Literature review of Participatory Design and Knowledge Mobilisation

Approach

A literature review was conducted to try to find links between Knowledge Mobilisation (KM) literature and Participatory Design Practice. The review was not intended to be exhaustive but to highlight connections and to act as an initial definition of the landscape that might inform more systematic reviews.

The aims of the review were:

  • To increase the authors personal knowledge and understanding of the field of KM
  • To identify any existing links between KM and Participatory Design Practice
  • To identify key frameworks and models within KM
  • To identify key frameworks and models within participatory design practice

An initial scoping review was conducted exploring terms linking Knowledge Mobilisation (KM) and Participatory Design Practice. Subsequently, a variation of a ‘Snowball’ sampling method was used (Booth et al. 2011). Three key papers were identified as origin points for this sampling method:

  • For KM literature: Damschroder, Laura J., et al. “Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.” Implement Sci 4.1 (2009): 50.
  • For what designers do and how they think: Cross, Nigel. Designerly ways of knowing. Springer London, 2006. (Cross 2006)
  • For Participatory Design Practice: Ehn, P., 2008. Participation in design things. Proceedings of the Tenth Anniversary Conference on Participatory Design 2008, pp.92–101

These three papers were used as snowball sampling origin points for these three different fields of enquiry and used to initially define a framework (along with the aims outlined above) for defining relevance (and hence inclusion criteria) for and subsequently exploring content of included results. This framework was iteratively evolved as the review process unrolled and was used to refine the included publications initially using a title and abstract review and later using a full paper review.

Results

The initial scoping review demonstrated that there were no direct links between KM literature and Participatory Design Practice. A limited number of results were returned from each database (20-35) but all of these were in the field of Human Computer Interaction (HCI) and none of them were specifically about Knowledge Mobilisation or Translation  - they simply had inferred conclusions that participation of relevant stakeholders would improve uptake of the intervention.

The snowball sampling methods returned initial results shown in Table 1.

Table 1: Table of initial snowball sampling results

Origin References Citations

(as of 26/03/2015)

Total
Damschroder 86 426 (Scopus) 512
Cross 107 1144 (Google Scholar) 1251
Ehn 53 175 (Google Scholar) 228

Subsequent refinement in two stages by title and abstract and secondly by full paper review reduced this to a more manageable level but also included some secondary level forward and backward publications. Some additional grey literature around KM was also added to the included material to enhance the context of this field on advice from KM experts.

Damschroder captures the KM field and consolidates 19 models and frameworks in this field (out of a a total of approximately 48).  Rycroft-Malone et al (2004) in their Promoting Action on Research Implementation in Health Services (PARIHS) framework (included in the Damschroder consolidated model) summarise the main considerations into three categories of ‘Evidence’, ‘Context’ and ‘Facilitation’. Damschroder goes into slightly more detail with five categories of ‘Intervention’, ‘Outer Context’, ‘Inner Context’, ‘Individuals’ and ‘Implementation Process’.  The first of these categories aligns with the Rycroft-Malone category of ‘Evidence’, the second two categories obviously align with Rycroft-Malone’s ‘Context’ category but make the distinction between micro-system and the macro-system (clinical and hospital or hospital and national policy) and has strong links to do with perceived and real loci of control. The fourth category (‘Individuals’) includes ‘facilitator’ considerations covered in the third of the PARIHS category.

Cross and related sources highlight the differences in the way that designers think compared to other disciplines. As generalizable summaries Cross defines:

  • ‘Science’ as studying the natural world with methods based on controlled experiments, classification and analysis, valuing objectivity, rationality, neutrality and a concern for the ‘truth’
  • ‘Humanities’ as studying the social world with methods based on analogy, metaphor, and evaluation, valuing subjectivity, imagination, commitment and a concern for the ‘justice’
  • ‘Design’ as studying the artificial world with methods including modelling, pattern formation, synthesis, valuing practicality, ingenuity, empathy and a concern for appropriateness

Ehn and related sources describe Participatory Design Practice as the engagement of relevant stakeholders in a design process such that the stakeholders can influence the process and the outcome; stakeholders include health services researchers, patients, health professionals, service managers and designers. It is based on both pragmatic and democratic values; pragmatic in that, engaging those who will use the product or service ensures that was is developed is something they will use and democratic in that those end users have a fundamental right to influence something that will affect their lives. The collective, practical and iterative prototyping and ‘making’ process accesses their explicit knowledge and through the practical activity, also accesses embodied tacit knowledge. The iterative making process is really an exploration of how these different forms of knowledge will best fit together. Terms such as ‘facilitator’ and ‘facilitation’ are applied to the designers and their role whilst terms such as ‘engaging’, ‘empowering’ are applied to the participatory experience of the non-designer participants. There are references to the power of graphical and physical language to cut across boundaries and make communication easier. Ownership is an important and underpinning value. There are references to the greater ability to reframe problems from multiply perspectives and the greater potential for ideas when participation is opened up and diverse stakeholders included.

