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Toward a communicative perspective of
collaborating in research: the case of the
researcher ^decision-maker partnership
Ka ren Golden -Biddle, Trish Rea y, St eve Pet z1, Christine Witt1, Ann Ca sebe er2,
Amy Pablo3, C R ( Bob) Hinings
School of Business, University of Alberta, Edmonton; 1East Central Health Authority, Camrose, Alberta; 2Department of Community Health
Sciences, University of Calgary, Calgary; 3Haskayne School of Business, University of Calgary, Calgary, Canada
In the shift to a post-industrial order, the production and use of knowledge is gaining greater importance in a world
beyond science. Particularly in the health sciences, research foundations are emphasising the importance of
translating research results into practice and are experimenting with various strategies to achieve this outcome,
including requiring practitioners to become part of funded research teams. In this paper, we present a case of a
partnership between researchers and decision-makers in Canada who collaborated on an investigation of
implementing change in health care organisations. Grounded in this case and recent empirical work, we propose
that such research collaborations can be best understood from a communicative perspective and as involving four
key elements: relational stance that researchers and decision-makers assume toward each other; purpose at hand
that situates occasions for developing and using knowledge; knowledge-sharing practices for translating knowledge;
and forums in which researchers and practitioners access knowledge. Our analyses suggest that partnerships are
most effective when researchers see the value of contextualising their work and decision-makers see how this work
can help them accomplish their purpose at hand.
Journal of Health Services Research & P olicy Vol 8 Suppl 2, 2003: S2: 20–25 #The Royal Society of Medicine P ress Ltd 2003
Introduction
The traditional view of science portrays research as
leading to the production of disinterested and objective
knowledge whose import is self-evident.1,2 In this view,
knowledge is independent of the knower and valued for
its contribution to extant academic literature.3Moreover,
knowledge production is restricted to members of the
scienti c community and does n ot i nvolve practi-
tioners.4,5 All of this sets up the construction of the
traditional gap between research and practice, between
researchers and practitioners; research is developed and
thereafter is moved into practice.4,6
The shift to a post-industrial order, however, calls this
view into question as the production and use of research
knowledge assumes signi cance in a w orld b eyond
science. P ractitioners use, and are increasingly involved
in generating, research knowledge. Accordingly, many
funding agencies now require researchers to explain how
they will disseminate their work beyond t he scienti c
community and how they will involve practitioners in
designing and conducting the research. Particularly in
the health sciences, funders are emphasising the impor-
tance of translating research results into practice and are
experimenting with various strategies to achieve this
outcome. For example, most now require researchers to
develop a dissemination or knowledge translation plan as
a condition of funding. Some require practitioners, or
speci cally decision-makers, to become part of the
funded research team as investigators or as users of the
research knowledge. In a recent article, one foundation
described how such linkage and exchange between
researchers and decision-makers is a cornerstone of
their efforts to facilitate the use of research in practice.7
These initiatives raise the question of what happens –
and what should happen – when researchers and
decision-makers come together to collaborate on
research. These partnerships are just beginning to be
examined in special journal issues such as this one.
Some were recently pro led in a special issue of the
Academy of Management Journal.5Not surprisingly,
perhaps, when the editors of that issue analysed the
complete pool of submissions, they found that the
majority of those accepted for publication were distinct
S2:20 J Health Serv Res Policy Vol 8 Suppl 2 October 2003
Essay
Karen Golden-Biddle P hD, Associate P rofessor and Director, Health
Organization Studies, Trish Reay PhD, Assistant P rofessor, School of
Business, University of Alberta, Edmonton T6G 2R6, Canada. Steve
Petz, Chief E xecutive O fc er, Christine Witt BEd, Regional Director–
Development, East Central Health, Camrose, Alberta. Ann Casebeer
PhD, Associ ate P rofessor, Department of Community Health Sciences,
University of Calgary, Calgary. Amy Pablo P hD, Associate Professor,
Haskayne School of Business, University of Calgary, Calgary. C R (Bob)
Hinings P hD, Professor Emeritus, School of Business, University of
Alberta, Edmonton, Canada.
