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Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned in… Cornelissen, Evelyn; Urquhart, Robin; Chan, Vivian W; DeForge, Ryan T; Colquhoun, Heather L; Sibbald, Shannon; Witteman, Holly Aug 25, 2011

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MEETING REPORT Open AccessCreating a knowledge translation traineecollaborative: from conceptualization to lessonslearned in the first yearEvelyn Cornelissen1*, Robin Urquhart2, Vivian WY Chan3, Ryan T DeForge4, Heather L Colquhoun5,Shannon Sibbald6 and Holly Witteman7AbstractTrainees (e.g., graduate students, residents, fellows) are increasingly identifying knowledge translation as theirresearch discipline. In Canada, a group of trainees have created a trainee-initiated and trainee-led nationalcollaborative to provide a vehicle for trainees to examine the diversity of knowledge translation research andpractice, and to link trainees from diverse geographical areas and disciplines. The aim of this paper is to describeour experience and lessons learned in creating the Knowledge Translation Trainee Collaborative. In this meetingreport, we outline the process, challenges, and opportunities in planning and experiencing the collaborative’sinaugural meeting as participant organizers, and present outcomes and learnings to date.BackgroundAs the field of knowledge translation (KT) grows, trai-nees (e.g., graduate students, residents, fellows) are iden-tifying KT as their research discipline. The mostefficient way to advance the science of KT while devel-oping new scholars will be to encourage new researchcollaborations and partnerships [1] and expose newresearchers to multiple modes of inquiry and perspec-tives [2].In 2008, KT Canada, along with its funding partners,established KT Summer Institutes (SI) to create oppor-tunities for students involved in KT to learn from andconnect with established KT researchers and othertrainees [3]. These three- to four-day workshops haveresulted in several subsequent collaborative efforts,including published papers [4,5] and successful grantapplications [6,7]. Following the 2008 SI, several trai-nees identified a need for ongoing training and peernetworking opportunities, and accordingly set out tocreate a collaborative that might serve to complementor supplement groups led and populated by experts inthe field.After an initial (unsuccessful) attempt to align a trai-nee networking meeting with a national health servicesresearch conference, two trainees [EC and VC] wereawarded a grant [6], along with funding and in-kindsupport from other organizations, to hold an inauguralmeeting to build such a collaborative. Thirteen addi-tional SI participants [including RU, RD, HC, and HW]volunteered to plan the event. Following a formal appli-cation and review process supported by national KTexperts, we held a two-day meeting in Winnipeg, Mani-toba, 6 and 7 March 2010.The aim of this paper is to describe our experienceand lessons learned in creating the KT Trainee Colla-borative (KTTC). We outline the process, challenges,and opportunities in planning and experiencing theKTTC inaugural meeting as participant organizers, andpresent outcomes and learnings to date.KTTC inaugural meetingThe inaugural meeting followed six months of planningvia teleconference and email. The planning committeeestablished three meeting objectives: forming our net-work; identifying areas for collaboration; and, with KTexperts, reviewing potential gaps and training areas inKT research. We developed an agenda toward thesegoals and distributed a call for applicants.* Correspondence: ecorneli@interchange.ubc.ca1University of British Columbia - Okanagan, Faculty of Health and SocialDevelopment, 3333 University Way, Kelowna, B.C. V1V 1V7 CanadaFull list of author information is available at the end of the articleCornelissen et al. Implementation Science 2011, 6:98http://www.implementationscience.com/content/6/1/98ImplementationScience© 2011 Cornelissen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.Sixty-six applications were received from 14 Canadianuniversities. The applications were peer-reviewed by agroup of planning committee members and KT experts.Review criteria included training, research interests,expectations, and anticipated contribution to the meet-ing. The aim of the review process was to assemble agroup of trainees that could both contribute to and gainfrom capacity building in the field of KT. Thirty traineesattended the meeting: 11 from the planning committeeand 19 accepted through the application process.Table 1 describes attendee characteristics.The meeting involved four activities, interspersed bynetworking opportunities: setting the stage for futureinteraction/collaborations; goal-setting; KT expert-leddiscussion on potential gaps/training areas in KTresearch; and post-meeting planning. Dr. Ian Graham,Canadian Institutes of Health Research (CIHR) VicePresident of KT, participated as the overall meetingfacilitator.Setting the stageTo begin the meeting, each attendee introduced her/himself in a two-minute prepared talk describing her/hisresearch, career stage, KT interests, and somethingabout her/himself. These introductions oriented us toeach other’s work, provided opportunity to practice afundamental skill in scholarship (concisely describingone’s work to an interdisciplinary audience), andensured that all attendees participated early on.Two planning committee members [RD, HC] thenfacilitated a ‘creating space’ exercise to establish princi-ples for interaction and a sense of ‘safety.’ We acknowl-edged that over time our ‘space’ would likely takedifferent forms because it was expected that, going for-ward, the KTTC would meet both in-person and vir-tually. However, the focus of this exercise was to co-construct shared principles for relating to and with oneanother in the context of this meeting. We alsoacknowledged that all shared spaces are inherently char-acterized by competing interests, agendas, needs, andexperiences. Our aim was to encourage these interestsand to conceive of new ways of working togetherwherein we each feel included and valued. The facilita-tors invited small groups to consider questions aboutcreating an inclusive and engaging workspace, then col-lated responses to form a foundation of shared under-standings upon which we continued our meeting.Goal settingTo make sense of our group’s goals and expectations,first, each attendee identified his/her individual goals.Then, we iteratively and thematically categorized indivi-dual goals into four collective goals: networking, colla-borative learning, collaborative work, and professionaldevelopment. Although it was evident that attendeesheld diverse research interests in a broad range of healthareas, the four collective goals reflected our commonperspectives and desires.Expert-led discussionsKT experts presented their perspectives and experiencesin three different areas identified as representing fruitfulareas for further research and training: behavioural the-ory in policy/decision support (Dr. Jamie Brehaut [8]),unintended consequences of KT (Dr. Maria Mathews[9]), and critical/qualitative inquiry in KT (Dr. AnnetteJ. Browne [10]). The experts then facilitated small groupdiscussions based on their presentation topics.Post-meeting planningWe ended the meeting by developing a post-meetingplan. We brainstormed activities to help us meet ourcollective goals, and elected a Steering Committee tooversee activities and establish a governance structure.Table 1 Attendee characteristicsPlanning Committee (n = 11)Count (percent) Number of institutions represented[institution names]Successful Applicants (n = 19)Count (percent) Number of institutions represented [institution names]Gender 1 male (9%)10 female (91%)5 male (26%)14 female (74%)*Province 1 Nova Scotia (9%) [Dalhousie University]1 Prince Edward Island (9%) [University of Prince EdwardIsland]4 Ontario (36%) 2 universities, 1 hospital [University ofWestern Ontario; McMaster University; St. Michael’s Hospital]1 Manitoba (9%) [University of Manitoba]1 Alberta (9%) [University of Calgary]2 British Columbia (18%) 1 university [University of BritishColumbia]1 University of Michigan (9%)1 Nova Scotia (5%) [Dalhousie University]2 Quebec (11%) 2 universities [McGill University; Universite de Laval]12 Ontario (63%) 6 universities [University of Waterloo; University of WesternOntario; McMaster University; University of Ottawa; York University;University of Toronto]1 Manitoba (5%) [University of Manitoba]2 Alberta (11%) 1 university [University of Alberta]1 British Columbia (5%) [University of British Columbia]Training 1 Post Doctoral/Fellows (9%)9 Doctoral (82%)1 Research Staff (9%)5 Post Doctoral/Fellows (26%)13 Doctoral (68%)1 Master’s (5%)*The high percentage of female participants is representative of the proportion of applicants who were female.Cornelissen et al. Implementation Science 2011, 6:98http://www.implementationscience.com/content/6/1/98Page 2 of 5We also reached agreement on preferred technologicalmechanisms to support ongoing collaboration with lim-ited resources.Meeting evaluationUsing a ‘two stars and a wish’ exercise to garner feed-back, wherein attendees were asked to list two thingsabout the meeting they enjoyed and one thing theywould like to see changed or improved, attendees indi-cated they felt: encouraged to be engaged in the process(’an interactive, open, and respectful atmosphere’);accomplished (’amazing how much we accomplished in1.5 days’); and well-facilitated (’gradual process’; ‘induc-tive approach’). Members wished for: a clearer vision(’more concrete sense of how to collaborate immedi-ately’) and more opportunities to network (’formal andinformal time’).KTTC outcomesFrom this meeting, the KTTC emerged as a uniquelytrainee-initiated and trainee-led national