The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: a critical interpretive synthesis

Background Middle Managers (MMs) are thought to play a pivotal role as knowledge brokers (KBs) in healthcare organizations. However, the role of MMs who function as KBs (MM KBs) in health care is under-studied. Research is needed that contributes to our understanding of how MMs broker knowledge in health care and what factors influence their KB efforts. Methods We used a critical interpretive synthesis (CIS) approach to review both qualitative and quantitative studies to develop an organizing framework of how MMs enact the KB role in health care. We used compass questions to create a search strategy and electronic searches were conducted in MEDLINE, CINAHL, Social Sciences Abstracts, ABI/INFORM, EMBASE, PubMed, PsycINFO, ERIC and the Cochrane Library. Searching, sampling, and data analysis was an iterative process, using constant comparison, to synthesize the results. Results We included 41 articles (38 empirical studies and 3 conceptual papers) that met the eligibility criteria. No existing review was found on this topic. A synthesis of the studies revealed 12 MM KB roles and 63 associated activities beyond existing roles hypothesized by extant theory, and we elaborate on two MM KB roles: 1) convincing others of the need for, and benefit of an innovation or evidence-based practice; and 2) functioning as a strategic influencer. We identified organizational and individual factors that may influence the efforts of MM KBs in healthcare organizations. Additionally, we found that the MM KB role was associated with enhanced provider knowledge, and skills, as well as improved organizational outcomes. Conclusion Our findings suggest that MMs do enact KB roles in healthcare settings to implement innovations and practice change. Our organizing framework offers a novel conceptualization of MM KBs that advances understanding of the emerging KB role that MMs play in healthcare organizations. In addition to roles, this study contributes to the extant literature by revealing factors that may influence the efforts and impacts of MM KBs in healthcare organizations. Future studies are required to refine and strengthen this framework. Trial registration A protocol for this review was not registered.

When teachers Google physical literacy: A cartography of controversies analysis

How physical literacy (PL) is presented on ‘the web’ (i.e. Google) has implications for how health and/ physical education (H/PE) teachers and coaches engage with and understand the concept, and ultimately how it is made to act in practice. This research sheds light on the type of PL content they are likely to encounter in their search via the web. Utilising Venturini's ‘cartography of controversies’ method, the top 100 Google search results for PL were analysed to observe and describe how PL is presented on the web, by whom and in the name of what. Findings show that PL has been ‘framed’ on the web by a heterogeneous network of actors who present different viewpoints, ideologies and suggested practices for PL within and across the contextual ‘spheres’ of education, sport and health. Further, the findings highlight how Google's algorithms prioritise and privilege particular PL viewpoints and ideologies. Consequently, variations in understanding and practices will be evident between H/PE teachers and coaches who only engage with the first page of Google results (top one to 10 URLs) and those who read more broadly. Rather than relying on Google's algorithms or policymakers’ interpretations of PL that commonly serve the interests of the sport and health ‘spheres’ we suggest that H/PE teachers and coaches need to act as ‘knowledge brokers’ and thus be reflexive and aware of the multiple versions of PL that are presented on the web. This is especially important if they use the web as a form of professional development.

How educational intermediaries connect research and practice

Indirect routes to strengthening research-practice connections, through intermediaries or knowledge brokers, have received little emphasis in discussions of education research and practice. Joel Malin compares direct and indirect approaches to making these connections and considers how indirect actors are situated in the education system and what roles and functions they perform. He describes some of the well-known intermediaries, assesses the effects of their efforts, and offers ideas for moving forward.

Barriers to the Adoption of Urban Living Labs for NBS Implementation: A Systemic Perspective

Urban Living Labs (ULLs) are widely believed to provide a safe environment for experimentation, co-creation and evaluation of innovations in real-life settings. A growing number of cities have been adopting ULLs to co-create and test Nature-Based Solutions (NBS). However, many of these cities have been facing major barriers in trying to adopt the ULL approach for implementing NBS. In this study, we seek to identify these barriers and provide a systemic understanding. Barriers are identified by means of workshops and interviews. Subsequently, interpretive structural modelling serves to identify the interdependencies among the barriers, resulting in a structural model of barriers in adopting ULLs for NBS. Our results show that political and institutional barriers are significantly limiting the adoption of ULLs. Moreover, knowledge brokers and other intermediaries, as well as cross-sectoral collaboration, play a key role in getting ULLs adopted. The findings from this study can help cities to develop strategies that overcome the main barriers for ULL adoption in the context of nature-based solutions.

