1. Knowledge Science: Empirical Measures in Knowledge Utilization
This area of research has its skeptics: a friend of mine at a conference in Halifax last May scoffed at all this activity as “just communications”. And my response is, well, yes, you’re right…but in the same way that the Internet is more than just 1s and 0s, Knowledge Science is more than just communications. Well, there are difficulties with this area…first, its huge. There is a massive literature out there that is growing every year. There are conceptual difficulties….part of what I’m calling “Knowledge Science” is devoted to producing research that describes/uncovers the conditions for which knowledge is applied, instrumentally, whereas other research studies are devoted only to how the research can be better translated, as in the case where scientific knowledge is translated to fit the appropriate audience: policy knowledge requires knowing the political consequences.
For example, research to uncover the “Information literacy skills of Nursing Students” can be considered a type of “knowledge utilization” study whereas the communication of that research to the right people, in the right journals, conferences, websites, administration can be considered a type of “Knowledge Translation” or “Transfer”. This is but the tip of the grand Iceberg of confusion of Knowledge Science.
Ultimately though, If research is bringing order or making sense of life then Knowledge Science is bringing order to the huge quantity and growing complexity of research. So, within the context of “Knowledge Science” I want to talk to you about “Knowledge Utilization” providing a snapshot overview.
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Paul J Graham
Research Associate & Librarian
Department of Sociology
University of Saskatchewan
December 2008

2. Presentation Contents
Part I: What is Knowledge Science?
State of the Art
Theory, Methods, Models, Concepts
Part II: Knowledge Science Today
Nursing Research
Research Examples
Part III: Problem Based Learning
How do we study a real life Problem?

3. Part I: Knowledge Science: State of the Art

4. State of the Art: Terminological Tangle
Terminology Tangle
Knowledge Management, Transfer, Translation, Utilization, Research Transfer, Implementation Research…the list goes on
Two Approaches to Knowledge Studies
Broad Approach (comprehensive)
Searching any possibility, any combination
Narrow Approach (Focused)
Searching specific terminology, Knowledge Translation
There many terms to describe this area of research: I’m using the term “Knowledge Science” to encapsulate the range of activities, processes and ideas that overlap into a genealogy or family of research studies. Here its instructive to consider the work of Ludwig Wittgenstein, Cambridge Philosopher of Language, and one of my heroes (Fortune to sisters; WW I; designs Jet Engine; whistle the Brandenburg concertos)…interestingly he made a good point in the Philosophy of Language on defining words. Try to define the word “Game” to include games like solitaire and Hockey and polo. What we can do is organize games into Family resemblances? Polo and Hockey games with Sticks; solitaire and poker are card games. You can’t find a definition that covers them all, but you can cluster them into family resemblances.
And so to with the Terminological Tangle…we need not be disturbed by not having a comprehensive definition, but simply note to cluster them into family resemblances. “Knowledge Transfer” is similar to “Translation” as well as “Diffusion of Innovation” whereas “Application” and “Implementation” have similarity in function of seeing knowledge be utilized instrumentally.
This leads to two strategies for understanding the literature:
Broad or comprehensive approach where you’re interested in finding all the “Knowledge Science” resources on a topic…for instance, everything on Adult Asthma protocols whether they’re called “Utilization” or “Transfer” or whatever.
There is a specific or focused approach where you say, “I want this research to be manageable, specific on the translation of research to policy makers” and so I’ll shape my search towards “Diffusion” “Transfer” “Translation”. The reason being that, even though there is overlap you can still investigate a specific genealogy of a term…it just so happens that “Translation” is more associated with communication, technology transfer and now Health in the use of the word by the CIHR, SHRF and many others.
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5. State of the Art: Broad Approach (Comprehensive)
Over 1800 publications
USA (32%) and Canada (26%) are top producers
English articles makes up 94%
Top Author: Carole Estabrooks from Nursing
Example of searching for many terms: Transfer, translation, Implementation, etc.