collaborativeto provide a vehicle for trainees to examine the diver-sity of KT research and practice, and to link traineesfrom diverse geographical areas and disciplines. Weidentify as a type of community of practice (CoP) [11]for KT trainees in Canada, with the underlying beliefthat junior researchers and practitioners can acquirevaluable KT knowledge and skills, and engage in bene-ficial collaborative learning and working processes,through social relationships with their peers. A recentsystematic review [12] identified four characteristics ofCoP groups that we perceive are shared by the KTTC:members interact with one another in formal andinformal settings; members share knowledge with oneanother; members collaborate with one another to cre-ate new knowledge; and groups promote the develop-ment of a shared, professional identity amongstmembers.To date, we have created a formal collaborative, andopened to new membership in February 2011. We haveidentity, mission, and vision statements (Table 2), a gov-ernance structure to guide our continued growth, andworking groups to develop and implement specific activ-ities toward our collective goals [13].We have assembled a database of current and poten-tial collaborators, held a second meeting in May 2010 tocoincide with a national conference [14] and a thirdmeeting in April 2011 funded by another peer-reviewedgrant [7], and launched a group blog hosted on anational KT website [15]. Traditional academic outputsinclude poster presentations at two academic confer-ences [16,17] and a successful funding application for afollow-up meeting [7]. That trainees from this collabora-tive have received two peer-reviewed grants from anational health research funding agency without a tradi-tional independent investigator is a significant achieve-ment that speaks to the commitment and initiative ofmembers.Moving forwardAs the meeting concluded, a number of challenges andopportunities were identified (Table 3). In order torespond to these challenges and opportunities, and par-ticularly in order to maintain our momentum, attendeesdecided to devote the subsequent six to twelve monthsto creating a vision, governance structure, and technolo-gical infrastructure before opening the KTTC to newmembership. As we plan the KTTC’s future, we arechallenged by our status as trainees and concerns aboutsustainability. Our commitment to the collaborativerequires creative thinking, and belief that time investednow–in our group, career development, and collabora-tive learning/work–will yield future benefit. Such chal-lenges are common in the early stages of many socialinnovations that eventually succeed [18], and challengesoften coexist with opportunities.Key LearningsThree key learnings that may be applicable to othergroups emerged from the meeting.First, we found the term ‘trainee’ was more conten-tious than we had foreseen. Some members felt theterm would soon cease to apply as members began theirTable 2 Identity, mission, and vision statementsWho WeAreThe Knowledge Translation Trainee Collaborative (KTTC) is a community of practice in knowledge translation (KT). Members of theKTTC are junior researchers and practitioners who are interested in continuing to learn about and advance the field of KT, and whowant to collaborate and build networks with other KT trainees. We define trainees as students, graduate students, postdoctoral fellows,faculty, community learners, scientists/researchers from a wide spectrum of academia, healthcare professionals, healthcareadministrators, and/or others who are new to KT and are interested in actively exploring and developing KT research and practice.Vision We envision a sustainable network that provides accessible, ongoing opportunities for collaboration and learning; represents diversityof thought in KT theory, methods and tools; and grows and advances the field of KT.Mission We are creating our vision by sharing opportunities for:1. collaborative learning2. collaborative work3. building networks4. career developmentCornelissen et al. Implementation Science 2011, 6:98http://www.implementationscience.com/content/6/1/98Page 3 of 5careers. Others, however, saw the word as one that con-notes life-long learning and as applicable to KT learners(within or outside academe) at all career stages. Even-tually, the group adopted the latter interpretation andclarified it in our Mission and Vision statements.Second, as with any large group aiming for inclusivityof all members, we encountered tension between thedesire for a ‘flat’ structure–with its potential for time-consuming and stagnating discussions–and the inevita-ble hierarchy of a formal collaborative. Further, at themeeting, open-ended questions to attendees such as,‘How would you like to do this?’ were sometimes moreoff-putting than welcomed. Ultimately, the planningcommittee reconciled these issues by being transparentabout the ‘tyranny of structurelessness’ [19] and