Correspondence to: KG-B.
from those no t accepted in tw o respects: rst, the
articles accepted viewed knowledge transfer as a bi-
directional process; and second, they included data that
were provided by both academics and practitioners. In
addition, articles in that issue illuminated the social
dimension of knowledge translation,8–10 an insight that
has also been developed elsewhere.11–13 In particular,
these articles point to the need for researchers to not
only pre sent but, more sig ni cantly, to proces s and
interpr et research ndings to gether wi th practiti oners,
preferably in face-to-face interaction.5,9,10
Our paper develops a case study of one such experi-
ment in collaboration between researchers and decision-
makers. While grounded in recently emerging work on
such partnerships, the case study also highlights the need
to go further in our thinking – to draw on and extend the
views of partnerships as social processes consisting of
elements of linkage and exchange. To do so, we develop a
communicative perspective on research collaborations
that emphasises the members and the communicative
elements called upon in knowledge-making and -using
efforts. Here, we develop four key elements: the
relational stance that researchers and decision-makers
assume toward each other; the purpose at hand that
situates occasions for developing and using knowledge;
knowledge-sharing practices for translating knowledge;
and forums in which researchers and practitioners access
knowledge. After detailing the context of the research
collaboration and the methodology, we develop each
element in the depiction of the case.
The context of colla borating in re sea rch
The case study we describe is based on a partnership
between researchers and decision-makers in the
province of Alberta, Canada. The Canadian health
care context has been one of almost continual restruc-
turing since the mid-1990s. Each province holds the
constitutional responsibility to provide all medically
necessary health services for its citizens.14 During the
1990s, provincial governments began to deal with
increasing ly bur densome nancial de cits by restruc-
turing their health care systems in ways they hoped
would reduce costs while maintaining high-quality
services. For example, in 1994, the Alberta system was
legislatively changed from one with more than 200
hospitals, nursing homes and public health boards, to a
new provincial structure with 17 regional health autho-
rities (RHAs) mandated to provide health services in a
more business-like way.15,16 The number of regions has
recently been reduced again, to nine. All provinces
(except Ontario) reorganised health service delivery to a
model based on RHAs, and even Ontario adopted a
reform strategy based on hospital mergers and other
structural changes.17
Within this broader context, the collaborative partner-
ship pro led here was f ormed as par t of a thr ee-year
research programme (2000–2003) funded by the
Canadian Health Services Research Foundation and
the Alberta Heritage Foundation for Medical Research.
The major objective of this research programme is to
advance knowledge on implementing and sustaining
organisational change for use by decision-makers in the
health s ector in achie ving system re form. Speci c
projects we are investigating include: the introduction
and institutionalisation of the nurse practitioner role,
recently introduced in Canada; the implementation of a
provincially mandated policy change in continuing care
for the disabled and elderly; the introduction of a new
regional strategy in primary health care; and the
restructuring of health regions. Our website, which
describes our research and team and also presents
resources for managers on sustaining change, can be
found at www.healthorgchange.com.
Our team is composed of researchers and decision-
makers from selected locations throughout Alberta,
Canada. Early in the process of preparing the research
proposal, the researchers sought and collaborated with
decision-making partners to help discern interesting
areas of policy implementation, as well as to frame
relevant questions. In all cases, decision-makers
continue to provide strong voices in de ning the
particular research areas now being investigated.
Moreover, they provide researchers with access to
observe real-time implementation of policy, including
observing meetings where decisions are being made,
interviewing key organisational people and reviewing
related printed material.
In t he particular par tnership pro l ed here, the
researchers and decision-makers did not know each
other prior to this research. The decision-makers are
from East Central Health, a rural region providing
services to more than 100 000 residents, with 13 health
centres, 16 community health services o f ces, ni ne
community mental health clinics and 10 Associate
Partners. The policy being studied is continuing care.
In early meetings, decision-makers from East Central
Health indicated they would participate in the research
since they expected it to help them understand and
implement change in the health care system, as well as to
assist them in changing the culture of their organisation.
Moreover, they commented that they expected that the
researchers would bring to the table expertise and
assistance in the area of organisational change.
