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Defining How We Get from Research to Practice: A Model Framework for Schools

• First Online: 24 June 2017

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• Elizabeth Farley-Ripple 5 ,
• Allison E. Karpyn 5 ,
• Kalyn McDonough 5 &
• Katherine Tilley 5  

Part of the book series: Educational Governance Research ((EGTU,volume 6))

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In this chapter, the authors argue that stronger connections between research and practice in education are inherently a public good. The authors discuss recent efforts by the US Government to encourage production of better education research, and more effective application of this research to practice. The current educational policy climate, generated in large part by the 2001 passage of No Child Left Behind and reiterated through reauthorization in the Every Student Succeeds Act, places immense pressure on schools and districts to use evidence to inform their decisions regarding student learning. However, due to the complexity of these decisions, such mandates have often fallen short in ensuring that evidence is incorporated. The chapter establishes the context of national education policy regarding research evidence use and explores recent efforts which seek to better understand and motivate the use of research in schools to inform the public good. As this discussion reveals problematic assumptions and solutions, the authors propose a bi-directional model for understanding the relationship between research and practice, and highlight current efforts that support use of research evidence in schools and districts.

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Asen, R., & Gurke, D. (2014). The Research on Education, Deliberation, and Decision-Making (REDD) project. In K. Finnigan & A. Daly (Eds.), Using research evidence in education: From the schoolhouse door to Capitol Hill (pp. 53–68). New York: Springer.

Chapter   Google Scholar  

Backer, T. E. (1986). Utilization: The challenge of transferring innovations in rehabilitation and special education . Washington, DC: National Rehabilitation Information Center.

Google Scholar  

Backer, T. E. (1993). Information alchemy: Transforming information through knowledge utilization. Journal of the American Society for Information Science, (1986–1998), 44 (4), 217.

Article   Google Scholar  

Behrstock-Sherratt, E., Drill, K., & Miller, S. (2011). Is the supply in demand? Exploring how, whey, and why teachers use research . Washington, DC: American Institutes for Research.

Biddle, B. J., & Saha, L. J. (2006). How principals use research. Educational Leadership, 63 (6), 72–77.

Birkeland, S., Murphy-Graham, E., & Weiss, C. H. (2005). Good reasons for ignoring good evaluation: The case of the drug abuse resistance education (D.A.R.E.) program. Evaluation and Program Planning, 28 , 247–256.

Blake, S. C., & Ottoson, J. M. (2009). Knowledge utilization: Implications for evaluation. New Directions for Evaluation, 124 , 21–34.

Bouffard, S. (2003). Doing what works: Scientifically based research in education. The Evaluation Exchange , 9 (1).

Bransford, J. D., Stipek, D. J., Vye, N. J., Gomez, L. M., & Lam, D. (2009). The role of research in educational improvement . Cambridge: Harvard Education Press.

Brenchley, C. (2011, March 14). It’s time to fix no child left behind . Retrieved from http://blog.ed.gov/2011/03/lets-fix-no-child-left-behind/

Broekkamp, H., & van Hout-Wolters, B. (2007). The gap between educational research and practice: A literature review, symposium, and questionnaire. Educational Researcher, 32 (9), 3–14.

Burkhardt, H., & Schoenfeld, A. H. (2003). Improving educational research: Toward a more useful, more influential, and better-funded enterprise. Educational Researcher, 32 (9), 3–14.

Caplan, N. (1979). The two-communities theory and knowledge utilization. American Behavioral Scientist, 22 (3), 459–470.

Center for Research Use in Education. (2016). About us . Retrieved from research4schools.org

Coburn, S. E., & Stein, M. K. (2010). Research and practice in education. Building alliances, bridging the divide . Lanham: Rowman & Littlefield Publishers.

Coburn, C. E., & Talbert, J. E. (2006). Conceptions of evidence use in school districts: Mapping the terrain. American Journal of Education, 112 (4), 469–495.

Coburn, C. E., & Turner, E. O. (2012). The practice of data use: An introduction. American Journal of Education, 118 (2), 99–111.

Coburn, C. E., Toure, J., & Yamashita, M. (2009). Evidence, interpretation, and persuasion: Instructional decision making in the district central office. Teachers College Record, 11 (4), 1115–1161.

Coburn, C. E., Penuel, W. R., & Geil, K. E. (2013). Research-practice partnerships: A strategy for leveraging research for educational improvement in school districts . New York: William T. Grant Foundation.

Corcoran, T. (2003). The use of research evidence in instructional improvement (RB-40) . Philadelphia: Consortium for Policy Research in Education, University of Pennsylvania.

Corcoran, T., Fuhrman, S. H., & Belcher, C. L. (2001). The district role in instructional improvement. Phi Delta Kappan, 83 (1), 78–84.

Corcoran, T., McVay, S., & Riordan, K. (2003). Getting it right: The MISE approach to professional development . CPRE Research Reports. Retrieved from http://repository.upenn.edu/cpre_researchreports/42

Cousins, J., & Simon, M. (1996). The nature and impact of policy-induced partnerships between research and practice communities. Educational Evaluation and Policy Analysis, 18 (3), 199–218.

Dagenais, C., Lysenko, L., Abrami, P. C., Bernard, R. M., Ramde, J., & Janosz, M. (2012). Use of research-based information by school practitioners and determinants of use: A review of empirical research. Evidence & Policy: A Journal of Research, Debate and Practice, 8 (3), 285–309.

Daly, A. J., Finnigan, K. S., Jordan, S., Moolenaar, N. M., & Che, J. (2014). Misalignment and perverse incentives: Examining the politics of district leaders as brokers in the use of research evidence. Educational Policy, 28 (2), 145–174.

Davidson, K., & Nowicki, E. (2012). An exploration of the utility of a knowledge utilization framework to study the gap between reading disabilities research and practice. Alberta Journal of Educational Research, 58 (3), 330–349.

Davies, H.T., & Nutley, S. (2008). Learning more about how research-based knowledge gets used. Unpublished Working Paper. New York: William T. Grant Foundation.

Drill, K., Miller, S., & Behrstock-Sherratt, E. (2012). Teachers’ perspectives on educational research. American Institute for Research . Retrieved from http://files.eric.ed.gov/fulltext/ED530742.pdf

Dunn, W. N. (1980). The two-communities metaphor and models of knowledge use. Knowledge, 1 , 515–536.

Every Student Succeeds Act. (2015). S. 1177-114th Congress. Retrieved from https://www.gpo.gov/fdsys/pkg/BILLS-114s1177enr/pdf/BILLS-114s1177enr.pdf

Fabelo, T., Thompson, M. D., Plotkin, M., Carmichael, D., Marchbanks, M. P., & Booth, E. A. (2011). Breaking schools’ rules: A statewide study of how school discipline relates to students’ success and juvenile justice involvement . New York: Council of State Governments Justice Center.

Farley-Ripple, E. N. (2008). Accountability, evidence and school district decision-making . Unpublished doctoral dissertation, University of Pennsylvania, Philadelphia, PA.

Farley-Ripple, E. N. (2012). Research use in central office decision-making: A case study. Education Management, Administration, and Leadership, 40 (6), 784–804.

Farley-Ripple, E. N., & Jones, A. (2015). Educational contracting, and the translation of research into practice: The case of Data Coach vendors in Delaware. International Journal of Educational Policy and Leadership, 10 (2).

Farrell, C., & Coburn, C. E. (2016, April 8). What is the conceptual use of research, and why is it important? Retrieved from http://wtgrantfoundation.org/conceptual-use-research-important

Feldman, M. S., & March, J. G. (1981). Information as signal and symbol. Administrative Science Quarterly, 26 (2), 171–186.

Finnigan, K.S., Daly, A.S., & Che, J. (2012). Proceedings from AERA ‘12: The acquisition and use of evidence districtwide . Vancouver, Canada.

Finnigan, K. S., Daly, A. J., & Che, J. (2013). Systemwide reform in districts under pressure. The role of social networks in defining, acquiring, using, and diffusing research evidence. Journal of Educational Administration, 51 (4), 476–497.

Fuhrman, S., & Elmore, R. F. (Eds.). (2004). Redesigning accountability systems for education (Vol. 38). New York: Teachers College Press.

Hanks, A. S., Just, D. R., & Wansink, B. (2013). Smarter lunchrooms can address new school lunchroom guidelines and childhood obesity. The Journal of Pediatrics, 162 (4), 867–869.

Hannaway, J. (1989). Managers managing: The workings of an administrative system . New York: Oxford University Press.

Hemsley-Brown, J. (2009). Using evidence to support administrative decisions. In T. J. Kowalski & T. J. Lasley II (Eds.), Handbook of data-based decision making in education (pp. 272–285). New York: Taylor & Francis.

Hemsley-Brown, J., & Sharp, C. (2003). The use of research to improve professional practice: A systematic review of the literature. Oxford Review of Education, 29 (4), 449–470.

Hernandez, D. J. (2011). Double jeopardy: How third-grade reading skills and poverty influence high school graduation . New York: The Annie E. Casey Foundation.

Hess, F. M., & Rotherham, A. J. (2007). NCLB and the competitiveness agenda: Happy collaboration or a collisions course? Phi Delta Kappa International, 88 (5).

Hightower, A. (2002). San Diego’s big boom: Systematic instructional change in the central office and schools. School districts and instructional renewal , 76–93.

Honig, M. I. (2003). Building policy from practice: District central office administrators’ roles and capacity for implementing collaborative education policy. Educational Administration Quarterly, 39 (3), 292–338.

Honig, M. I., & Coburn, C. (2008). Evidence-based decision making in school district central offices: Toward a policy and research agenda. Educational Policy, 22 (4), 578–608.

Honig, M. I., & Venkateswaran, N. (2012). School–central office relationships in evidence use: Understanding evidence use as a systems problem. American Journal of Education, 118 (2), 199–222.

Honig, M., Venkateswaran, N., McNeil, P., & Twitchell, K. (2014). Leaders’ use of research for fundamental change in school district central offices: Processes and challenges. In K. Finnigan & A. Daly (Eds.), Using research evidence in education (pp. 33–52). New York: Springer International Publishing.

Huberman, M. (1990). Linkage between researchers and practitioners: A qualitative study. American Educational Research Journal, 27 (2), 363–391.

Institute of Education Sciences. (2014). Funding opportunities . Retrieved from http://ies.ed.gov/funding/ncer_rfas/randd_knowledge.asp

Institute of Education Sciences. (2016a). Regional Educational Laboratory Program . Retrieved from http://ies.ed.gov/ncee/edlabs/

Institute of Education Sciences. (2016b). What works clearinghouse . Retrieved from http://ies.ed.gov/ncee.wwc

Kennedy, M. M. (1982). Evidence and decision. In M. M. Kennedy (Ed.), Working knowledge and other essays (pp. 59–103). Cambridge, MA: The Huron Institute.

Knorr, K. (1977). Policymakers’ use of social science knowledge: Symbolic or instrumental? In C. H. Weiss (Ed.), Using social research in public policymaking . Lexington: Lexington Books.

Labaree, D. F. (1997). Public goods, private goods: The American struggle over educational goals. American Educational Research Journal, 34 (1), 39–81.

Landry, R., Amara, N., & Lamari, M. (2001). Climbing the ladder of research utilization evidence from social science research. Science Communication, 22 (4), 396–422.

Lavis, J.N., Robertson, D., Woodside, J., McLeod, C., & Abelson, J. (2003). How can research organizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly , 81(2). Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/1468-0009.t01-1-00052/epdf

Louis, K. S. (1992). Restructuring and the problem of teachers’ work. In A. Lieberman (Ed.), The changing contexts of teaching (Vol. I, pp. 138–156). Ninety-first Yearbook of the National Society for the Study of Education , Chicago, IL.

Mac Iver, M. A., & Farley, E. (2003). Bringing the district back in: The role of the central office in improving Instruction and student achievement. Center for Research on the Education of Students Placed at Risk.

March, J. G. (1994). A primer on decision making . New York: The Free Press.

Massell, D., & Goertz, M. E. (2002). District strategies for building instructional capacity. In A. M. Hightower, M. S. Knapp, J. A. Marsh, & M. W. McLaughlin (Eds.), School districts and instructional renewal (pp. 43–60). New York: Teachers College Press.

Massell, D., & Goertz, M. E. (2012, April). State education department acquisition and use of research in school improvement. Paper presented at the 2012 Annual Meeting of the American Education Research Association, Vancouver.

May, H., Sirinides, P., Gray, A., & Goldsworthy, H. (2016). Reading recovery: An evaluation of the four-year i3 scale-up . Philadelphia: Consortium for Policy Research in Education.

Book   Google Scholar  

Maynard, L. M. (2006). The role of repetition in the practice sessions of artist teachers and their students. Bulletin of the Council for Research in Music Education, 167 , 61–72.

Miretzky, D. (2007). A view of research from practice: Teachers talk about research. Theory Into Practice, 46 (4), 272–280.

National Board for Education Sciences. (2008). National Board for Education Sciences: 5-year report, 2003 through 2008 . (NBES 2009–6011). Washington, DC.

National Board for Education Sciences. (2015). National Board for Education Sciences: 2014 NBES annual report, July 2013 through June 2014 . Washington, DC.

National Center for Research in Policy and Practice. (2016). Our work . Retrieved from http://ncrpp.org

Nicholson-Goodman, J., & Garman, N. B. (2007). Mapping practitioner perceptions of ‘It’s research based’: Scientific discourse, speech acts and the use and abuse of research. International Journal of Leadership in Education, 10 (3), 283–299.

No Child Left Behind Act. (2001). Pub. L. 107–110. 115 Stat. 1425- 107th Congress. Retrieved from http://www2.ed.gov/policy/elsec/leg/esea02/107-110.pdf

Ottoson, J. M. (2009). Knowledge-for-action theories in evaluation: Knowledge utilization, diffusion, implementation, transfer, and translation. New Directions for Evaluation, 124 , 7–20.

Penuel, W. R., Briggs, D. C., Davidson, K. C., Herlihy, C., Sherer, D., Hill, H. C., Farrell, C., & Allen, A. (2016). Findings from a national study on research use among school and district leaders. Retrieved from ncrpp.org/pages/ourwork

Porter, R. W., & Hicks, I. (1997). Knowledge utilization and the process of policy formation: towards a framework for action. In D. W. Chapman, L. O. Mahlck, & A. E. M. Smulders (Eds.), From planning to action: Government initiatives for improving school-level practice (pp. 32–67). Paris: UNESCO International Institute for Educational Planning.

