Evidence for the 'dimmer switch': results from a realist evaluation of a knowledge transfer policy

The concept of the dimmer-switch has been developed by Dalkin and colleagues as a way to explain how professionals might reason over time as they experience the effects of change (Dalkin, Greenhalgh, Jones, Cunningham, &... [ view full abstract ]

The concept of the dimmer-switch has been developed by Dalkin and colleagues as a way to explain how professionals might reason over time as they experience the effects of change (Dalkin, Greenhalgh, Jones, Cunningham, & Lhussier, 2015) . This analogy was useful when exploring the way researchers react and reason in response to changes being put in place by a health research funder to close the gap between health research findings and their eventual take-up. Researchers were observed to have differing degrees of intensity of change in response to the policy of requiring them to provide evidence of plans for the use and uptake of their research in their applications for research funding. The implicit theory is that this policy works by changing the behaviour of researchers so they are encouraged to proactively prepare and make connections with those who will implement their findings (O). Yet the results of a realist evaluation found a pattern of reasoning that was less about a particular behaviour or activity being switched on or off, and more about the degree to which the policy affirmed a behaviour that was a defining feature of the research community the researchers identified with. The concept of the dimmer switch used by Dalkin and colleagues to explain differing levels of anxiety for healthcare professionals working with palliative care patients, was developed further to explain differing levels of affirmation and sensitisation in the reasoning of health researchers to the knowledge transfer policies being put in place by a New Zealand-based health research funder. I will describe how three phases of work were undertaken, iterating between: (1) the perspectives of those that design knowledge transfer policies (a first phase involving interviews with policy makers and reviews of policy and planning documents); (2) the perspectives of those that are the recipients of the policy (a second phase comprising interviews with researchers based on a sample of their written knowledge transfer sections in research applications); and (3) the perspectives of those that manage the policy (a final third phase surveying assessors of research applications). The findings highlight the circumstances where researchers are more or less likely to make an effort to proactively prepare and make connections with others (O), in response to contexts relating to the type of health research being undertaken, and the beliefs and prior experiences of the researchers (C) with different types of “sensitising” mechanisms being fired or affirmed (M).