title: Expanding the knowledge translation metaphor.
abstract: BACKGROUND
  Knowledge translation (KT) is a buzzword in modern medical science. However, there has been little theoretical reflection on translation as a process of meaning production in KT. In this paper, we argue that KT will benefit from the incorporation of a more theoretical notion of translation as an entangled material, textual and cultural process.
  
  
  CONCLUSIONS
  We discuss and challenge fundamental assumptions in KT, drawing on theories of translation from the human sciences. We show that the current construal of KT as separate from and secondary to the original scientific message is close to the now deeply compromised literary view of translation as the simple act of copying the original. Inspired by recent theories of translation, we claim that KT can be more adequately understood in terms of a 'double supplement' - on the one hand, KT offers new approaches to the communication of scientific knowledge to different groups in the healthcare system with the aim of supplementing a lack of knowledge among clinicians (and patients). On the other, it demonstrates that a textual and cultural supplement, namely a concern with target audiences (clinicians and patients), is inevitable in the creation of an 'autonomous' science. Hence, the division between science and its translation is unproductive and impossible to maintain. We discuss some possible implications of our suggested shift in concept by drawing on pharmaceutical interventions for the prevention of HIV as a case. We argue that such interventions are based on a supplementary and paradoxical relation to the target audiences, both presupposing and denying their existence. More sophisticated theories of translation can lay the foundation for an expanded model of KT that incorporates a more adequate and reflective description of the interdependency of scientific, cultural, textual and material practices.
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, BOX 1130, Blindern, 0318, Oslo, Norway. eivind.engebretsen@medisin.uio.no.
authors.forename: Eivind
authors.initials: E
authors.lastname: Engebretsen
authors.affiliation: Department of Cultural Studies and Oriental Languages, Faculty of Humanities, University of Oslo, BOX 1010, Blindern, 0315, Oslo, Norway.
authors.forename: Tony Joakim
authors.initials: TJ
authors.lastname: Sandset
authors.affiliation: Department of Cultural Studies and Oriental Languages, Faculty of Humanities, University of Oslo, BOX 1010, Blindern, 0315, Oslo, Norway.
authors.forename: John
authors.initials: J
authors.lastname: Ødemark
mesh_terms: D019317:Evidence-Based Medicine; D006809:Humanities; D006801:Humans; D019365:Metaphor; D016032:Randomized Controlled Trials as Topic; D012942:Social Sciences; D057170:Translational Research, Biomedical
keywords: Evidence-based medicine; Humanities; Knowledge translation; Social science