Knowledge Mobilisation in General Practice in the English NHS

UoM administered thesis: Phd

  • Authors:
  • Tina Wulff

Abstract

Although knowledge mobilisation (KM) is claimed to improve the impact of knowledge on practice, the application of KM by healthcare practitioners is variable. Moreover, there are few descriptions of how KM concepts are actually used in healthcare settings, particularly in the context of general practice. This research focuses on how KM occurs within the general medical practice setting, considering what kinds of knowledge and evidence are mobilised, by whom and through what activities. The research question considered is: How are KM concepts relevant to general medical practice in the English NHS? The research comprises a scoping literature review and 29 semi-structured interviews with general practitioners (GPs). Participants were recruited using purposive and snowball sampling. Data were analysed with grounded theory. The research question was addressed by considering the following: • KM concepts in the literature. These were identified as knowledge and evidence, knowledge inquiry and encounters, guidelines, barriers and facilitators, and KM activities and interventions. • KM processes in general practice. The findings showed that a wide range of sources of knowledge and evidence were important in general practice. Many barriers to KM were reported, although these were not systematically assessed. Various reasons for guideline adoption were identified, with guideline adoption shown to be a heterogeneous and not necessarily systematic process. However, the individual adoption of guidelines to the patient was particularly important to GPs. A variety of KM interventions were used, which differed according to the condition and complexity of the patient and were often pragmatic (as opposed to systematic). Ultimately, patients played a crucial role in KM in general practice. • Differences between KM concepts and practice. The findings showed that even though KM concepts are applicable to describe KM in general practice, they are of limited relevance to GPs as they do not take into account many of the features of general practice. • New perspectives on KM concepts through insights from general practice. The findings showed that KM in general practice is a non-linear process that is a pragmatic and inherent part of practice. It is patient-driven and reactive, with the processes varying according to the condition and complexity of the patient. This research offers an understanding of KM in general practice, which can be used as a theoretical and empirical evidence base to design more effective practice-based KM concepts, strategies and tools that take into consideration the special characteristics of KM in general practice.

Details

Original languageEnglish
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Award date1 Aug 2018