6. State of the Art: Broad Approach (Comprehensive)1
Management -- R&D, Human resources, Technology networks, Multi-national corporations, cost of information, including information science.
372 2
Nursing – Building Social Capital, Barriers to research utilization, translation to practice, overlapping into evidence based medicine
218 3
Business – Time management, international business, customer knowledge transfer, vertical alliances, absorptive capacity
198 4
Public, Environmental Health – Health technology assessment, teen pregnancy, cancer management
108 5
Operations Research and Management Science – Technology performance, network size and organizational culture, product development process
101
Nursing is second on that broad search. Very impressive.

7. State of the Art: Narrow Approach (Focused)
Over 500 Articles
Canada (39%) and US (39%)
99% in English and 1% in German
Estabrooks is Top author
Example of searching Web of Science for Knowledge Translation and Research Utilization only we see a slightly different picture.

8. State of the Art: Narrow Approach (Focused)1
Nursing -- Building Social Capital, Barriers to research utilization, translation to practice, overlapping into evidence based medicine
188 2
Public, Environmental Health - Health technology assessment, teen pregnancy, cancer management 60 3
Health Care Sciences – Mentorship strategy, Research Based Theatre, health care policy making 47 4
Emergency Medicine – Knowledge Translation, adult asthma guidelines, Knowledge Translation systems 33 5
Education, Scientific Disciplines – Stroke rehabilitation programme, Guides to KT, improving performance & evaluation 23
This shows very clearly that terminology does count when you’re investigating these issues.
Even the other subjects are primarily health or medical subjects.

9. State of the Art: Components to Study
Subjects
Health, Business, Governance, Social Sciences
Roles (as intermediaries)
Knowledge Brokering, Funding agencies, Implementation Units, Librarians, Database Technicians
Approaches or Theory
Specific Approaches (Roger’s Diffusion of Innovation model)
General Approaches (Social Engineering, Mode 2, Triple Helix)
Models
Instrumental (Rational)
Educational/Enlightenment (Conceptual)
Symbolic (Aesthetic)
Interactive (Collaborative)

10. State of the Art: Components to Study
Environments to Analyze
Policy, Administration, Politics
Clinical Application & Technology
Theory/Research/Academic (educational)
Levels to Analyze
Individual (psychological)
Group (sociological)
Organizational (culture and structure)
Methods (General)
Bibliometrics; Factor Analysis; Structured Equation Modeling
General Surveys, qualitative and quantitative methods
Methods (Specific)
Devising Special models and ways to interpret Knowledge Science activities.
Environment here refers to the surrounding areas of the study.
Attitude to research; motivation; intention to share knowledge

11. State of the Art: General Models
Information Utilization Scale
Stage of Concern Scale
Levels of Use Scale
Research Utilization Index
Overall Policy Impact Scale
Diffusion of Innovations
AHRQ Knowledge Transfer Framework

12. State of the Art: Knowledge System for Clarification
Holzner & Marx (1979) Knowledge Application: The Knowledge System in Society
The Knowledge System represents the different, but sometimes overlapping, processes in society:
Production
Management (Organization, Storage & Retrieval)
Transfer (or Translation)
Application
Implementation
Evaluation
Mobilization (inter-systematic)
HAND OUT no. 1

13. Part II: Knowledge Science Today: Nursing Research

14. Nursing Research: Setting the Foundation
Literacy is the Key
The basis of Knowledge Science is the basis of academic activity: critical reading skills, database skills, systematic thinking and synthesis of concepts.
Nursing Research: Setting the Foundation
Undergraduate Research Programmes
Research Mentorship
Evidence Based Literacy
Number needed to treat; risk assessment; interpreting context of research problem
Information Literacy
You can’t analyze what you can’t find!
Consult with librarians; enroll in skills development
Communication Skills & Diplomacy
Don’t take your skill set for granted
You might consider a Critical Thinking course
Vessey & DeMArco, 2008 published a paper on the importance of undergradute programmes
Welk (2007) stresses the need for nurses to be able to
Paul Graham (at all times) stresses this…
I take my skills for granted.