Methodology
This case is based on systematic observations of the
researchers’ and decision-makers’ experiences over two
and a half years. Data were collected from our
conversations and interviews and recorded in
researchers ’ eld notes or via e- mail. Begi nning wit h
the earliest meetings concerning possible partnership,
decision-makers and researchers discussed both the
content of the projects and the processes in collabora-
tion. These conversations continued to occur in person,
by phone and via e-mail. Later, after deciding to write up
our observations on collaborating, we conducted open-
ended interviews in which pairs of one researcher and
one decision-mak er discussed a series of ve que stions
Toward a communicative perspective of collaborating in research Essay
J Health Serv Res Policy Vol 8 Suppl 2 October 2003 S2:21
(what are the bene ts and disadvantage s of the
collaboration to date; what can be strengthened; and
how is the collaboration similar to and different from
what was expected). In addition to these data, because
we were studying our own collaborating process, we
explicitly called upon personal experiences and insights.
For example, when one decision-maker said she thought
we were beginning to ‘see below the waterline’, her
remark resonated with others’ experiences and was
incorporated into the analyses. We inductively gener-
ated themes in the details18,19 and discussed these
themes, which led to conversations generating further
data and interpretations.
The case of the re searcher^decision-ma ke r
partnership
Disclosing the relational stance: seeing below the
waterline
In our w ork together, we noti ced how dif cul t it was to
see below the waterline in our relations as we adopted
taken-for-granted stances toward each other as
researchers and decision-makers. In one respect,
seeing below the waterline meant treating each other
as equals in the research programme. It illuminated how
we each could learn from the other in the recognition
that critical knowledge is acquired in management and
research. Decision-makers commented:
The stance that researchers take to those they study is really
important. As decision-makers, we have worked with some
researchers who convey that the practice of health care is
secondary to research in health care. Their stance was more
of ‘this [research] is good for you’ rather than how can we
work together on mutually important issues. A genuine and
mutual respect was missing in these working relationships.
Seeing below the waterline also means acknowledging
and gaining an awareness of the different worlds or
environments in which the researchers and decision-
makers live and accomplish their respective work. Each
comes to appreciate the complexities, constraints and
opportunities of the other. As the decision-makers
suggested:
In developing the present partnership, we noticed immedi-
ately that the typical relationship was and is playing out
differently. Our research partners are trying to understand
our world and share about their world as well. So, what does
this look like? The researchers do not hang around together
during meeting breaks or lunchtime. Rather, they mingle
with us and they sit at lunch so they can interact individually
with organisation members. In addition, they tend to safety
issues by not talking about any member of the organisation
in a negative way. They observe, not evaluate. Thus, the
researchers attend to the relationship – not just to the issues
of con dentiality an d rese arch ethics, th ough the se are
important, but also to the everyday interactions out of which
partnerships develop or die.
As the researchers commented:
As we begin to interact, we gain an awareness and greater
understanding of ‘their’ world and who they are, just as they
gain a better understanding of ‘our’ world and who we are.
We see rst hand how decision-make rs gain importan t
knowledge in experience about health care delivery. We also
become aware of the challenges, joys, frustrations and
outright fatigue people in health organisations face as they
attempt to change h ealth care practice. And nally, we g ain
an appreciation for the local knowledge so necessary to
effectively implementing real change on the ground.
Seeing below the waterline ultimately involves how we
engage each other every day as humans in our respective
lifework: when we talk on the phone with each other,
share lunch, negotiate access for research, discuss issues,
deal with differences, collect data and so on. This
relational stance provides the grounding for collabor-
ating in research.
Engaging the purpose at hand for developing and
using knowledge
Humans develop and use knowledge in particular
circumstances with particular purposes. To sidestep
these situated purposes is to miss the focused nature
of activity involved in developing and using knowledge.
When researchers enter the eld to create a partnership
with decision-makers, the situated purposes of both
partners take centre stage. As the decision-makers
commented:
From our perspective, we need research that will help us
understand and more effectively enact our major goal: to
effectively improve and change the delivery system and
culture of our organisations . We bene t immediately when
our researcher partners share their observations about our
efforts to deal with organisational culture and change, or
when they encourage us to think about our efforts to
implement policy from a systems perspective. Changing the
delivery system is a complex endeavour that requires much
skill, time, resources and perseverance and very few in the
health world are comfortable and capable of doing this.
