1. Research Implementation Lecture 1: Introduction and Overview Carl Thompson

2. Aims of the Module  Theoretical  Concepts (knowledge, information, change management)  Organisation of concepts/models (information seeking, organisational complexity)  Practical  Reflection on change & thinking differently about strategic approaches to change  Techniques and skills – SWOT, force field

3. What Do We Mean by Utilisation? Utilisation  Instrumental  Conceptual  Symbolic

4. Information Vs Knowledge Vs Data “Information usually seen as the precondition of debate, is better understood as its by-product. When we get into arguments that focus and engage our attention, we become avid seekers of relevant information. Otherwise we take in information passively – if we take it in at all.” Lasch 1995 p162.

5. Hierarchy… Data Information Knowledge Meaning

6. Shannon’s Mathematical Theory of Communication (‘Information Theory’) sourcetransmitterreceiverdestination noise messagesignal sentsignal received message Shannon & Weaver 1949

7. Knowledge  Knowledge as information that is sifted, organised and understood.  Information acquired by being told.  Knowledge acquired by thinking – internal and cannot be received it must be created (Hayes 1993).  Information implies transfer.  Knowledge is a state (knowing).  Knowledge = actionable understanding.

8. Policy Making Models  How policy is made  Rationality (and its bounded ‘real world’ alternative) Herbert Simon (1957)  Incrementalism  Charles Linblom (1959)

9. (Bounded) Rationality  Decide on the values to guide the policy  Decide on the goals to be achieved  Search for possible means to achieve goals  Evaluate each set of means and options  Select the ‘best’ option and implement it

10. Problems…  Relies on (value and political) consensus with little or no ideological conflict  Discounts ‘competing rationalities  Within (elite) group bargaining  It is prescriptive rather than descriptive  Discounts cognitive limitations of humans (error, info processing, heuristics)

11. Economic Vs. Administrative Man ‘While economic man maximises – selects the best alternative among all those available to him, his cousin, whom we shall call administrative man, satisfices – looks for a course of action that Is satisfactory or ‘good enough’ Simon 1957, p.198)

12. Incrementalism  Decision makers ‘muddle through’. Decision making:  Has previous policy as its start point  Proceeds through incremental change  Involves mutual adjustment and negotiation  Excludes options by accident rather than systematically or deliberately  Policies are not cast in stone  A ‘good’ decision is agreement rather than objective meeting  Involves trial and error

13. Evidence Based Decision Making  Active process.  Combining the clinical expertise, patient’s preferences, and research evidence within the context of available resources.  Research evidence weighted.  Forming a clinical question from recognised information needs.  Searching.  Appraising.  Incorporating evidence into planned action.  Evaluating impact.  Prescriptive, information deficit model…

14. Information Behaviour Models  Wilson  Krikelas  Johnson  Leckie

15. Context of Information need Activating mechanism Intervening variable Activating mechanism Information Seeking behaviour Person-in-context Stress/coping theory psychological Risk/reward theory Passive attention demographic Role-related or interpersonal environmental Source characteristics Passive search Active search Self-efficacy Ongoing search Social learning theory Information Processing And use Wilson’s Information Behaviour Model Wilson 1999

16. Krikelas’ Information Seeking Model Information gathering Information giving Need creating event/environment Needs (deferred) Needs (immediate) Source preference internalexternal Direct (structured) observations memory Personal files Direct (interpersonal) Contact Recorded literature Krikelas 1983

17. Johnson’s Information Seeking Model demographics beliefs salience Direct experience utilities characteristics Actions Background factors Personal relevance factors ANTECEDENTSINFORMATION CARRIER FACTORS INFORMATION SEEKING ACTIONS Johnson 1997

18. Leckie et al. Work roles Tasks Characteristics of information needs Sources of information Awareness of information outcomes Information issought feedback

19. Importance of Context for Knowledge Transfer  The environment or setting in which the proposed change is to be implemented (Kitson et al. 1998)  Prevailing culture  The quality of work relationships (evidenced by leadership roles)  Org approach to routine monitoring of systems and services (measurement)  Implementation = ExCxF

20. Myths Surrounding Info for EBP Number One: Only Objective Information Is Valuable  Normatively – possibly  Descriptively - untrue

21. Two:more Information Is Better  Problem is making sense of existing information rather than adding to it.  Increasing the flow of info as a route to knowledgeable doers is not the answer.

22. Three: Objective Information Can Be Transmitted Out of Context  Nurses reject ‘acontextual’ information sources in favour of context-rich advice  Lack the appraisal skills to inject context into information

23. Four: Information Can Only Be Acquired From Formal Sources  Information is ‘differences that makes a difference’ (Bateson 1979)  Differences that made a difference (with the exception of drug-reference material) are informally located

24. Five: Relevant Information Exists for Every Need  Nurses don’t recognise (or cannot verbalise) information needs.  Satisficing.  Nurses (like doctors) may acquire [over] confidence quickly (Urquhart 1999).

25. Six: Every Information Need Situation Has a Solution  Information seeking = transforming need into workable format  Unfitness for purpose = negative feedback

26. Seven: Information Can Always Be Made Accessible  Physical sense = yes  Intellectual/cognitive = no

27. Eight: Functional Units of Information Sources Fit the Needs of Individuals  EBN functional units = systems, synopses, syntheses and studies (Haynes 2001)  Nurses functional units = colleague advice, ideas and consultation

28. intuition ‘pure’ scientific experiment Peer aided judgement System aided judgement good Task Structure poor + Time, Visibility Of process - intuitionAnalysis (cf. Hammond, Hamm, Dowie 1963-2002) Nine: time and space ignored

29. Ten: Easy Conflict Free Connections Between External Information and Internal Reality  Defensiveness and conflict  We simply do not know!