Enabling in-person knowledge exchange in the health sector

Workplace-based knowledge exchange activities between researchers, policymakers and providers in the health and care sector have the potential to solve problems, stimulate innovation, and offer career development opportunities. pIn our attempt to better understand their contribution to the health and care sector, we encountered challenges that led us to outline a clearer nomenclature and reporting principles to help with evaluation of programmes and future attempts to study the sector.

In-person knowledge exchange programmes aim to improve relationships between participants, helping them to better understand each other’s challenges and find solutions in common in order to improve the delivery of health and care. They can include job shadowing, work-placements, project-based collaborations, and secondments. Examples include the Paired Learning programme, involving hospital-based doctors and managers shadowing one another; the Wessex Model for Workplace Exchanges, involving GPs and secondary care consultants spending time in each other’s workplace; or Harkness Fellowships involving individuals committed to strengthening health policy spending a year working in the US.

The challenges facing knowledge exchange participants

As a research priority for Research England and as a group of clinicians and researchers interested in knowledge mobilisation, we sought to better understand the contribution of workplace-based exchanges in the health and care sector by systematically identifying and describing the characteristics of opportunities available to people working in health or care in the United Kingdom.

Through a scoping study and mapping exercise we systematically identified 147 academic articles and 74 websites on in-person exchanges for people working in the health or care sector. Programmes had a wide range of duration, lasting anywhere from one day to five years. Their objectives spanned from individual benefits around building networks, through to organisational level benefits around bringing innovation back to employers. Some were one-way exchanges, while others were two-way. Many included activities like networking, action-learning sets, mentorship, or joint quality improvement projects – often described more broadly as a ‘fellowship’ programme. Funding was not consistently provided.

We found it challenging to systematically identify opportunities online – resulting in over a third of our identified websites coming from word-of-mouth recommendations from well-connected researchers and exchange organisers. Once identified, we found inconsistent and vague language often was used to describe opportunities.

As part of the scoping study, we also interviewed people who had taken part in or organised an exchange who described a range of barriers to participation. These included a lack of knowing how to identify with whom to undertake an exchange (varying ‘tribes’), alongside the burdens of time, costs, and administration regarding arranging exchanges. Exchanges were reported to work best where there was a perceived sense of shared purpose, a long-standing relationship, and trust between organisations.

Based on our research, we propose the use of two new resources to enable exchanges to become easier to search for, describe and evaluate:

Resource 1: Nomenclature of exchange activities

Building on existing knowledge mobilisation theories (c.f. Ward 2017), and drawing on the articles and programmes identified, we developed a framework describing activities involved in exchanges. Exchanges identified typically included of one or two of these in-person activities:

• Job shadowing involves a visitor accompanying a host in their work activities for professional development or curiosity. It can be observational, involve regular briefings, or hands-on tasks under supervision. As an experiential learning tool, shadowing provides first-hand insights into different roles, functions, and practices in various fields. These typically last between one day to two weeks.
• Work placements are a supervised period where participants gain experience in a specific role within an organisation or across settings. In post-qualification settings they tended to feature as part of a broader professional development programme, often as part of a ‘Fellowship’. These typically last for up to a year.
• Project-based collaborations involve ad-hoc arrangements where individuals contribute their external expertise to project teams. It can be part-time, combined with other work, and can include pre-arranged meetings for co-creating solutions or collaborating on specific topics. These vary in length.
• Secondments are temporary transfers to a different position or employment, either within the same organisation (internal) or at a different organisation (external). After the term ends, the employee returns to their original employer. These typically last one to two years.

Resource 2: Reporting principles for workplace-based exchanges

Adapting the TIDier framework, and building on the proposed nomenclature above, we recommend a set of reporting principles that can be used by exchange organisers in their advertisements, as well as participants reporting of experiences post-participation. The principles ask questions prompting clear descriptions of the programme’s aims, actions, and outcomes – essentially describing a theory of change, which would enable the evaluation and comparison of these programmes.

Next steps for exchanges

Workplace-based exchanges can be an invaluable asset in bridging gaps between different sectors, sub-sectors and disciplines, fostering a culture of continuous learning and improvement. As we continue to utilise and realise potential of such exchange programmes to mobilise knowledge, it is essential to promote consistent terminology (e.g., job shadowing, work placements, project-based collaborations, and secondments), report experiences comprehensively, and invest in evaluation mechanisms to maximise their impact.

- Stephanie Kumpunen, UCL Department of Applied Health Research and Nuffield Trust

- Luisa Pettigrew, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine