Use Of Conceptual Frameworks Research Articles

Implementation Science to Achieve Equity in Heart Failure Care: A Scientific Statement From the American Heart Association.

Guideline-directed medical therapies and guideline-directed nonpharmacological therapies improve quality of life and survival in patients with heart failure (HF), but eligible patients, particularly women and individuals from underrepresented racial and ethnic groups, are often not treated with these therapies. Implementation science uses evidence-based theories and frameworks to identify strategies that facilitate uptake of evidence to improve health. In this scientific statement, we provide an overview of implementation trials in HF, assess their use of conceptual frameworks and health equity principles, and provide pragmatic guidance for equity in HF. Overall, behavioral nudges, multidisciplinary care, and digital health strategies increased uptake of therapies in HF effectively but did not include equity goals. Few HF studies focused on achieving equity in HF by engaging stakeholders, quantifying barriers and facilitators to HF therapies, developing strategies for equity informed by theory or frameworks, evaluating implementation measures for equity, and titrating strategies for equity. Among these HF equity studies, feasibility was established in using various educational strategies to promote organizational change and equitable care. A couple include ongoing randomized controlled pragmatic trials for HF equity. There is great need for additional HF implementation trials designed to promote delivery of equitable guideline-directed therapy.

Factors Influencing the Use of Conceptual Frameworks in The Field of IT Management

The field of IT management is one of the most discussed areas. This was initiated by changes in IT development, its importance, and the view of IT. IT is no longer just a view of the technologies themselves, but also a view on their importance in business activities and IT management in the business context.

Patient-reported outcome measures in MS: Do development processes and patient involvement support valid quantification of clinically important variables?

BackgroundPatient-reported outcomes (PROs) are widely measured in multiple sclerosis (MS) studies. However, the quality of instrument development processes varies, raising concerns about the meaningfulness of associated data.ObjectivesTo review the development of selected PROs commonly used in MS studies, including definitions of the concepts measured, use of conceptual frameworks, and degree of input from people living with MS (PlwMS). To gain insights and recommendations from PlwMS on their experience with these PROs.MethodsWe assessed 6 PROs (FSIQ-RMS, modified-FIS, MSQoL-54, Leeds 8-item MSQoL, MSIS-29 and EQ-5D) for alignment with regulatory and scientific requirements on PRO structure/development. PlwMS evaluated the degree to which the PROs reflect disease aspects they perceive important.ResultsDefinitions, clarifications and conceptualisations of the measurement variables were often lacking. PlwMS were variably involved in PRO development. Ethnic diversity was rarely documented. PlwMS identified individualisation, ease of understanding, time burden, and mode of administration as factors affecting PRO usability.ConclusionsTo date, the PRO development process has consistently lacked clear definitions of concepts of interest, use of conceptual frameworks and patient involvement, thereby compromising the validity of data they generate. PRO instrument development must be conducted more robustly to maximise the value of pivotal clinical trials.

Virtual Reality in Medical Students' Education: Scoping Review.

BackgroundVirtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education.ObjectiveThe objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research.MethodsWe performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.ResultsOf the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR.ConclusionsDespite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy.International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2020-046986

Air pollution and environmental health disparities: how disadvantaged communities may be particularly susceptible to poor reproductive outcomes

BACKGROUND AND AIM: Disadvantage communities face differential exposure to high levels of air pollution and other environmental hazards. In addition to having fewer resources and several co-occurring risk factors such as increased psychosocial stress, fewer opportunities for health promoting behaviors and less access to high quality health care, they also have less access to protective factors. These factors drive differential susceptibility across population subgroups and can explain why disadvantaged populations suffer disproportionately from the negative health effects of air pollution. The aim of this presentation is to describe different models that frame differential exposure and susceptibility and provide evidence to support these phenomenon specifically among pregnant people and those who may become pregnant. METHODS: I will present three frameworks/conceptual models that are rooted in theory and capture the way social and environmental factors interact to produce environmental health disparities. RESULTS:The social production of disease model, the integrated social-environmental model of health and well-being, and the stress-exposure-disease model will be discussed. I will highlight the important contributions of each. Shared mechanistic pathways such as those involved with the stress response system (i.e., allostatic load), the inflammatory and sympathathic nervous systems will be emphasized. Lastly, I will present empirical evidence to support the theorized mechanisms and upstream social and contextual factors that contribute to environmental health disparities, with a specific emphasis on race and socioeconomic status, in reproductive health. CONCLUSIONS:The use of conceptual frameworks rooted in theory can strengthen environmental health disparities research. KEYWORDS: air pollution, environmental health disparities, conceptual models, reproductive health

Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity.

Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and antiracism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Grounded in extant research on structural racism and antiracism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We outline recommendations for explicitly applying an antiracism lens to address structural racism and its manifests through IS. An anti-racism lens provides a framework to guide efforts to confront, address, and eradicate racism and racial privilege by helping people identify racism as a root cause of health inequities and critically examine how it is embedded in policies, structures, and systems that differentially affect racially and ethnically diverse populations. We provide guidance for the application of an antiracism lens in the field of IS, focusing on select core elements in implementation research, including: (1) stakeholder engagement; (2) conceptual frameworks and models; (3) development, selection, adaptation of EBIs; (4) evaluation approaches; and (5) implementation strategies. We highlight the need for foundational grounding in antiracism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration. We conclude with a reflection on how this is a critical time for IS to prioritize focus on justice, racial equity, and real-world equitable impact. Moving IS towards making consideration of health equity and an antiracism lens foundational is central to strengthening the field and enhancing its impact. There are important gaps and opportunities that exist in promoting health equity through implementation science. Historically, the commonly used frameworks, measures, interventions, strategies, and approaches in the field have not been explicitly focused on equity, nor do they consider the role of structural racism in shaping health and inequitable delivery of evidence-based practices/programs. This work seeks to build off of the long history of research on structural racism and health, and seeks to provide guidance on how to apply an antiracism lens to select core elements of implementation research. We highlight important opportunities for the field to reflect and consider applying an antiracism approach in: 1) stakeholder/community engagement; 2) use of conceptual frameworks; 3) development, selection and adaptation of evidence-based interventions; 4) evaluation approaches; 5) implementation strategies (e.g., how to deliver evidence-based practices, programs, policies); and 6) how researchers conduct their research, with a focus on racial equity. This is an important time for the field of implementation science to prioritize a foundational focus on justice, equity, and real-world impact through the application of an anti-racism lens in their work.

Enhancing independent eating among older adults with dementia: a scoping review of the state of the conceptual and research literature

BackgroundAddressing eating difficulties among older individuals with dementia living in nursing homes requires evidence-based interventions. However, to date, there is limited evidence of effective interventions designed to maintain and/or increase independent eating. In a field in which evidence is still lacking, a critical analysis of the state of research describing its main features can help identify methodological gaps that future studies should address. Hence, the aim of this study was to map the state of the research designed to maintain and/or promote independent eating in older individuals with dementia living in nursing homes.MethodsA scoping review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Reviews and conceptual analyses performed with different methodological approaches, published in indexed journals, and written in English were included. Keywords Were searched for in the MEDLINE, the Cumulative Index of Nursing and Allied Health, and in the Scopus databases to identify papers published up to 31 May 2018.Results17 reviews were included, assessing interventions’ effectiveness (n = 15) and providing conceptual frameworks for eating/mealtime difficulties (n = 2). Conceptual frameworks supporting interventions’ effectiveness have rarely been described in available studies. Moreover, interventions tested have been categorized according to non-homogeneous frameworks. Their effectiveness has been measured against (1) eating performance, (2) clinical outcomes, and (3) adverse event occurrence.ConclusionAn increased use of conceptual frameworks in studies, as well as greater clarity in intervention categorization and outcomes, is necessary to enhance the reviews’ value in providing useful cumulative knowledge in this field. Interventions delivered should embody different components that integrate individual, social, cultural, and environmental factors, while when evaluating an intervention’s effectiveness, eating performance, clinical outcomes and adverse events should be considered. Together with more robust studies, involving clinicians could prove to be useful, as their knowledge of practice developed from direct experience can help develop innovative research questions.

