The use of research evidence to inform decision-making is a foundational principle for allied health professionals to provide optimal quality care.1 The process of using research evidence to inform, guide, and change practice is known as knowledge translation2 and has been reported to be complex3 and challenging to achieve.4 To translate research knowledge into clinical practice,5 clinicians and health care organizations are required to identify robust evidence to inform clinical care.6 They may need to adapt the research knowledge to a local context,7 use behavioral change strategies to improve the uptake of research to inform clinical decision-making,8 and evaluate and monitor the uptake of evidence into practice.5 An impact of poor knowledge translation practices9 is that health care consumers do not receive an intervention that is supported by research evidence, potentially resulting in an intervention providing no benefit or a harmful effect.10 Mentoring has been described as a strategy to influence the knowledge translation capability of health professionals.11
According to Abdullah et al.,12 “Mentoring is the process of providing individualized support based on mentees’ learning needs and goals by a mentor who is more experienced as it relates to the mentee's needs.”(p.1) Mentoring facilitates personal and professional growth for both the mentor and mentee through the development of skills and knowledge during an active professional interpersonal relationship.13 A mentor is a person who has established skills in the concepts being discussed.11 A mentee is a person who has identified individualized learning needs.13 While there may be overlap between some of the functions of mentoring and other professional support relationships, such as clinical supervision and coaching, these are generally considered to be separate processes from mentoring. Clinical supervision may focus on facilitating professional development and personal growth but also includes an emphasis on clinical governance and accountability to the employing organization and profession.14,15 Coaching provides individual instruction to develop a specific skill.16
A framework described by Karcher et al.17 identified six characteristics that are described as essential components to understand a mentoring program: context (the geographical and health care settings in which mentoring occurs); structure (how a mentoring program is delivered); goals (why it is being delivered); content (the topics of focus); infrastructure (resources to deliver and support the program); and dosage (frequency and the amount of time required to deliver the program). Additional to these characteristics, barriers to mentoring implementation18,19 and the measurement of mentoring impact13,18,19 have been reported to be important considerations when understanding how to deliver and evaluate mentoring programs to support knowledge translation.
Previous systematic and scoping reviews have reported benefits from using mentoring as a knowledge translation strategy for the disciplines of nursing and medicine,19 management, and social sciences.20 Mentoring programs have been reported to vary in structure, delivery, and content.19,20 For example, mentoring sessions have ranged from three to 12 sessions spanning over one to 12 months.19 Due to the varied study design and methodological quality of the source studies of previous reviews,19,20 a treatment effect has yet to be estimated. The reported benefits from having health professionals participate in mentoring have included improved clinical outcomes,13 improved professional communication skills,18 career advancement,20 and enhanced capability to create practice change as informed by research evidence.12 In contrast to the benefits, mentoring relationships can fail due to poor mentor training or ineffectual communication between the mentee and mentor.18 Although benefits from mentoring as a knowledge translation strategy have been identified for some health professionals, it is not clear how findings from previous reviews are applicable to allied health staff who want to use mentoring as a knowledge translation strategy.
To identify allied health's use of mentoring as a knowledge translation strategy, a preliminary search of PROSPERO, MEDLINE, the Cochrane Database of Systematic Reviews, and the JBI Database of Systematic Reviews and Implementation Reports was conducted and no current or in-progress systematic or scoping reviews on the topic were identified. A preliminary search of databases identified that mentoring has been reported in studies investigating the use of research evidence to influence the clinical health care practice of allied health staff.21-23 To the authors’ knowledge, no synthesis of research evidence on how allied health professionals have used mentoring to improve the processes of knowledge translation exists.
The primary objective of the review is to identify how mentoring has been used as a knowledge translation strategy by allied health. The expected result of this review is that, firstly, the findings of the review will inform the feasibility of a mentor program to be established in a regional Australian health service to improve knowledge translation capability of allied health staff. Secondly, the scoping review will identify the knowledge gaps about the use of mentoring as a knowledge translation strategy by allied health, providing a guide to future research.
- i) How has mentoring been used by allied health professionals to enable the use of research knowledge in practice?
- ii) What are the barriers to using mentoring as a knowledge translation strategy?
- iii) How has the impact of mentoring been measured?
The review will consider studies that include participants identifying with at least one of the allied health disciplines as described by the Australian government health workforce program.24 These disciplines may include audiology, dietetics, exercise physiology, occupational therapy, physiotherapy, podiatry, psychology, social work, and speech pathology. If studies with allied health staff have also included participants from either the medical or nursing professions, only studies that have a majority of participants from allied health will be included.
The review will exclude a study if it reports that the majority of participants are students, as the scoping review is investigating the use of mentoring by allied health staff employed in a health care setting.