Indeed, the health system is so far behind in change that we
think we’re in rst place! Our research partners’ experti se,
investigation of and assistance in the area of organisational
change brings complementary skills and knowledge that we
can use in managing the system.
As the researchers noted:
From our vantage point, we need local knowledge about
implementing change in order to enrich our research
ndings. By goi ng into health organis ations and observing
people’s efforts to effect change, and learning about the
challenges and opportunities in doing so, we gain a
particular, nuanced and contextually grounded under-
standing of what is really involved. We draw extensively on
this local knowledge in developing scientic knowledge
about implementing system change in organisations.
A key purpose that overlaps for us, then, is a focused
and sustained interest in helping organisations imple-
ment change – whether by developing knowledge about
change or by implementing change. Decision-makers
are interested in using knowledge to implement change;
Essay Toward a communicative perspective of collaborating in research
S2:22 J Health Serv Res Policy Vol 8 Suppl 2 October 2003
researchers are interested in gaining an awareness of the
issues to inform and contextualise their study of change.
More generally, researchers want to develop knowledge
in a particular investigative area; decision-makers want
to access knowledge for use in particular types of
decisio ns. This overlap consti tutes a signi cant core
for collaborating in a m utually bene cial manner. Thus,
identifying, understanding and engaging the overlap-
ping and situated purposes at hand enriches the
partnership and facilitates both the development and
use of research knowledge.
Enacting knowledge-sharing practices
Recent work in organisational studies suggests that
humans develop and use knowledge in practices.12,13
In o ur partnershi p, we ide nti ed knowl edge-sharing
practices denoti ng spe ci c strategies undertaken to
enhance the use of rese arch ndings in healt h
organisations. We formulated these practices in joint
conversation after a decision-maker posed the question:
‘How could the researchers provide information that
would add value to the issues faced in real time by the
decision-makers?’ In addressing this question, we
identi ed and experim ented with practices to shar e
knowledge that maintained the research mandate and
became more responsive to the issues, time constraints
and practical realities faced by the decision-makers. We
delineated four knowledge-sharing practices most often
used, offering them here for wider examination and
re ecti on as we continue t o experime nt wi th these and
other emerging practices.
Pr ov idi n g rel eva nt r es ea rc h and m a n agem e nt
ar t icles
In our conversations, decision-makers suggested that
researchers could provide them with articles relevant to
their efforts in implementing change. Because the
researchers had become cognisant of the real-time
issues and struggles in implementing policy, and
change was their area of expertise, the decision-makers
said it would be helpful if current studies (and past
exemplar studies) could be provided that would help
inform their efforts. In a sense, the decision-makers
asked the researchers to act as selective screeners to help
them cull the best of the vast amounts of published
material.
Pr esent ing r esear ch findings a long t he w ay
Providing results midstream is something that many
researchers prefer to avoid as a misleading and proble-
matic practice. Yet decision-makers, who are dealing
with time-bound situations and time-frames that are
quite different from those of researchers, want results as
soon as possible to inform their actions. Amabile et al
pro led this classi c conve rsation between practitione rs
who ‘stated that one goal of the study should be the
demonstration of value at every stage of the research
process’ and researchers who ‘countered that exam-
ining data when less than 25% had been collected was
likely to be misleading and biasing’.8In their research
collaboration, the team decided to share early results.
They described how this practice provided relevant
information to the decision-makers and, importantly,
led to ‘signi cant progress in the study itself, through
the validity testing of the coding scheme’.
In the present case, we too experienced mutually
positive outco mes when sharing nding s along the way.
In particular , we noti ced that sharing early nding s
happened most readily w hen the speci c needs of
decision-makers overlapped with data being collected or
were incorporated into collection efforts in advance. For
example, decision-makers were most intrigued with
implementing the new continuing care policy in a way
that in ue nced major change in their region. In
analysing points of actual change in practice,
researchers we re deve loping the early nding that
activity by individuals placed in the middle of the
organisational structure, although largely invisible in the
literature on change, was critically shaping how change
unfolded. Shari ng this nding led to a decis ion-maker
focus in implementing change initiatives on those staff
just above the front-line worker.
