Using Dialogic Methods as a Participatory Knowledge Translation Approach to Promote Integration of Nurse Practitioners in Primary Healthcare Settings.

Background: Nurse practitioners (NPs) were introduced in British Columbia (BC) in 2005 as a new category of health provider. Given the newness of NPs in our health system, it is not unexpected that continued work is required to better integrate NPs in healthcare in BC. Aim: This paper will focus on a research study using dialogic methods as a participatory knowledge translation approach to facilitate integration of NPs in primary healthcare (PHC) settings. Methods: Deliberative dialogue (DD) is a useful knowledge translation tool in health services delivery. Through facilitated conversations with stakeholders, invited to consider research evidence in the context of their experience and tacit knowledge, collective data are generated. DD is a powerful tool to engage stakeholders in the development and implementation of evidence-informed policies and services through discussion of issues, consideration of priorities and development of concrete actions that can be implemented by policy makers and decision-makers. Two DD sessions were held with stakeholders involved in supporting NP integration in a health authority in southern interior BC. Stakeholders were provided syntheses of a literature review and interview results. The first session resulted in the collective development of 10 actions to promote NP integration in PHC settings. The second session was conducted six months later to discuss progress and revisions to actions. Discussion: The use of the dialogic methods used in studying NP integration in PHC settings proved useful in promoting real conversation about the implications of research evidence in living contexts, enabling diverse stakeholders to co-create collaborative actions for further NP integration. The conversations and actions were used to support further NP integration during the study and beyond. Conclusion: DD is a useful approach for transforming health services policy and delivery. It has the potential to move change forward with co-created solutions by the stakeholders involved.