As I write this blog, David, Marla and I are all on a flight back from the 3rd Annual NIH Conference on the Science of Dissemination and Implementation and my head is spinning! We went because we were given the opportunity to host a think tank titled “How can we CAPTURE practice-based evidence?” We thought what better place to talk about CAPTURE than with a bunch of like minded folks interested in knowledge exchange and the messy world of implementing what we know and finding out whether it worked?
On the first day, there were a number of very interesting presentations many of which spoke to the rigor necessary in assessing dissemination and implementation. By the end of the day I had a growing sense of unease that maybe we had incorrectly guessed the nature of the people attending the conference. Although the comments from Francis Collins, the new Director of NIH and Julio Frenk, the new Dean of Harvard’s School of Public Health were well received, I began to think that the audience might be mostly interested in dissemination and implementation in the clinical environment and that anything other than rigorous controlled experiments would be less than acceptable. This message was driven home by the last speaker of the day, Michael Lauer, Director, Division of Cardiovascular Sciences at the National Heart Lung and Blood Institute who spoke about comparative effectiveness research. It was an excellent talk, which certainly had appeal to the basic scientist left in me, but the image we were left with was that without rigor we will be doomed to repeat our experiences over the last several hundred years with unproven approaches like bloodletting as the normative treatment for all kinds of ailments!
Over alligator beignets (don’t ask), David, Marla and I speculated on the reception we might receive the next morning; I for one was not optimistic. I thought maybe we had misjudged the audience at this conference. But there was not much we could do about it at that point, so we headed back to the hotel, polished up the presentation and had a lousy night’s sleep.
Although the room was not full to capacity for our session, there was a good crowd of about 25-30 in attendance. This was a good sign, but even better were the heads that started to nod up and down as we talked about our vision for CAPTURE and answered their questions about what CAPTURE is and what it is not. I was both relieved and a bit surprised to find the group to be the most engaged of the four concurrent sessions I had attended. Our intent at this session was not just to focus on CAPTURE but also to zero in on the ideas of reflective practice, the capturing of tacit knowledge and the conversion of this knowledge to explicit knowledge. While they had lots of questions, they also gave us lots of ideas and an incredible sense of support for the work we are doing and the goals we have set for CAPTURE.
Thank you Curtis Olson from the University of Wisconsin for planting the idea in my brain that the tacit knowledge we would like to collect is more useful when considered as hypothesis generating rather than evidence in support (or not) of a hypothesis. And thank you Kandy Ferree President and CEO of the National AIDS Fund for her offer to work with us by bringing her large network of community based organizations in to help us test prototypes. We will be in touch. And thank you Seong-Yi Baik (Sunny Beck) for the concrete demonstration of your support in the form of a hug at the end of the session; what a way to make us feel good about what we are doing! Clearly our fears were not justified. The like minds sought us out and provided a wonderful confirmation that our efforts to support evaluation and collect practice-based evidence were on an important and valued track.