Prov idi ng education a l r esour ces t hat as sist
change efforts i n a qua li fied m anner
Academics cultivate research expertise in particular
areas. As a result, they have experience with various
educational resources in classrooms that may be of
bene t to decision-maker partners, especiall y as they
connect with real-time issues. The researchers may share
the resources with decision-makers or work with them to
implement the resources in the organisation.
The researchers in our programme bring strong
knowledge of organisational change and the implemen-
tation of policy. In a lunch discussion between two
researchers and a decision-maker, the topic of funda-
mental change surfaced. In particular, the decision-
maker indicated that because the implementation of the
new policy was being taken so seriously in her organisa-
tion, it was going to produce fundamental change not
only to the structure but also to the culture. As this
decision-maker talked, she delineated the need to help
managers as well as other staff become aware of this
cultural shift. The researchers suggested that a short,
interactive video clip they had used in class might be
helpful because it enabled people to experience how
current ways of thinking could prevent thinking in new
ways. The manager also thought that the video clip
sounded like a good resource to use at their next team
meeting.
One researcher facilitated the showing and discussion
of the video at the next team meeting. After a general
debrie ng of the video, the decision-maker picked up
the facilitation by asking the team how this video could
Toward a communicative perspective of collaborating in research Essay
J Health Serv Res Policy Vol 8 Suppl 2 October 2003 S2:23
be applied to their efforts in implementing change. The
researcher returned to the unobtrusive seat at the back
of the room. After the meeting, a few team members
and the manager talked about videotaping such discus-
sions for use in the organisation. In following up on that
conversation, she asked the entire team to consider
videotaping, noting that she had ‘received many
comments . . . [from] team members . . . that the good
ideas and information that all of you shared would be
important to share with staff as we move the plan
through the organisation’. She suggested that video-
taping a discussion could ‘provide an important
historical archive to our process and would also enable
other groups working on this initiative (or other
initiatives) to have access to the process, the ideas,
etc.’ At the next team meeting, they videotaped a
discussion of issues emerging from the video concerning
managing change.
Sh ar i ng r es ea rc h obs er v at io ns , but not a dv ic e
In collecting data, researchers often develop in-process
observations that may or may not be developed into
ndings but which are useful for decision-m akers. In the
present case, the researchers collected data through the
observation of formal meetings. The decision-makers
requested and negotiated with the researchers to share
these observations with the teams responsible for
implementing a policy change. Through joint discus-
sions regarding what might be useful, we arrived jointly
at a practice of sharing research observations but not
advice. That is, researchers present observations that stay
at the descriptive levels of analysis and engender a
conversation about the possible interpretations of these
observations. Normative judgments are intentionally
avoided as they are viewed as inhibiting conversation
and moving too quickly to solutions.
Observations were shared with the region’s teams
involved in implementing the continuing care policy
change. Sharing observations with one team charged
with implementing part of the changes, researchers
noted that the transfer of information about the policy
change had occurred among team members but it had
not yet reached local settings. Team members discussed
differ ent ways to accomplish this and id enti ed a
strategy for action in these settings to inform staff.
Other observations were shared with a senior manage-
ment team overseeing the change, including their
noticeable dedication to implementing this change,
the tasks they had accomplished in moving this change
forward, the areas in which they were struggling with the
change, and those are as for potential furth er r e ection.
In discussing the observations, these team members
focused on how best to target their action going
forward. One decision-maker commented:
The observations were pivotal in giving us the push we
needed to make major changes in implementin g the change
required. We changed the membership of our strategic
team; we revised this team’s roles and responsibilities; we
just went ahead and made our strategic plan and imple-
mented it. We just did it.
In both instances, researchers presented these obser-
vations with the goal of generating conversation about
them that was useful both for organisational members
implementing change and for researchers studying and
writing about it.
