Knowledge Translation and the Governance of Health Research in Canada: A Critical Discourse Analysis

Ellis, Kathleen S., "Knowledge Translation and the Governance of Health Research in Canada: A Critical Discourse Analysis" (2014). Electronic Thesis and Dissertation Repository. Paper 2198

Abstract

Knowledge translation (KT) is a dominant discourse in the governance of health research in Canada, constructing new roles and responsibilities for researchers and decision makers. In this thesis, I critically examine the knowledge translation discourse of the Canadian Institutes of Health Research (CIHR), Canada’s major health research funder. Informed by a governmentality perspective, I explore how the KT discourse operates to shape the directions of health research and the activities of health researchers in Canada using critical discourse analysis with a sample of publicly available CIHR documents.

My results show how this KT discourse is constructed through three powerful rationales: a “gap” between knowledge creation and its application in health and health care; financial and health care accountabilities for public investment in health research; and, the expectation of economic prosperity and an international competitive edge for Canada. Through these rationales, the use of health research becomes problematized and knowledge translation is constructed as an unquestioned solution.

KT is constructed as all-encompassing, and action-oriented, positioned to function in ways consistent with the three rationales in shaping health research and researchers in particular directions. Ideal health research is “innovative”, “world-class”, and demonstrates an economic return on taxpayers’ investment. Health researchers are constructed as the workforce in a transformed “research enterprise”, expected to work outside of their areas of expertise through cross-sector collaborations, and to “tailor” and disseminate their research to meet knowledge “users’” needs. Discursive strategies are used to increase researchers’ capacities for KT activities, and ideally, to adopt KT-researcher oriented subjectivities. Finally, CIHR is constructed through the KT discourse as the Government of Canada’s “health research investment agency”, a national manager of health research and researchers and international authority in knowledge translation. These results illustrate how KT operates as a technology of governance, with potential effects in prioritizing particular health research agendas and privileging particular kinds of researcher orientations to their research programs within the context of neoliberal rationalities of government. The three rationales are considered in relation to discourses on evidence-based medicine and new public management to critically reflect on the contemporary governance of health research and researchers in Canada.

Keywords: knowledge translation; governmentality; health research; Canada; Canadian Institutes of Health Research (CIHR); critical discourse analysis; research governance; evidence based medicine; new public management.

http://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=3663&context=etd