15. Nursing Research: Bibliometrics
Empirical Analysis
This is a library science assessment that requires understanding databases; Information Science Skills (Boolean Searching); Content Analysis; Citation Analysis; co-authoring with Librarians.
Nursing Research: Bibliometrics
Estabrooks et al. (2004) “Mapping the Field”
Purpose
Map the characteristics of “research utilization” in the nursing research field.
Methodology
Searching bibliographic databases resulting in 630 articles on research utilization between 1972 and 2001
Used available bibliographic software (freeware from Internet) to organize results
Results & Conclusions
Models important to Nursing (Iowa Model of Research in Practice, Multidimensional framework, Ottawa Model of Research Use)
Top Journals (Journal of Advanced Nursing, Nursing Standard)
Important Authors (Cheryl Stetler, Jo-Anne Horsley, Carole Estabrooks)
DESCRIPTIVE ANALYSIS
We’ll start with reviewing Estabrooks’ Bibliometric work: Bibliometrics is a method for measuring information usage or tracking the effect of authorship. It is a commonly quoted fact at almost all talks that Noam Chomsky gives that he is the most cited academic in the world: The citation of his work puts him in good company: Marx, Lenin, Shakespeare, Aristotle, the Bible, Plato, Freud, Hegel, and Cicero.
Estabrooks uses bibliometrics to map the literature, discover who is writing on the topic, how many publications do they have, and what journals are publishing their work. Estabrooks et al have a new general bibliiometric study out titled: “The intellectual structure and substance of the knowledge utilization field”
What’s the Relevance?
To engage in a bibliometric study is one of the best ways to put your information skills and critical thinking to the test. It is also one of the cheapest ways to start publishing. It is the extension of the skills you have right now and using databases in innovative ways. All of you should be thinking, “How can I turn the subject I’m studying into a bibliometric study?” regardless if its on Knowledge utilization or not.
If you were doing research on “Knowledge Utilization” or really, any major project, looking to Bibliometric methods is a good way to at least understand the development of a field.
And, just to note: There is another new article titled “bibliometrics, citation indexing and the journals of Nursing” in “Nursing and Health Sciences”
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16. Nursing Research: Systematic Reviews
Empirical Analysis
Although using Bibliometrics and Information literacy as the basis, it extends on this basis by needing the nursing knowledge identify specific content for systematic review.
Nursing Research: Systematic Reviews
Estabrooks et al. (2003) Individual Determinants of research utilization
Purpose
Review studies that examine individual characteristics & determinants
Method
Advanced searching of relevant databases
Using an inclusion criteria for systematically reviewing specific content
Employed a validity Score
Results & Conclusions
Research was organized into: beliefs and Attitudes, involvement in research activities, information seeking, professional characteristics, education, socio-economic status.
Support for a positive association between individual beliefs and attitudes and increased research utilization.
Development of a strong interdisciplinary body of work, relevant to nursing is important
DESCRIPTIVE ANALYSIS
This next study by Estabrooks not only uses bibliometric methods but extends on that skills set to engage in a content review or systematic review. There is still a rigorous search strategy employed looking for resources; however, there are sets of inclusion or exclusion criteria for ignoring some articles. Citations and tracking knowledge is less important that systematically culling out valuable information.
For each article, the methodology was to identify if the study includes one or more “Individual determinants of research utilization”; does it measure utilization; specify type of measurement (what instrument was used). They devised a dichotomous score (Met or Not Met) out of 14 possible points; they were interested in studying. Their point system gave weight to objective validity measures over Self-Report. So, self-report gets a lower score.
0-6 were considered weak
7-9 were moderate
10 or more strong
All 20 articles that were included shared a weakness: measurement of nurses’ use of research was always by self-report only…I mention this because it poses an interesting contradiction in this study…the authors have chosen to give lower scores to Self-reported measures, but then in the articles themselves state: “the self-reported use of research was measured with acceptable levels of reliability”.
What’s the Relevance?
Well, we know that Chomsky is the most cited living intellectual…but we don’t know why he’s cited. Doing the review gets us at the content of the articles in question…we know that Chomsky’s work is divided into two major areas: his work as a Linguistics Philosopher revolutionizing the field of language philosophy but we also know he’s a social critic…so why is he being cited.
Doing this type of work in Knowledge Utilization means identifying ways that Research Utilization tools are being used via the content.
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17. Nursing Research: Nursing Models
Important Contribution
Recommend the creation of a database/website to track, organize and discuss Nursing models in Knowledge Science.
Nursing Research: Nursing Models
Conduct and Utilization of Research in Nursing
Iowa Model of Research in Practice
Collaborative research utilization model
Stetler/Marram Model for application of research findings in practice
Framework for dissemination and utilization of research for healthcare policy and practice
Multidimensional Framework
BARRIERS to Research Utilization Scale
Research Factor Questionnaire
DESCRIPTIVE ANALYSIS
Here are a few samples of specifically designed research where you might want to apply a survey to a group of clinicians.