Identifying forums for accessing and sharing
research knowledge
Recently, as researchers and decision-makers in our
partnership had the op portunity to pre sent ndi ngs and
insights from the research to different audiences, we
became aware of the importance of forums for accessing
and sharing research knowledge. Some prior work
demonstrated that the creation of joint interpretive
forums in which researchers and decision-makers
participate facilitated the perceived usefulness of
research.10 By forums we mean dedicated platforms for
interaction over and exchange of knowledge. The main
feature of forums for knowledge use is the creation of an
interactive space and occasion for various community
members to access and interpret knowledge.
The forum may be local and informal, such as one-to-
one conversations in person, by phone or by e-mail.
They are usually, although not exclusively, initiated by
researchers. In our experience, the importance of these
forums is their regularity. This local forum may also be
formal, such as the interpretive forums described in the
literature in which researchers and decision-makers
gather spe ci cally to discuss the rese arch and nding s.
In addition, the forum may create access to a wider
audience, such as conferences or other planned events.
For example, at the request of decision-makers, the
researchers organised a workshop on implementing
policy changes in continuing care. Managers from all
rural regional health organisations attended and
discussed knowledge about organisational change and
shared their particular initiatives to implement conti-
nuing care change. More broadly, the decision-makers,
often in conjunction with the researchers, presented
their research e xperiences and ndings abo ut organisa-
tional change at formal forums such as conferences in
Alberta and elsewhere in Canada.
Conclusion
Viewing the decision-maker–researcher collaboration
from a communicative perspective moves us beyond an
emphasis on developing communication strategies.
Though useful, such an emphasis highlights a one-way
model of knowledge translation in which researchers
rephrase their ndings to m ake the m m ore acce ssible to
different audiences. In contrast, a communicative
perspective highlights the focused nature of the
activity involved in not only developing but also in
using knowledge. The relational stance, including
values and attitudes about partnership, shapes the
Essay Toward a communicative perspective of collaborating in research
S2:24 J Health Serv Res Policy Vol 8 Suppl 2 October 2003
collaborative efforts and connects members in their
purposes at hand that situate knowledge generation and
use. In order to foster collaboration, three issues need to
be dealt with:
.Do members take a long-term view toward the
collaboration, or do they see it as a transaction in
which the researcher comes in, does research and
leaves?
.Is the partnership characterised by a give-and-take in
which both researchers and decision-makers make
valuable contributions to the purposes at hand for
developing and using knowledge?
.Moreover, do forums and practices exist to enable
collaborators to access and share knowledge?
In this paper, we pro le d o ne p artnership betw een
decision-makers and researchers. We readily notice,
however, the similarities in communicative elements in
the other partnerships and suggest that the concepts of
relational stance, knowledge-sharing practices, purposes
at hand and forums may apply to other cases of
collaborating in research. It would be fruitful for
future research to investigate other such partnerships
to assess their conceptual generalisability. It would also
be valuable to follow partnerships on an even longer-
term basis, similar to the work conducted in other
sectors by Huxam and Vangen,20 in order to further
specify the best knowledge-sharing practices or the most
effective forums for accessing and interpreting research
knowledge.
Finally, the present case also suggests that researchers
wanting to develop a partnership with decision-makers
need to ent er the e ld – reg ardles s of data colle ction
methods used – in order to gain an understanding of
decision-makers’ particular circumstances and purposes
at hand for knowledge use. If we take seriously the
relational stance in the communicative perspective, then
it suggests that effective partnerships require attention
to the people who use and generate knowledge and to
the settings in which they conduct their everyday work.
In adopting this perspective, researchers become inter-
ested not only in se curing data fro m the eld but also in
placing research in a wider application context. As a
result, as some recent work has also suggested, the
research–practice gap recedes in importance as our
attention is directed instead to understanding and
appreciating different ways of relating to accomplish
our situated purposes at hand for using and developing
research knowledge.6
Ack now ledgements
We thank Jonathan Lomas and Michelle Campbell of the Canadian
Health Services Research Foundation and Sarah Hayward of the
Alberta Heritage Foundation for Medical Research for their comme nts
on an earlier manuscript, and Lana Bzdel, Denise Thomson, Karan
Sonpar and P hil Yo on in the Health Organization Studies group at the
University of Alberta for their helpful comments. The authors thank
the Canadian Health Services Research Foundation and the Alberta
Heritage Foundation for Med ical Research for funding the research on
which this article is based.
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