The power of narrative in knowledge transfer

John Parboosingh MB, FRCSC Professor emeritus University of Calgary

Objectives
Why the recent interest in narrative in knowledge translation? How does narrative enhance knowledge transfer? What is the link between knowledge transfer, narrative and CoPs at work?

Some definitions
Narrative: a construct created in a suitable format to describe a sequence of events.

Story" refers to the sequence of events described in a narrative.

McKinsey research suggests .. analyzing information flows and personal relationships, could speed the adoption of vaccines.

By studying narratives power to influence beliefs, researchers are discovering how we analyze information and accept new ideas.

EVIDENCE & STORIES are TOOLS for different conversations

EVIDENCE is used to determine team direction

STORIES change peoples values & behaviours

How we traditionally change values & behaviors?

E-B Information Delivered by expert Evidence = value We put information to work

E-B message

Traditional methods are limited

Effectiveness of methods of implementing Best Practices

In a systematic review, Grimshaw et al (2004) found that the mean rate of improvement in practice was less than 10 percent.

Why?

The workplace is changing 1. Nature of practice > Tacit work 2. More workers & multiple disciplines 3. Complex Adaptive System
McKinsey Quarterly, 2005 # 4 I.O.M , 2001

Clinical settings are complex adaptive systems (CAS)

Different disciplines, different perspectives, values We are autonomous professionals acting independently, but influenced by each other Our actions are in patterns, based on in-grained, robust habits that make us feel secure.

So how do these in-grained patterns change?

Methods used by practitioners to enhance their practice McKinsey Quarterly, 2005 # 4

Interact with peers, Use stories to reconstruct practice, Mentor each other

- Communities of Practice -

Nature & flow of information in the workplace` CoPs

Generative dialogue: We use stories to reconstruct practice and express perspectives on issues. It is a how can we do this better conversation. Traditional discourse: provides points of view, seeks agreement or settling differences. It is often directive, advocating and defensive.

Team level

Practice level

Accuracy #1 e.g., SBAR report about a critical situation

Healthcare professionals' intentions and behaviours:

A systematic review of studies based on social cognitive Godin et al : Implementation Science Aug 2008 theories
Beliefs about consequences Beliefs about capabilities

Social influences Moral norms

Intention

Behavior

Role & Identity

Habit & past behavior

Characteristics of HP

Bandwidth of generative dialogue

Beliefs about consequences Beliefs about capabilities

There is more to dialogue than the E-B message

Social influences Moral norms

Intention

Behavior

Role & Identity

Habit & past behavior

Characteristics of HP

Its all in narratives

CoPs build relationships which in turn enhance quality of conversation

Relationships can control the bandwidth of conversation

Narrative does more than pass information

Narrative is a vehicle to:

Learn about different perspectives, norms, values Build trust between people Create new knowledge Build professional identify, job satisfaction

Evaluate learning applied to practice

http://www.ustream.com

DIGITAL STORYTELLING METHODS

http://voicethread.com/

The stories have two purposes: First, to recognize an employee's commitment in front of peers and second, to reinforce a service value.

http://www.businessweek.com/smallbiz/content/feb2007/sb20070213_171606.htm?campaign_id=rss_daily

Thank you for your attention Questions, comments? Share information John Parboosingh parboo@telusplanet.net