title: Knowledge 'Translation' as social learning: negotiating the uptake of research-based knowledge in practice.
abstract: BACKGROUND
  Knowledge translation and evidence-based practice have relied on research derived from clinical trials, which are considered to be methodologically rigorous. The result is practice recommendations based on a narrow view of evidence. We discuss how, within a practice environment, in fact individuals adopt and apply new evidence derived from multiple sources through ongoing, iterative learning cycles.
  
  
  CONCLUSIONS
  The discussion is presented in four sections. After elaborating on the multiple forms of evidence used in practice, in section 2 we argue that the practitioner derives contextualized knowledge through reflective practice. Then, in section 3, the focus shifts from the individual to the team with consideration of social learning and theories of practice. In section 4 we discuss the implications of integrative and negotiated knowledge exchange and generation within the practice environment. Namely, how can we promote the use of research within a team-based, contextualized knowledge environment? We suggest support for: 1) collaborative learning environments for active learning and reflection, 2) engaged scholarship approaches so that practice can inform research in a collaborative manner and 3) leveraging authoritative opinion leaders for their clinical expertise during the shared negotiation of knowledge and research. Our approach also points to implications for studying evidence-informed practice: the identification of practice change (as an outcome) ought to be supplemented with understandings of how and when social negotiation processes occur to achieve integrated knowledge. This article discusses practice knowledge as dependent on the practice context and on social learning processes, and suggests how research knowledge uptake might be supported from this vantage point.
authors.affiliation: Graduate Program, Health and Rehabilitation Sciences, Western University, London, ON, Canada. kcharle2@uwo.ca.
authors.forename: K L
authors.initials: KL
authors.lastname: Salter
authors.affiliation: Graduate Program, Health and Rehabilitation Sciences, Western University, London, ON, Canada.|School of Health Studies, Western University, London, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Kothari
mesh_terms: D002983:Clinical Competence; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine / Q000193:education; D006801:Humans; D008962:Models, Theoretical; D000067570:Social Learning; D057170:Translational Research, Biomedical / Q000193:education* / Q000379:methods