Brehaut Jamie C, Hamm Robert, Majumdar Sumit, Papa Frank, Lott Alison, Lang Eddy
Clinical Epidemiology Unit, Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada.
Acad Emerg Med. 2007 Nov;14(11):984-90. doi: 10.1197/j.aem.2007.06.025. Epub 2007 Sep 24.
The individual practitioner is a linchpin in the process of translating new knowledge into practice, particularly in the emergency department, where physician autonomy is high, resources are limited, and decision-making situations are complex. An understanding of the cognitive and social processes that affect knowledge translation (KT) in emergency medicine (EM) is crucial and at present understudied. As part of the 2007 Academic Emergency Medicine Consensus Conference on KT in EM, our group sought to identify key research areas that would inform our understanding of these cognitive and social processes. We combined an online discussion group of interdisciplinary stakeholders, an extensive review of the existing literature, and a "public hearing" of the recommendations at the Consensus Conference to establish relative preference for the recommendations, as well as their relevance and clarity to attendees. We identified five key research areas as follows. 1) What provider-specific barriers/facilitators to the use of new knowledge are relevant in the EM setting? 2) Can social psychological theories of behavior change be used to develop better KT interventions for EM? 3) Can the study of "distributed cognition" suggest new vehicles for KT in the emergency department? 4) Can the concept of dual-process reasoning inform our understanding of the KT process? 5) Can patient-specific, immediate feedback serve as a vehicle for KT in EM? We believe that exploring these key research questions will directly lead to improved KT interventions and to further discussion of the cognitive and social factors impacting KT in EM.
个体从业者是将新知识转化为实践过程中的关键人物，在急诊科尤其如此，因为急诊科医生自主性高、资源有限且决策情况复杂。了解影响急诊医学（EM）知识转化（KT）的认知和社会过程至关重要，而目前这方面的研究还很不足。作为2007年急诊医学知识转化学术共识会议的一部分，我们小组试图确定关键研究领域，以增进我们对这些认知和社会过程的理解。我们结合了跨学科利益相关者的在线讨论组、对现有文献的广泛综述以及在共识会议上对建议的“公开听证”，以确定对这些建议的相对偏好，以及它们对与会者的相关性和清晰度。我们确定了以下五个关键研究领域。1）在急诊医学环境中，使用新知识的特定提供者障碍/促进因素有哪些？2）行为改变的社会心理学理论能否用于开发更好的急诊医学知识转化干预措施？3）“分布式认知”的研究能否为急诊科的知识转化提出新的途径？4）双过程推理的概念能否增进我们对知识转化过程的理解？5）针对患者的即时反馈能否作为急诊医学知识转化的一种途径？我们相信，探索这些关键研究问题将直接带来改进的知识转化干预措施，并引发对影响急诊医学知识转化的认知和社会因素的进一步讨论。
