Girts Racko

Knowledge translation in healthcare: Incorporating theories of learning and knowledge from the management literature

PURPOSE The authors draw selectively on theories of learning and knowledge, which currently have received little attention from knowledge translation (KT) researchers, and suggest how they might usefully inform future development of the KT literature. The purpose of this paper is to provide conceptual tools and strategies for the growing number of managers, clinicians and decision makers navigating this arena DESIGN/METHODOLOGY/APPROACH The authors conducted a narrative review to synthesise two streams of literature and examine evolving conceptual landscape concerning knowledge translation over the previous three decades. Conceptual mapping was used iteratively to develop and synthesise the literature. Iterative feedback from relevant research and practice stakeholder groups was used to focus and strengthen the review. FINDINGS KT has been conceptualised along three competing frames; one focusing on linear (largely unidirectional) transfer of knowledge; one focusing on KT as a social process; and another that seeks to more fully incorporate contextual issues in understanding research implementation. Three overlapping themes are found in the management literature that inform these debates in the health literature, namely knowledge boundaries, organisational learning and absorptive capacity. Literature on knowledge boundaries problematizes the nature of boundaries and the stickiness of knowledge. Organisational learning conceptualises the need for organisational wide systems to facilitate learning processes; it also draws on a more expansive view of knowledge. Absorptive capacity focuses at the firm level on the role of developing organisational capabilities that enable the identification, assimilation and use of new knowledge to enable innovation. RESEARCH LIMITATIONS/IMPLICATIONS The paper highlights the need to consider KT processes at multiple levels, including individual, organisational and strategic levels. These are important not only for research but also have practical implications for individuals and organisations involved in KT processes. ORIGINALITY/VALUE This review summarises and integrates two largely separate literature streams on knowledge translation - namely health services research and management scholarship. In addition to outlining and organising the conceptual landscape around knowledge transfer, the paper contributes by highlighting how management literature on knowledge and learning theories might inform health services research on knowledge translation.

The Dimensions of Occupational Gender Segregation in Industrial Countries

It is well known that women and men tend to work in different occupations, and generally held that this disadvantages women. In order to understand how far this occupational segregation entails gender inequality it is necessary to examine the vertical and horizontal dimensions of the segregation. The horizontal dimension measures difference without inequality while the vertical dimension measures the extent of the occupational inequality. Two measures of vertical inequality are used: pay and social stratification (CAMSIS). Measurements over a number of industrially developed countries show the expected male advantage with regard to pay. However, contrary to popular beliefs, women are consistently advantaged in terms of stratification. Also, it is found that the position of women is more favourable where the overall segregation is higher – the lower the male advantage on pay and the greater the female advantage on stratification.

Balancing exploration and exploitation in transferring research into practice: a comparison of five knowledge translation entity archetypes

BackgroundTranslating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature—namely exploration, exploitation, and ambidexterity—to examine these structures and activities as well as the ensuing tensions between research and implementation.MethodsUsing a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops.ResultsIn this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation.ConclusionThis work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process.

Understanding gender inequality in employment and retirement

The paper is concerned with the occupation-based inequalities of women and men in economically developed societies. The inequalities in their working lives lead to inequalities in retirement, and particularly the greater poverty endured by women. Occupational gender segregation, the tendency for women and men to work in different occupations, results in gender inequalities. The inequalities are measured by pay and class-status. The extent of the inequality in a country is measured as the vertical dimension of the occupational segregation, which varies appreciably across countries. In employment, men almost always have an advantage on the vertical dimension of pay, while on class-status the advantage lies with women. The gender inequalities in working lives carry over into retirement, though in a somewhat different manner. In retirement there is a wide range of experience from affluence to poverty, with a great many experiencing poverty. Those from lower class-status levels who earned too little to save for pensions, including those who worked part-time, suffer poverty in retirement. The occupational status advantage of women disappears, while their income disadvantage combines with greater life expectancy, with the consequence that women are among the majority of retired people in poverty.

The role of technical progress, professionalization and Christian religion in occupational gender segregation: a cross-national analysis

Studies have linked cross-national variations in occupational gender segregation with various economic, social and normative characteristics of countries. This study contributes to the research on the role of normative or ‘cultural’ characteristics by examining the influence of the level of technical progress, professionalization and Christian religion on cross-national variations in occupational gender segregation. The analysis is based on a sample of 33 countries. Variations in gender distribution are assessed using a reliable measure of occupational segregation, marginal matching. The analysis uses recent survey data (collected between 2002 and 2006) and a differentiated occupational classification scheme at the ISCO-88 3-digit level. Controlling for other confounding influences, the study finds higher occupational segregation of sexes in countries with higher levels of technical progress and in countries where Catholicism or Protestantism is a dominant religion.

Values of Bureaucratic Work

While understanding values of bureaucratic work has been a fundamental concern of organizational sociology, research has remained divided over the nature of the values that underpin it. Examining the more generalized sociological insights on the values of bureaucratic work using a rigorous approach to value measurement, this study contributes to the reconciliation of the divergent conceptual insights on these values. Using the European Social Survey data of highly rationalized societies, this study finds employed senior managers to place systematically higher value on self-enhancement and openness to change and lower value on self-transcendence and conservation than their self-employed, entrepreneurial counterparts. The study also contributes to the understanding of the values of bureaucratic work, by examining the value implications of the duration of the employment of senior managers in bureaucratic organizations, and the organizational and the managerial bureaucratization of their work.

The Goals of the Foundation of Ethnic Minority Non-Governmental Organizations in Latvia

The transition to liberal democracy and market economy in Latvia after the breakdown of the Soviet regime was related to an increase in ethnic minority non-governmental organizations (NGOs). Drawing on the results of in-depth interviews with leaders and the analysis of the statutes of ethnic minority NGOs, the study presented here compares the goals of the foundation of ethnic minority NGOs in 1993 and 2003 in relation to historical opportunity structures that have made their institutionalization possible. Following Bourdieus theory of social reproduction, the study reveals distinctive goal priorities among the older and more recently registered organizations.1

Developing collaborative professionalism: an investigation of status differentiation in academic organizations in knowledge transfer partnerships

Abstract In recent years, there has been a significant growth in knowledge transfer partnerships to improve the quality and timeliness of health care. These activities require an increasing level of interdependence between academic and health care professionals, with important implications for human resource management. To understand these knowledge transfer partnerships, we conducted an in-depth longitudinal study based on 99 interviews and 5 focus group workshops across academic and health care professionals in nine university-based knowledge transfer partnerships in England. We explore how academic professionals of lower and higher status organizations develop a new form of professional work, based on the principles of collaborative professionalism, during their involvement in partnerships with health care professionals. We illuminate how the interdependent work between academic professionals and health care professionals in the development of a new academic specialization is shaped by the status of their organizations.