18. Nursing Research: Utilizing a Nursing Model
Does the Instrument Fit?
The question to ask yourself when you read what instrument is being used is “Does this fit”? Will the model actually measure what the authors want it to measure?
Nursing Research: Utilizing a Nursing Model
McCloskey (2008) Nurses’ Perceptions of Research Utilization in a Corporate Health Care System
Purpose
Investigate selected characteristics of nurses based on educational level, years of experience, hospital position that might affect Research Utilization
Methods
Nurses in five hospitals were surveyed using Research Utilization Questionnaire
ANOVA was used to analyze data
Results & Conclusion
Significant differences (p <.001) were found in perceived use of research, attitude toward research, availability of research resources, or perceived support for research activities based on education and organizational position.
Fit of instrument: What is really great in this article is that they actually have an assessment of the instrument allowing you to follow up on the information. If there is no information on the fit of the instrument then, if you are unaware of that tool, that’s a sign you’d better look it up, find out if that tool has been valididated…which leads me to.

19. Nursing Research: Validating a Nursing Model
Reflect on Knowledge Process
Communities of Practice are important to this model; it is a concept that is overlapping with a large “Knowledge Management” literature, another important part of Knowledge Science.
Nursing Research: Validating a Nursing Model
Tolson et al. (2008) “Achieving evidence-based nursing practice”
Purpose
Determine the impact of the Caledonian Development Model (version 2), designed to promote evidence based practice
Participants engage in Communities of Practice, focus on a specific goal, and learn how to use and participate in a “virtual college”
Method
24 nurses and 18 practice sites formed 3 Communities of Practice.
Pre- and post intervention Revised Nursing Work Index; focus groups
SPSS and Nvivo used for analysis
Results
The model performed well as an agent of knowledge translation supporting the implementation of values-based evidence-based care guidance within the context of nursing older people.
Purpose
The Caledonian Model is the product of a longitudinal action research study (2006) which sought to develop, in partnership with practicing nurses, a sustainable approach to attaining evidence based nursing care of older people. The main component that binds the study together is using the Community of Practice model, developed and originating in the Knowledge Management literature (Wenger).
There is an emphasis here on Face to Face meetings alluding to Tacit Knowledge exchange.
Use of Cops, Best practice statements, and a Virtual college
In this case, each Community of Practice selects a Best Practice statement as a focus for developmental activities (Preventing Depression, Nutrition and physical activity) and learned over 6 months how to use the “virtual college”.
Method of Evaluation
The purpose is to test the impact or evaluate the model…so in the method that’s why another tool or instrument is used to measure effectiveness.
They’re engaged in the process for the Caledonia Model…and then asking, Okay, fill out this survey to give us feedback on importance.
Data Audits
Facilities Audits:
Patient Audits:

