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Knowledge use is a critical element in provider adherence to evidence-based practices and recommendations. Knowledge use can:
- change attitudes and beliefs about a particular practice (i.e., a health-care provider becomes knowledgeable about a best practice, develops positive attitudes toward it and develops motivation to apply it);
- be complex since health-care providers may choose to follow some recommendations but not others; and
- be affected by structures and processes in the clinical setting.
Types of knowledge use
There are three main types of knowledge use that change agents should consider when measuring knowledge use (Strauss et al., 2013):
| Type of knowledge use | Definition | Example | Dimensions to measure | Example of monitoring knowledge use |
|---|---|---|---|---|
| Conceptual | The understanding and internalization of new knowledge. The results indicate changes in knowledge, understanding, or attitudes toward a practice or an intervention. | The use of literature reviews, peer-reviewed studies, and policy briefs may change thinking and inform decision-making, but not change practice. |
Attitude Level of knowledge Beliefs Interest Self-efficacy |
A knowledge test is administered before and after an education session on handwashing, hygiene to determine health-care providers' understanding. |
| Instrumental |
The concrete application of knowledge. It describes the changes in behaviour or practice and knowledge when it is translated into a usable form. |
Use of decision aids, a new intervention, or practice. |
Research use Acceptability Feasibility Adoption Fidelity Quality indicators |
Conduct a chart audit to determine if the BPG recommendations are being followed and/or observe practice in real-time settings. |
| Persuasive (symbolic/strategic) | Knowledge is being used as a persuasive tool. It relates to the use of knowledge to achieve specific power or to influence outcomes or goals (e.g., a policy change). | Include results on a patient satisfaction survey that indicated patients were dissatisfied with the way their need for pain relief was managed to help practitioners adopt the recommendations in the Pain BPG. | Change in policy | Interview practitioners whether there is a change in policies for a particular practice in the work setting |