Reichardt, R. (2000). The state’s role in supporting data-driven decision-making: A view of Wyoming . Aurora: Mid-Continent Research for Education and Learning.

Rich, R. F. (1977). Use of social science information by federal bureaucrats: Knowledge for action versus knowledge for understanding. In C. H. Weiss (Ed.), Using social research in public policymaking (pp. 199–211). Lexington: Lexington Books.

Short, E. C. (1970). A review of studies on the general problem of knowledge production and utilization .

Spillane, J. P. (1998). State policy and the non-monolithic nature of the local school district: Organizational and professional considerations. American Educational Research Journal, 35 (1), 33–63.

Supovitz, J. A., & Klein, V. (2003). Mapping a course for improved student learning: How innovative schools systematically use student performance data to guide improvement. University of Pennsylvania: Consortium for Policy Research in Education.

Tseng, V., & Nutley, S. (2014). Building the infrastructure to improve the use and usefulness of research in education. In Using research evidence in education (pp. 163–175). New York: Springer.

U.S. Department of Education. (1983). A nation at risk: The imperative for educational reform. Retrieved from http://www2.ed.gov/pubs/NatAtRisk/index.html

U.S. Department of Education. (2011). Secretary Duncan, Attorney General Holder announce effort to respond to school-to-prison pipeline by supporting good discipline practices . Retrieved from http://www.ed.gov/news/press-releases/secretary-duncan-attorney-general-holder-announce-effort-respond-school-prison-p

Viadero. (2004). Ed. Dept. issues practical guide to research-based practice. Education Week, 23 (16), 12.

Weiss, C. H. (1995). Nothing as practical as good theory: Exploring theory-based evaluation for comprehensive community initiatives for children and families. In J. P. Connell, A. C. Kubisch, L. B. Schorr, & C. H. Weiss (Eds.), New approaches to evaluating community initiatives: Concepts, methods, and contexts (pp. 65–92). Washington, DC: The Aspen Institute.

Weiss, C. H., & Bucuvalas, M. J. (1980). Social science research and decision-making . New York: Columbia University Press.

Wentworth, L., Carranza, R., & Stipek, D. (2016). A university and district partnership closes the research-to-classroom gap. Phi Delta Kappan, 97 (8), 66–69.

West, R. F., & Rhoton, C. (1994). School district administrators’ perceptions of educational research and barriers to research utilization. ERS Spectrum, 12 (1), 23–30.

Wong, K. K., & Mid-Atlantic Lab. for Student Success, P. P. A (1998). Laying the groundwork for a new generation of policy research: Commentary on “Knowledge utilization in educational policy and politics”. Spotlight on student success No. 303 . Washington, DC: Office of Educational Research and Improvement.

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Farley-Ripple, E., Karpyn, A.E., McDonough, K., Tilley, K. (2017). Defining How We Get from Research to Practice: A Model Framework for Schools. In: Eryaman, M., Schneider, B. (eds) Evidence and Public Good in Educational Policy, Research and Practice. Educational Governance Research, vol 6. Springer, Cham. https://doi.org/10.1007/978-3-319-58850-6_5

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• Published: 09 October 2020

Bridging the research–practice gap in healthcare: a rapid review of research translation centres in England and Australia

• Tracy Robinson   ORCID: orcid.org/0000-0002-3512-7023 1 , 2 , 3 ,
• Cate Bailey 1 ,
• Heather Morris 1 ,
• Prue Burns 4 ,
• Angela Melder 1 , 3 , 5 ,
• Charlotte Croft 6 ,
• Dmitrios Spyridonidis 2 , 6 ,
• Halyo Bismantara 1 , 3 ,
• Helen Skouteris 1 , 3   na1 &
• Helena Teede 1 , 3 , 5   na1  

Health Research Policy and Systems volume  18 , Article number:  117 ( 2020 ) Cite this article

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Large-scale partnerships between universities and health services are widely seen as vehicles for bridging the evidence–practice gap and for accelerating the adoption of new evidence in healthcare. Recently, different versions of these partnerships – often called academic health science centres – have been established across the globe. Although they differ in structure and processes, all aim to improve the integration of research and education with health services. Collectively, these entities are often referred to as Research Translation Centres (RTCs) and both England and Australia have developed relatively new and funded examples of these collaborative centres.

This paper presents findings from a rapid review of RTCs in Australia and England that aimed to identify their structures, leadership, workforce development and strategies for involving communities and service users. The review included published academic and grey literature with a customised search of the Google search engine and RTC websites.

RTCs are complex system-level interventions that will need to disrupt the current paradigms and silos inherent in healthcare, education and research in order to meet their aims. This will require vision, leadership, collaborations and shared learnings, alongside structures, processes and strategies to deliver impact in the face of complexity. The impact of RTCs in overcoming the deeply entrenched silos across organisations, disciplines and sectors needs to be captured at the systems, organisation and individual levels. This includes workforce capacity and public and patient involvement that are vital to understanding the evolution of RTCs. In addition, new models of leadership are needed to support the brokering and mobilisation of knowledge in complex organisations.

Conclusions

The development and funding of RTCs represents one of the most significant shifts in the health research landscape and it is imperative that we continue to explore how we can progress the integration of research and healthcare and ensure research meets stakeholder needs and is translated via the collaborations supported by these organisations. Because RTCs are a recent addition to the healthcare landscape in Australia, it is instructive to review the processes and infrastructure needed to support their implementation and applied health research in England.

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Introduction

“ If you think competition is hard, you should try collaboration ” (Kings Fund Report, 2019)

Over the past decade, there has been wide international concern that new health research and evidence is not translated into practice in a timely fashion [ 1 , 2 ]. The 17-year time lag between evidence and clinical practice change has been widely touted [ 3 ]. Systemic barriers such as lack of integration between health and research, dissonant metrics, organisational and professional silos, pervasive competition, lack of collaboration, and a failure to engage relevant stakeholders have all been identified as contributors to translation ‘gaps’ [ 4 , 5 , 6 ]. An international response to accelerate the translation and mobilisation of new knowledge has been the development of large-scale partnerships between universities, research institutes and health services that aim to integrate healthcare, research and education [ 7 ]. In world-leading United Kingdom and Australian health systems [ 8 ], these partnerships include a focus on evidence translation and health impact.

In England, these ‘partnerships’ include Collaboration for Leadership in Applied Health Research Centres (CLAHRCs), Academic Health Science Centres (AHSC) and Academic Health Science Networks (AHSNs). Collectively, these entities are often referred to as Research Translational Centres (RTCs) and they have been established internationally in the United States, Canada, England and Australia. In 2008, the National Institute for Health Research (NIHR) established nine CLAHRCs to increase the uptake of promising clinical research into practice and improve outcomes by engaging service users and the public in applied health research [ 9 ]. CLAHRCs competed with each other for NIHR funding in 5-year cycles. Subsequently, AHSCs were established in 2009. They are not formally part of the NIHR and, unlike CLAHRCs, did not receive NIHR funding [ 9 ]. These centres originally developed through interactions between rival institutions and occurred in a policy context that supported and accredited a limited number of prestigious AHSCs that continue to operate in strong institutional competition [ 10 ].

In 2013, a second round of competitive CLAHRC funding saw the recognition of 13 centres across England. Simultaneously, AHSNs were established with clear structures of accountability and budget and a focus on promoting and adopting innovation in healthcare. Commissioned by the National Health Service (NHS), concerns that the future of these networks may be constrained by budgetary pressures have been expressed [ 11 ], even though improving the uptake of innovation is valued in improving the quality and sustainability of healthcare in England. CLAHRCs were tasked with strengthening collaborations with the AHSNs [ 9 ]. A third round of CLAHRC funding, announced in 2019, saw the centres renamed as Applied Research Centres (ARCs), with increased focus on social care and public health. Strengthening the links between the ARCs and the AHSNs remains a priority, with AHSNs expected to take up and implement evidence generated by the ARCs.

In Australia, the McKeon review (2013) identified that the best performing health systems are those that embed research in healthcare and recommended the establishment of integrated RTCs that combine hospital networks, universities and medical research institutes [ 12 ]. The review also recommended a doubling of investment in medical research to grow applied health research that drives efficiency and impacts on communities. Since 2015, the National Health and Medical Research Centre (NHMRC) has accredited seven Advanced Health Research Translation Centres and three Centres for Innovation in Regional Health (CIRHs) to encourage leadership in health research and implementation [ 13 ]. The accreditation process is competitive to a benchmark but RTCs do not compete against each other. The Advanced Health Research and Translation Centres and CIRHs are, to some extent, modelled on RTCs elsewhere, including England, but are uniquely ‘health service-led’ collaborations. The CIRHs have a specific focus on the healthcare needs of regional and remote Australian populations.

Another unique feature of the RTCs in Australia is that they have developed a national alliance – the Australian Health Research Alliance (AHRA). The Australian Federal and State Governments have since invested in these RTCs across the AHRA. Funds are shared equally across all RTCs accredited by the NHMRC and, hence, the system enables collaboration for greater benefit from existing funding rather than promoting competition. The AHRA has increasingly prioritised research on RTC operations and activities, including how best to mobilise strategic prioritised health research in practice and how to measure and capture impact. This is because, despite significant government investment, the optimal collaboration models and activities are yet to be fully understood, especially in Australia where the RTCs and AHRA are relatively recent constructs. In England, several evaluations of the CLAHRCs and AHSCs have been undertaken [ 9 , 14 , 15 , 16 ] but these have mostly been internal evaluations and limited in scope. Given that both England and Australia have world-leading universal health systems [ 8 ] and that the recently established Australian centres are modelled on the English centres, a rapid review of RTCs (confined to England and Australia) was conducted to inform the ongoing development of these partnerships.

This rapid review is timely, with the CLAHRCs and AHSNs in England focusing on greater collaboration and the Australian centres recently being funded $300 million over 10 years, with a clear need for more research to guide evolution. Knowledge ‘gaps’ identified by Australian RTCs include workforce development, strategies for consumer and community involvement (CCI), optimal collaborations, governance arrangements and structures to drive collaboration. CCI and workforce development needs are diverse, yet here we focus on strategies aligned with the RTCs’ aim to integrate research and healthcare and to build collaborations and drive evidence-based healthcare improvement.

Rapid reviews have emerged as an efficient way of supporting health policy-making and systems development by providing evidence in a timely and cost-effective fashion [ 17 ]. They employ a wide variety of methods [ 18 ] and, although we acknowledge that rapid and limited evidence searches can lead to missed information, these methods were chosen as pragmatic and timely and because they capture both academic and grey literature. Traditional systematic review processes were not amenable to the time-frame required by our health partners (the AHRA) and would not capture the diverse reports and evaluations found largely in the grey literature, although it is acknowledged that the grey literature is not rigorously peer reviewed and that combining published and grey literature may lead to bias [ 19 ]. However, rapid reviews do meet the needs of end-users in addressing emerging issues within limited time-frames.

The scope of this review included the vision, governance and structure of RTCs, their CCI, (public and patient involvement (PPI) in England), and workforce development strategies. This review included published academic and grey literature with a customised search of the Google search engine and RTC websites. Since abstracts were unavailable for reports in the grey literature, executive summaries, recommendations and table of contents were reviewed. We searched for academic publications in EMBASE and SCOPUS databases using the following search terms: “Collaboration for Leadership in Applied Health Research and Care” OR “Academic Health Science Centre*” OR “Academic Health Science Network*” OR “Advanced Health Research and Translation Centre*” (acronyms were excluded, as they failed to yield results). In terms of the grey literature, the above terms linked to “AND evaluation” were searched on Google, then sorted by relevance. We also searched the websites of RTCs in England and Australia.

The search period was limited to the previous 10 years (2008 to August 2019) to ensure currency of our findings in a landscape where RTCs continue to evolve. Inclusion criteria for the published and grey literature included reports or evaluations that addressed structure, governance, community and consumer engagement, and/or workforce development. Although the heterogeneity of grey literature means it is less amenable to traditional forms of analysis, it did extend the scope of findings by incorporating information on the applied topic areas and by filling gaps that were apparent in the academic literature. Permission to conduct this study was received from the Monash University Human Research Ethics Committee.

A search of EMBASE and SCOPUS identified a total of 272 relevant papers (after duplicates removed) over 10 years (2008 to August 2019). A review of titles and abstracts identified 41 scientific papers for consideration, all of which addressed the evaluation domains of interest and were retained after full-text review, as shown in the PRISMA diagram in Fig. 1 . This included one systematic review of CLAHRC evaluations [ 20 ] but no evaluations of RTCs in Australia. The evaluations of CLAHRCs were diverse, and often descriptive and exploratory in nature with a paucity of evidence about the overall impact of centres, particularly in relation to knowledge mobilisation processes [ 20 ]. Of the evaluations reviewed, most focused on partnerships, structures and processes. Likewise, a scoping review of AHSCs found most of the literature to be descriptive case studies or commentaries [ 7 ]. This highlights the challenges involved in evaluating complex systems that may require different methods (such as social network analysis) to better capture their dynamics [ 20 ]. The grey literature and review of all RTC websites provided additional information specific to each centre.

PRISMA diagram

RTCs’ vision, governance and structure

Although RTCs share a common aim to integrate research and training with health services, there was considerable variation in their vision, governance and structure in both countries. In England, the CLAHRCs have a declared mission to support high-quality applied research that meets the needs of local health and care systems [ 21 ], yet there was considerable variation across individual centres. Table 1 demonstrates that collaboration for patient benefit, translation and the harvesting of evidence were commonly identified in the vision statements for CLAHRCs, while the AHSNs had a focus on innovation as a key part of their mission. The AHSNs were created to connect the NHS and academic organisations, local authorities and industry with a clear focus on improving patient outcomes [ 22 ]; they aim to foster opportunities for industry to work effectively with the NHS by leading regional networks and generating economic growth in their regions. The AHSCs in England share a similar aim to improve health education and patient care and are commonly ‘nested’ within an AHSN but their focus is more on research excellence and the translation of new innovation from the laboratory to the bedside. Governance structures in England appear well developed, albeit highly variable. Most RTCs had all partners represented on their governing boards, with specific steering, advisory and PPI committees. The AHSNs reported over-arching executive boards with discrete advisory committees that help define and advise on regional issues and the inclusion of clinical commissioning groups in their governance. The governance and structure of AHSCs was variable – some reported having academic leaders who determined themes, while others reported having equal representation from all partners.

