Global Health, Policy and Innovation Unit, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London E1 2AB, UK.
J R Soc Med. 2011 Dec;104(12):501-9. doi: 10.1258/jrsm.2011.110285.
The literature on 'knowledge translation' presents challenges for the reviewer because different terms have been used to describe the generation, sharing and application of knowledge and different research approaches embrace different philosophical positions on what knowledge is. We present a narrative review of this literature which deliberately sought to highlight rather than resolve tensions between these different framings. Our findings suggest that while 'translation' is a widely used metaphor in medicine, it constrains how we conceptualise and study the link between knowledge and practice. The 'translation' metaphor has, arguably, led to particular difficulties in the fields of 'evidence-based management' and 'evidence-based policymaking' - where it seems that knowledge obstinately refuses to be driven unproblematically into practice. Many non-medical disciplines such as philosophy, sociology and organization science conceptualise knowledge very differently, as being (for example) 'created', 'constructed', 'embodied', 'performed' and 'collectively negotiated' - and also as being value-laden and tending to serve the vested interests of dominant élites. We propose that applying this wider range of metaphors and models would allow us to research the link between knowledge and practice in more creative and critical ways. We conclude that research should move beyond a narrow focus on the 'know-do gap' to cover a richer agenda, including: (a) the situation-specific practical wisdom (phronesis) that underpins clinical judgement; (b) the tacit knowledge that is built and shared among practitioners ('mindlines'); (c) the complex links between power and knowledge; and (d) approaches to facilitating macro-level knowledge partnerships between researchers, practitioners, policymakers and commercial interests.
“知识转化”文献为评论员带来了挑战，因为不同的术语被用来描述知识的产生、共享和应用，不同的研究方法对知识是什么持有不同的哲学立场。我们对这一文献进行了叙述性综述，故意强调而不是解决这些不同框架之间的紧张关系。我们的研究结果表明，虽然“转化”是医学中广泛使用的隐喻，但它限制了我们对知识与实践之间联系的概念化和研究方式。“转化”隐喻在“循证管理”和“循证决策”领域带来了一些特殊的困难——在这些领域，知识似乎顽固地拒绝毫无问题地被转化为实践。许多非医学学科，如哲学、社会学和组织科学，对知识有非常不同的概念化，例如知识是“创造”、“构建”、“体现”、“执行”和“集体协商”的——而且知识还具有价值倾向，并倾向于为占主导地位的精英阶层的既得利益服务。我们提出，应用更广泛的隐喻和模型将使我们能够以更具创造性和批判性的方式研究知识与实践之间的联系。我们的结论是，研究不应局限于狭隘的“知-行差距”，而应涵盖更丰富的议程，包括：（a）支撑临床判断的具体情况的实践智慧（phronesis）；（b）从业者之间建立和共享的隐性知识（mindlines）；（c）权力与知识之间的复杂联系；以及（d）促进研究人员、从业者、政策制定者和商业利益之间宏观层面知识伙伴关系的方法。
