title: Affordances of knowledge translation in medical education: a qualitative exploration of empirical knowledge use among medical educators.
abstract: OBJECTIVE
  Little is known about knowledge translation processes within medical education. Specifically, there is scant research on how and whether faculty incorporate empirical medical education knowledge into their educational practices. The authors use the conceptual framework of affordances to examine factors within the medical education practice environment that influence faculty utilization of empirical knowledge.
  
  
  METHODS
  In 2012, the authors, using a purposive sampling strategy, recruited medical education leaders in undergraduate medical education from a Canadian university. Recruits all had direct teaching and curricular development roles in either preclinical or clinical courses across the four years of the undergraduate curriculum. Data were collected through individual semistructured interviews on participants' use of empirical evidence, as well as the factors that influence integration of empirical knowledge into practice. Data were analyzed using thematic analysis.
  
  
  RESULTS
  Fifteen medical educators participated. The authors identified both constraining and facilitating affordances of empirical medical education knowledge use. Constraining affordances included poor quality and availability of evidence, inadequate knowledge delivery approaches, work and role overload, faculty and student change resistance, and resource limitations. Facilitating affordances included faculty development, peer recommendations, and local involvement in medical education knowledge creation.
  
  
  CONCLUSIONS
  Affordances of the medical education practice environment influence empirical knowledge use. Developing strategies for effective knowledge translation thus requires careful assessment of contextual factors that can enable, constrain, or inhibit evidence use. Empirical knowledge use is most likely to occur among medical educators who are afforded rich, facilitative opportunities for participation in creating, seeking, and implementing knowledge.
authors.affiliation: Dr. Onyura is research and evaluation consultant, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Dr. Le´gare´ is Canada Research Chair in Implementation of Shared Decision Making in Primary Care and professor, Department of Family Medicine and Emergency Medicine, Laval University, Québec, Québec, Canada. Ms. Baker is research and education consultant, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Dr. Reeves is professor of interprofessional research, Faculty of Health, Social Care and Education, Kingston University and St. Georges, University of London, London, United Kingdom. Dr. Rosenfield is professor, Faculty of Medicine, and vice dean of undergraduate medical education, University of Toronto, Toronto, Ontario, Canada. Dr. Kitto is a medical sociologist and assistant professor, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr. Hodges is professor, Faculty of Medicine and Faculty of Education, University of Toronto, and vice president of education, University Health Network, Toronto, Ontario, Canada. Dr. Silver is professor, Faculty of Medicine, University of Toronto, and vice president of education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Curran is professor, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada. Dr. Armson is director of research, Foundation of Medical Practice Education, and professor, University of Calgary, Calgary, Alberta, Canada. Dr. Leslie is director, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, and associate professor, Department of Pediatrics, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.
authors.forename: Betty
authors.initials: B
authors.lastname: Onyura
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.forename: Lindsay
authors.initials: L
authors.lastname: Baker
authors.forename: Scott
authors.initials: S
authors.lastname: Reeves
authors.forename: Jay
authors.initials: J
authors.lastname: Rosenfield
authors.forename: Simon
authors.initials: S
authors.lastname: Kitto
authors.forename: Brian
authors.initials: B
authors.lastname: Hodges
authors.forename: Ivan
authors.initials: I
authors.lastname: Silver
authors.forename: Vernon
authors.initials: V
authors.lastname: Curran
authors.forename: Heather
authors.initials: H
authors.lastname: Armson
authors.forename: Karen
authors.initials: K
authors.lastname: Leslie
mesh_terms: D002170:Canada; D004501:Education, Medical; D004504:Education, Medical, Undergraduate; D005180:Faculty, Medical; D007407:Interviews as Topic; D057170:Translational Research, Biomedical