Evidence map›Paper›PMID 41345614›Full record

ArticleBMC health services research2025

Knowledge translation in surgery: a scoping review of implementation strategies, effectiveness and contextual barriers and enablers.

Elizabeth Manafò, Elyette Lugo, Amit Jain, Lisa Petermann, Benjamin Davies, Olesja Hazenbiller, Janneke I Loomans, Muzahem M Taha, Klaus John Schnake, Michael P Kelly and 6 more

Abstract readScoping Review
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Elizabeth ManafòEXEP Consulting Inc, Calgary, AB, Canada.
Elyette LugoJohn Hopkins School of Medicine, Baltimore, MD, United States of America.
Amit JainJohn Hopkins School of Medicine, Baltimore, MD, United States of America.
Lisa PetermannEXEP Consulting Inc, Calgary, AB, Canada.
Benjamin DaviesUniversity of Cambridge, Cambridge, UK.
Olesja HazenbillerAO Foundation, Davos Platz, Switzerland.
Janneke I LoomansAO Foundation, Davos Platz, Switzerland.
Muzahem M TahaOrthopaedic Surgery Department, Kirkuk University, Kirkuk, Iraq.
Klaus John SchnakeCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien Erlangen, Erlangen, Germany.
Michael P KellyDepartment of Orthopaedic Surgery, University of California, San Diego, CA, United States of America.
Asdrubal FalavignaUniversity of Caxias do Sul, Caxias do Sul, Brazil.
Anne VersteegDepartment of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.
Richard BransfordDepartment of Orthopaedic Surgery, University of Washington, Harborview Medical Center, Seattle, WA, United States of America.
Riccardo CecchinatoDepartment of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Charles FisherDepartment of Orthopaedics, Division of Spine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada. Charles.Fisher@vch.ca.
AO Knowledge Translation Steering Committee

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnowledge translation (KT) interventions are essential for implementing evidence-based practices in healthcare. However, despite their proven effectiveness in addressing global health challenges, KT strategies in surgery remain challenging to apply. This scoping review examines KT strategies in surgery, their effectiveness, and key barriers and enablers to their implementation.

methodsThis scoping review followed the Arksey and O'Malley and Levac et al. frameworks, integrating the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and the PRISM (Practical Robust Implementation Sustainability Model) models to evaluate the effectiveness of knowledge translation interventions in surgical practice change and associated contextual barriers and facilitators. A systematic search was conducted across MEDLINE (PubMed, OVID), CINAHL (EBSCO), and PsycINFO (ProQuest). Articles were screened using predefined selection criteria, emphasizing experimental and quasi-experimental studies. Data extraction categorized KT interventions: knowledge diffusion, dissemination, and implementation approaches.

resultsA total of 34 studies met the inclusion criteria. Most were hospital-based (88%) and focused on guideline adherence. The review identified three primary KT strategies: (i) educational materials and educational outreach, (ii) reminders and prompts, and (iii) audit and feedback systems. The most effective KT strategies used a combination of these interventions to maximize impact. Barriers included physician resistance, limited leadership support, financial constraints, and workflow disruptions, while enablers included institutional leadership, structured training programs, financial incentives, and interdisciplinary collaboration. A notable finding was the lack of standardized validation processes for adopting changes in the surgical setting, which often burdens individual surgeons and their institutions, thereby constraining both capacity and motivation for practice change.

conclusionsFindings suggest that layered, interdisciplinary KT strategies are the most effective for driving surgical practice change and overcoming institutional barriers. The integrated application of RE-AIM and PRISM frameworks proved valuable in assessing the interventions' sustainability and real-world effectiveness. This comprehensive analysis contributes to the growing body of knowledge on effective implementation strategies in surgical settings and provides a foundation for future practice improvement initiatives. Future research should focus on refining KT methodologies, expanding implementation frameworks, and addressing barriers to sustainability across diverse surgical settings.

Indexed as

General SurgeryTranslational Research, BiomedicalDiffusion of InnovationHumansImplementation scienceInnovationKnowledge translationPractice changeSurgeons

Identifiers

PMID41345614
PMCPMC12797646

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.