Knowledge translation in surgery: a scoping review of implementation strategies, effectiveness and contextual barriers and enablers
Rattachement africain : us, gb, iq, br, ca, it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Background Knowledge translation (KT) interventions are essential for implementing evidence-based practices in healthcare. However, despite their proven effectiveness in addressing global health challenges, KT strategies in surgery remain challenging to apply. This scoping review examines KT strategies in surgery, their effectiveness, and key barriers and enablers to their implementation. Methods This scoping review followed the Arksey and O’Malley and Levac et al. frameworks, integrating the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and the PRISM (Practical Robust Implementation Sustainability Model) models to evaluate the effectiveness of knowledge translation interventions in surgical practice change and associated contextual barriers and facilitators. A systematic search was conducted across MEDLINE (PubMed, OVID), CINAHL (EBSCO), and PsycINFO (ProQuest). Articles were screened using predefined selection criteria, emphasizing experimental and quasi-experimental studies. Data extraction categorized KT interventions: knowledge diffusion, dissemination, and implementation approaches. Results A total of 34 studies met the inclusion criteria. Most were hospital-based (88%) and focused on guideline adherence. The review identified three primary KT strategies: (i) educational materials and educational outreach, (ii) reminders and prompts, and (iii) audit and feedback systems. The most effective KT strategies used a combination of these interventions to maximize impact. Barriers included physician resistance, limited leadership support, financial constraints, and workflow disruptions, while enablers included institutional leadership, structured training programs, financial incentives, and interdisciplinary collaboration. A notable finding was the lack of standardized validation processes for adopting changes in the surgical setting, which often burdens individual surgeons and their institutions, thereby constraining both capacity and motivation for practice change. Conclusions Findings suggest that layered, interdisciplinary KT strategies are the most effective for driving surgical practice change and overcoming institutional barriers. The integrated application of RE-AIM and PRISM frameworks proved valuable in assessing the interventions’ sustainability and real-world effectiveness. This comprehensive analysis contributes to the growing body of knowledge on effective implementation strategies in surgical settings and provides a foundation for future practice improvement initiatives. Future research should focus on refining KT methodologies, expanding implementation frameworks, and addressing barriers to sustainability across diverse surgical settings.
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Le contrôle bibliographique ouvert
Où se fait cette recherche
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Johns Hopkins University pays non établi dans la noticeUniversité ou école supérieure
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University of Cambridge pays non établi dans la noticeUniversité ou école supérieure
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University of Kirkuk pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego pays non établi dans la noticeUniversité ou école supérieure
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Universidade de Caxias do Sul pays non établi dans la noticeUniversité ou école supérieure
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University of Toronto pays non établi dans la noticeUniversité ou école supérieure
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Harborview Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Milan pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Ospedale Galeazzi - Sant'Ambrogio pays non établi dans la noticeÉtablissement de santé
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Vancouver General Hospital pays non établi dans la noticeÉtablissement de santé
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AO Foundation pays non établi dans la noticeOrganisation à but non lucratif
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University of Caxias Do Sul pays non établi dans la noticeUniversité ou école supérieure
Johns Hopkins University, University of Cambridge et University of Kirkuk, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.