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38 JCPSLP Volume 14, Number 1 2012 Journal of Clinical Practice in Speech-Language Pathology
pathology. The search terms (speech patholog* OR speech
language therap*) AND (evidence based practice) returned
many more hits; however, very few of these papers
appeared to address “translation” specifically or in a
systematic way.
Clinical bottom line
The references identified in Table 1 provide a useful
foundation for exploring the research in evidence translation
in the speech pathology field and the opportunity to
examine strategies that have been proactively used, either
successfully or unsuccessfully, to address KTA gaps. The
articles by Molfenter et al. (2009) and Simmons-Mackie et
al. (2007) have most relevance for the clinical scenario and
clearly illustrate the “knowledge transfer and exchange”
(KTE) processes or KTA interventions that were used and
evaluated. The critically appraised evaluation for the
Simmons-Mackie et al. (2007) study is provided in Table 2.
The main themes to emerge from this review are
provided in Box 1 and explored below, providing some
useful tips for clinicians addressing KTA gaps in their own
workplace. Overall, the body of work highlights the promise
of KTE as a unique skill set for addressing KTA gaps in
practice to improve service provision, drive policy change,
and most importantly optimise therapeutic outcomes.
result, to address evidence–practice gaps like those
described in the clinical scenario we should look to current
evidence into “research translation” and “knowledge
transfer” to identify strategies and models that work. This
step does not seek to address the specific clinical scenario
directly; rather it seeks to provide some recommendations
for clinicians who want to demonstrate and address the
evidence–practice gaps they observe in their workplace.
Searching for the evidence
So, what is the evidence for “evidence translation”? To
answer this question we can turn to the research databases
to look at what has been published in the field. The search
undertaken sought to find research studies that tested
intervention strategies with a primary purpose of translating
research evidence into clinical practice with outcomes
measured at the level of the professional (e.g., change in
practice, knowledge, or attitudes), the patient or consumer
(e.g., improved client satisfaction or outcomes), and/or the
service itself (e.g., change in policy, programs, or staffing
ratios). Identifying key search terms can be a challenge to
EBP, especially when narrow keywords are utilised to find
relevant evidence. Search strategies from the related
literature, such as those of Evenson, Sanson-Fisher, D’Este,
and Fitzgerald (2010), were used to help define the search
terms for this review. Starting with PsycINFO (Psychological
Abstracts), Medline, and Google Scholar, a title search
using the terms (knowledge OR evidence practice gap OR
practice guideline* OR recommendation* OR best practice*
OR implementation OR knowledge translation) AND
(speech patholog* OR speech language therap*) was
undertaken. Aphasia, communication, and stroke were
additional search terms used. However, very few relevant
papers were identified, as shown in Table 1. Interestingly,
replacing speech pathology with (nursing) resulted in a
much higher return of translation research and review
papers, suggesting that more translational research and
discussion is taking place in fields beyond speech
Table 1. Identified relevant evidence translation articles
Article Type/Level of Summary
evidence*
Kagan, A., Simmons-Mackie, N., Brenneman, G., Conklin, J., Review article Provides a comprehensive overview of theoretical models
& Elman, R.J. (2010). Closing the evidence, research, and and principles of knowledge transfer and exchange for
practice loop: Examples of knowledge transfer and exchange clinicians and researchers.
from the field of aphasia. Aphasiology, 24(4), 535–548.
MacDonald, S., & Wiseman-Hakes, C. (2010). Knowledge Systematic review Presents a model for consolidating and disseminating
translation in ABI rehabilitation: A model for consolidating existing evidence for cognitive-communication
and applying the evidence for cognitive-communication interventions that is accessible for end users and
interventions. Brain Injury, 24(3), 486–508. promotes knowledge transfer.
Molfenter, S.M., Ammoury, A., Yeates, E.M., & Steele, C.M. Level IV Presents the outcomes of a successful knowledge-to-
(2009). Decreasing the knowledge-to-action gap through action intervention targeting clinicians’ hesitance to adopt
research-clinical partnerships in speech-language pathology. a new therapeutic tool (sEMG) in practice despite didactic
Canadian Journal of Speech-Language Pathology and training and “knowledge”.
Audiology, 33(2), 82–88.
Rose, M., & Baldac, S. (2004). Translating evidence into Book chapter Provides a useful overview of the challenges of, and
practice. In S. Reilly, J. Douglas, & J. Oates (Eds.), Evidence- barriers to, the translation of EBP into practice with
based practice in speech pathology (pp. 317–330). practical and theoretically driven strategies for addressing
Philadelphia: Whurr Publishers. them.
Simmons-Mackie, N.N., Kagan, A., Christie, C.O., Huijbregts, Level IV Outlines the outcomes of an implementation project
M., McEwan, S., & Willems, J. (2007). Communicative targeting systems-level change to improve access to
access and decision making for people with aphasia: health care information and supported decision-making
Implementing sustainable health care systems change. for people with aphasia.
Aphasiology, 21(1), 39–66.
*Source: NH&MRC levels of evidence:
Box 1. Themes guiding successful EBP translation
into practice
• Draw upon frameworks, models, and theories to guide
knowledge transfer and exchange
• Clearly identify a knowledge-to-action or evidence-practice gap
• Use clients as partners and agents for change
• Identify readiness for and barriers to change
• Form partnerships and collaborations as drivers of change
• Evaluate, measure, and disseminate change outcomes
• Ensure continued KTE dialogue between clinicians and
researchers