Background: This thesis aimed to develop, implement, and evaluate a multi-faceted integrated knowledge translation (iKT) intervention to disseminate and support adoption of the ‘F-words in Childhood Disability’. Grounded in the WHO’s ICF framework, the ‘F-words’ (Function, Family, Fitness, Fun, Friends, and Future) offer a holistic family-centred approach to childhood disability. Methods: This thesis was guided by the action cycle of Graham et al.’s (2006) knowledge-to-action (KTA) framework. Chapter 2 reports a knowledge translation (KT) initiative (i.e., an online video) to disseminate the ‘F-words’ and explore people’s reception of these ideas. Chapter 3’s scoping review identifies and assesses KT strategies that directly target families raising children and youth with special health care needs. Chapter 4 describes a pilot study to evaluate the usability and utility of an online ‘F-words’ KT resource. Chapter 5 reports a case study of our longitudinal KT research program, and uses Diffusion of Innovation (DOI) theory to understand the factors that contributed to the adoption of the ‘F-words’. Results: Multi-faceted KT strategies, co-developed with stakeholders, were essential to moving the ‘F-words’ into practice. The video (Chapter 2) reached >700 views in two months and 98% of 137 survey respondents indicated they ‘extremely liked’/‘liked’ the ideas. The scoping review (Chapter 3) identified six studies, all of which evaluated educational materials and deemed them to be useful and important to families. The pilot evaluation (Chapter 4) revealed the online resource to have positive usability and utility for families and service providers. The case study (Chapter 5) highlighted that diffusion, dissemination and implementation strategies were all needed and that DOI factors (i.e., the innovation characteristics, communication channels, social networks, and time) contributed to the adoption of the ‘F-words’. Based on a multi-faceted integrated KT research program we now have extensive examples of ‘F-words’ adoption by families, service providers, and health care organizations. Conclusions: This thesis illustrates a step-wise theory-informed approach to the development and evaluation of a multi-faceted iKT intervention. By studying each step of the action cycle, this work contributes new knowledge to both the processes involved in disseminating research evidence, and associated outcomes from a multi-faceted iKT intervention. Findings from this thesis contribute new discoveries to both KT practice and science. / Thesis / Doctor of Philosophy (PhD) / In the 21st century, research supports a holistic family-centred approach to childhood disability. Unfortunately, a research to practice gap remains, and the professional-led biomedical approach still informs many practices. In 2012, Rosenbaum and Gorter published “The ‘F-words’ in childhood disability: I swear this is how we should think!” They highlighted the importance of ‘Function, Family, Fitness, Fun, Friends, and Future’, grounded in the World Health Organization’s framework for health. This thesis developed and evaluated a knowledge translation research program to move the ‘F-words’ into practice. Objectives, all achieved, were to: i) apply strategies to spread awareness of the ‘F-words’ and explore people’s reception of these ideas; ii) identify and assess strategies to share research with families; iii) develop and evaluate an online resource to support use of the ‘F-words’; and iv) study the processes involved and factors that contributed to the ‘F-words’ adoption. These findings have implications for both doing and studying knowledge translation.

Reflective practice, though ill-defined, has become an accepted educational concept within many health care disciplines particularly in nursing. Subsequently it has become benchmarked within Paramedic Sciences as a professional requirement for continuing education and clinical practice. However, despite the vast literature in nursing and the increasing growth of reflective practice in paramedic curricula it is unclear how it influences the students’ learning in preparation for graduate practice as future reflective practitioners. This research explored ‘to what extent does reflective practice in the paramedic curriculum influence the students’ academic and clinical learning leading to graduate practice’? A mixed methods approach with cohort samples of undergraduate health care students comprised four studies including surveys and non-participant observations of clinical simulation that were conducted in a university learning environment. The results showed overall that Paramedic students believed that they understood reflective practice and perceived it to be useful for their academic studies and clinical practice; although this is probably influenced more by formal teaching rather than the result of their own views. Students were able to describe reflective practice in ideal theoretical terms and were positive towards it regardless of their individual learning styles. However, in a clinical context, they applied it differently with significant emphasis on technical reflection. Evidence of the nature of reflective practice as it occurred during and after clinical simulation scenarios highlights a need for revised approaches to existing learning/teaching strategies with paramedic students. An extended understanding and refinement of reflective practice concepts including a new pedagogic framework to promote enhanced reflectivity are proposed. This theoretical framework is designed to accommodate reflective learning for both personal and collaborative learning related to curriculum outcomes. The use of clinical simulation for the development of reflective practice in the paramedic curriculum is supported with recommendations for further studies in academic and clinical settings.