The core concept is mentoring. To demonstrate the characteristics of mentoring, a study must demonstrate (a) involvement of at least one mentor and one mentee, (b) an interactive process over time between a mentor and a mentee, and (c) that the mentoring relationship aims to promote benefit for the mentee. Mentoring can be used as either a singular strategy or as part of a multi-pronged strategy for knowledge translation.
The second concept is knowledge translation. The concept of knowledge translation will be demonstrated by the study reporting on an outcome or experience as related to the use of research evidence in a health care setting. Outcomes may be reported on (but not limited to) behavior, knowledge, policy, or clinical outcomes. Experiences may describe the perceptions and viewpoints of allied health staff who are participating in mentoring to influence the use of research evidence in practice.
The review will exclude a study if mentoring is solely supporting allied health staff to conduct research activities in a health care setting. Research activities may include activities such as writing a research protocol, preparing and submitting ethics applications, conducting research activities as described in the research protocol, or the dissemination of research findings.
The review will consider studies in a health care setting in which mentoring enables the knowledge, and knowledge translation skills, of allied health staff. Studies may include participants of any gender, geographical location, cultural background, or health care setting.
Types of sources
This scoping review will consider both experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before-and-after studies, and interrupted time-series studies. In addition, analytical observational studies, including prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies, will be considered for inclusion. This review will also consider descriptive observational study designs including case series, individual case reports, and descriptive cross-sectional studies for inclusion.
Qualitative studies will be considered including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description, action research, and feminist research.
In addition, systematic reviews that meet the inclusion criteria will also be considered. Gray literature will be considered.
Opinion papers will not be considered for inclusion in this scoping review.
The proposed review will be conducted in accordance with the JBI methodology for scoping reviews25,26 using the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI; JBI, Adelaide, Australia).
A three-step search strategy will aim to locate both published and unpublished studies. An initial limited search of MEDLINE (Ovid) and CINAHL will be undertaken to identify articles on the topic. The text words contained in the titles and abstracts of the relevant studies retrieved in the initial search will then be used to develop the second round of searching. The initial search strategy, including all identified keywords and index terms, will be adapted for each database. The databases to be searched include MEDLINE (Ovid), Embase (Ovid), CINAHL, PsycINFO, PDQ-Evidence, CDARE, and CDSR. The reference lists of all studies selected for critical appraisal will be screened for additional studies. A detailed search strategy for the MEDLINE and CINAHL initial search is listed in Appendix I. The date of publication will not be used to limit the search. Only studies published in English will be included. A gray literature search will be conducted using OpenGrey.
Following the search, all identified citations will be collated and uploaded into the RefWorks (ProQuest LLC, Ann Arbor, USA) citation management platform and duplicates removed. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant studies will be retrieved in full and their citation details imported into JBI SUMARI. The full text of selected citations will be assessed in detail against the inclusion criteria by two independent reviewers. Reasons for exclusion of full-text studies that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the study selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram.27
The framework by Karcher et al. will guide the data extraction, as the framework has been used successfully in a previous knowledge synthesis study.17 Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction tool developed by the reviewers. The data extracted will include specific details about the allied health participants, study design, the research evidence being translated into practice, mentoring characteristics (context, structure, goals, content, infrastructure, and dosage), barriers to using mentoring as a knowledge translation strategy, and how mentoring impact was measured. An MS Excel (Redmond, Washington, USA) spreadsheet will be used to collect the details from the eligible studies. The draft data extraction tool (Appendix II) will be modified and revised as necessary during the process of extracting data from each included study. Modifications will be detailed in the full scoping review report. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Authors of papers will be contacted to request missing or additional data, where required.
The extracted data will be presented in tabular or diagrammatic form in a manner that identifies the study's design, mentoring characteristics, barriers to implementation, and method of measuring mentor impact. A narrative summary will accompany the charted results and will describe the significance of findings.
