A well executed course in implementation science

Before Christmas, Haukeland University Hospital hosted a course on the use of implementation science in global health. The Norwegian Research School of Global Health provided assistance to the CIH/CISMAC research school in organizing the course.

With the course, participants gained knowledge of implementation science principles and procedures in global health, with an emphasis on the problems with global health in low- and middle-income nations. It is hoped that by the end of the course, participants will be able to define implementation science and be familiar with the many theories, models, and frameworks used to weigh the benefits and drawbacks of use.

Leif Eriksson and Anna Bergström from Sweden's Uppsala University taught the course. According to them, the course is meant to provide as an introduction to implementation research.

"There are many guidelines in the field of health, and new guidelines frequently develop. They frequently become something different than what they were intended to be when used in actual practice, i.e. in clinics. According to the report, many policies are either not implemented at all or not applied adequately. Patients may not receive the proper care as a result of this. It may result in legal disputes and large financial losses in some circumstances. Implementation science is about, to put it simply, aligning new knowledge and new guidelines with what is done in clinics," Bergström explained.

According to Eriksson, implementation science is a new field of science, and students will learn about it through this course.

"They must learn how to study implementation and apply new knowledge in the workplace. Is there anything they can contribute to make the implementation process more effective and correct?"

Eriksson goes on to say that while it may be tempting to believe that implementation can be completed quickly, in reality it is a lengthy process. Many implementations fail because several guidelines are often implemented at the same time, and there is a lot of pressure to get them in place as soon as possible.

"Prioritization and planning, like many other things, are important when it comes to implementation. It is common to receive an e-mail from superiors stating that this is how we will do things from now on. After that, a few days pass before another email arrives with a new rule that everyone must follow. We must improve our ability to see each case separately and plan implementation accordingly," Eriksson said.

Participants from all over the world

One of the participants in this course was Barsha Pathak from India. She currently works as a researcher at the Society for Applied Studies in New Delhi. This course forms part of her PhD education. As a supervisor, she has, among others, Ingvild Fossgard Sandøy from the Center for International Health. She found the course very rewarding.

"The course's primary emphasis is on the foundations of implementation science. Our teachers in the course explain how to do implementation research using the frameworks and models. We also receive assistance in learning how to use the frameworks in practice through this course," Pathak explained.

The first days were spent getting to know the concept and the fundamentals of implementation science. Then, the following days they went deeper into the issue.

"At the conclusion of the course, we will do an oral assignment.," she says. According to Pathak, there, they must demonstrate that they have a thorough understanding of the material.

She is very pleased with the chance to collaborate with other course participants and, in doing so, has the chance to discuss the course material and exchange experiences from their various home countries.

First in-person course following COVID

The students completed seven days of the course before being placed into groups of four to work on the assignment, which must be provided verbally online.

"We are leaving for home right away, but stay in touch on WhatsApp," Pathak says. 

The groups will meet on Zoom an hour before the assignment to have the final discussions. The specific assignment will then be completed. The course instructors will also provide them with feedback and suggestions.

The interactions that was fostered between the students and the course teachers, in Pathak's opinion, is what makes the course the most worthwhile.

- I believe everyone here has done and read about implementation research in their native countries. The issue is that we did it on our own without having the chance to have in-depth conversations with our peers from a differnt setting. When we can actually be here together and spend time talking about our experiences with one another, it became entirely different. As it was not possible during COVID, I really missed this."

She calls the instruction extremely vibrant and interactive. There was time for debate and questions throughout the course, and the issue was addressed in a plenary session.

"The conversations were at a very high level. Everyone offered solutions and ideas for resolving the issue. I really appreciated the chance to return home before participating in a few Zoom lectures and finishing with an oral presentation that includes instructor feedback. As a result, we have the opportunity to consider and process what we have learned as well as place it in the perspective of what we already know from our home countries."

She is very pleased with the caliber of the course, not to mention how Bergström and Eriksson delivered their lectures.

"They had no pressing need to complete the syllabus. Twenty students and researchers from various backgrounds make up our organization. Some are from nations with noticeably superior regulatory environments, while some are from low-income nations. This could imply that some implementations are simple in one location but challenging in another. When we relate the circumstances in our home countries, Anna and Leif pay attention and offer constructive criticism. This kind of involvement in the classroom appeals to me greatly, and I believe implementation research courses should be taught using this manner."