byinviting all attendees to collectively endorse some execu-tive decision-making and organizational structure,grounded in our principles from the creating spaceactivity. Such an endorsement later empowered theSteering Committee to make decisions required to buildthe collaborative.Third, in the same way that facilitation is important inKT initiatives [20,21], we found it equally crucial in thedevelopment of our collaborative. While the continuathat Harvey et al. [21] present to conceptualize facilita-tion might be interpreted as an either/or dichotomy (i.e.,either task-oriented, doing for others, or holistic/enabling others), our experience was one of and/both.As facilitators, we needed to provide some structure tothe meeting, but also needed to ensure that each activityunfolded in a way that left all attendees feeling theircontributions were authentically valued. In other words,and as Harvey et al. [21] postulate, effective facilitatorsneed to be flexible and possess a range of task-focusedand enabling skills that can be employed according tocontextual needs. We relied on tenets of empoweringdialogue [22] by focusing on attendees’ concerns, using(inter)active learning strategies, and engaging attendeesin processes to identify their needs and priorities. Theintegration of task and holistic facilitation, withempowering dialogue, helped us realize our meetingobjectives. Beyond enabling group formation, it is oursense that strategies such as these also serve to identifyand respect unique disciplinary perspectives of groupmembers, which is essential in fostering a KT climatethat espouses growth from multi- to inter-disciplinarity[23]. In this way, we feel the KTTC also serves to startaddressing the challenges of cross-disciplinarycollaboration.ConclusionAdvances in KT will necessitate multiple perspectives,research approaches [2], and open cross-pollinationamongst disciplines [24]. By bringing together a diversegroup of trainees, the trainee-led KTTC offers thepotential to complement or supplement the formaltraining activities of expert- or mentor-led groups, suchas KT Canada, by allowing for more peer interactionand peer leadership opportunities. Through such experi-ences, we expect members of the collaborative to betterachieve the benefits of inter- and trans-disciplinarity[23]; that is, we expect the field and our own individualresearch products to be improved through exposure todiverse and challenging ideas in a community of KTscholar and practitioner peers. Expanded membershipand continued commitment from KT trainees will, wehope, produce further collaborative learning and workexperiences that can continue to contribute to the fieldof KT and benefit other trainees in the field.To learn more about membership in the KTTC, go tohttp://www.ktclearinghouse.ca/kttc/.AcknowledgementsWe are grateful for the funding received from the Canadian Institutes ofHealth Research (CIHR MPD grant), KT Canada and the Western RegionalTraining Centre for Health Services Research (WRTC) to host our inauguralmeeting. We thank WRTC (and Dr. Sam Sheps) and the CIHR Institute forHealth Services and Policy Research (IHSPR) (and Ms. Meg McMahon) for in-kind support of our meeting, KT Canada and the Knowledge TranslationProgram at Li Ka Shing Knowledge Institute of St. Michael’s, University ofToronto for hosting our blog, and Dr. Sharon Straus for her mentorship. Wethank Ms. Isabella Losinger, WRTC manager, for her administrative supportTable 3 Challenges and opportunities identified during and after the inaugural meetingChallenges Opportunities▪ Ensuring the KTTC achieves diversity (e.g., in research methodologies, disciplines,geography, and academic vs. practice environments)▪ Maintaining momentum▪ Ensuring active and effective external and internal communication▪ Providing value for all members (e.g., senior and junior)▪ Meeting the expectations of all active members▪ Workload for members involved in administration▪ Growing academic and administrative interest in KT▪ Increasing number of KT trainees across Canada*▪ Committed membership comprised of trainees fromdiverse backgrounds and experiences▪ Members who value innovative thinking on andapproaches to KT▪ A ‘safer’ space for trainee dialogue and discourse▪ Ability to complement and network with existing KTresearch groups and agencies*The increasing number of KT trainees is reflected by the growing number of trainee awards and opportunities in Canada: e.g., the Canadian Institutes of HealthResearch (CIHR) now provides doctoral research awards and new investigator awards focused on KT science and KT Canada holds a Strategic Training Initiative inHealth Research grant from CIHR to create an internationally-recognized national training initiative to train graduate and post-doctoral students in KT and KTscience.Cornelissen et al. Implementation Science 2011, 6:98http://www.implementationscience.com/content/6/1/98Page 4 of 5with