IKT: what it is not

To begin, we outline our own position on what IKT is not. IKT is not what is sometimes called team science2 ,3 for which a multidisciplinary group of researchers, sometimes across a large geographical area, is brought together to partner for the purposes of sharing research resources, training or expertise. IKT differs from team science in that its core aim is to develop research questions that are informed by needs in practice or policy. IKT is also not a practice-based knowledge sharing or quality improvement network (eg, Stop HIV/AIDS4) where the primary aim is to disseminate research to practitioners rather than generate research and knowledge collaboratively.

There is less certainty about whether action research, community-based participatory research (CBPR), or their variants are, or should be, classified as IKT. The Canadian Institutes of Health Research, a funder which has had a major influence on the worldwide development of knowledge translation research and practice, suggests that CBPR is indeed a type of knowledge translation methodology.5 From our own readings and experiences, we would argue that IKT is somewhat different from CBPR in that the invited IKT knowledge users usually have the authority to invoke change in the practice or policy setting—this is not often, or explicitly, the case in CBPR. Another difference between IKT and CBPR is that the former is explicitly concerned with identifying practice/policy changes or interventions that are based on research findings.

Finally, implementation science (also called translation research) is an approach that overlaps with IKT in that it endeavours to incorporate, or ‘scale-up’, an existing programme or treatment with demonstrated efficacy into practice sites.6 ,7 In these types of projects, partnerships with knowledge users are often developed to understand local barriers and facilitators, and researchers are interested in exploring issues related to fidelity, adaptation and outcomes.

IKT: what it is

The concept of knowledge co-creation is taken up by a number of contemporary scholars. Gibbons et al8 discuss at length the need to revisit the social contract between science and society. They position traditional research processes (called mode 1 research) as unidisciplinary, researcher-driven, subject to peer review and based on a positivist epistemology. In contrast, they describe the new mode 2 knowledge-generation processes as multidisciplinary, inclusive of stakeholder participation and needs, and working from a problem-solving epistemology. From a management science perspective, Van de Ven and Johnson9 argue that the area of knowledge translation arises from the view that research is directly applicable to practice, and therefore a focus on improving transfer strategies ought to improve practice and policy. They suggest, however, that knowledge of theory is distinct from knowledge of practice. Van de Ven and Johnson's9 idea of engaged scholarship—where researchers and practitioners co-produce knowledge—is a reconciliation of these perspectives, and is a way for practice-relevant research to be generated. Both mode 2 research and engaged scholarship align with the IKT model of knowledge production presented above; a robust conceptual analysis of a range of collaborative research traditions is currently underway. The essential elements underlying these frameworks are that: researchers and practitioners/policymakers come together to work on a complex problem relevant to the real world; there is a recognition that both communities hold distinct norms and values but they also bring valuable knowledge to the problem; and the work of knowledge generation is done collaboratively.

Much work is required to support the study and application of these traditional IKT models. For example, empirical work can uncover the outcomes and impacts related to collaborative knowledge production.10 A 2016 scoping review of 13 IKT studies2 found that it was difficult to identify beneficial outcomes across studies given the limited reporting and/or evaluation of IKT activities. Nevertheless, seven studies identified positive outcomes related to researcher and knowledge user capacity development. Among the 13 articles, outcomes seemed to be independent of the initiator of the collaboration, dedicated funding, collaboration maturity, nature of knowledge user involvement, presence of particular, or more, enablers than barriers, or the number of different IKT activities. Surprisingly, common barriers and enablers did not emerge across the majority of these studies, although four of them noted the advantage of multiple and varied opportunities for interaction and five studies suggested that differing needs and priorities were a barrier. A 2014 scoping review of 19 IKT studies focused on rehabilitation research also found lack of evidence related to outcomes, but perceived outcomes included the formation of collaborations, support for the research and its implementation, and the empowerment of knowledge users.11 Both scoping reviews recommend that researchers report their IKT strategies in detail, including how knowledge users were engaged (eg, team meetings, working groups, web portals and training sessions), at which points during the research process users were involved (eg, question development, data interpretation, dissemination) and the intensity of that involvement or level of engagement. A body of research is needed to identify promising approaches to supporting IKT in different organisational settings. The development of outcomes to measure the effectiveness of IKT models is also required.