20. Nursing Research: Evaluation or Testing
Empirical Analysis
We are still interested in the individual determinants, but we are building on our previous examples: you need to know more quantitative analysis, structural equal modeling & LISREL
Nursing Research: Evaluation or Testing
Estabrooks (1999) Modeling the Individual Determinants of Research Utilization
Purpose
This study’s objectives were to develop and test a series of structural equation models that included individual factors believed to influence research utilization
Method
Using Instrumental, Conceptual & Persuasive research utilization
Using a 1996 Nurses Survey
Model fit was assessed by examining chi-square, the adjusted goodness of fit index
Scaling and reliability in LISREL
Results
Some individual factors: Activism, Affiliation, attitude, Autonomy, Awareness of policy, Belief suspension, Cosmopoliteness, Dogmatism, Educational level, Problem solving ability, Theoretical orientation, Time spent reading professional journals, Trust
DESCRIPTIVE ANALYSIS
This study is an example that puts some of our conceptual models to the test: These are not the constructed research quesionnaires but our previous conceptual definitions for types of Knowledge Utilization: Instrumental, Conceptual, Symbolic; there is also measuring of individual factors.
What’s the Relevance?
We’re introduced now to the concept of using Structural Equation modeling for testing, not developing, Utilization research. SEM is used for testing and LISREL is a software package for doing SEM. The person who uses this in our department is Dr. Liz Quinlan; she is sharp with her analysis.
“We must conceptualize and operationalize research utilization in ways that reflect the idea that nurses’ personal assessments of instrumental, conceptual, and persuasive research utilization contribute to their assessment of overall research utilization.”
Cosmopolitness: Degree to which a nurse is oriented outside the immediate work sphere.

21. Nursing Research Clinical Realm
Reflect on Types of Models
The author calls the work a “description” of research activities, similar to the Educational or Conceptual Model of Knowledge Utilization
Nursing Research Clinical Realm
Oh, E.G. (2008) Research activities and perceptions of barriers to research utilization among critical care nurses in Korea
Purpose
Analyze data from Nurses and Nurse Managers working in critical care units to describe research activities and to identify barriers
Method
Data from 63 critical care nurses describing research activity such as reading journals / week, additional nursing courses, etc.
Barriers to Research Utilization Scale (Funk, 1991) used.
Results
Critical care nurses share a strong sense of value for the contribution that research makes to improving their practice, bus also perceived barriers in the lack of administrative support
The nurse does not see the value of research for practice.
The nurse feels the benefits of changing practice will be minimal.
Administration will not allow implementation.
• Physicians will not cooperate with implementation.
Results
Reading frequency and research participation rates were lower compared to previous studies: results of low research activities indicate that evidence-based nursing is a relatively new and emerging concept in Korea.

22. Nursing Research: Nursing Culture
Mixed Methods
We can note the role of qualitative data as the preliminary stage in forming Knowledge Utilization theory or method.
Nursing Research: Nursing Culture
Watson et al. (2005) Exploratory Factor Analysis of the research and development culture index among qualified Nurses
Purpose
Factor analysis of a rating instrument for assessing the strength of organizational Research and Development (R&D) Culture
Methods
Qualitative research is the basis for creating the formal index
R&D Culture Index used as means of appraising R&D culture
Results
Both Individual and Organizational Factors are important and distinctive.
Three components must be developed: Skill base of practitioners, infrastructure of organizations, and reflective development nature of the immediate work environment
Focused on practice development and research capacity and culture
Creating a climate to fulfill potential
Creating an environment that fosters and approves of research oriented activities.

