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How knowledge translation is improving during the COVID-19 pandemic.

Implications for Nurses

* Nurses should engage with learning by seeking out topics that evoke an emotional response or seem timely. Emotion and urgency can both be powerful motivators of knowledge translation.

* Knowledge can be found in creative and unexpected places, but ensure the knowledge source is always reputable and trusted.

* Knowledge translation is a unique process to every profession, and nursing is no exception. The COVID-19 pandemic may be an optimal time to explore how nurses incorporate research into practice.

Preface

At first, only a rustle is heard coming down the corridor. Then the group, a haze of white coats and green scrubs, appear at the end of the patient bay. The team's presence signals the beginning of critical care rounds.

Although critical care rounds are not new to my unit, the rounds have looked quite a bit different these past few weeks. All staff wear personal protective equipment, family members are absent, and patient room doors are kept closed. But, perhaps, the starkest change can be noted in our conversations. Previous to the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the resulting coronavirus disease (COVID-19) pandemic, rounds were more procedural and transactional in nature. Now, however; the team engages in long runs of debate. "I read in The Lancet..." says one resident, while another adds "My friends in Italy tweeted ..." Then a nurse will point out an article she read in The New York Times, or a respiratory therapist will bring forth a recommendation from their respective professional college. We are all trying, as complicated as it is, to make sense of this disease through the cumulation and sharing of knowledge that has been in constant evolution.

Knowledge translation is changing

Knowledge translation (KT), often described as "bridging the gap of what is known and what is actually done" (World Health Organization, 2004, p. V), surfaced as a concept four decades ago (Wallin, 2008; Wensing & Grol, 2019). Since that time, what constitutes as effective KT in healthcare and health research has been in a constant state of flux (Wensing & Grol, 2019). I would argue that the COVID-19 pandemic has seen the most consequential improvement to date in how KT occurs in healthcare settings.

Specifically, from my position as a critical care nurse, I see colleagues both collecting and utilizing new evidence in innovative, creative, and advantageous ways. The motivation to seek out new information related to COVID-19, a disease we are only just beginning to understand, is indeed a large part of this new KT shift. Yet, the impact of the pandemic amassed with social media dissemination and digital innovation has forged new synergy within the realm of KT. Long term, this recent progression in KT could reap unique and positive outcomes for the nursing profession.

New motivation for KT

Motivation is considered an important part in the KT process by influencing individual healthcare professionals to initially engage with evidence-based practice (Barton & Merolli, 2019). Beyond rationale, emotion and urgency are considered especially powerful motivators for KT (Barton & Merolli, 2019; Heath & Heath, 2010). For healthcare professionals, the COVID-19 pandemic has played strongly on each of these entities. The emotions of doubt, anxiety and fear surrounding COVID-19 are driving healthcare professionals to seek informative and innovative knowledge (Chan et al., 2020; Rochwerg et al., 2020). Likewise, urgency has created a need to locate effective and safe treatments for COVID-19 in the face of rapid disease transmission and burden (Kim et al., 2020; Rochwerg et al., 2020). As such, healthcare professionals have been continually motivated to engage in KT during the COVID-19 pandemic.

Added motivation to pursue KT during the COVID-19 pandemic may be garnered from the positive affects KT can have on mental health and well-being. Increasing workplace demands and occupational risks during a pandemic can be psychologically harmful to healthcare professionals (Chan et al., 2020). Knowledge translation has the potential to remedy such challenges by increasing feelings of control and empowerment among professionals over their workplace environments (Kitson & Harvey, 2016). Although further research is required to validate this phenomenon, researchers suspect that clear communication and dissemination of knowledge within healthcare organizations has already been empowering to individuals working during the COVID-19 pandemic (El-Jardali et al., 2020; Van den Broucke, 2020). As well, a rapid review of psychological distress among healthcare professionals experiencing various infectious disease outbreaks over the last 20 years found mental well-being could be benefited through workplace education (Kisely et al., 2020).

Social media optimizes dissemination

During the 2003 Severe Acute Respiratory Syndrome (SARS) global epidemic, access points for KT between researchers and healthcare professionals were limited. Internet and email alone were not sufficient tools (Chan et al., 2020). In today's COVID19 pandemic, there are many more options to connect and find emerging research using social media, which was designed to rapidly spread information and share content (Chan et al., 2020). Twitter[TM] and WeChat[TM] dispersed infographics, displaying the management of COVID-19 patients in operating theatres and critical care settings, were positive contributors to timely KT in the early days of this pandemic (Chan et al. 2020).