Discussion

Overview

A literature review in the space of ‘Knowledge Mobilisation’ and ‘Participatory Design’ is problematic. The terminology on both sides of this fence is generic, even ubiquitous and does not lend itself to literature searching. There is wide spread interpretation, use, misuse and abuse of the words ‘design’ and ‘participation’. Likewise with both ‘knowledge’ and ‘mobilisation’ where ‘knowledge’ is interchangeable with ‘research’ and ‘evidence’ (all three very generic words) and ‘mobilisation’ is interchangeable with ‘exchange’, ‘transfer’, ‘translation’, ‘utilisation’, ‘implementation’ or ‘brokerage’.

This is compounded further by the tendency of the two domains to disseminate their work in different ways that aren’t typically referenced by the same databases or even published in the same formats. A recently completed Arts and Humanities Research Council (AHRC) network project exploring the Extent of the Art of Design in Health included a literature review of publications reporting design related activity in a healthcare context. Hence the reason that the Cross and Ehn papers focused on sources from Google Scholar whilst Damschroder focused on sources from Scopus.

Knowledge Translation/Mobilisation

A systematic review (Damschroder et al. 2009) pulled together a number of different models and frameworks of KM and explored the different concepts and constructs within each model, accounting for label variation with overlapping definitions. This was continued until there were no new concepts arising from the addition of further models and frameworks. This was pulled together into a consolidated framework covering 19 different models based loosely on the ‘diffusion of innovation’. Knowledge Translation or Mobilisation strategies roughly fall into two categories; Integrated Knowledge Translation (iKT) and End-of-grant Knowledge Translation (KT) (Graham 2012). Generally, public health initiatives tend to use iKT (Powell et al. 2013) more than acute health care services that tend to favour KT models more. Initial and superficial inspection would suggest that participatory design would sit within iKT but as discussed later, it may have something to offer to more general KT models also.

There are several references in KM literature to the potential for co-creation or co-production methods to benefit sustainability and spread of evidence (Wilkinson et al. 2012). There is also a strand of KM literature that explores the use of creative practices to elicit different forms of knowledge (Simons & McCormack 2007). This endorses many aspects of what this author would claim that Design can bring to the field of KM. There is a distinct difference, however with participatory design in that the creative practices are employed as a way of knowing and understanding experiences whereas the author here would claim that collective making or prototyping also achieves this but in addition, it is purposefully seeking to make something else, something new and better (Bevan et al. 2007).

Designers and Participatory Design Practice

In the context of this paper, designers and design practice would appear to offer some inherent attributes that are valuable to KM.  However, there are specific aspects of designers and participatory design practice, that are worth expanding on in more detail:

  • Designers enable greater potential for generation of new ideas
  • Collective making can access tacit knowledge and enable real-time knowledge synthesis

Conceptualising things (products, services) that don’t already exist is difficult. Enabling others to come up with new ideas is even harder. If one only ever frames what is possible based on what one has previously experienced, then creativity would be ‘stuck’ within the circle of our current knowledge and radical leaps would be much fewer. Participatory design practice enables people to imagine alternative future possibilities and scenarios, to hold up visions of something completely new and different.

The collective and iterative making process makes concepts tangible, sharing them and letting them evolve. The physical activity of making can be used to elicit subconscious or tacit knowledge. The collective making process acts as triggers to enable participants to contribute their explicit and tacit knowledge. The iterative prototyping can be utilised via ‘sacrificial’ prototypes (2D, 3D or digital) to test priorities and assumptions of different stakeholders using an abductive approach, offering up a range of appropriate solutions rather than trying to find the ‘right’ one. The real time nature of the collective making enables the synthesis of knowledge from different stakeholders and learning about the problem-solution, with relevant context specific knowledge, experiential knowledge and in-practice knowledge.

Conclusions

With reference back to the original aims of the review,

  • There are a number of key KM frameworks that enable readers to gain an oversight of general strategies to KM but these tend not to offer specific practical guidance on how to mobilise knowledge, just what to consider in implementation.
  • There are references in KM literature to the potential for co-production to be a valuable approach to sustainability and spread.
  • There are references to creative practice in KM literature as a strategy for inclusive dialogue aimed at created shared understanding.

Participatory design practice embodies many attributes that are beneficial to KM strategies; not unique to design but conveniently packaged:

  • It is engaging, empowering, ‘bottom-up’ approaches, levelled hierarchies, reduced power structures, common language, cultural relevance and external facilitation. Multiple perspective enable problem reframing.

Participatory design practice also includes attributes that are significant strengths or even unique attributes other approaches do not include:

  • Generation of new ideas
  • Real time knowledge synthesis
  • Eliciting and embodying tacit, experiential knowledge

Participatory design practice has great potential to provide practical KM strategies but this would benefit from more case study evidence.

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