managing the meeting logistics and budget. We thank Dr. Ian Graham,Dr. Jamie Brehaut, Dr. Maria Mathews, and Dr. Annette J. Browne forparticipating in our meeting. Evelyn Cornelissen and Vivian Chan werefunded by the WRTC. Robin Urquhart is funded by the CIHR/CCNS Team inAccess to Colorectal Cancer Services in Nova Scotia and the Nova ScotiaHealth Research Foundation. Ryan DeForge is funded through a CIHRFrederick Banting - Charles Best Canada Graduate Scholarship - DoctoralResearch Award. Heather Colquhoun is funded through a CIHR StrategicTraining Fellowship in Rehabilitation Research, a CIHR Doctoral Scholarship,and the Canadian Occupational Therapy Foundation. Shannon Sibbald is aCanadian Health Services Research Foundation post-doctoral fellow based atthe University of Western Ontario. Holly Witteman holds a post-doctoralfellowship at the University of Michigan funded by grants from the U. S.National Institutes of Health (R01 CA087595 and P50 CA101451).Author details1University of British Columbia - Okanagan, Faculty of Health and SocialDevelopment, 3333 University Way, Kelowna, B.C. V1V 1V7 Canada.2Dalhousie University, Interdisciplinary PhD Program, 1276 South Park Street;Room 804, Victoria Building; Halifax, N.S. B3H 2Y9 Canada. 3University ofBritish Columbia, Interdisciplinary Studies Graduate Program, Green College.Green Commons, Room 153A, 6201 Cecil Green Park Rd; Vancouver, B.C. V6T1Z1 Canada. 4The University of Western Ontario, Faculty of Health Sciences,1151 Richmond St; London, O.N., N6A 5B9 Canada. 5McMaster University,School of Rehabilitation Sciences, IAHS Building; 1400 Main St. W.; Hamilton,O.N., L8S 1C7 Canada. 6University of Western Ontario, Faculties of HealthSciences and Information and Media Studies, 1151 Richmond St; London, O.N., N6A 5B9 Canada. 7University of Michigan, Center for Bioethics and SocialScience in Medicine, 300 North Ingalls Building 7C27, Ann Arbor, M.I. 48109-5429 USA.Authors’ contributionsEC developed the outline of the paper, coordinated the content from allauthors, and prepared the first draft with assistance from RU and HW. Allauthors contributed to the final content. EC, RU, VC, and HW edited the finaldraft. EC, RD, HW, RU, and HC revised the manuscript according toreviewers’ comments. All authors have read and approved the finalmanuscript.Competing interestsThe authors declare that they have no competing interests.Received: 28 January 2011 Accepted: 25 August 2011Published: 25 August 2011References1. Graham I, Tetroe J: Whither Knowledge Translation: An InternationalResearch Agenda. Nursing Research 2007, 56(4 Suppl):S7-S23.2. Kitson A: The need for systems change: reflections on knowledgetranslation and organizational change. Journal of Advanced Nursing 2009,65(1):217-228.3. KT Canada. [http://ktclearinghouse.ca/ktcanada/education/summerinstitute],retrieved Nov. 2, 2010.4. Kho M, Estey E, DeForge R, Mak L, Bell B: Riding the knowledgetranslation roundabout: lessons learned from the Canadian Institutes ofHealth Research Summer Institute in knowledge translation.Implementation Science 2009, 4(33).5. 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Urquhart R, Chan V, Cornelissen E, Colquhoun H: Development of anational knowledge translation trainee collaborative towards advancingthe field of knowledge translation in Canada. Family Medicine Forum 20102010, Vancouver, (poster).18. Westley F, Zimmerman B, Patton MQ: Getting to maybe: how the world ischanged Toronto: Vintage Canada, Random House of Canada Limited; 2007.19. Freeman J: The tyranny of structurelessness. Berkeley Journal of Sociology1972, 17:151-165.20. Kitson A, Harvey G, McCormack B: Enabling the implementation ofevidence based practice: A conceptual framework. Quality in Health Care1998, 7(3):149-158.21. Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A,McCormack B, et al: Getting evidence into practice: The role and functionof facilitation. Journal of Advanced Nursing 2002, 37(6):577-588.22. Freiré P: Education for Critical Consciousness New York: Continuum; 1973.23. Choi BCK, Pak AWP: Multidisciplinarity, interdisciplinarity andtransdisciplinarity in health research, services, education and policy: 1.Definitions, objectives, and evidence of effectiveness. Clinical andInvestigative Medicine 2006, 29(6):351-364.24. Lather L: Paradigm proliferation as a good thing to think with: teachingresearch in education as a wild profusion. International Journal ofQualitative Studies in Education 2006, 19(1):35-57.doi:10.1186/1748-5908-6-98Cite this article as: Cornelissen et al.: Creating a knowledge translationtrainee collaborative: from conceptualization to lessons learned in thefirst year. Implementation Science 2011 6:98.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitCornelissen et al. Implementation Science 2011, 6:98http://www.implementationscience.com/content/6/1/98Page 5 of 5

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