According to Oxford Dictionaries, knowledge is … facts, information, and skills acquired through experience or education; and the theoretical or practical understanding of a subject. It is more than the just published research evidence. In a typical encounter between a person and a health practitioner, there are at least 3 different ‘worlds’ of knowledge coming together: knowledge from the patient, practitioner and the research evidence.Therefore, there is an inherent challenge is understanding and defining what knowledge is translated for best healthcare practice.
Perhaps this is a philosophical question, where the search for the ultimate truth prioritises the knowledge that is most objective and free from bias. Alternatively, knowledge might best represent the shared and social meaning of most people. At the pragmatic level, it might represent the overlap from all 3 perspectives: meaning the combination between what patients expect, the research evidence supports and what practitioners know and can provide.
Whatever stance you take, there are at least 2 potential filters for what is often perceived as the objective research evidence. Patients carry within them, their own motivations, belief systems, values, interpretations and expectations of health systems. Healthcare practitioners also accumulate professional experience alongside their level of skill, expertise and opinion. The extent to which clinical judgements and decisions truly integrate patient and professional ‘knowledge’ with the scientific evidence is contentious. Perhaps there is a continuum between patient demand and professional recommendation that is informed by the research evidence.
In summary the knowledge to be translated is not a single entity and therefore the translation process cannot be a linear one. This sets the scene for looking to understand the order and patterns within the complexity, rather than assuming it is all chaos and random actions.