Strategic intelligence as an art and a science: creating and using conceptual frameworks

ABSTRACTThis article describes a major output of strategic intelligence: conceptual frameworks. Drawing on concepts from epistemology, ontology, and analytical methodology, it finds a philosophical foundation for conceptual frameworks in pragmatism and the ideas of Wittgenstein. Through the production and use of conceptual frameworks, strategic intelligence is revealed as both art and science, performing both creation and discovery. The use of such frameworks enables strategic intelligence to notice shifts as they begin to emerge. The article highlights Israeli theoretical perspectives, illustrates the practical utility of conceptual frameworks by applying them to Israeli cases, and suggests that using them contributes to strategy.

Quality improvement and implementation science in cancer care: Identifying areas of synergy and opportunities for further integration.

29 Background: Efforts to improve cancer care delivery have been driven by two approaches: quality improvement (QI) and implementation science (IS). QI and IS have developed independently but have potential for synergy. To inform efforts to better align these fields, we examined 20 cancer-related QI and IS articles to identify differences and areas of commonality. Methods: We searched PubMed for cancer care studies that used IS or QI methods and were published in the past 5 years in one of 17 leading journals. Through consensus-based discussions, we categorized studies as QI if they evaluated efforts to improve the quality, value, or safety of care, or IS if they evaluated efforts to promote the adoption of evidence-based interventions into practice. We identified the 10 most frequently cited studies from each category (20 total studies), characterizing and comparing their objectives, methods – including use of theoretical frameworks involvement of stakeholders – and terminology. Results: All IS studies (10/10) and half (5/10) of QI studies addressed barriers to uptake of evidence-based practices. The remaining five QI studies sought to improve clinical outcomes, reduce costs, and/or address logistical issues. QI and IS studies employed common approaches to change provider and/or organizational practice (e.g., training, performance monitoring/feedback, decision support). However, the terminology used to describe these approaches was inconsistent within and between IS and QI studies. Fewer than half (8/20) of studies (4 from each category) used a theoretical or conceptual framework and only 4/20 (2 from each category) consulted key stakeholders in developing their approach. Most studies (10/10 IS and 6/10 QI) were multi-site, and most were observational, with only 4/20 studies (2 from each category) using a randomized design to evaluate their approach. Conclusions: Cancer-related QI and IS studies had overlapping objectives and used similar approaches but used inconsistent terminology. The impact of IS and QI on cancer care delivery could be enhanced by greater harmonization of language and by promoting rigor through the use of conceptual frameworks and stakeholder input.

Implementation of Shared Decision-Making in Clinical Practice in Rheumatology.

Implementation of Shared Decision-Making in Clinical Practice in Rheumatology.

Research funding impact and priority setting \u2013 advancing universal access and quality healthcare research in Malaysia

BackgroundHealth Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia.MethodsResearch impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search.ResultsSeventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders’ expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare.ConclusionThe concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.

How health care may modify the effects of illness determinants on population outcomes: the Leicester SEARCH conceptual framework for primary care.

To research, evaluate, and deliver health care that effectively improves health outcomes across populations, relationships between the numerous variables that determine these outcomes should be understood. Conceptual frameworks can aid the description and analysis of health in populations. Investigators usually have an implicit framework underpinning their research. Population health lags behind other disciplines, such as psychology and sociology, in the use of conceptual frameworks;1 currently published frameworks are not configured ideally for primary care-focused research. In this article, we aim to fill an important gap by describing a new and comprehensive conceptual framework for population health that can assist both research and service in primary care. The framework provides a schematic overview of presumed relationships between variables, recognising that many variables do not ‘behave’ consistently in every situation. ### Population health: definitions and its role in improving health care The World Health Organization (WHO) defines health as ‘a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity’.2 Disease is a disorder of structure or function, which produces specific symptoms or affects a specific location; it is not solely a direct result of trauma. Health needs are ‘deficiencies in health that require health care, from promotion to palliation’.2 Health outcomes are the end results or effects of events or processes or situations. Health care is the organised provision of medical care to individuals or a community,3 covering a range of interventions (actions taken to improve health). Healthcare systems are the combined activities of people, institutions, and resources whose primary purpose is to promote, restore, and/or maintain health.3 Illness determinants are the range of personal, social, economic, and environmental factors that decisively affect health status or cause illness.3 Healthcare systems can struggle to deliver better health outcomes for whole populations. Effective interventions are more likely to be delivered if the relevant …

A Structured Framework and Resources to Use to Get Your Medical Education Work Published.

