This is a summary of an article by Jean Bartunek, Jordi Trullen, Eduard Bonet and Alfonso Sauquet published in the Journal of Health Services Research & Policy in 2003.

For centuries, it was felt that academics working in universities were the only people who produced knowledge. Now we understand this is much more widespread. Academics specialize in “explicit knowledge” — formalized knowledge that can be taught with symbols, words and numbers. Practitioners, on the other hand, develop tacit knowledge, which is personal, gained through action and experience, and often hard to communicate formally. Tacit knowledge is what takes practitioners beyond their training and gives them expertise to apply what they were taught to the situations of individual patients, but it is often ignored by academics because it is difficult  to capture and pass on.

Bridging the Gap

Academics have traditionally tried to create context-free theories that can be generalized to suit any situation. But this tends to make their work seem disconnected to practitioners, who are usually looking for practical information they can use in concrete ways for specific patients. The authors of “Sharing and expanding academic and practitioner knowledge in health care” identify the challenge of bridging the gap between explicit and tacit knowledge to enhance research and provide health professionals with knowledge they find useful.

Communities of Practice

Both academics and practitioners learn through communities of practice — groups of people in the same field who work together to develop a collective understanding of what they do. They communicate knowledge informally through the language they use, stories about their different work practices, and in their social interactions, which are like masters and apprentices working together. Learning comes through participation in the core activities of the group.

It is not easy, however, to move knowledge between the academic community of practice and the practitioner community. Academics worry practitioners’ knowledge is not tested and could be biased. Practitioners can feel that academics are not dealing with the issues that real patients and healthcare organizations present. And each group tends to take a simplistic view of the knowledge of the other group, creating further barriers in knowledge transfer.

Overcoming Challenges

The first step toward sharing knowledge between researchers and practitioners is to break down stereotypes. Researchers need to see healthcare practitioners as more than just research subjects. At the same time, practitioners must be persuaded that research results can be used to improve practice. It is important to build social relationships that will help the groups develop empathy for each other and find common ground. In particular, academics have to learn to avoid dictating their ideas and accept that practitioners may have answers and insights that academics don’t.

Organizing joint forums for academics and practitioners to discuss problems and data can lead to better research projects and better use of research results in practice. The forums can be electronic, such as chat rooms or bulletin boards, or meetings, such as consensus conferences.

The language of researchers and practitioners can be quite different, so developing the ability to “translate” from one to the other is key to getting the groups working together. Shared training can help develop that common understanding. But it’s also important to find a way to share tacit knowledge, which means the two groups need to work closely together in each other’s settings to develop an understanding of the context of each other’s practices. It’s often effective for members of the different groups to attempt to trade places, which tends to break down the idea that the other’s world is simple.

Effective collaborations between academics and practitioners can be achieved if both explicit and tacit knowledge are recognized and respected and if individuals in each group take time to get to know each other and each other’s jobs. Understanding grows from insight into the context of each other’s work.

Reference

Bartunek J et al. 2003. “Sharing and expanding academic and practitioner knowledge in health care.” Journal of Health Services Research & Policy 8(4): S2:62-S2:68.