23. Nursing Research: Organizational Measures
Organizational Readiness
The Canadian Health Services Research Foundation developed a “readiness” assessment guide for analyzing the organization’s preparedness
Nursing Research: Organizational Measures
Fink, Thompson, Bonnes (2005) Overcoming Barriers and Promoting the Use of Research in Practice
Purpose
Identify Nurses changes in attitudes toward research utilization and the organization’s environment pre-implementation and post-implementation.
Method
Descriptive, cross-sectional, pre-survey, post-survey design to identify inpatient nurses’ personal and professional characteristics, perceptions of organizational culture and the effectiveness of organizational strategies.
Results & Conclusion
Research activities most participated: Shared research findings with peers (70%), attended conference (67%) Evidence based council meetings (55%); participant in data collection (n = 123), attending Journal club (n = 105)
Barriers to Research included: Nurse had no authority to change practice, aware of research, administration not allowing implementation, nurse is isolated from colleagues, access to research, no time on the job to read research.
AIMS identify nurses’ attitudes and perceptions about organizational culture and research utilization, identify perceived barriers and facilitators to nurses’s use of research in practice and 3) determine which factors are correlated with research utilization.
Instruments: BARRIERS to Research Utilization Scale and Research Factor Questionnaire.
In the particular study, they claim to have supported/validated the Rogers Diffusion of Innovations theory constructs. So we see Research Utilization studies fulfilling a confirmatory role in justifying theory.

24. Nursing Research: Qualitative Analysis
Using Qualitative Software
Nvivo 7/8 is now available at the university; you can seek out training from the Qualitative Research Centre. The author provides Nvivo sessions.
Nursing Research: Qualitative Analysis
Thompson et al (2008) The relationship between busyness and research utilization
Purpose
Explore the concept of busyness in nursing and to understand the relationship between busyness and nurses’ research utilization better
Method
Conducted a secondary analysis of data collected in a large ethnographic multiple case study examining the use of research by Canadian nurses in the context of adult and pediatric pain management
Results & Conclusions
Lack of time or busyness refers to the mental time and energy required to use research and the culture of busyness in nursing rather than physical time required to perform routine tasks.

25. Nursing Research: Research Environment
The Reality of Implementation
The need for education and attitudinal changes are real; you will need to know how to communicate new ideas, changes and be able to argue for their implementation.
Nursing Research: Research Environment
Ax, Susanne (2001). Nursing Students’ Perceptions of Research: Usefulness, Implementation and Training
Purpose
Investigate Nursing Research perceptions of usefulness, implementation, interest and personal involvement
Investigate Nursing Training in structure and design of classes, reading materials, personal study and stress
Methodology
One to one Interviews of 13 Nursing Students
Findings
Improving Practice by testing assumptions of current practice
Many students voiced difficulties voicing suggestions for change
Feeling of a lack of understanding, a disconnect to application
The findings were interesting:
--Nursing Students felt they had a role in testing and improving research application by being involved in studies.
“I think its very important that nurses can do their own research when required. . . I think it gives them a better understanding, say for drug trials and that. They can use their own input, can’t they? They can put their own ideas forward if they’re interested in a certain subject, or a specialty that they work in , they can put their input into it…to help better deliver the care or something like that.”
There was reported difficulty in suggestions for change
“I found that research was relevant to practice, although you don’t like saying that when your’re out on the wards. If you say ‘Oh, there’s some research which says this’, you can hear a wave of sighs and they say “Oh no, there’s a student on the ward’. “Don’t bother with that, get your gloves on and your hands in there.”
Lack of Understanding was voiced as a feeling of disconnect between course work and “real work” nursing.
The general sentiment here was that although research was important, there was difficult seeing how it will occur in their nursing placement: “I don’t really understand how we will use it when we are nursing”.
And there were other components to this study as well:
Students indicated that the course work had helped them learn how to read research papers.
Students felt that skills they learned would help them in everyday life.
Many had thought about being involved in research projects after a few years of working life.

26. Part III: Problem Based Learning Plan your own Knowledge Science Project
Let’s Apply what we’ve learned…

27. Possible Scenario: Descriptive Assessment
Knowledge Management
Identify Knowledge Brokers (800 million rural poor)
Professionals
Local Authorities
Trusted persons
Cultural Component/Indexes
Mapping the flow of knowledge
Diffusion of Innovation
Conceptual/Educational Model
Learning about the System
Level of Analysis
Policy AND Practice level (Government)