Text: Peter van Splunteren and Barbara van der Linden, editors KiZ.
We spoke with Leah Bührman, scientific secretary European Implementation Collaborative (EIC), and PhD candidate at the University of Amsterdam and VU University Amsterdam, with Esther Bisschops, scientist practitioner academic workplace ’s Heeren loo and VU University Amsterdam, and with Eva de Groot, researcher and advisor at Berenschot, Healthcare team.
What do you encounter as a starting implementation researcher?
Esther Bisschops: “In practice, there is little knowledge about what works during implementation, and certainly no scientific knowledge. So, if you delve into implementation, you will soon be the expert. But as a starting researcher you also have to look for useful knowledge yourself. And that was quite a search for me when I started my PhD work (see link below for a description of the research project). In the end it worked out, but often I was on my own. I looked for a specific implementation research training program and eventually found it in Sweden at Per Nilsen’s group (Linköping University).”
Eva de Groot: “At Berenschot we use scientifically based models or frameworks that we then adjust so that they match the practice of the client and the research questions as closely as possible. It is always a search for the correct terminology and appropriate analysis frameworks. For our project commissioned by the National Health Care Institute, we used a Medical Research Council model on evaluation research and also examined and integrated CMO configurations (context, mechanism, outcome) (see link below for a description of the research project). This helps the client but also other professional organizations to clarify expectations about the effects of measures and to determine which mechanisms strengthen or weaken the impact. It is particularly relevant when quantitative measures of implementation and effects are difficult. I learned a lot from a colleague who introduced me to the different methods of meaningful evaluation research.”
Esther Bisschops: “As a researcher you have a dual focus, on the one hand the content of your research, the intervention, method or protocol and its effectiveness in practice, and on the other hand the implementation proces and its effect. Within my research group I sometimes found it difficult to explain that both topics are important. It is about both the WHAT and the HOW. This is not always understood and requires explanation and discussion.”
Leah Bührman: “The embedding of starting researchers is usually there at the university, but specifically on the issue of implementation it’s often difficult. It takes a lot of searching to find your way there. That is why we are paying special attention to the theme of Early Career during the EIE.”
What do you need as a starting implementation researcher / professional?
Esther Bisschops: “After 20 years as a remedial educationalist in practice, everything was new to me: the language, the jargon, the university, the subject of implementation. As I said, I had to invent it all. Looking back, I would have benefited a lot from someone to show me the way. An experienced colleague to guide me towards important literature, people who can help me further, relevant projects, et cetera. I do notice, now that I have advanced a bit and have more knowledge about implementation, that I have become a source for colleagues from academic workplaces who are just starting research into implementation.”
Eva de Groot: “It works differently for us. In consultancy you have less time to do an extensive literature study, for example, because assignments must be completed within a limited time. In addition to support from my colleagues, I have benefited a lot from the people at the National Health care institute who look at implementation issues in a scientific way. I am certainly interested in further expanding my network in the field of implementation and have therefore also signed up for the various program components of the EIE.”
Leah Bührman: “For both the researcher and the practitioner, building a network as you begin your career is essential. This is not a given in the field of implementation. You usually start from the background of the department, for example clinical psychology or organizational development. The department has its own learning networks. Then on the other side there is implementation science. Your own implementation network does not come naturally, you actually have to find your own way, find your own path outside the bubble of your discipline. As an implementation specialist, you need your own network that can open doors for you, and where you can go with questions and uncertainties. It should be a learning environment where both content and emotional support is available. A learning community where you can exchange ideas and experiences. As a young implementation researcher there are special challenges, firstly solving issues that every young researcher encounters, and in addition discovering specific implementation issues. (See article Chris Woolston in Nature for a description of the situation of PhD students).
There are implementation groups and networks spread throughout Europe (especially in the UK, Scandinavia and the Netherlands) but that is not enough, there is an absolute need for more. That is why we want to give an impulse to the further development of learning networks for early career implementation professionals during the EIE. We hope to create a place for young professionals where they can go with questions and exchange experiences about their practice.”
In general, how do you get your training as a young implementation professional?
Leah Bührman: “It essentially goes two ways. The first is the more general training on implementation, what is it, what concepts are there, what do you do about implementation as a professional in practice? This general training is not standard in every master’s program, but is fortunately becoming more and more available. The second way is more specialized learning about implementation. There are such a number of facilities in Europe where you can follow training specifically aimed at implementation (for a recent overview, see the EIC website).
The European Implementation Science Education Network (EISEN) (co-funded by the EU Erasmus + Program) has conducted a pilot with two curricula on implementation, one for masters, the other for PhD students. We, as a European Implementation Collaborative, would like to connect with this network, as an example of developing an implementation education infrastructure. What we need is continuity in learning and development in terms of implementation.”
What is the role of the Netherlands Implementation Collective (NIC) for the early career professional?
Esther Bisschops: “The research area for implementation is still small, so I definitely advocate a European network because then the chance that you will find more like-minded people is somewhat greater. On the other hand, it is also nice to be able to knock on your neighbor’s door, so to speak, if you have a question. The Netherlands Implementation Collective can play an important role in this. Everyone should know and be able to consult the NIC. That is is certainly a challenge for the NIC.”
Eva de Groot: “I would like to make it broader. Not only a network for researchers, but also for implementation experts in practice, such as policy advisers and healthcare professionals. In my practice, the latter two groups also have relevant questions about the effective design and implementation of policy or changes. It is often about a connection between research, practice and policy. That trilogy should also be reflected in the support structure.
In addition to all the challenges that lie ahead, let us also pay attention to what makes implementation so fascinating and important, and that is making the connection between scientific insights and practice. Putting science into practice and vice versa, that’s what it’s all about and you can add a lot of value to both. Everything you present and teach about this is gratefully accepted. Let’s not forget that!”
What does the special program for the Early Career Professional (ECP) look like at the Event?
Leah Bührman: “The program consists of four parts.
Firstly, a keynote has been reserved for ECP’s. We have called on them to submit an abstract. So far 20 abstracts have been submitted. The best one will be chosen for a 30 minute keynote on the second day of the conference.
Second, there is a breakfast session on the first day, in which we provide space for exchange and networking. There is no program, we give them free space to exchange with each other. Anything is allowed!
Third, the scavenger hunt, which is a rally in which groups of ECP’s can participate. The groups are challenged during the two days to solve all kinds of implementation questions and challenges. This creates exchange and interaction between the young professionals.
And finally, on May 18 (pre-conference!) There will be a free interactive workshop on implementation concepts, especially about research, but also the relationship with practice will be discussed. The workshop is intended for both researchers and practitioners. You can register for this after registering at the event.
We now already have 160 registrations from ECPs and about 50% of these come from practice. I find that high number of registrations from the practice of implementation (policy, practice and government) both surprising and encouraging. We hope that the EIE can provide a stimulus for the development of national and international networks in the field of implementation. Ultimately, as EIC, we want to realize an infrastructure where early career implementation researchers and practitioners can meet for exchange, learning and meeting.”