In cases where multiple practice guidelines have been published (e.g., at the level of the country, region and internationally), knowledge users (e.g., clinicians) may find it challenging to decide which, if any, are consistent with their needs and complimentary to their practice. There may also be instances were inter-guideline comparisons reveal inconsistencies or outright disagreements with each other, which can be confusing for the knowledge user. Guideline producers should understand their stakeholders’ needs and respond to them.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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One of the factors practitioners may cite as an impediment to applying research-based knowledge is requirement for specialized skills or equipment, which may not be available.
Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
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One of the factors that can impede the application of research-based knowledge (evidence) is the fact that relevant practitioners, or their entire profession, are not ready to adopt (or able to justify the use of) the new knowledge. This is referred to as ‘technology push.’ (The reverse may also occur, where the practitioner/profession has an identified need that researchers have not acted upon. This is known as ‘practice pull.’)
Literature review and professional reflections.
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Research-based scholarly publications rarely include information that itemizes associated costs and benefits, or facilitates planning and budgeting. Other common absences of information include implementation-related factors such as the availability of practice guidelines, staffing requirements, educational prerequisites, training needs, and performance life-cycles. Researchers often have many of the answers, but journals rarely consider the information to be within their scope of coverage.
Literature review and professional reflections.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is critical to identify potential barriers that may interfere with the successful application of the new knowledge. One way to identify potential barriers is to conduct focus groups with key stakeholders.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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Incubators often tout networking as a major attribute because social networks are informal and valuable relationships which take time and positioning to build.  
Case study findings
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An important aspect of knowledge transfer is enhancing the knowledge application process. This can be achieved through rich communication and collaboration (theory of communication). A knowledge transfer process model can encourage knowledge users to answer some key questions, such as: Who needs the knowledge (receiver)? What organizational units are involved in the knowledge transfer process? What is the most appropriate “source” to acquire the required knowledge (awareness)? What is/are the type(s) of knowledge to be transferred? How should it be transferred (modes of knowledge transfer)? What are the factors that will influence the process of knowledge transfer and what are their potential impacts? What can be done to enhance the factors that positively influence the process of knowledge transfer and what can be done to avoid/lessen negative impacts? What approaches can the receiver take to apply the knowledge? Did the knowledge transfer process achieve its goals (performance measurement)?
Literature review.
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Knowledge application is considered by many to be the most significant stage of the knowledge transfer process.It is the phase during which acquired knowledge is brought to bear on a specific problem or opportunity. Value is created only when knowledge that is transferred from its original site is successfully applied where it is needed.
Literature review.
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Provided that both receiver and source have the willingness and the ability to do so, facilitate the knowledge acquisition process. This refers to “an organisation’s capability to identify and acquire externally generated knowledge that is critical to its operations.” Zahra and George introduce three main attributes that can influence the process of knowledge acquisition, i.e. intensity, speed, and direction. The intensity and speed of an organisation’s efforts to identify and gather knowledge can determine the quality of a knowledge acquisition process. The greater the effort, the more quickly the organisation will build its knowledge-base. Sometimes, there are limits to an organisation’s ability to achieve this speed. The direction of accumulating knowledge can also influence the paths that the organisation follows in obtaining external knowledge. These activities vary in their richness and complexity.
Literature review.
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Typically, acquired knowledge requires some sort of a conversion in order to make it “useful” for the knowledge receiver. This is a complicated process as it involves ensuring that the knowledge receiver has a knowledge-base heterogeneous enough to be able to take in new knowledge while still making sure existing knowledge is well leveraged and developed.The process of converting knowledge into “useful” knowledge at the receiver’s end involves two steps. The first step is “knowledge transformation.” Transformation of knowledge can be accomplished by simply adding or deleting knowledge or by means of “translation.” The second step of knowledge conversion involves relating the transformed knowledge to internal needs of the organisation. This step is called “knowledge association.”
Literature review.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to formally survey knowledge users (clinicians) about their use of research knowledge in their practice.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to conduct focus groups with knowledge producers (researchers) and knowledge users (clinicians) to explore why there are gaps between the availability of research evidence and its application in a clinical setting.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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When evaluating a knowledge translation process, one of the questions an evaluator can asks is: In what ways do the appliers of the new knowledge differ from the resistors (or non-appliers)?
Literature review and synthesis.
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When evaluating a knowledge translation process, one of the questions an evaluator can asks is: What were the attributes of the process that facilitated or impeded application of the new knowledge?
Literature review and synthesis.
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In a practice context that requires research knowledge to be valued above all other forms of knowledge, practitioners may rebel and apply, in substitution and without disclosure, their own experience-based (tacit) knowledge.
Source: Whiteford (2009). In: Metzler, M. J. & Metz, G. A. (2010)

One of the factors practitioners may cite as an impediment to engaging in the knowledge translation process is a discomfort with the perceived rigidity of some research products (e.g., clinical reviews, clinical practice guidelines, care maps and critical pathways). Practitioners may be concerned that the products will reduce their autonomy and supersede their clinical judgement.
Source: Metacalfe (2001). In: Metzler, M. J. & Metz, G. A. (2010)

Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is a misalignment between the knowledge (evidence) context and a specific practice context.
Source: Cheater (2005); Grol (2003). In: Metzler, M. J. & Metz, G. A. (2010)

Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is the practitioner’s ability to critically evaluate the available knowledge (evidence).
Source: Grol (2003). In: Metzler, M. J. & Metz, G. A. (2010)

Peer-reviewed journals can be challenging sources of knowledge for practitioners. One factor that can impede knowledge translation is the sheer volume of available knowledge (evidence).
Source: Grol (2003); Bannigan (1997); Cusick (2000). In: Metzler, M. J. & Metz, G. A. (2010)

Peer-reviewed journals can be challenging sources of knowledge for practitioners.One factor that can impede knowledge translation is the ability of the knowledge (evidence) to be applied in practice.
Source: Grol (2003); Straus (2009). In: Metzler, M. J. & Metz, G. A. (2010)

When designing a knowledge translation communication strategy, researchers should consider conducting a field test prior to full implementation.
Source: Herie (2002). In: Wilson, P.M., Petticrew, M., Calnan, M. W. & Nazareth, I. (2010)