Finally, theoretical developments supporting IKT approaches are also in short supply.10 Kitson et al12 contribute to this gap in knowledge by developing a co-KT Framework based on a critical review of the literature and their own case study. The authors describe co-KT as “a framework for actioning the intent of researchers and communities to co-create, refine, implement and evaluate the impact of new knowledge that is sensitive to the context (values, norms, and tacit knowledge) where it is generated and used” (p. 3).12 This Framework encompasses five steps through which information is shared between the researcher context and the study context. The researcher context represents the site of research knowledge generation, methodological attention and the facilitation of exchange processes. The study context is the site where improvements are meant to happen, and where context-specific information is generated. Issues are framed; research and local knowledge are synthesised, adapted and tested; and interventions are evaluated and embedded through the five-step framework. Essentially, the authors acknowledge the need for universal and local knowledge to direct change efforts. Additional theorising like this preliminary Framework can result in a stronger foundation for the IKT field.

IKT: what it could be

Considerations and cautions

Thus far, we have described the traditional concept of IKT accompanied by examples of other collaborative work models that may in fact fall within IKT's scope. Recent reviews of IKT studies demonstrate that there is still much to learn about what makes IKT work and what factors impede IKT progress. There is also room for the development of innovative tools that support a process whereby ‘society can speak to science and science can speak to society’ through IKT involvement. We suggest that the next major frontier in IKT evaluation is determining appropriate outcomes and impacts. In particular, we need to assess the meaning, value, effectiveness and efficiency of IKT teams from multiple perspectives, including those of our knowledge users. This includes attention to how individual IKT team members transform their understanding of a problem and solutions to a common, collective world view—Does our prediction of this transformation hold, and does it matter? Work is needed to identify the important impacts resulting from IKT processes, with the acknowledgement that impacts might be diffuse and not readily measurable. As Greenhalgh and Fahy10 argue, such impacts are “less linear, more complex and multi-stakeholder, and thus harder to demonstrate” (p. 8). The authors note that using a complex systems theoretical lens, for example, might lead to definitions of impact encompassing interactions between organisations or sectors. They also recommend the explicit consideration of power differentials and conflicts of interests, and their influence on impact, in assessing co-production models of research like IKT.

In our previous paper, we noted some risks associated with IKT, such as traditional performance evaluations that do not recognise the efforts of those working with IKT approaches. Other risks include partnership imbalances with research priorities driven by the researcher or knowledge user rather than jointly determined, leading to ineffective health practices or policies, or indifference to research rigour. There are also a number of ethical and methodological issues that researchers might find useful to consider when entering into IKT approaches to research. First, the knowledge produced by research, especially individual studies, does not always fit unproblematically with knowledge user needs. In our experience, negative or null results can prove very disappointing to those expecting research to demonstrate support for a specific intervention or programme. This can cause ruptures in the immediate IKT collaborating team, and also in broader networks of stakeholders, where results that cause dissonance can be misrepresented, partially appropriated, ignored and even vilified.35–37 Evidence and knowledge are rarely fixed and objective, and their application even less so.38

Also, while we and others have outlined the many potential benefits of IKT approaches to addressing research–practice gaps and discontinuities, one potential limitation for researchers, and for science and society more broadly, is that the entire IKT approach is premised on the fact that knowledge users come to the research process with specific needs for evidence that will address their already-existing problems. In effect, this can serve as a barrier to true innovation in that major breakthroughs that require paradigm shifts are unlikely to be pursued. The more that funding agencies require partnered, IKT-modelled research projects, the less room there is for curiosity-driven, potentially ‘game-changing’, research. This might be especially true in industry-sponsored or industry-partnered initiatives (as in public–private partnerships), where success is defined primarily in immediate economic terms.