Of course, social media is not a fail-proof method to improve KT. The over-simplification and interpretation of research findings is a notable challenge that can be exacerbated by social media. One example that was readily observed during the early phase of the COVID-19 pandemic was information circulated on social media related to the antimalarial, hydroxychloroquine (Kim et al., 2020; Rochwerg et al., 2020). Additionally, it is reasonable to verify information stemming from the COVID-19 pandemic across multiple sources (El-Jardali et al., 2020). However, due to the unprecedented speed of knowledge generation seen during this pandemic, published research may be less rigourous than under typical circumstances (El-Jardali et al., 2020) and requires thorough critical appraisal before its uptake into clinical practice.

Overall, the accuracy of content from social media must be critically appraised by individual healthcare professionals (Barton & Merolli, 2019; Chan et al., 2020). Preference on social media should continue to be given to reputable, transparent organizations or Free Open Access Medical (#FOAMed) education platforms that contextualize content and sources appropriately (Chan et al., 2020). However, if used responsibly and appropriately, the success of social media in rapidly sharing disease-specific knowledge and optimizing opportunities for KT in the COVID-19 pandemic will continue (Barton & Merolli, 2019; Ghosh et al., 2020).

Digital innovation provides connection

The final component I perceive as improving KT during this pandemic is digital innovation, which has led to the creation of multimedia. In my clinical work, I have recently seen healthcare professionals gravitating to varying forms of media to suit their personal learning preferences. Where media like mainstream news, peer-reviewed journals, and emails can invoke uneasiness, colleagues have found improved comprehension and engagement among podcasts, videos, and blogs. Like social media, multimedia content must be appraised for quality, but effective KT is still possible across these formats too (Barton & Merolli, 2019; El-Jardali et al., 2020).

The assertion that multimedia is forging improved KT in year 2020 is best supported by the idea that an emotional connection is created with learners through this content. Multimedia formats of learning during the COVID-19 pandemic have been primarily rich narratives that openly share the sacrifices, successes, and humour of creators (Rosenberg et al., 2020). In turn, these stories promote human intimacy and comfort in a difficult time of crisis and isolation (Rosenberg et al., 2020; Ghosh et al., 2020). Such connection may keep learners coming back to the content, or better reinforce the knowledge taken in (Rosenberg et al., 2020). A specific example of connection can been seen in the tweets of Dr. Yale Tung Chen, an emergency physician, who shared knowledge of COVID-19 through his own personal experience of contracting the disease (Rosenburg et al., 2020). Positive narratives from multimedia may also be more effective at promoting KT in the COVID-19 pandemic by offering a 'lift of the spirits' to healthcare professionals (Kisely et al., 2020; Rosenberg et al., 2020).

Evolving KT in the nursing profession

Adoption and challenges with KT vary widely between professional groups (Thompson et al., 2007; Wensing & Grol, 2020). For nursing, the profession's relationship with KT has not been without deficiencies (Thompson et al., 2007). In particular, there is little evidence to direct nurses how and when to engage in KT, which leads to a systemic failure in the incorporation of research into practice (Thompson et al., 2007; Yost et al., 2015).

The COVID-19 pandemic, a time where an immense volume of information is being produced across society, presents as an opportune time to derive guidelines for successful KT within the nursing profession (Rochwerg et al., 2020). Understanding the influence of motivation, social media, and digital innovation on KT during the COVID-19 pandemic, could be the shift needed to advance research implementation among nurses. Other professional groups, like physicians specialized in pain management and surgery, have started to form and put into action lessons learned about KT from the first month of the pandemic (Ghosh et al., 2020). Nurses can likewise look to promote KT by the same means, taking a multi-discplinary approach where gaps exist for the nursing profession itself (Wensing & Grol, 2002). Channeling the attributes that have promoted KT during the COVID-19 pandemic into post-pandemic healthcare, could reasonably push the profession's capacity for evidence-based care to new heights.

The field of KT has undergone many trends and false 'break throughs' in the past (Barton & Merolli, 2019; Wensing & Grol, 2020). I am open to the possibility that the events experienced during the COVID-19 pandemic may not have a continuous or long-term impact on nurses' engagement with KT. Yet, if we can understand the desire and actions of healthcare professionals seeking information on COVID-19 in this unique time in history, then we could ignite a turning point for KT in healthcare that is both necessary and sustained.

Acknowledgements

None.

Address for correspondence

Crystal McLeod, BScN, RN (corresponding author), University of Western Ontario, Arthur Labatt Family of Nursing, 1151 Richmond St, London, ONN6A 3K7 Email: cmcleo25@uwo.ca

Declaration of conflict of interest

The author declares that there is no conflict of interest.

Funding

No funding has been provided towards the creation of this manuscript.

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By Crystal McLeod. BScN, RN

McLeod, C. (2020). How knowledge translation is improving during the COVID-19 pandemic. The Canadian Journal of Critical Care Nursing, 31(3), 6-8.
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Author:McLeod, Crystal
Publication:The Canadian Journal of Critical Care Nursing
Geographic Code:1CANA
Date:Dec 22, 2020
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