The stated vision of RTCs in Australia emphasised the integration of research with healthcare and partnerships. The translation of evidence was a strong and consistent focus, largely funded by the Medical Research Future Fund (MRFF) that provides grants for rapid applied research translation [ 23 ]. Early funding priorities have been identified by the MRFF and include reducing unwarranted variation, improving clinical pathways, improving the health of vulnerable groups, increasing primary care research and reducing risk factors for chronic diseases [ 23 ]. In terms of their structure and governance, RTCs in Australia appeared to have more consistency, with all partners represented on boards or councils and various advisory, translation or management committees. Healthcare leadership (rather than academic) was a key feature of Australian RTCs as a means of enhancing the accountability, relevance and impact of research. This governance structure is challenged by the fact that universities are federally funded, whereas healthcare is funded by state governments [ 24 ]. However, this is being addressed by the fact that both the RTCs and the AHRA are federally funded. One RTC in Australia has a unique ‘bottom up’ structure, where governance is strongly led by Aboriginal community controlled organisations and Aboriginal ‘voice’ is embedded across all levels of the organisation (the Central Australian Academic Health Science Network). Few RTCs in either country report on their websites how their vision or governance was developed or whether a strategic plan was in place.

In terms of structure, or the ‘architecture’, some RTCs were built around clinical themes (largely disease focused with flagship programmes), with some being structured around platforms or fields of work such as public health and health services. In England, leading figures with particular research experience acted as Directors and many centres reported having a three-tier structure with a Board, management committee and working groups that align with the clinical themes/projects. While RTCs in both countries identified diverse clinical themes, few reported information on how they developed priorities for themes or whether they involved collaborations with services users and healthcare providers to inform structures and processes.

3.2. Workforce development

The review identified that workforce capacity is being developed across the system, organisation and individual levels to build capacity in translational research and healthcare improvement. This requires leaders with broader skills and support to operate across organisational boundaries and address system-level barriers to change. In England, national efforts to develop leadership include the NHS Leadership Academy and NHS Horizons, which collaborate to identify future leadership development directions [ 25 ]. While the Horizons team supports leaders of change, the Leadership Academy provides a range of tools, models and programmes to support individuals and organisations to develop leaders [ 26 ]. In Australia, there is no coordinated national effort but some initiatives are emerging. In this context, Table 1 demonstrates that RTCs in both countries are all undertaking workforce capacity-building. At the individual level, diverse training needs were identified, including research and data skills, CCI and translation literacy.

The literature confirms the focus on and importance of skills in implementation research, knowledge mobilisation, evaluation skills and collaborative priority-setting with potential end-users of research [ 3 , 27 ]. Time and space are needed to build effective collaborations and, while the ARC model did facilitate collaborative priority-setting, Cooke et al. [ 27 ] reported that scant knowledge exists about processes or guidance on how best to achieve meaningful collaboration. Platforms for negotiation and decision-making (such as special interest groups and advisory groups) were possible enabling factors, as were formal consensus methods for priority-setting [ 27 ]. In England, the James Lind Alliance brings patients, carers and clinicians together to identify research priorities [ 28 ]. In Australia, Delphi and Nominal Group Techniques have been adapted and used for eliciting priorities across stakeholders [ 29 , 30 ].

In England, an important organisational workforce enabler for meaningful engagement, embedding research into healthcare and the translation of new evidence, was leadership. Leadership was identified as a key factor in the overall success of RTCs, including in their workforce capacity for knowledge mobilisation [ 20 , 31 , 32 , 33 ]. Currie et al. [ 33 ] stressed the importance of understanding the social position of senior members of CLAHRCs. Although well-known clinical academics are likely to lead the centres, this study found that privileging pre-existing relationships may constrain much-needed change and meaningful engagement with service users and frontline clinicians [ 33 ]. Leadership in CLAHRCs has been enacted in three ways: ‘push’ models for top down leadership that focus on technical infrastructure, pull methods that aim to increase leadership capacity among project leads and more collective approaches that dispersed leadership to drive new relations between academia and clinical practice [ 32 ]. Aligned with this, a recent Kings Fund report highlights the importance of system leadership (being comfortable with chaos) in driving meaningful change [ 6 ].

Although dispersed leadership approaches were crucial for the exchange of new knowledge, push and pull models continued to influence how knowledge was ‘moved’ within CLAHRCs, especially in relation to the development of technical infrastructures and translating knowledge at the project level [ 32 ]. While more distributed models of leadership were associated with increased potential for engagement with the CLAHRCs [ 20 ], a longitudinal realist evaluation of three centres found that a blend and alignment of designated leadership with distributed leadership was a necessary condition for collective action and implementation [ 34 ]. The presence of both these leadership styles appeared to be important for ensuring alignment and integration across streams [ 34 ]. As such, workforce development in leadership appears important in the context of RTCs.

The need to move knowledge across professional ‘silos’ resulted in several RTCs creating new system approaches such as knowledge-brokering roles (although they varied considerably across centres) [ 20 , 35 , 36 , 37 , 38 ]. For example, some deployed ‘diffusion fellows’, who were senior health staff seconded to actively bridge the research–practice gap [ 35 ]. Despite showing much promise, knowledge brokering and other hybrid roles were often unrecognised and lacked support within their organisations [ 39 , 40 ]. Although management theory identifies that knowledge mobilisation relies on relationships and is an inherently social undertaking [ 9 , 41 ], the deployment of hybrid roles as a means of overcoming system barriers requires particular capabilities and was found to be challenging [ 20 ]. Nevertheless, workforce capabilities, such as stakeholder engagement, co-design, collaboration and team-work, and the co-production of knowledge, rely on understanding complexity and working across multiple levels (individual and organisational) to enact new knowledge [ 42 ]. The importance of developing skills for mobilising knowledge across disciplines and different users was confirmed in the literature [ 27 , 33 , 43 , 44 , 45 , 46 , 47 ]. Mobilising knowledge that is multidisciplinary requires different communities to interact [ 15 ] and RTCs are well placed to enable this kind of cross-silo collaboration, including with health, business, IT, social sciences, engineering and other disciplines.

Individual workforce capabilities for supporting RTC endeavours are not all technical and may include observational skills, appreciative inquiry, systems thinking, improved understanding of data, distributive or collective leadership, and quality improvement – all of which are increasingly found in English workforce programmes but are not yet incorporated into workforce programmes in Australia. At the level of the system and organisation, key workforce development approaches identified in this review include leadership and mentoring [ 48 ], processes for stakeholder engagement [ 27 ], and the creation of new hybrid roles to move knowledge across discipline and organisational boundaries. Despite a focus on leadership, the evaluation of three CLAHRCs by Rycroft-Malone et al. [ 49 ] identified that, on balance, they tended to conduct research rather than focus on ‘how’ to use and apply new research evidence. This means that closing the knowledge–practice gap and methods for translating evidence into improved patient outcomes are yet to be clearly established [ 49 ]. However, AHSNs are now more aligned with the CLAHRCs to increase the translation of generated evidence.

CCI (Australia) and PPI (England)

One significant difference between Australian and English centres was the latter’s strong focus on PPI. England has a national PPI strategy, with PPI a policy and funding requirement and a key strategy for situating patients at the centre of research and healthcare improvement [ 27 ]. The importance of PPI in healthcare has been acknowledged for some time in England; however, there is still limited research on the optimal methods for driving and enabling PPI [ 34 , 50 ]. The literature highlights a significant gap in understanding how PPI can inform implementation research that often focuses on the behaviour of health professionals and health systems and policies (as opposed to clinical research) [ 34 ]. Despite significant advancement in England, cultural barriers persist, including the narrowness of PPI models that fail to address empowerment, equality or diversity strategies [ 51 ]. Often, the level of PPI operates more as consultation rather than as active co-production and empowerment.

Other processes for authentic PPI enshrined in all CLAHRCs include providing payment for PPI representatives to attend meetings and training to enable more informed and active participation. The provision of training and remuneration for PPI representatives is a significant difference between England and Australia; however, real progress in PPI in England cannot be realised without an effective mechanism for coordinating efforts across the complex network of organisations that comprise the NIHR [ 51 ]. The systematic review conducted by Kislov et al. [ 20 ] reported that none of the NIHR-funded evaluations had a particular focus on PPI, although one included interviews with PPI representatives [ 9 ] and three investigated how PPI was enacted [ 52 , 53 , 54 ]. These evaluations all acknowledged the difficulties of quantifying PPI elements and Marston and Renedo [ 52 ] recommend the inclusion of patient voices and tracking dynamic social processes and networks to better understand the key elements and impact of PPI. It is important to identify the dynamic processes and networks through which PPI can contribute to healthcare improvement efforts [ 20 ] as well as the key time-points and strategies for PPI to have the most impact in the translational research cycle [ 51 ].

In Australia, only three RTCs included dedicated information on CCI on their websites. However, across all RTCs, the AHRA have prioritised CCI as a national system-level initiative and have developed a CCI strategy with key stakeholders and completed both an environmental scan of the literature and a national survey on the extent and nature of CCI. In 2018, a national workshop was convened to prioritise the next steps and RTCs committed funding and staff to collaboratively progress this work. To date, findings from Australia confirm that CCI is complex (consistent with the English experience) and that the locus of control for involvement in Australia remains largely with researchers [ 55 ]. The AHRA report also identified a need for more resourcing and better policy aligned with England. They recommended a range of strategies to promote and explore the value and impact of CCI. This report included the development of minimum standards for good practice in CCI involvement in RTCs and guidance on how to incorporate it across the research life cycle [ 55 ], alongside training and capacity-building. Currently, the report recommendations are being implemented collaboratively and co-ordinated nationally through the AHRA.

This review explored the visions, structures and governance processes of RTCs, their workforce development activities and CCI/PPI as key factors for integrating research with health service and community needs. Centres in both England and Australia share a common architecture in that they generally have boards that represent all partners and are organised along research themes that reflect their research strengths, with cross-cutting platforms to enable collaboration with health services. In terms of their vision, RTCs in England appear to have a greater research focus on innovation (AHSNs), collaborative and applied research (CLAHRCs), and a traditional push model of discovery and clinical research into practice (AHSCs). In Australia, RTC visions are aligned with translation, partnerships, and impact and have a strong and consistent focus on research translation.

In terms of workforce development (aligned with RTC visions to integrate research into healthcare, build collaboration and drive evidence-based healthcare improvement), leadership was a key enabling factor. Given that they are an amalgam of stakeholders with potentially competing demands, it is perhaps not surprising that leadership is a prominent theme. Leadership approaches appear to require both dispersed and distributed or top-down and bottom-up approaches to facilitate working collectively with multiple stakeholders [ 32 , 36 ]. Collective and distributed leadership approaches have also been shown to enable healthcare improvement and transformational change [ 32 , 56 , 57 ]. Evaluation reports and published literature identified knowledge mobilisation as another key workforce skill for evidence translation. Historically, the evidence translation gap was perceived as a practice/service responsibility and challenge, rather than a problem of implementation or knowledge creation [ 34 ]. This highlights the need for systems approaches with a more nuanced understanding of how knowledge moves and can be brokered within complex organisations to enable improvement.

In England, structural solutions, such as the creation of new hybrid roles, has proved challenging – particularly in relation to working across all levels of complex organisations and diverse contexts [ 58 , 59 , 60 ]. However, skills and capabilities for moving knowledge in healthcare organisations were identified, including process and systems thinking, the involvement of stakeholders, change management, facilitation, negotiation, and advocacy skills [ 34 , 61 ]. These are yet to find their way into traditional healthcare innovation and knowledge mobilisation roles, where the focus is often organisational and inward looking rather than collaborative with stakeholders and engaging with external evidence [ 40 ]. At this stage, workforce capacity development is more developed in English centres compared with Australia. However, Australian RTCs are now working together with nationally coordinated efforts to improve and scale workforce development activity.

Likewise, in England, PPI is well established and embedded in policy and funding requirements, although there is also a recognition that optimal processes for PPI and their impact should be better understood [ 14 , 15 , 16 ]. When utilised effectively, PPI appears to have the potential to transform services and address the research–practice divide [ 62 , 63 ], but it is important to research and translate how patient input can be best integrated at all levels within and between RTCs. In England, funding, dedicated staff and training are available for both PPI members and frontline staff with co-design and co-production with stakeholders; this is not yet mirrored in Australia, where training programmes for the public and service users are emerging but remain under-developed. However, the AHRA has strongly prioritised and developed a national framework and is focusing on a coordinated approach to CCI. Funding bodies encourage but do not require CCI. One RTC in Australia, with community controlled Aboriginal health service members, appears to be leading in terms of processes for community engagement and clinical and corporate governance participation. Further research and evaluation are needed on the optimal methods and impact of CCI in research and healthcare improvement.

Overall, the findings from this review are important for the evolving RTCs in Australia, which are relatively young organisations and are due for re-accreditation by the NHMRC in 2022. Although this review focused on the structures, leadership, workforce development and engagement with communities of RTCs, it is important to acknowledge that these highly complex interventions, with their relational interactions and processes for collaboration, are often poorly captured and articulated in the literature. In order to understand these nuances, qualitative research is warranted as a means of capturing the range of activities and outcomes generated by these collaborative platforms. Australia has yet to evaluate their RTCs but it is notable that the Australian government has recently committed a 10-year funding strategy, which validates the perceived potential and importance of these entities and provides for long-term strategic planning. It also mandates more evidence-based approaches and the need for evaluation. The Australian MRFF was announced as part of the 2014–2015 federal budget and will build to a $20 billion perpetual fund over the next decade [ 64 ]. The MRFF scheme will complement and enhance current research funding schemes but will focus on delivering a health system fully informed by research with community and patient impact [ 65 ]. This approach is supportive of RTC visions and directly aligns with strategic prioritised research rather than conventional investigator-led research [ 66 ]. This is important because the systematic review of CLAHRC evaluations identified that 5-year funding cycles in England were insufficient to foster and embed collaborations between academic and service providers [ 20 ].