In the Land of the Blind, the One-Eyed Man Is King: Knowledge Brokerage in the Age of Learning Algorithms

This paper presents research on how knowledge brokers attempt to translate opaque algorithmic predictions. The research is based on a 31-month ethnographic study of the implementation of a learning algorithm by the Dutch police to predict the occurrence of crime incidents and offers one of the first empirical accounts of algorithmic brokers. We studied a group of intelligence officers, who were tasked with brokering between a machine learning community and a user community by translating the outcomes of the learning algorithm to police management. We found that, as knowledge brokers, they performed different translation practices over time and enacted increasingly influential brokerage roles, namely, those of messenger, interpreter, and curator. Triggered by an impassable knowledge boundary yielded by the black-boxed machine learning, the brokers eventually acted like “kings in the land of the blind” and substituted the algorithmic predictions with their own judgments. By emphasizing the dynamic and influential nature of algorithmic brokerage work, we contribute to the literature on knowledge brokerage and translation in the age of learning algorithms.

Sustainable Communication

In chapter 5, Sustainable Communication, the role of PR firms as international knowledge brokers is given its due. The chapter demonstrates the impact of a network of American public relations firms in spreading “green” PR across European and Mexican borders during a critical historical period. With the consolidation of the European Union and NAFTA on the horizon, corporate clients in a range of industries (from tobacco to chemicals to oil, coal, and gas) adopted promotional methods that advertised their commitment to environmentalism in an effort to sidestep sweeping regulations. By diffusing its core principles of sustainable communication over sustainable environmental behavior, PR networks helped to define environmental communication as a field in its own right, acting as a key cultural producer in the realm of international environmental governance.

Cross-Boundary Information Sharing By Knowledge Brokers During A Disaster

<p>This thesis explores and investigates the process of cross-boundary information sharing by knowledge brokers (KB) during a disaster using lenses of knowledge management and naturalistic decision making. The study integrated interpretivist and positivist stances, conducted using qualitative methods. It used a multiple case embedded research design and in-depth face-to-face interviews as the method of inquiry and an inductive process of theory generation. The cases were in the context of disasters that occurred in New Zealand. The unit of analysis was the scenarios that KB experienced during disasters. Based on a four stage analysis of the data, there were two phases that KB went through in assessing the veracity of the information they received and deciding to whom the information is relevant. In each phase, KB were relying on different cognitive resources to filter and to match the information. It was also found that there were different types of boundary, information and disasters. Interestingly, it was found that KB used different tactics to make the decision on the information’s veracity and to whom it is relevant. The primary contribution of this thesis is the generation and explanation of the theoretical model of cross-boundary information sharing by KB during a disaster. This theory can also be used by practitioners as a guide to improve disaster management training and for the community to prepare stronger resilience plans.</p>

Cross-Boundary Information Sharing By Knowledge Brokers During A Disaster

<p>This thesis explores and investigates the process of cross-boundary information sharing by knowledge brokers (KB) during a disaster using lenses of knowledge management and naturalistic decision making. The study integrated interpretivist and positivist stances, conducted using qualitative methods. It used a multiple case embedded research design and in-depth face-to-face interviews as the method of inquiry and an inductive process of theory generation. The cases were in the context of disasters that occurred in New Zealand. The unit of analysis was the scenarios that KB experienced during disasters. Based on a four stage analysis of the data, there were two phases that KB went through in assessing the veracity of the information they received and deciding to whom the information is relevant. In each phase, KB were relying on different cognitive resources to filter and to match the information. It was also found that there were different types of boundary, information and disasters. Interestingly, it was found that KB used different tactics to make the decision on the information’s veracity and to whom it is relevant. The primary contribution of this thesis is the generation and explanation of the theoretical model of cross-boundary information sharing by KB during a disaster. This theory can also be used by practitioners as a guide to improve disaster management training and for the community to prepare stronger resilience plans.</p>