Medical educators often have great ideas for medical education scholarship but have difficulty converting their educational abstract or project into a published manuscript. During this workshop, participants addressed common challenges in developing an educational manuscript. In small-group case scenarios, participants discovered the importance of the "So what?" in making the case for their project. Incorporating conceptual frameworks, participants chose appropriate outcome metrics, discussed how to frame the discussion section, and ensured appropriate journal fit. After each small-group exercise, large-group discussions allowed the small groups to report back so that facilitators could highlight and reinforce key learning points. At the conclusion of the workshop, participants left with a checklist for creating an educational manuscript and an additional resources document to assist them in avoiding common pitfalls when turning their educational abstract/project into a publishable manuscript. This workshop was presented in 2016 and 2017. Presenter evaluations were completed by 33 participants; 11 completed conference evaluations. The mean overall rating on presenter evaluations was 4.55 out of 5, while the conference evaluations mean was 3.73 out of 4. Comments provided on both evaluation tools highlighted the perceived effectiveness of the delivery and content. More than 50% of respondents stated that they planned to incorporate the use of conceptual frameworks in future work. This workshop helped participants address common challenges by providing opportunities for hands-on practice as well as tips and resources for use when submitting a medical education manuscript for publication.

Using operative models (ICF and CBR) within an interprofessional context to address community needs

Background. The use of conceptual frameworks has been advocated when implementing interprofessional initiatives. Objective. To present the use of the International Classification of Functioning Disability and Health (ICF) and the community-based rehabilitation (CBR) matrix for identifying and addressing the health needs of the community. Methods. The ICF care plan and the CBR matrix were used to conduct a retrospective document analysis. The documents were completed by interprofessional groups of students who were involved in an interprofessional community-based intervention. Data were captured on a sheet and analysed descriptively using the domains of the ICF and the CBR matrix. Ethical clearance was obtained from the University of the Western Cape, Cape Town, South Africa. Results. A total of 30 senior nursing, physiotherapy and biokinetics students were divided into groups and interacted with five community-based groups. Each group of students completed one ICF care plan and one CBR matrix. The needs documented in the ICF care plans included impairments, activity limitations, participation restrictions and environmental challenges. Impairments included sensory, motor and psychological impairments, while activity limitations included limitations in activities of daily living and mobility. Limited social interaction and physical environment were identified as experienced environmental challenges. The interventions documented to address these needs included health promotion, prevention, medical care, skills development and facilitation of access to justice. Conclusion. The ICF and CBR matrix can be used to facilitate students’ identification of the needs of communities and the implementation of interventions to address these needs in an interprofessional manner.

An Official American Thoracic Society Research Statement: Implementation Science in Pulmonary, Critical Care, and Sleep Medicine.

Many advances in health care fail to reach patients. Implementation science is the study of novel approaches to mitigate this evidence-to-practice gap. The American Thoracic Society (ATS) created a multidisciplinary ad hoc committee to develop a research statement on implementation science in pulmonary, critical care, and sleep medicine. The committee used an iterative consensus process to define implementation science and review the use of conceptual frameworks to guide implementation science for the pulmonary, critical care, and sleep community and to explore how professional medical societies such as the ATS can promote implementation science. The committee defined implementation science as the study of the mechanisms by which effective health care interventions are either adopted or not adopted in clinical and community settings. The committee also distinguished implementation science from the act of implementation. Ideally, implementation science should include early and continuous stakeholder involvement and the use of conceptual frameworks (i.e., models to systematize the conduct of studies and standardize the communication of findings). Multiple conceptual frameworks are available, and we suggest the selection of one or more frameworks on the basis of the specific research question and setting. Professional medical societies such as the ATS can have an important role in promoting implementation science. Recommendations for professional societies to consider include: unifying implementation science activities through a single organizational structure, linking front-line clinicians with implementation scientists, seeking collaborations to prioritize and conduct implementation science studies, supporting implementation science projects through funding opportunities, working with research funding bodies to set the research agenda in the field, collaborating with external bodies responsible for health care delivery, disseminating results of implementation science through scientific journals and conferences, and teaching the next generation about implementation science through courses and other media. Implementation science plays an increasingly important role in health care. Through support of implementation science, the ATS and other professional medical societies can work with other stakeholders to lead this effort.