In Australia, the AHRA has prioritised streamlining and the consistency of structures and processes, whilst respecting regional differences. This Australian collaboration is possible in the context of avoiding direct competition for accreditation or funding. This has enabled a more collaborative approach to challenges and coordinated activities nationally within and between centres. This is consistent with recommendations from England that more research is needed that focuses on how collaboration occurs between RTCs [ 16 ] and with the recent Kings Fund report [ 6 ] on the vital need for more collaboration and less competition in healthcare improvement.

RTCs are complex system-level interventions that will need to disrupt the current paradigms and silos inherent in healthcare, education and research in order to meet their aims. This is likely to require vision, leadership, collaborations and shared learnings, alongside structures, processes and strategies to deliver impact in the face of complexity. The impact of RTCs in overcoming the deeply entrenched silos across organisations, disciplines and sectors needs to be captured at the systems, organisation and individual levels. Collectively, the creation of structures and streamlined processes to accelerate stakeholder engagement and collaboration, evidence synthesis, knowledge transfer, data systems and the effective integration of implementation and improvement into healthcare are the holy grail of RTCs. However, many centres appear to still focus on clinical themes and siloed projects. As these RTCs mature, capturing and learning effective ways to promote system change will rely on capturing higher level learnings from the plethora of RTC projects.

This includes better understanding of how to strategically prioritise research and how to build the capacity of the workforce to translate new knowledge into action. Recently, RTCs have developed novel ways of demonstrating these processes, including the use of ‘casebooks’ that detail the impact of research on NHS practice [ 67 ]. A consistency of purpose and activity is needed, alongside a focus on regional needs. Associated policy intentions and funding objectives that support shared learnings and collaborations are also important. Regardless of how RTCs are structured or where they are situated, these collaborative entities all share common potentials and challenges, mostly around how to collaborate in a siloed and competitive system and how to ensure that research and service delivery are integrated and evidence generated and translated for the benefits of the community they serve.

Limitations

This rapid review synthesises diverse literature about broad and complex collaborative RTCs that have become key entities in policy and healthcare service improvement. Combining diverse information sources is challenging and, in the current review, may have limited the depth of findings. Although rapid reviews allow for the inclusion of grey literature, it is important to acknowledge that optimal methods for conducting these reviews are evolving and are yet to be determined. These reviews may lack rigour even while they may prove more viable in terms of cost, timeliness and the breadth of information accessed. However, there is a growing recognition that an understanding of systems perspectives and their inherent complexity require reviews from diverse sources and are not always well served by traditional approaches such as those afforded by systematic reviews [ 68 ]. The review only focuses on England and Australia as world leading universal health systems with strong policy and funding commitment to the integration of research and healthcare, evidence-based improvement and RTCs.

A challenge for all RTCs is how to integrate research and healthcare and overcome competition to build collaboration and deliver impact. The English experience highlights that this requires a better understanding of the structure and vision of centres, their workforce capacity needs, and the nature of their collaborations with service users and communities. Although workforce capacity-building and the involvement of consumers and the community are more developed in England, the development of an alliance between centres in Australia is providing a platform for national coordination, shared learning and rapid collaborations. This alliance has facilitated and shared a national agenda in a range of areas. Given that the development and funding of RTCs represents one of the most significant shifts in the health research landscape, it is imperative that we continue to explore how we can progress the integration of research and healthcare and ensure that research meets stakeholder needs and is translated via the collaborations supported by these organisations.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Academic Health Science Centres

Academic Health Science Networks

Applied Research Centre NIHR

National Institute for Health Research

Australian Health Research Alliance

consumer and community involvement

Collaborations for Leadership in Applied Health Research

Medical Research Future Fund

National Health and Medical Research Council

National Health Service

public and patient involvement

• Research Translation Centres

Fineout-Overholt E, Melnyk BM, Schultz A. Transforming health care from the inside out: advancing evidence-based practice in the 21st century. J Prof Nurs. 2005;21(6):335–44.

Article   PubMed   Google Scholar  

Westfall JM, Mold J, Fagnan L. Practice-based research—“blue highways” on the NIH roadmap. JAMA. 2007;297(4):403–6.

Article   CAS   PubMed   Google Scholar  

Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510–20.

Article   PubMed   PubMed Central   Google Scholar  

Currie G, Suhomlinova O. The impact of institutional forces upon knowledge sharing in the UK NHS: the triumph of professional power and the inconsistency of policy. Public Adm. 2006;84(1):1–30.

Article   Google Scholar  

Martin GP, Currie G, Finn R. Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce. Soc Sci Med. 2009;68(7):1191–8.

Timmins N. Leading for integrated care ‘If you think competition is hard, you should try collaboration’. London: The Kings Fund; 2019. https://www.kingsfund.org.uk/sites/default/files/2019-11/leading-for-integrated-care.pdf . Accessed 5 Nov 2019.

French CE, Ferlie E, Fulop NJ. The international spread of Academic Health Science Centres: A scoping review and the case of policy transfer to England. Health Policy. 2014;117(3):382–91.

Schneider EC, Sarnak DO, Squires D, Shah A. Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better US Health Care; The Commonwealth Fund. 2017. http://www.hcfat.org/Mirror_Mirror_2017_International_Comparison.pdf . Accessed 5 Nov 2019.

Soper B, Hinrichs S, Drabble S, Yaqub O, Marjanovic S, Hanney S, et al. Delivering the aims of the Collaborations for Leadership in Applied Health Research and Care: understanding their strategies and contributions. Southampton: NIHR Journal Library; 2015.

Google Scholar  

Fischer MD, Ferlie E, French C, Fulop N, Wolfe C. The Creation and Survival of an Academic Health Science Organization: Counter-Colonization Through A New Organizational Form? University of Oxford - Said Business School Working Paper No. 2013–26. 2013. https://ssrn.com/abstract=2331463 . Accessed 6 Jan 2020.

Bienkowska-Gibbs T, Exley J, Saunders CL, Marjanovic S, Chataway J, MacLure C, et al. Evaluating the role and contribution of innovation to health and wealth in the UK: a review of innovation, health and wealth: phase 1 final report. Rand Health Q. 2016;6(1):7.

PubMed   PubMed Central   Google Scholar  

McKeon S, Alexander E, Brodaty H, Ferris B, Frazer I, Little M. Strategic Review of Health and Medical Research, Summary Report. Department of Health and Ageing: Canberra; 2013.

NHMRC. Recognition of Advanced Health Research and Translation Centres and Centres for Innovation in Regional Health a report to NHMRC from the International Review Panel. Canberra: Australian Government; 2017. https://www.nhmrc.gov.au/file/5791/download?token=SZ1tzqiB . Accessed 23 Sept 2020.

Kislov R, Boaden R. Evaluation of the NIHR CLAHRCs and publication of results: a brief reflection. Manchester: Manchester Business School; 2015. https://pdfs.semanticscholar.org/5e50/0118b60c329721d14569fb26c390ebdf7e92.pdf . Accessed 5 Nov 2019.

Lockett A, El Enany N, Currie G, Oborn E, Barrett M, Racko G, et al. A formative evaluation of Collaboration for Leadership in Applied Health Research and Care (CLAHRC): institutional entrepreneurship for service innovation. Health Services and Delivery Research. Southampton: NIHR Journals Library; 2014.

Rycroft-Malone J, Wilkinson JE, Burton CR, Andrews G, Ariss S, Baker R, et al. Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC). Implement Sci. 2011;6:74.

Langlois EV, Straus SE, Antony J, King VJ, Tricco AC. Using rapid reviews to strengthen health policy and systems and progress towards universal health coverage. BMJ Glob Health. 2019;4:e001178.

Ganann R, Ciliska D, Thomas H. Expediting systematic reviews: methods and implications of rapid reviews. Implement Sci. 2010;5:56.

Hopia H, Latvala E, Liimatainen L. Reviewing the methodology of an integrative review. Scand J Caring Sci. 2016;30(4):662–9.

Kislov R, Wilson PM, Knowles S, Boaden R. Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations. Implement Sci. 2018;13:111.

NIHR. NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). 2018. https://www.nihr.ac.uk/explore-nihr/support/collaborating-in-applied-health-research.htm . Accessed 23 Sept 2020.

TheAHSNNetwork. About Academic Health Science Networks United Kingdom: TheASHNNetwork; 2019. https://www.ahsnnetwork.com/about-academic-health-science-networks . Accessed 5 Nov 2019.

Department of Health. Rapid Applied Research Translation Initiative Canberra: Australian Government; 2019. https://www.health.gov.au/initiatives-and-programs/rapid-applied-research-translation-initiative#how-will-these-goals-be-met . Accessed 23 Sept 2020.

Fisk NM, Wesselingh SL, Beilby JJ, Glasgow NJ, Puddey IB, Robinson BG, et al. Academic health science centres in Australia: let’s get competitive. Med J Aust. 2011;194(2):59–60.

Horizons. Programmes of Work United Kingdom: Horizons; 2019. http://horizonsnhs.com/programmes-of-work/ . Accessed 23 Sept 2020.

National Health Service. About us United Kingdom: NHS; 2019. https://www.leadershipacademy.nhs.uk/about/ . Accessed 26 Aug 2019.

Cooke J, Ariss S, Smith C, Read J. On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap. Health Res Policy Syst. 2015;13:25.

James Lind Alliance, National Institute for Health Research. The James Lind Alliance Guidebook. 2018. https://www.jla.nihr.ac.uk/jla-guidebook/ . Accessed 23 Sept 2020.

Rankin NM, McGregor D, Butow PN, White K, Phillips JL, Young JM, et al. Adapting the nominal group technique for priority setting of evidence-practice gaps in implementation science. BMC Medical Res Methodol. 2016;16:110.

Teede HJ, Norman RJ, Garad RM. A new evidence-based guideline for assessment and management of polycystic ovary syndrome. Med J Australia. 2019;210(6):285 e1.

Fischer MD, Dopson S, Fitzgerald L, Bennett C, Ferlie E, Ledger J, et al. Knowledge leadership: mobilizing management research by becoming the knowledge object. Hum Relat. 2016;69(7):1563–85.

Spyridonidis D, Hendy J, Barlow J. Leadership for knowledge translation: the case of CLAHRCs. Qual Health Res. 2015;25(11):1492–505.

Currie G, Lockett A. Distributing leadership in health and social care: concertive, conjoint or collective? Int J Manag Rev. 2011;13(3):286–300.

Rycroft-Malone J, Burton C, Wilkinson JE, Harvey G, McCormack B, Baker R, et al. Collective action for knowledge moblisation: a realist evaluation of the Collaborations for Leadership in applied Health Research and Care. Health Services and Delivery Research. Southampton: NIHR Journals Library; 2015;3(44).

Rowley E, Morriss R, Currie G, Schneider J. Research into practice: collaboration for leadership in applied health research and care (CLAHRC) for Nottinghamshire, Derbyshire, Lincolnshire (NDL). Implement Sci. 2012;7:40.

Kislov R, Walshe K, Harvey G. Managing boundaries in primary care service improvement: a developmental approach to communities of practice. Implement Sci. 2012;7:–97.

Evans S, Scarbrough H. Supporting knowledge translation through collaborative translational research initiatives: ‘Bridging’ versus ‘blurring’ boundary-spanning approaches in the UK CLAHRC initiative. Soc Sci Med. 2014;106:119–27.

Sinfield P, Donoghue K, Horobin A, Anderson ES. Placing interprofessional learning at the heart of improving practice: the activities and achievements of CLAHRC in Leicestershire, Northamptonshire and Rutland. Qual Prim Care. 2012;20(3):191–8.

PubMed   Google Scholar  

Gerrish K. Tapping the potential of the National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care (CLAHRC) to develop research capacity and capability in nursing. J Res Nurs. 2010;15(3):215–25.

McLoughlin I, Burns P, Looi E, Sohal A, Teede H. Brokering knowledge into the public sector: understanding improvement facilitators’ priorities in the redesign of hospital care. Public Manag Rev. 2020;22:836–56.

Ovseiko PV, Heitmueller A, Allen P, Davies SM, Wells G, Ford GA, et al. Improving accountability through alignment: the role of academic health science centres and networks in England. BMC Health Serv Res. 2014;14:24.

Ferlie E, Crilly T, Jashapara A, Peckham A. Knowledge mobilisation in healthcare: a critical review of health sector and generic management literature. Soc Sci Med. 2012;74(8):1297–304.

D’Andreta D, Scarbrough H, Evans S. The enactment of knowledge translation: a study of the Collaborations for Leadership in Applied Health Research and Care initiative within the English National Health Service. J Health Serv Res Policy. 2013;18(Suppl. 3):40–52.

Fitzgerald L, Harvey G. Translational networks in healthcare? Evidence on the design and initiation of organizational networks for knowledge mobilization. Soc Sci Med. 2015;138:192–200.

Heaton J, Day J, Britten N. Inside the “black box” of a knowledge translation program in applied health research. Qual Health Res. 2015;25(11):1477–91.

Rycroft-Malone J, Wilkinson J, Burton CR, Harvey G, McCormack B, Graham I, et al. Collaborative action around implementation in Collaborations for Leadership in Applied Health Research and Care: towards a programme theory. J Health Serv Res Policy. 2013;18(Suppl. 3):13–26.

Hewison A, Rowan L. Bridging the research-practice gap. Br J Healthc Manag. 2016;22(4):208–10.

Athanasiou T, Patel V, Garas G, Ashrafian H, Shetty K, Sevdalis N, et al. Mentoring perception and academic performance: an Academic Health Science Centre survey. Postgrad Med J. 2016;92(1092):597–602.

Rycroft-Malone J, Burton CR, Bucknall T, Graham ID, Hutchinson AM, Stacey D. Collaboration and co-production of knowledge in healthcare: opportunities and challenges. International J Health Policy Manage. 2016;5(4):221–3.

Staniszewska S, Herron-Marx S, Mockford C. Measuring the impact of patient and public involvement: the need for an evidence base. Oxford: Oxford University Press; 2008.