Appendix I: Search strategy
Searched 6 Dec 2019
1 exp Occupational Therapists/ or exp Occupational Therapy/ (12,905)
2 occupational therap∗.mp. (19,149)
3 exp Exercise Therapy/ (47,683)
4 exercise therap∗.mp. (38,414)
5 exp Physical Therapists/ (1589)
6 (Physiotherapist∗ or physio∗ or physio therap∗).mp. (5,234,997)
7 physical therap∗.mp. (51,088)
8 exp Nutritionists/ (1070)
9 dieti#ian.mp. (3792)
10 exp Dietetics/ (7630)
11 dietetic∗.mp. (13,142)
12 exp Audiologists/ (78)
13 exp Audiology/ (2023)
14 audiolog∗.mp. (10,968)
15 exp Podiatry/ (2209)
16 podiatr∗.mp. (3959)
17 exp Speech Therapy/ or exp Speech-Language Pathology (8893)
18 (speech therap∗ or speech patholog∗).mp. (9356)
19 exp Social Work/ or exp Social Workers/ (17,727)
20 social work∗.mp. (26,368)
21 exp Psychology/ (65,850)
22 psycholog∗.mp. (1,416,566)
23 exp Allied Health Occupations/ or exp Allied Health Personnel/ (96,932)
24 allied health.mp. (18,649)
25 or/1-24 (6,394,766)
26 exp Mentors/ (10,395)
27 exp Mentoring/ (1289)
28 mentor∗.mp. (20,395)
29 mentee∗.mp. (761)
30 coach∗.mp. (13,457)
31 buddy∗.mp. (585)
32 academic detail∗.mp. (526)
33 local opinion leader∗.mp. (116)
34 knowledge broker∗.mp. (224)
35 educational outreach∗.mp. (516)
36 advis#r.mp. (2340)
37 or/26-36 (36,854)
38 exp Translational Medical Research/ (9933)
39 exp Evidence-Based Practice/ (85,803)
40 evidence based.mp. (160,156)
41 exp Evidence-Based Medicine/ (71,718)
42 exp Implementation Science/ (224)
43 Implementation science.mp. (1993)
44 exp Quality Improvement/ (22,712)
45 quality improv∗.mp. (49,667)
46 exp “Diffusion of Innovation”/ (19,285)
47 diffusion of innovation.mp. (17,532)
48 (knowledge transfer or knowledge exchange).mp. (2251)
49 or/38-48 (235,364)
50 25 and 37 and 49 (718)
Searched 6 Dec 2019
S1 (MH “Occupational Therapy+”) (22,058)
S2 (MH “Occupational Therapists”) (7225)
S3 “occupational therap∗” (38,818)
S4 (MH “Therapeutic Exercise+”) (47,255)
S5 “exercise therap∗” (1318)
S6 (MH “Physical Therapists”) (10,577)
S7 “physical therap∗” OR physiotherap∗ OR Physio∗ (664,340)
S8 (MH “Dietitians”) (4620)
S9 (MH “Nutrition Services+”) (2982)
S10 dietitian∗ or dietician∗ or nutritionist∗ (9025)
S11 (MH “Audiologists”) OR (MH “Audiology”) (7320)
S12 audiolog∗ (12,517)
S13 (MH “Podiatry”) (2686)
S14 podiatr∗ (11,742)
S15 (MH “Speech Therapy+”) (3416)
S16 (MH “Speech-Language Pathologists”) (6241)
S17 “speech therap∗” OR “speech patholog∗” OR “speech language patholog∗” (17,070)
S18 (MH “Social Work+”) (11,713)
S19 (MH “Social Workers”) (34,639)
S20 “social work∗” (34,639)
S21 (MH “Psychology+”) (20,529)
S22 psycholog∗ (271,620)
S23 (MH “Allied Health Personnel+”) OR (MH “Allied Health Professions+”) (247,958)
S24 “allied health” (17,125)
S25 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 (1,170,567)
S26 (MH “Mentorship”) (13,620)
S27 mentor∗ (18,771)
S28 mentee∗ (562)
S29 coach∗ (10,022)
S30 buddy∗ (452) (452)
S31 adviser OR advisor (7477)
S32 “academic detail∗” (290)
S33 “local opinion leader∗” (48)
S34 “knowledge broker∗” (161)
S35 “educational outreach” (260)
S36 S26 OR S27 OR S28 OR S29 OR S30 OR S31 OR S32 OR S33 OR S34 OR S35 (36,641)
S37 “knowledge translation” (1604)
S38 “translational medical research” (8)
S39 (MH “Professional Practice, Evidence-Based+”) OR (MH “Physical Therapy Practice, Evidence-Based”) OR (MH “Occupational Therapy Practice, Evidence-Based”) OR (MH “Medical Practice, Evidence-Based”) (71,361)
S40 “evidence based practice∗” OR “evidence based medicine∗” (17,112)
S41 (MH “Implementation Science”) (72)
S42 “implementation science∗” (853)
S43 (MH “Quality Improvement+”) (56,410)
S44 “quality improve∗” (56,583)
S45 (MH “Diffusion of Innovation+”) (12,749)
S46 “diffusion of innovation∗” (12,910)
S47 “knowledge transfer” or “knowledge sharing” or “knowledge exchange” (1583)
S48 S37 OR S38 OR S39 OR S40 OR S41 OR S42 OR S43 OR S44 OR S45 OR S46 OR S47 (152,810)
S49 S25 AND S36 AND S48 (474)
Appendix II: Data extraction tool
Angela Mundy and Angela Johns-Hayden (Bendigo Health librarians) for assisting with writing the search strategy.
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