of technology)

Acknowledges that evidence distribution is not always perfect and that policy makers tend to draw upon previously availible information

Question 9

Describe the research transfer model as a three-pronged mechanism.

Answer 9

• Input—Emphasis on preparing practitioners to gather and assimilate new information.
• Throughput—Interpreting knowledge to be useful for individuals, preparing to teach others the
  knowledge.
• Output—Reflection on research process and improvements; feedback loop.

Question 10

What are practice guidelines?

Answer 10

Consist of series of clinical recommendations that have been assembles from the best possible evidence

Question 11

Describe the difference in how researchers and decision makers see evidence in policy.

Answer 11

Researchers see evidence in policy as a fundamentally linear and rational process; decision makers see more variety and are less likely to act on a single piece of evidence.