Staniszewska S, Denegri S, Matthews R, Minogue V. Reviewing progress in public involvement in NIHR research: developing and implementing a new vision for the future. BMJ Open. 2018;8(7):e017124.

Marston C, Renedo A. Understanding and measuring the effects of patient and public involvement: an ethnographic study. Lancet. 2013;382:S69.

Renedo A, Marston CA, Spyridonidis D, Barlow J. Patient and Public Involvement in Healthcare Quality Improvement: how organizations can help patients and professionals to collaborate. Public Manag Rev. 2015;17(1):17–34.

Ariss S, Cooke J, Smith C, Reed J, Nancarrow S. NIHR CLAHRC for South Yorkshire internal evaluation report November 2011: executive summary. Sheffield: National Institute of Health Research (NIHR); 2012.

Australian Health Research Alliance. Consumer and Community Involvement in Health and Medical Research : An Australia-wide Audit Western Australia: Australian Health Research Alliance. 2018. https://www.wahtn.org/wp-content/uploads/2019/03/AHRA-CCI_Final-Report_Full_Dec2018.pdf .

El Enany N, Currie G, Lockett A. A paradox in healthcare service development: professionalization of service users. Soc Sci Med. 2013;80:24–30.

Ocloo J, Matthews R. From tokenism to empowerment: progressing patient and public involvement in healthcare improvement. BMJ Qual Saf. 2016;25(8):626–32.

Braithwaite J. Growing Inequality: Bridging Complex Systems, Population Health and Health Disparities. Oxford: Oxford University Press; 2018.

Greenhalgh T, Papoutsi C. Studying complexity in health services research: desperately seeking an overdue paradigm shift. BMC Med. 2018;16:95.

Kitson A, Brook A, Harvey G, Jordan Z, Marshall R, O’Shea R, et al. Using complexity and network concepts to inform healthcare knowledge translation. Int J Health Policy Manage. 2018;7(3):231–43.

Kislov R. Boundary discontinuity in a constellation of interconnected practices. Public Admin. 2014;92(2):307–23.

Barnes M. Users as citizens: collective action and the local governance of welfare. Soc Policy Admin. 1999;33(1):73–90.

NHS England. Everyone Counts: Planning for Patients 2013/14. London: HMSO; 2013.

Cunningham AL, Anderson T, Bennett CC, Crabb BS, Goodier G, Hilton D, et al. Why Australia needs a Medical Research Future Fund. Med J Aust. 2015;202(3):123–4.

Department of Health. About the MRFF: Australian Government; 2019. https://www.health.gov.au/initiatives-and-programs/medical-research-future-fund/about-the-mrff . Accessed 23 Sept 2020.

Department of Health. Australian Medical Research and Innovation Strategy 2016–2021. Canberra: Australian Government Department of Health; 2018. https://beta.health.gov.au/resources/publications/australian-medical-research-and-innovation-strategy-2016-2021 . Accessed 23 Sept 2020.

Martin GP, Ward V, Hendy J, Rowley E, Nancarrow S, Heaton J, et al. The challenges of evaluating large-scale, multi-partner programmes: the case of NIHR CLAHRCs. Evid Policy. 2011;7(4):489–509.

Petticrew M, Knai C, Thomas J, Rehfuess EA, Noyes J, Gerhardus A, Grimshaw J, Rutter H, McGill E. Implications of a complexity perspective for systematic reviews and guideline development in health decision making. BMJ Global Health. 2019;4(Suppl. 1):e000899.

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This work was supported by a small internal grant from the Monash Warwick Alliance (Monash University and Warwick University).

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Helen Skouteris and Helena Teede contributed equally to this study as lead authors.

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Monash Centre for Health Research & Implementation, School of Public Health & Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia

Tracy Robinson, Cate Bailey, Heather Morris, Angela Melder, Halyo Bismantara, Helen Skouteris & Helena Teede

School of Nursing, Midwifery & Indigenous Health, Charles Sturt University, Bathurst, NSW, 2795, Australia

Tracy Robinson & Dmitrios Spyridonidis

Monash Partners Academic Health Science CENTre, Clayton, Victoria, Australia

Tracy Robinson, Angela Melder, Halyo Bismantara, Helen Skouteris & Helena Teede

School of Management, College of Business, RMIT University, Melbourne, Australia

Monash Health, Clayton, Victoria, Australia

Angela Melder & Helena Teede

Warwick Business School, Gibbet Hill Road, Coventry, CV4 7AL, United Kingdom

Charlotte Croft & Dmitrios Spyridonidis

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TR was the lead author, study investigator, drafted manuscripts and response to reviewers. CB conducted the reviewed the websites and the scientific literature. HM assisted with rapid review and references. PB was a study investigator and contributed to and revised the manuscript. AM, CC and DS were study investigators and revised the manuscript. HB assisted with website review and revised the manuscript. HS was the lead investigator on the study and revised the manuscript. HT was the lead investigator and provided significant contributions to the study design and manuscript. The authors read and approved the final manuscript.

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Robinson, T., Bailey, C., Morris, H. et al. Bridging the research–practice gap in healthcare: a rapid review of research translation centres in England and Australia. Health Res Policy Sys 18 , 117 (2020). https://doi.org/10.1186/s12961-020-00621-w

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Neuroscience and education: from research to practice?

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Nature Reviews Neuroscience volume  7 ,  pages 406–413 ( 2006 ) Cite this article

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Cognitive neuroscience is making rapid strides in areas highly relevant to education. However, there is a gulf between current science and direct classroom applications. Most scientists would argue that filling the gulf is premature. Nevertheless, at present, teachers are at the receiving end of numerous 'brain-based learning' packages. Some of these contain alarming amounts of misinformation, yet such packages are being used in many schools. What, if anything, can neuroscientists do to help good neuroscience into education?

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Economic and Social Research Council Teaching and Learning Research Programme (ESRC TLRP) seminar series. Collaborative Frameworks for Neuroscience and Education . [online] , Education and Brain Research: Neuroscience, Teaching and Learning conference. 25–27 July 2005, Faculty of Education, University of Cambridge, UK.

Stern, E. Pedagogy meets neuroscience. Science 310 , 745 (2005).

Article   CAS   Google Scholar  

Smith, A. Accelerated Learning in the Classroom (Network Educational Press Ltd, Bodmin, UK, 1996).

Google Scholar  

Cohen, I. & Goldsmith, M. Hands On: How to Use Brain Gym R in the Classroom (Hands On Books, Sea Point, South Africa, 2000).

Hoffman, E. Introducing Children to their Amazing Brains (LTL Books Ltd, Middlewich, UK, 2002).

Organisation for Economic Co-operation and Development. Understanding the Brain: Towards a New Learning Science (2002).

Bruer, J. T. Education and the brain: a bridge too far. Educ. Res. 26 , 4–16 (1997).

Article   Google Scholar  

Blakemore, S. J. & Frith, U. The Learning Brain: Lessons for Education (Blackwell, Oxford, UK, 2005).

Byrnes, J. P. Minds, Brains and Learning (Guilford Press, New York, 2001).

Tallal, P. Improving language and literacy is a matter of time. Nature Rev. Neurosci. 5 , 721–728 (2004).

Fiez, J. A. & Petersen, S. E. Neuroimaging studies of word reading. Proc. Natl Acad. Sci. USA 95 , 914–921 (1998).

Paulesu, E. et al. Dyslexia: cultural diversity and biological unity. Science 291 , 2165–2167 (2001).

Siok, W. T., Perfetti, C. A., Jin, Z. & Tan, L. H. Biological abnormality of impaired reading is constrained by culture. Nature 431 , 71–76 (2004).

Cohen, L. & Dehaene, S. Specialisation within the ventral stream: the case for the visual word form area. Neuroimage 22 , 466–476 (2004).

Dehaene, S. et al. The neural code for written words: a proposal. Trends Cogn. Sci. 9 , 335–341 (2005).

Price, C. J. et al. Cortical localisation of the visual and auditory word form areas: a reconsideration of the evidence. Brain Lang. 86 , 272–286 (2003).

Goswami, U. & Ziegler, J. C. A developmental perspective on the neural code for written words. Trends Cogn. Sci. (in the press).

Ziegler, J. & Goswami, U. Reading acquisition, developmental dyslexia, and skilled reading across languages: a psycholinguistic grain size theory. Psychol. Bull. 131 , 3–29 (2005).

Turkeltaub, P., Gareau, L., Flowers, D. L., Zeffiro, T. A. & Eden, G. F. Development of neural mechanisms for reading. Nature Neurosci. 6 , 767–773 (2003).

Pugh, K. R. et al. Neurobiological studies of reading and reading disability. J. Commun. Disord. 34 , 479–492 (2001).

Shaywitz, B. A. et al. Disruption of posterior brain systems for reading in children with developmental dyslexia. Biol. Psychiatry 52 , 101–110 (2002).

Temple, E. et al. Neural deficits in children with dyslexia ameliorated by behavioural remediation: evidence from functional fMRI. Proc. Natl Acad. Sci. USA 100 , 2860–2865 (2003).

Simos, P. G. et al. Dyslexia-specific brain activation profile becomes normal following successful remedial training. Neurology 58 , 1203–1213 (2002).

Ziegler, J. C. & Goswami, U. Becoming literate in different languages: similar problems, different solutions. Dev. Sci. (in the press).

Goswami, U. in Mind, Brain and Education (eds Fischer, K. & Batro, A.) (Pontifical Academy of Sciences, Rome, in the press).

Molfese, D. Predicting dyslexia at 8 years of age using neonatal brain responses. Brain Lang. 72 , 238–245 (2000).

Goswami, U. Neuroscience and Education. Brit. J. Educ. Psychol. 74 , 1–14 (2004).

Nicolson, R. I. & Fawcett, A. J. Developmental dyslexia: the role of the cerebellum. Dyslexia 5 , 155–177 (1999).

Reynolds, D., Nicolson, R. I. & Hambly, H. Evaluation of an exercise-based treatment for children with reading difficulties. Dyslexia 9 , 48–71 (2003).

Dehaene, S. The Number Sense (Oxford Univ. Press, New York, 1997).

Dehaene, S., Molko, N., Cohen, L. & Wilson, A. J. Arithmetic and the brain. Curr. Opin. Neurobiol. 14 , 218–224 (2004).

Pinel, P., Dehaene, S., Riviere, D. & LeBihan, D. Modulation of parietal activation by semantic distance in a number comparison task. Neuroimage 14 , 1013–1026 (2001).

Dehaene, S., Piazza, M., Pinel, P. & Cohen, L. Three parietal circuits for number processing. Cogn. Neuropsychol. 20 , 487–506 (2003).

Dehaene, S. & Cohen, L. Towards an anatomical and functional model of number processing. Math. Cogn. 1 , 83–120 (1995).

Dehaene, S., Bossini, S. & Giraux, P. The mental representation of parity and numerical magnitude. J. Exp. Psychol. Gen. 122 , 371–396 (1993).

Hubbard, E. M., Piazza, M., Pinel, P. & Dehaene, S. Interactions between number and space in parietal cortex. Nature Rev. Neurosci. 6 , 435–448 (2005).

Zorzi, M., Priftis, K. & Umilta, C. Brain damage: neglect disrupts the mental number line. Nature 417 , 138–139 (2002).

Szucs, D. & Csépe, V. The parietal distance effect appears in both the congenitally blind and matched sighted controls in an acoustic number comparison task. Neurosci. Lett. 384 , 11–16 (2005).

Temple, E. & Posner, M. I. Brain mechanisms of quantity are similar in 5-year-old children and adults. Proc. Natl Acad. Sci. USA 95 , 7836–7841 (1998).

Bramald, R. Introducing the empty number line: the Dutch approach to teaching number skills. Education 3–13 28 , 5–12 (2000).

Griffin, S. A., Case, R. & Siegler, R. S. in Classroom Lessons: Integrating Cognitive Theory (ed. McGilly, K.) 25–50 (MIT Press, Cambridge, Massachusetts, 1995).

Kosc, L. Developmental dyscalculia. J. Learn. Disabil. 7 , 46–59 (1974).

Molko, N. et al. Functional and structural alterations of the intraparietal sulcus in a developmental dyscalculia of genetic origin. Neuron 40 , 847–858 (2003).

Ross, J., Zinn, A. & McCauley, E. Neurodevelopmental and psychosocial aspects of Turner Syndrome. Ment. Retard. Dev. Disabil. Res. Rev. 6 , 135–141 (2000).

Riviere, D. et al. Automatic recognition of cortical sulci of the human brain using a congregation of neural networks. Med. Image Anal. 6 , 77–92 (2002).

Isaacs, E. B., Edmonds, C. J., Lucas, A. & Gadian, D. G. Calculation difficulties in children of very low birthweight: a neural correlate. Brain 124 , 1701–1707 (2001).

Posner, M. I. & Rothbart, M. K. Influencing brain networks: implications for education. Trends Cogn. Sci. 9 , 99–103 (2005).

Rueda, M. R., Rothbart, M. K., McCandliss, B. D., Saccomanno, L. & Posner, M. L. Training, maturation and genetic influences on the development of executive attention. Proc. Natl Acad. Sci. USA 102 , 14931–14936 (2005).

Morris, J. S. et al. A differential neural response in the human amygdala to fearful and happy facial expressions. Nature 383 , 812–815 (1996).

Schumann, C. M. et al. The amygdala is enlarged in children but not adolescents with autism; the hippocampus is enlarged at all ages. J. Neurosci. 24 , 6392–6401 (2004).

Dawson, G., Webb, S. J., Carver, L., Panagiotides, H. & McPartland, J. Young children with autism show atypical brain responses to fearful versus neutral facial expressions of emotion. Dev. Sci. 7 , 340–359 (2004).

Carr, L. et al. Neural mechanisms of empathy in humans: a relay from neural systems for imitation to limbic areas. Proc. Natl Acad. Sci. USA 100 , 5497–5502 (2003).

Dapretto, M. et al. Understanding emotions in others: mirror neuron dysfunction in children with autism spectrum disorders. Nature Neurosci. 9 , 28–30 (2006).

Schultz, D., Izard, C. E. & Bear, G. Children's emotion processing: relations to emotionality and aggression. Dev. Psychopathol. 16 , 371–387 (2004).