A partnership model for a reflective narrative for researcher and participant.

Background Conceptual frameworks are important to ensure a clear underpinning research philosophy. Further, the use of conceptual frameworks can support structured research processes. Aim To present a partnership model for a reflective narrative for researcher and participant. Discussion This paper positions the underpinning philosophical framework of the model in social constructionism (the idea that jointly constructed understandings form the basis for shared assumptions) and narrative enquiry. The model has five stages - study design, invitation to share a research space and partnership, a metaphorical research space, building a community story, and reading the community story to others. Core principles of the partnership model are continual reflection by the researcher, potential reflections by participants, reciprocal sharing, and partnership in research. Conclusion A 'trajectory of self' for both participants and researchers can be enhanced within reflective partnerships. Implications for practice This model can be applied to studies that use narrative enquiry and are seeking a humanistic approach with participant engagement.

Content and Rationale of Junior and Senior Preceptors Responding to Residents' Educational Needs Revisited

Theory: Feedback and debriefing, as portrayed in expertise development and self-assessment, play critical roles in providing residents with useful information to foster their progress. Hypotheses: Prior work has shown that clinical preceptors' use of conceptual frameworks (CFs; ways of thinking based on theories, best practices, or models) while giving feedback to residents was positively associated with a greater diversity of responses. Also, senior preceptors produced more responses, used more CFs, and asked more probing-challenging questions than junior preceptors. The purpose was to confirm the generalization of these initial findings with a broader and better defined sample of preceptors. Method: We conducted a mixed-method study with 20 junior and 20 senior preceptors in a controlled environment to analyze their responses and rationales to residents' educational needs as portrayed in 6 written vignettes. The preceptors were recruited from 3 primary care specialties preceptors (family medicine, internal medicine, pediatrics) of the 3 French-speaking faculties of medicine in Québec, Canada. Results: The preceptors increased the 2012 list of response topics (96 to 126) and doubled the number of distinct CFs (16 to 32). The junior and senior preceptors expressed the same number and diversity of CFs. On average, senior preceptors asked more clarification questions and reflected more than juniors on the learning process that occurs during case discussions. Preceptor specialty and prior training in medical education did not influence the number and diversity of responses and CFs, except that preceptors with prior training generated more responses per vignette and were more reflective. Senior preceptors had a stronger positive relationship between the number of total and distinct CFs and the number of responses than the juniors. Conclusions: Although senior preceptors did not give more responses or use more CFs compared to the prior study, they continue to probe residents more and reflected more. The positive relationship between responses and CFs has important implications for faculty development and calls for more research to better understand the specific contribution of CFs to feedback.

The contribution of conceptual frameworks to knowledge translation interventions in physical therapy

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap.

The contribution of conceptual frameworks to knowledge translation interventions in physical therapy.

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap.

Medical education... meet Michel Foucault.

There have been repeated calls for the greater use of conceptual frameworks and of theory in medical education. Although it is familiar to few medical educators, Michel Foucault's work is a helpful theoretical and methodological source. This article explores what it means to use a 'Foucauldian approach', presents a sample of Foucault's historical-genealogical studies that are relevant to medical education, and introduces the work of four researchers currently undertaking Foucauldian-inspired medical education research. Although they are not without controversy, Foucauldian approaches are employed by an increasing number of scholars and are helpful in shedding light on what it is possible to think, say and be in medical education. Our hope in sharing this Foucauldian work and perspective is that we might stimulate a dialogue that is forward-looking and optimistic about the possibilities for change in medical education.