Essential Content for Teaching Implementation Practice in Healthcare: A Mixed-Methods Study of Teams Offering Capacity-Building Initiatives

Background Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content for teaching implementation practice. Methods We conducted a convergent mixed-methods study with participants who had developed and/or delivered a capacity-building initiative focused on teaching implementation practice. Participants completed an online questionnaire to provide details on their capacity-building initiatives; took part in an interview or focus group to explore their questionnaire responses in depth; and offered course materials for review. We analyzed a subset of data that focused on the capacity-building initiatives’ content and curriculum. We used descriptive statistics for quantitative data and conventional content analysis for qualitative data, with the data sets merged during the analytic phase. We presented frequency counts for each category to highlight commonalities and differences across capacity-building initiatives. Results Thirty-three individuals representing 20 capacity-building initiatives participated. Study participants identified several core content areas included in their capacity-building initiatives: (1) taking a process approach to implementation; (2) identifying and applying implementation theories, models, frameworks, and approaches; (3) learning implementation steps and skills; (4) developing relational skills. In addition, study participants described offering applied and pragmatic content (e.g., tools and resources), and tailoring and evolving the capacity-building initiative content to address emerging trends in implementation science. Study participants highlighted some challenges learners face when acquiring and applying implementation practice knowledge and skills. Conclusions This study synthesized what experienced capacity-building initiative developers and deliverers identify as essential content for teaching implementation practice. These findings can inform the development, refinement, and delivery of capacity-building initiatives, as well as future research directions, to enhance the translation of implementation science into practice

How to Make the Most of your Therapy: Putting Research into Practice!

Introduction to BC RSRnet and Evidence- Based Practice. How do I get the best information quickly? Step 1: How to ask the question and quickly access the most relevant literature. This is a workshop presented by BC RSRnet (BC Rehabilitation Sciences Research Network) for British Columbia physiotherapists and occupational therapists on November 9, 2006 and recorded by Eugene Barsky, Physiotherapy Outreach Librarian.BC RSRnet, Irving K. Barber Learning Centre, UBC, UBC Library, Physiotherapy Association of British ColumbiaMedicine, Faculty ofPhysical Therapy, Department ofLibrary, UBCUnreviewedFacult

How do I know the article is any good? Step 2: How to appraise the literature (Quantitative articles – practical session).

EBP STEP 2 - APPRAISING THE EVIDENCE - How do I know the article is any good? Step 2: How to appraise the literature (Quantitative articles – practical session). This is a workshop presented by BC RSRnet (BC Rehabilitation Sciences Research Network) for British Columbia physiotherapists and occupational therapists on January 11, 2007 and recorded by Eugene Barsky, UBC Physiotherapy Outreach Librarian.Irving K. Barber Learning CentreMedicine, Faculty ofPhysical Therapy, Department ofOccupational Science and Occupational Therapy, Department ofUnreviewedFacult

So how do I know that this article is any good? (Quantitative Articles)

EBP STEP 2 - APPRAISING THE EVIDENCE : So how do I know that this article is any good? (Quantitative Articles) This is a workshop presented by BC RSRnet (BC Rehabilitation Sciences Research Network) for British Columbia physiotherapists and occupational therapists on December 14, 2006 and recorded by Eugene Barsky, Physiotherapy Outreach Librarian.Irving K. Barber Learning CentreMedicine, Faculty ofPhysical Therapy, Department ofUnreviewedFacult

Knowledge brokering : An innovative model for supporting evidence-informed practice in respiratory care

The process of adopting research findings in the clinical setting is challenging, regardless of the area of practice. One strategy to facilitate this process is the use of knowledge brokering. Knowledge brokers (KBs) are individuals who work to bridge the gap between researchers and knowledge users. In the health care setting, KBs work closely with clinicians to facilitate enhanced uptake of research findings into clinical practice. They also work with researchers to ensure research findings are translatable and meaningful to clinical practice. The present article discusses a KB’s role in a respiratory care setting. Working closely with both researchers and clinicians, the KB has led teams in the process of conceptualizing, developing, testing, disseminating and evaluating several projects related to respiratory care, including projects related to mobility in critical care settings and acute exacerbations of chronic obstructive pulmonary disease; inspiratory muscle training; and the use of incentive spirometry in postsurgical populations. The KB role has provided an important communication link between researcher and knowledge user that has facilitated evidence-informed practice to improve patient care.Medicine, Faculty ofOther UBCNon UBCPhysical Therapy, Department ofReviewedFacultyResearche

Safe and effective prescription of exercise in acute exacerbations of chronic obstructive pulmonary disease : rationale and methods for an integrated knowledge translation study

BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions. OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD. METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD. RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework. CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.Medicine, Faculty ofOther UBCNon UBCPhysical Therapy, Department ofReviewedFacult

Current Practice and Barriers to Physiotherapists’ Use of Resistance Exercise for Older Adults in Acute Care

Purpose: The purpose of this cross-sectional study was to 1) describe the current use of resistance exercise (REx) and 2) identify barriers and facilitators for physiotherapists using REx among older adults in acute care. Methods: An online questionnaire measure guided by the Theoretical Domains Framework was distributed to physiotherapists across British Columbia (BC). Responses were scored on a five point Likert scale. Thematic analysis was used to code open text data from the questionnaire. Results: 105 physiotherapists (male=23, age 39.9±10.3 years, 12.4±10.3 years of experience) completed the questionnaire. Respondents reported frequently performing functional testing (95%) and assessing muscle strength (70%) in older adults, but few often prescribe REx to patients (34%). Prioritization of REx among other duties (2.62±1.02) and perceived poor patient motivation (2.97±0.88) were ranked among the greatest barriers. Open text data revealed physiotherapists felt some patients were unable to perform REx, they lacked a clear definition of REx, and sufficient support personnel. Conclusions: Addressing priorities, patient motivation, and providing resources may support physiotherapists to increase REx use, an important strategy for reducing the incidence of hospital associated deconditioning among older adults in the acute care setting.Education, Faculty ofMedicine, Faculty ofNon UBCKinesiology, School ofPhysical Therapy, Department ofReviewedFacultyResearche

Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Rationale and Methods for an Integrated Knowledge Translation Study

BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions.OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD.METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD.RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework.CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.Peer Reviewe