Scott, S., Knapp, M., Henderson, J. & Maughan, B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. Brit. Med. J. 323 , 1–5 (2001).

Golan, O. & Baren-Cohen, S. Systemizing empathy: teaching adults with Asperger syndrome and high functioning autism to recognise complex emotions using interactive media. Dev. Psychopathol. 18 , 589–615 (2006).

Adolphs, R. Neural systems for recognising emotion. Curr. Opin. Neurobiol. 12 , 169–177 (2002).

Vasa, R. A. et al. Neuroimaging correlates of anxiety after pediatric traumatic brain injury. Biol. Psychiatry 55 , 208–216 (2004).

Rauch, S. L., Shin, L. M. & Wright, C. I. Neuroimaging studies of amygdala function in anxiety disorders. Ann. NY Acad. Sci. 985 , 389–410 (2003).

Muris, P., Merckelbach, H. & Damsma, E. Threat perception bias in nonreferred, socially anxious children. J. Clin. Child Psychol. 29 , 348–359 (2000).

International Mind, Brain and Education Society [online]

Mind, Brain and Education Useable Knowledge Conference , 7–8 October 2004, Graduate School of Education, University of Harvard, [online]

International Mind, Brain and Education Summer School , 16–20 July 2005, Erice, Sicily.

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Goswami, U. Neuroscience and education: from research to practice?. Nat Rev Neurosci 7 , 406–413 (2006). https://doi.org/10.1038/nrn1907

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Politics of plasticity: implications of the new science of the “teen brain” for education.

• Suparna Choudhury
• William Wannyn

Culture, Medicine, and Psychiatry (2022)

• Veronica P. Y. Kwok

npj Science of Learning (2020)

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Reflective Language Teaching: From Research to Practice

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Rod Bolitho, Reflective Language Teaching: From Research to Practice, ELT Journal , Volume 63, Issue 2, April 2009, Pages 186–188, https://doi.org/10.1093/elt/ccp012

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This is one of the most recent additions to the literature on reflective practice. The author is based in Canada, but also draws on his experience as a teacher and trainer in other contexts. The subtitle of the book raised an immediate question for me: Why would a book about teaching and for teachers use research as a point of departure? The first (and rather convoluted) sentence in the author's preface gives us a clue:

Reflective Language Teaching is a book unique in existence because it presents up-to-date research on reflective language teaching and also presents case studies, most of which have been conducted by this author in collaboration with other language teachers, that illustrate topics covered in each chapter. (p. vi)

This is quite a claim but it does provide a yardstick against which to assess the book's value to potential readers. It also hints at the approach taken to chapter design, which is based on a template leading from an introduction to research findings, followed by one or more case studies, a section entitled ‘From research to practice’, questions to reflect on, a conclusion followed, rather oddly, by a so-called ‘Chapter scenario’ and finally another set of questions. While the template lends structure to the book, it also becomes repetitive and predictable and does not always make for a smooth read.

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Autism: from research to practice

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• 1 University of Michigan.
• PMID: 21058793
• PMCID: PMC3035483
• DOI: 10.1037/0003-066X.65.8.815

Autism is the most commonly studied of a spectrum of developmental disorders that are believed to be neurobiologically based but which, at this point, for lack of good biomarkers, are defined purely by behavior. In the last 20 years, the definition of autism has shifted in emphasis from extreme aloofness and positive signs of abnormality in repetitive and sensorimotor behaviors to a greater awareness of the importance of more subtle reciprocal social communication deficits as core features. Standard diagnostic instruments were developed for research purposes to acquire information both through caregiver interviews and direct clinical observation. Use of these instruments in clinical practice resulted in major improvements, which in turn affected research results. These results yielded further improvements that led to changes in clinical practice over time. The synergism between research and clinical practice in the understanding of autism is discussed.

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Research to Practice (r2p) is an approach to collaborations with partners and stakeholders on the use, adoption, and adaptation of NIOSH knowledge, interventions, and technologies. We need to move research into practice in order to reduce and eliminate injuries, illness, and fatalities. At NIOSH, we feel it is important to work with our partners to:

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Evaluation is a systematic assessment of the extent to which a r2p effort meets measurable objectives, milestones, or goals. Results of evaluations may inform the planning of an effort (i.e., feasibility, or need), process (i.e., tracking), progress toward outcomes and objectives, or provide a final measure of impact.

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• Early Childhood Research Summit helps connect research, practice, policy

08 May 2024     By Chuck Green, CYFS

Creating connections among early childhood research, practice and policy — and how each can enhance the lives of young children and their families — provided the central theme of the 202 4 CYFS Early Childhood Research Summit .      

Almost 200 attendees, including researchers from across the University of Nebraska system, practitioners, administrators, community partners and policymakers, gathered April 2 3 at Nebraska Innovation Campus for the daylong, s eventh biennial summit, which highlighted the latest research to advance early childhood education and development , and implications for practice and policy .      

“ Collaboration and partnership are essential to our ability to make positive impacts in the lives of young children and their families — and in the communities in which they live , ” said Sue Sheridan , CYFS director , as she welcomed summit participants. “ M y hope is that each of you — whether you are a researcher, practitioner, administrator, community partner or policymaker — leaves today having forged new connections and strengthen ing existing ones .”    

Keynote speaker  Chrishana Lloyd , research scholar at Child Trends , discussed the relationship between research, policy and practice in early care and education , highlighting innovative approaches and strategies to advance field.        

Lloyd outlined a research project on which she was involved that focused on a historical exploration of early care and education compensation, policy and solutions , particularly among Native American and Black women. The study explored the level to which the groups were minoritized and marginalized , and how the resulting systemic racism continues to have significant effects on the child care workforce .     

Lloyd also discussed the work of her National Early Care and Education Workforce Center, and its future goals. One feature, the Grow Your Own campaign, draws from within communities to support a diverse, qualified and well-compensated early care and education workforce.    

Grow Your Own helps launch signature services such as campaign webinars, technical assistance , facilitating connections among local innovators to build research capacity .     

“ What works tends to happen locally, ” she said.    

Lloyd emphasized the i mportance of flexibility in early childhood research , practice and policy.    

“ Turnover is a natural thing; nobody stays in one job forever, ” she said. “ We learn and grow and progress. When you do this work, you have to be ope n to growth and change. ”    

Throughout the day ’ s breakout sessions and panel discussions, research topics spanned children ’ s school readiness, parent engagement, special education, health and nutrition, STEM , social-emotional development, and workforce development .      

Jason Prokop, director of First Five Nebraska , and Walter Gilliam , executive director of the Buffett Early Childhood Institute , also shared their thoughts with the attending educators, researchers and policymakers.    

Gilliam stressed the importance of Nebraska’s policy, practice and research communities acting together to ensure positive impacts for children and their families.    

“All three elements work together to positively impact lives, ” he said. “ We have to make sure we communicate and collaborate to ensure that the work we ’ re doing is translating into meaningful change for children and their families. ”    

Jason Ball, president of the Lincoln Chamber of Commerce, spoke during lunch, assuring attendees that the Chamber views early childhood research and development as an integral part of Lincoln ’ s economic growth and future workforce development.    

“ We are involved in the public policy that is essential to shaping the future, collectively as a state, that will serve our families and children better, ” he said.  

Nick Pace , interim dean of the College of Education and Human Sciences , shared closing thoughts, noting how early childhood research drives future success. He thanked researchers for their work and collaboration in aligning research, practice and policy.     

“ Working together is crucial to generating the best outcomes — and to ensuring that high-quality early childhood research continues to flourish and thrive in Nebraska ,” Pace said. “I know everyone here will benefit from the research information shared today , and will develop a deeper understanding of our strengths, progress and dedication to early childhood research at the University of Nebraska. ”      

The event concluded with a poster session that featured more than 20 graduate students showcasing their early childhood research and answering questions about their work.      

The summit was presented by CYFS in partnership with the Nebraska Academy for Early Childhood Research (NAECR). Sponsors included the College of Education and Human Sciences ; the Buffett Early Childhood Institute ; and First Five Nebraska .      

View summit videos, research presentations and posters    

View summit photo gallery    

View #ECSummit2 4 Twitter posts    

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• Jenna Rogers turns passion for people with disabilities into lasting impact at Nebraska
• Three CEHS students earn awards at Research Days
• Meet a Husker: Hayley Corbridge
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• Meet a Husker: Kelsey Wathen
• Five CEHS students inducted into Innocents Society, Mortar Board for 2024-25
• Masters Tournament experience a 'masterclass in hospitality' for Husker HRTM students
• Sheree Moser retiring from Child, Youth and Family Studies

Welsh leads equity-centered research practice partnership to reduce racial disparities in school discipline

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May 13, 2024, 11:51 AM

By Jenna Somers

Last year, Richard Welsh reported findings on the persistence of racial disparities in exclusionary school discipline practices. Despite suspensions declining over the past decade as schools reformed their policies, exclusionary disciplinary rates remained higher for African American students. Across the South, in-school suspensions (ISS) are particularly prevalent and disruptive to the education of racially minoritized students. Given these facts, Welsh has embarked on a new co-design process of ISS that leverages an existing research-practice partnership with a school district in Georgia to crack the code on truly resolving racial inequities in school discipline policies and practices.

Supported by a $474,178 grant from the William T. Grant Foundation and a $125,000 grant from the American Institutes of Research Equity Initiative, Welsh is leading a three-year project with the school district to understand the role of race and power in equity-centered research-practice partnerships, how the dynamics of the partnership affect partnership activities, and how these activities influence research use by school administrators, district leaders, and school board members.

“These are the three key decisionmakers who can advance racial equity in school districts through policies, programs, and personnel. They make decisions about codes of conduct, which disciplinary programs to implement, and who to hire, including behavioral specialists to support students’ social-emotional development,” said Welsh, associate professor of education and public policy at Vanderbilt Peabody College of education and human development.

“Improving the use of research evidence among education leaders via equity-centered research-practice partnerships can possibly lead to disruptive decisions necessary to addressing persistent racial inequities in school discipline. Also, turning the analytical lens on ourselves to examine how inequities might manifest in the partnership has implications for partnership and student outcomes,” Welsh added.

The research team will analyze their interviews with key decision makers, research-practice partnership primary investigators, and co-design team members. They will also observe school board meetings, school discipline committee meetings, and partnership meetings, as well as co-design workshops, district- and school-level documents, and materials to record the partnering process as well as the use of research evidence and disruptive decision-making. By engaging in cycles of disciplined inquiry to improve ISS processes, the partnership aims to reach its goal of improving youth outcomes.

The co-design process includes working with a team of school leaders and school personnel at three middle schools to analyze and reimagine their ISS process and infrastructure.

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An Ancient Maya Practice Could Be the Key to Growing Vegetables on Mars

Researchers are exploring whether intercropping—a technique of growing different types of plants in close proximity to one another—could be the secret to agriculture on the Red Planet

Daily Correspondent

If humans build settlements on Mars, how will they  feed ourselves ? Waiting on deliveries from Earth would take too long and costs would be exorbitant, since getting to the Red Planet is currently a nine-month one-way journey . On top of that, dehydrating foodstuff—the best preservation method for perishables sent to space—removes vital nutrients.

More than likely, Martian settlers will need to grow their own food.

Researchers are now exploring how best to optimize crop yield on Mars using intercropping, a technique perfected by Maya farmers centuries ago that involves growing multiple plants in close proximity to one another. Their findings—published this month in the journal Plos One —could not only benefit the pioneers who end up colonizing the Red Planet, but also farmers here on Earth amid a rapidly changing climate.

Building upon past research, scientists at Wageningen University & Research in the Netherlands conducted greenhouse experiments that mimicked the conditions of similar structures that could eventually be built on Mars.

Inside the greenhouses, they filled pots with a mixture of rocks, dust and sand, known as regolith, that simulates Martian soil. Separately, they also filled some pots with standard potting soil and some with river sand. They added a small amount of organic soil to both the regolith and river sand pots to help improve water retention and root growth.

Then, they planted peas, carrots and tomatoes in each of the different soil types, both on their own (a practice known as “monocropping”) and together (intercropping). Past research had shown that these three crops could grow in Martian regolith, which allowed the team to focus specifically on their questions about intercropping. Peas, carrots and tomatoes are also promising Mars crops because they are high in beta carotene, vitamin C, antioxidants and other nutrients that are typically reduced or destroyed during dehydration.

In the end, they had 12 different experimental treatments. They produced five pots for each treatment, for a total of 60 pots. After 105 days, they harvested their crops and calculated the yield and nutritional value of each plant. Then, they crunched the numbers.

Their results were a bit of a mixed bag. In the simulated Martian soil, tomatoes grew much better when planted alongside carrots and peas. They had more potassium, a higher biomass and a better yield under the intercropping condition compared to being planted alone.

The carrots, meanwhile, produced less biomass and had a lower yield in intercropping compared to monocropping. The peas fared similarly under both conditions.

"It is very important how you select the crop species that you combine, because the tomato did profit from the peas, but the carrot most certainly did not,” says study co-author Wieger Wamelink , an ecologist at Wageningen University & Research, to Reuters’ Will Dunham. “This was probably due to lack of light. The tall tomato and pea plants did out-compete the carrot by taking light from it.”

Even though intercropping in Martian regolith produced varied results, researchers say they can now build on these takeaways while conducting future experiments. These and other future findings might also help growers on Earth, where rising global temperatures and unpredictable rainfall spurred by climate change could make farming more challenging .

More broadly, the paper adds to the growing body of research on our potential Mars’ food supply. Elsewhere, scientists are considering whether fly larvae could help add nutrients to Martian regolith, whether vegetables could grow vertically or in pods , and whether it’s possible to grow the grains needed to brew beer on the Red Planet.

“If we can unlock the secret to regenerating poor soils while developing a high-yielding, self-sustainable food production system—exactly the goal of Martian agriculture research—we will have found a solution for a lot of the issues we are having here on Earth as well,” says study co-author Rebecca Gonçalves, an astrobiologist at Wageningen University & Research, to Popular Science ’s Laura Baisas.

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Sarah Kuta is a writer and editor based in Longmont, Colorado. She covers history, science, travel, food and beverage, sustainability, economics and other topics.

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From Research to Practice: Ten Lessons in Delivering Digital Mental Health Services

Nickolai titov.

1 MindSpot Clinic and Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia

Heather D. Hadjistavropoulos

2 Online Therapy Unit, Department of Psychology, University of Regina, Regina, Saskatchewan, SK S4S 0A2, Canada

Olav Nielssen

David c. mohr.

3 Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA

Gerhard Andersson

4 Department of Behavioural Sciences and Learning, Linköping University, Linköping SE-581 83, Sweden

5 Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden

Blake F. Dear

There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.

1. Introduction

Globally, mood and anxiety disorders affect more than 700 million people each year and are associated with considerable burden and disability [ 1 , 2 ]. However, in a 12-month period, fewer than half of those affected seek or receive evidence-based treatments [ 3 , 4 , 5 ] for reasons that include cost, limited availability of services in many areas, limited awareness of both illness and the potential benefit of treatment, stigma and preference to self-manage [ 6 ].

Delivering psychological services via the internet is one way of increasing access to care. A large number of randomised controlled trials have demonstrated that internet-delivered cognitive behavioural therapy (ICBT) is effective at treating anxiety and depression [ 7 , 8 , 9 , 10 ]. However, attempts to extend ICBT to routine care have produced mixed results. Several attempts at implementation have either been unsuccessful [ 11 ] or were not found to have added value to existing face to face services [ 12 ], which has raised doubt as to whether internet-delivered psychological services can be implemented successfully in typical health care settings [ 13 ]. Notwithstanding the challenges, the successful use of ICBT as part of routine clinical care has been reported in Sweden [ 14 , 15 , 16 , 17 ], the Netherlands [ 18 , 19 ], Norway, Denmark [ 20 , 21 ], Canada [ 22 , 23 , 24 , 25 ], and Australia [ 26 , 27 , 28 , 29 , 30 ]. In addition to reports of outcomes from individual clinics, and reflecting the maturing state of the field, there is now an increasing number of studies describing barriers [ 20 , 23 , 31 , 32 ], guidelines for implementation [ 33 , 34 ], and comparisons of clinics across different countries [ 35 ]. The successful clinics typically deliver ICBT interventions via so-called virtual or digital mental health services (DMHS). Common features of the successful clinics include high standards of both clinical and organisational governance, and robust systems for staff training and supervision [ 35 ].

This paper describes key lessons learned during our own efforts to develop and deliver DMHS. The MindSpot Clinic, Australia, and the Online Therapy Unit (OTU) in the province of Saskatchewan, Canada accept referrals directly from consumers as well as via general practitioners. Together, these DMHS have provided assessments to more than 100,000 people and treatment to more than 30,000 people. The authors have worked closely together for several years and have served on advisory bodies to each other’s services. The lessons we describe draw on our shared experiences in service development, delivery and collaboration.

We narrowed down our experience to ten key lessons that were not fully described in other papers. These lessons were not immediately apparent to us when we set about translating our research findings to routine care but have been of fundamental importance in how we developed and now operate our DMHS. Hence, we anticipate that these lessons may help those launching similar clinics.

We intentionally avoided specific frameworks of reporting [ 36 , 37 ], because an aim of this paper was to describe the experiences of operating mature services, rather than just the implementation phase. We also acknowledge that some of these lessons overlap, may not apply in other jurisdictions or even to other DMHS within our own countries.

We chose to organise our lessons according to the model shown in Table 1 , which represents the lessons learned from working with (1) consumers, (2) therapists, (3) operating DMHS, and (4) when operating in the broader health systems, including when engaging with funders and policy makers.

Lessons learned at four levels of analysis of digital mental health services (DMHS).

Before further describing the lessons learned, key aspects of the MindSpot Clinic and OTU are summarised below.

2.1. The MindSpot Clinic, Sydney, Australia

MindSpot was launched in 2013 and operates from Macquarie University, Sydney. MindSpot is funded by the Australian Government Department of Health, with funding initially provided for a 3-year period as a result of the competitive tender process. MindSpot aims to improve access to evidence-based education, triage, assessment, referral, and treatment services throughout Australia to adults with symptoms of depression and anxiety [ 28 , 29 ]. Clinic services are provided free of charge.

Patients can either self-refer after learning about MindSpot via the website (mindspot.org.au), online advertising, links from other mental health websites, recommendations by previous users or can take up referrals from health professionals. Patients first register online or via telephone and complete a detailed assessment questionnaire followed by telephone or secure email contact with a therapist to discuss symptoms and treatment options. Patients then choose between information to assist with self-management, referral to another service or ICBT. The clinic offers seven ICBT programs that have been validated in clinical trials, including transdiagnostic treatments designed to treat symptoms of anxiety and depression in several age groups [ 24 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ] and disorder-specific treatments for obsessive compulsive disorder [ 48 , 49 ], post-traumatic stress disorder [ 50 ], and chronic pain [ 51 ]. All the treatment programs comprise of five lessons which provide the core information, delivered over eight-weeks. Additional resources targeting specific symptoms or difficulties are made available during treatment to assist patients tailor treatment to their own needs. Outcomes are measured using validated symptom scales that are administered weekly during treatment, on completion, and at a three-month follow-up. The therapists are all registered or provisionally registered mental health professionals who contact and monitor participants weekly during treatment via a secure email system or by telephone. The treatment patients are enrolled in cohorts every two weeks, with therapists each responsible for 50 or so patients. To date, more than 100,000 people have registered to use the clinic, and 25,000 have opted to receive ICBT.

2.2. Online Therapy Unit, Canada

The OTU has operated from the University of Regina in Saskatchewan since October 2010. Initial funding was provided by a federal research grant, but since 2015, the OTU has received stable funding from the Saskatchewan Ministry of Health. The OTU aims to provide therapist-guided ICBT for depression and anxiety and to educate providers of mental health care and conduct research on ICBT in routine practice [ 25 ]. Clinic services are also provided to patients free of charge.

The OTU promotes services to patients via word of mouth primarily from health care providers, media reports, and both digital and print communication. Patients are encouraged to visit the clinic online (onlinetherapyuser.ca) and can either self-refer or are referred by a health professional. Patients first complete an online screening followed by telephone assessment.

The OTU delivers several ICBT programs including an adaptation of the Wellbeing course developed at Macquarie University and used at the MindSpot Clinic [ 44 , 47 , 52 ]. Clinically validated patient reported outcome measures (PROMS) of anxiety and depression are administered regularly during treatment, at post-treatment, and at three-month follow-up. Therapists are registered mental health professionals or graduate students under supervision employed by the clinic or by publicly funded community clinics located in other parts of Saskatchewan. During treatment, patients receive weekly therapist contact primarily via secure email or by telephone to assist in applying the skills taught during treatment. Since October 2010, the clinic had assessed more than 5400 patients, 4200 of whom have received ICBT [ 23 , 24 , 35 ].

3. The Ten Lessons

3.1. level 1: lessons working with consumers.

The first three lessons refer to the way DMHS can improve access to care and serve a broad section of the community, and how they deliver services other than treatment.

3.1.1. Lesson 1: DMHS Can Improve Access to Care for Those Who Really Need Care

One of the most profound lessons we learned is that DMHS improve access to mental health services for many people who would not otherwise seek care. For example, at least a third of the users of both MindSpot and OTU report that they have not previously spoken to a health professional about symptoms and 80% of MindSpot and 55% of OTU users are not using other mental health services at the time of assessment [ 28 , 53 ].

The users of these services often have chronic and disabling symptoms. A third of MindSpot users have been troubled by their symptoms for between one and five years with a further third reporting symptoms for more than six years. Among users of the OTU, 45% report symptoms for two or more years and those in paid employment report an average of 7 days off work in the last 30 days due to symptoms. Moreover, the mean symptom scores reported by users of MindSpot are in the moderate–severe range, a quarter report suicidal thoughts and 2.4% disclose suicidal plans.

We were also surprised at how people use our DMHS. While most users access content online, many others download information and refer to it when they do not have internet access [ 54 ]. In addition, for those who prefer or require printed materials, we send all the treatment course content in printed form [ 28 ]. For these reasons, we sometimes think of our services as delivering virtual rather than digital care, however, we are reluctant to introduce new terms to describe this already definitionally challenged field.

3.1.2. Lesson 2: DMHS Deliver More than Treatment

Contrary to our expectations, not all consumers using our DMHS seek treatment, especially in Australia, where most users report they are primarily seeking a confidential assessment and recommendations about treatment options. This should not have come as a complete surprise, given the high proportion who had not previously sought treatment. However, we learned that for many people, the assessment itself serves as a brief but helpful clinical intervention, particularly when the consumer and therapist create a shared clinical formulation, discuss treatment options that include self-help strategies, and explore barriers and facilitators to recovery. This assessment process is highly regarded by the patients of both clinics.

Consumers also frequently report enormous difficulty understanding and navigating the existing mental health service eco-system and some report using our services to seek advice about other health services, a theme which we return to below. Consequently, our second lesson is that DMHS need to offer a range of services in addition to online treatment, including information, assessment, triage and referral to other services. It should be noted that there are differences between our two clinics, with more people using the OTU reporting they are seeking treatment compared with users of MindSpot [ 55 ]. Thus, the specific services offered by DMHS may vary between jurisdictions, possibly reflecting differences in how the clinics are perceived and promoted, and differences in the needs of the local community.

3.1.3. Lesson 3: DMHS are used by a Broad Cross Section of the Population

Our third lesson is that a diverse cross section of our communities access our services, including indigenous Australians and Canadians [ 56 ], people on low incomes, people living in rural and remote regions, and other groups who often under-utilise traditional health services. We stress that our DMHS are not a panacea in this regard. Instead, we note that the widespread use of internet-enabled devices to access a range of services, including education, banking, entertainment and other domains, has extended to healthcare. In a similar way, DMHS have considerable potential to reduce, to some degree, the inequality of access to mental health.

A striking example is the ability of DMHS to reach people living in rural areas. Almost 40% of MindSpot users report living outside major metropolitan areas, with many living in rural or remote parts of Australia, including islands off the mainland. Similarly, 28% of OTU users are from rural locations and 32% from small cities. Collectively, these people live in locations where access to health services is limited or sometimes non-existent [ 55 ]. A further example relates to engagement by older adults. Across both clinics, approximately 6% of users are over the age of 60, which is a group that often experience difficulty accessing mental health services, including for reasons related to physical impairments. The experience at both clinics is that older adults strongly engage in treatments and often obtain large improvements in symptoms [ 42 ].

A final example relates to socio-economic disadvantage. A recent analysis of MindSpot data found that users come from all socio-economic backgrounds, including 33% from the lower four deciles of socio-economic status, a group who are more prone to experience a disadvantage and difficulties accessing mental health services.

3.2. Level 2: Lessons Working with Therapists

Both clinics have now trained large numbers of therapists, previously experienced in delivering face-to-face care, to deliver DMHS. Key lessons have been that therapists working in DMHS require specialised skills and therefore, require specialised training and supervision to acquire and maintain those skills.

3.2.1. Lesson 4: DMHS Require Specialised Therapist Skills

An important lesson is that the skills and knowledge required for effective delivery of DMHS are sufficiently different to those associated with traditional models of care to warrant specialised training and supervision [ 57 ]. Obvious examples include the need for DMHS therapists to become competent in the use of clinical software platforms and in engaging with patients via telephone or text-based communication, including responding appropriately to very long messages or technical questions, skills that are not taught in most clinical training programs [ 23 , 40 , 58 ].

However, there are less obvious reasons for providing specialised training and supervision. First, therapists new to DMHS often intellectually understand that DMHS treatments can result in similar outcomes to face-to-face treatment [ 10 , 59 ] but may initially expect DMHS treatments to produce poorer outcomes, a sentiment they may communicate to consumers [ 23 ]. New therapists also often find that their assumptions about mechanisms or facilitators of recovery are challenged, particularly when they learn that DMHS patients can develop very strong therapeutic alliances [ 60 ] and may obtain large clinical improvements, even after choosing not to have regular therapist contact [ 55 ]. Related to this, therapists are often surprised to learn that the structured educational aspects and resources associated with DMHS offer significant advantages over traditional clinical care where such resources may not be used.

A second reason for providing specialised training and supervision is to support DMHS therapists to successfully process the transference and other dynamics that occur when delivering DMHS to large groups of patients at once. An example of this is the temporary increase in symptoms experienced by many consumers at mid-treatment when they begin to apply skills learned in treatment in their everyday lives. These lapses usually resolve and most continue to recover. This process is familiar to experienced therapists, who can help patients understand this trajectory and can manage their own reactions. However, the effect can be magnified by the large numbers of patients in each treatment cohort, leading to feelings of intense elation or sometimes disillusionment, particularly when some patients choose not to engage with the therapist but have not made this clear at the outset. A strong framework of training and supervision can assist therapists to understand and adapt to these patterns and maintain confidence in both their own performance and the effectiveness of the treatment programs.

3.2.2. Lesson 5: DMHS Require Specialised Clinical Processes

This lesson reflects important differences in the clinical procedures and processes used in DMHS compared to traditional mental health clinics. An obvious example is the use of structured ICBT interventions, questionnaires and outcome measures used in DMHS, the delivery of which are governed by procedures which regulate therapists’ actions more than they would in typical in face-to-face services.

This level of structure reflects how DMHS attempt to manage both quality assurance and treatment to large numbers of consumers. Therapists experienced in working at DMHS can efficiently deliver individualised care within these structured frameworks, but this is more difficult for less experienced therapists. Another lesson has been the importance of robust systems for not only training and supervision [ 58 , 61 ], but also the recruitment and retention of clinicians who are comfortable with relatively high levels of structure and process [ 23 ].

Another example of how DMHS differ from traditional face-to-face mental health services, at least in our jurisdictions, relates to the use of PROMS and patient-reported experience measures (PREMS) [ 62 , 63 , 64 ]. Despite the documented utility of PROMS and PREMS in clinical care, they are infrequently used in traditional services, and rarely as a therapeutic tool for guiding discussions or decisions about treatment or as a method for improving the quality of care. Since our clinics routinely administer PROMS and PREMS during and after treatment, we provide specific training for new therapists to increase their comfort and competence in using measures of outcome and experience [ 61 ].

3.3. Level 3: Lessons Operating Services

3.3.1. lesson 6: the operation of dmhs require specialised systems and skills.

This lesson is obvious, but we include it here because we underestimated the complexity of developing and delivering safe and effective DMHS. We expected that our DMHS would be similar to traditional face-to-face clinical mental health services or an extension of the operations used in our large-scale clinical research trials. However, we quickly learned that safely and effectively operating DMHS required attention in at least four areas.

First, DMHS require robust procedures to define and effectively manage safety risks for people presenting with more severe and complex needs than seen in our clinical trials [ 30 ] and who often live in remote locations. This requires developing expertise in evaluation of risk via telephone or online communication, the ability to contact emergency services that are available near where the patient is located, how to refer to such services, and how to stay abreast of changes in their referral and contact details.

Second, although operating DMHS involve similar skills as those required for operating traditional mental health services, including management, human resources, marketing and IT [ 25 ], we found that DMHS were sufficiently different to warrant employing people with additional expertise, including skills relevant to telehealth, social media and online marketing.

Third, and in addition to the urgent requirement for establishing robust systems of organizational and clinical governance we recognised that in order to effectively lead our services, we personally needed to develop commercial and management skills, domains in which we, as clinical researchers, had little or no experience. We also needed to address challenges relating to regulation; for example at MindSpot, we needed to determine which of the myriad of possible regulatory frameworks applied to our activities [ 65 ] given that most [ 66 ] had been developed for traditional face-to-face services. Within the OTU, a similar issue requiring attention was how to meet the different regulatory requirements for services provided by therapists from psychology and social work.

Establishing, maintaining, and subsequently improving our operational systems has required a considerable work effort. Whilst we have recruited specialist staff to assist with such efforts, due to the novelty of DMHS, we often also sometimes found it necessary to train and develop our own staff in these operational and managerial roles.

3.3.2. Lesson 7: Digital Mental Health Clinics Evolve

This lesson represents another difference between DMHS and traditional clinical services. Traditional services may change frequently, but the change is usually limited to organisational structure or branding, with less frequent changes to the service or delivery models. By contrast, our DMHS regularly undergo significant changes in procedures, systems, and even service delivery models due to developments in research, technology, the changing expectations of consumers, and changes in the policy priorities of the funding bodies. However, the most frequent changes stem from reviewing our outcomes and procedures.

For example, within the OTU, changes within recent years include (1) replacing disorder-specific ICBT programs with a transdiagnostic treatment program in light of the extensive comorbidity found among patients seeking services and the efficiency of delivery compared to disorder-specific programs [ 24 ], (2) ongoing trials to determine the best level of support and specialisation by therapists [ 40 , 67 ], and (3) the expansion of services to address other needs in the community, such as ICBT for pain [ 22 ].

Regular change has significant implications for the operation of our clinics. For example, management needs systems for reliably collecting and analysing data, the ability to develop and test alternative models, and the skills and authority to make decisions. The individuals given the task of implementing change need project leadership and change management skills and procedures to plan and deploy changes. Furthermore, therapists and other staff need to be prepared for and willing to implement changes. This means that all staff members need to be adaptable and change needs to become part of the culture of the DMHS.

3.4. Level 4: Lessons Working with Health Systems, Funders, and Policy Makers

This final group of lessons summarises key learnings derived from working with and influencing health systems, in particular, the future role and value of DMHS within health systems.

3.4.1. Lesson 8: Integrating DMHS within Health Systems Is Challenging

Our DMHS reside within enormously complex health systems which might be more accurately described as interconnected nodes of care rather than true systems . For example, mental health services, while all purporting to share the aim of improving mental wellbeing, often target different groups and may be accountable to different policy and regulatory frameworks. Health services also differ with respect to funding, and in both Canada and Australia, funding for different types of mental health services can be provided by the federal government, state/provincial government, state mental health commissions, non-governmental organisations and individual consumers. As a result, mental health services are often fragmented, poorly connected, and difficult for consumers to navigate.

The complexity of health systems and their resistance to change created a number of threats to the sustainability and stability of our DMHS, particularly in our early years of service delivery. We were able to overcome such challenges by building strong relationships with key stakeholders and in particular, by publishing outcome data that documented the value of the services. This data has also assisted in defining the role of DMHS in the broader mental healthcare system, including as services which improve access to patients who would otherwise not access mental health services.

These so-called external-facing activities have required considerable time and effort. Participation in such activities has required us to learn the sometimes-subtle rules of engaging with other organisations, to commit to regular participation in networking activities, and to make frequent efforts to build and maintain collaborations. Such activities can be enormously time consuming but we have found that they are an essential component of successfully delivering our DMHS.

3.4.2. Lesson 9: DMHS May Change the Mental Health System

By providing services to large numbers of consumers and because of our routine collection of outcome data, our clinics are having a growing influence on the health system and are increasingly seen as agents or examples of change. In Canada, the experiences and activities of the OTU have influenced the development of e-mental health in several ways [ 68 ]. In Australia, data from MindSpot has helped inform long-term government planning and funding strategies for mental health services [ 69 ], not only DMHS. The data and outcome driven reports prepared by our services are often in marked contrast to submissions by other groups, which may be based more on opinion rather than on evidence. Hence, an important role of DMHS is to inform policy makers and funders to help improve the broader mental health system by presenting data drawn from a broad cross section of the community and also to nudge traditional services to adopt systems of measurement and reporting of outcomes.

3.4.3. Lesson 10: DMHS Are Not a Panacea

We are struck by how often mental health funders and policy makers, when presented with the evidence from our DMHS, become enthusiastic about their potential without an appreciation of their limits. These limits include the so-called digital divide, that is, the group in society who does not use digital devices, those with very low levels of literacy, and those in crisis, who can benefit from contact with DMHS, but may be better off with a mental health service that includes direct human interaction, as well as those who prefer to see someone face-to-face.

In all our communication, we emphasise that DMHS should complement and not replace existing services. We also emphasise that attention must be paid to systematically evaluating delivery methods that combine the best elements of DMHS with traditional services, including blended care [ 70 , 71 , 72 , 73 , 74 ]. We also stress that consumer knowledge of DMHS is still limited and that even brief education about DMHS can improve consumer perceptions and uptake of services [ 75 ]. These observations lead to our final lesson that whilst acknowledging that DMHS can significantly improve access to safe, clinical and cost-effective care, our DMHS are not a panacea.

4. General Discussion

This paper aimed to assist other emerging DMHS by sharing ten lessons we learned from successfully delivering DMHS to very large numbers of consumers. Some of these lessons might seem obvious, but their importance was not always apparent when we started our services. Several key themes are discussed below, followed by recommendations.

One theme is that we expect that demand for this service model will grow. The number of patients treated using ICBT in the OTU has more than doubled in the past four years. The threshold for accessing this model of care is significantly lower than traditional face-to-face services and consumers are becoming increasingly comfortable with using technology to access a broad range of services, including health services. Along with a growth in numbers, we expect that existing DMHS will become more tailored to different populations, for example, people in certain occupations, different cultures, or who have been referred from different pathways, although our experience is that the extent to which the treatment course materials need to be customised is considerably less than expected [ 56 , 76 , 77 , 78 ].

A second theme is that the workforce requires specialised training, clinical supervision and support. This raises broader issues about workforce planning and training programs. We note that many professional bodies have recognised the importance of education and training of mental health professionals and standards in this model of care [ 79 , 80 , 81 , 82 ] but that few training programs in any mental health discipline offer courses or training opportunities specifically for digital mental health. The absence of such training opportunities poses significant risks for the future sustainability and quality of the field.

A third theme is that the delivery of DMHS requires specialist skills in both clinical and operational domains. We also note that although the costs to entry of developing a DMHS, especially a low volume service, might be relatively low, the costs of maintaining quality services can be high. Inadequate funding and inadequate organisational governance can affect the reputation, credibility, and therefore, the potential of the emerging field of DMHS [ 83 ]. Hence, we strongly encourage anyone seeking to launch a DMHS to carefully consider the governance frameworks that will ensure the safe and sustainable delivery of services, or to consider licensing their interventions to groups who have proven success in implementing similar services.

Another theme is that the field of DMHS is rapidly evolving. We encourage those seeking to start a DMHS to consider trialing different models of care to those currently used by existing DMHS, including testing different levels of therapist support [ 24 , 40 , 55 ] and testing care which combines both face-to-face and online delivery. We note the important work conducted by our European colleagues on blended care [ 70 , 71 , 72 , 73 , 74 ] and by others on mobile services [ 13 ] and encourage collaboration in order to collectively develop the most effective models of care.

Our final theme relates to recognising the true value proposition of DMHS. We maintain that they are not a panacea but instead serve several valuable functions, including as a useful complement to existing services, as a way of improving equity of access to mental health care for common psychological disorders, and as a stepping stone to other services. Over-promising may increase the likelihood of short-term funding, but poorly designed and delivered services might harm consumers, disappoint stakeholders and risk the future of DMHS.

4.1. Recommendations

These observations lead to several recommendations which we encourage those contemplating developing DMHS to consider. First, we recommend that new DMHS recruit not only appropriately skilled therapists, but also people with commercial and professional skills, ideally with experience in digital service delivery. Second, given the unique challenges of DMHS, we recommend the development of both thorough initial training of therapists, as well as of systems for ongoing training and supervision. Third, given the likelihood that demand for DMHS will grow, we strongly encourage that organisations involved in training and certification of mental health professionals add content and training opportunities relevant to the competencies required in DMHS.

Fourth, we recommend that emerging DMHS measure and publish their outcomes, including disappointing and negative effects outcomes [ 84 ]. We also encourage DMHS to engage with policy makers and funders to develop mental health policy grounded in evidence rather than in opinion. Finally, we strongly encourage DMHS to engage with their consumers in appropriate co-design and evaluation activities to ensure services are not only effective but acceptable to consumers.

4.2. Strengths and Limitations

We believe that the main strength of this paper stems from the authors’ shared experience in launching and steadily improving successful high volume DMHS. However, we acknowledge several weaknesses, including that the list of lessons is non-exhaustive and did not include some of the significant challenges associated with managing funding insecurity or bureaucratic and professional challenges within the field of mental health, topics we will return to in a subsequent publication. We also acknowledge that our experiences may not reflect those of other DMHS.

4.3. Conclusions

This paper described ten key lessons learned by the authors when developing, delivering, and evaluating DMHS. Despite the challenges, provided they are delivered safely, effectively and with strong clinical, operational and organisational governance, we remain highly optimistic about the potential of DMHS to reduce the global burden of the high prevalence of mental disorders.

Acknowledgments

The Online Therapy Unit is funded by Saskatchewan Ministry of Health. Research conducted by the Unit is currently funded by the Canadian Institutes of Health Research (152917), the Saskatchewan Health Research Foundation, and the Saskatchewan Centre for Patient-Oriented Research. The MindSpot Clinic is funded by the Australian Department of Health and supported by MQ Health, Macquarie University. The authors gratefully acknowledge their funders, supporting institutions, the patients for allowing the use of their data, and their clinical, management, and technical teams for their efforts in launching and operating the Clinics. We also acknowledge the achievements and leadership shown by early and current researchers in the field of psychological internet interventions. Their work has strongly influenced the models and outcomes reported here and continue to inspire our attempts at reducing barriers to evidence-based psychological services.

Author Contributions

Conceptualisation, N.T. and B.F.D.; Writing—Original Draft Preparation, N.T., H.D.H., O.N., and B.F.D.; Writing—Review & Editing, N.T., H.D.H., O.N., D.C.M., G.A. and B.F.D.

Conflicts of Interest

H.D.H. is funded by Saskatchewan Ministry of Health to operate the Online Therapy Unit. Research conducted by the Unit is currently funded by the Canadian Institutes of Health Research (152917), the Saskatchewan Health Research Foundation, and the Saskatchewan Centre for Patient-Oriented Research. Funders had no involvement in the design of the paper, collection, analysis, or interpretation of the data. N.T. and B.F.D. are funded by the Australian Government to operate the national MindSpot Clinic. O.N. is a member of a Lundbeck advisory board for an antipsychotic medication. The other authors report no financial relationships with commercial interests. This paper was investigator initiated. It was funded by Departmental funds from the authors’ university, which had no role in the design, execution, interpretation, or writing of the study.

How systems transitions can improve sustainable development

Clark, William, et al. Systems transitions research and sustainable development: Challenges, progress, and prospects ,” Proceedings of the National Academy of Sciences (Vol. 120, No. 47, Nov. 2023).

Faculty Authors

William Clark

What’s the issue.

Making development sustainable is a central challenge of our age. The field of sustainability science tries to figure out how interactions of nature and society can support sustainable development. One key goal is figuring out how to restructure complex consumption-production systems. Examples of these systems are production and consumption of food, energy, and mobility. Scientists are studying how transitions in these production-consumption systems can bend development pathways toward sustainability.

What does the research say?

Writing in a special edition of the Proceedings of the National Academy of Sciences, scholars Frank Geels of the University of Manchester, Florian Kern of the Institute for Ecological Economy Research in Berlin, and William C. Clark of Harvard Kennedy School bring together insights from experts on system transitions that shape sustainable development. This work weighs how potential solutions might fundamentally shift consumption-production systems. The authors note that radical innovations in small niches can lead to major transitions in large consumption-production systems. The three lead authors call on more than a dozen sustainable development scholars to examine specific innovations and obstacles to progress. These experts look at the drivers and barriers to sustainability in electricity, food, and mobility systems; they also consider larger cross-cutting systems issues. For example, one essay analyzes the British electricity system since World War Two, and the role that increasing concerns about climate change played in generating a more interventionist policy approach to shift electricity production and consumption. These systems changes led to an 86% reduction in emissions from 2006 to 2019. The authors note that political and economic struggles as well as technological advances drove this transition. Another paper analyzes how recent technology advances in energy storage, microgrids, and digitized systems in the United States have helped undermine long-time obstacles to small-scale solar energy development. Other essays look at the adoption of electric vehicles in Norway, the systems issues involved in car-sharing, agroecology in Nicaragua, and the shift to plant-based alternatives to meat production. 

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For more than four decades, professor bill clark has championed sustainability, walking the talk: how students can contribute to the hks sustainability agenda, pursuing sustainability: a guide to the science and practice.

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