Systemic Reflections on Knowledge Transfer; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis”

Document Type : Commentary


1 College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia

2 International Society for Systems and Complexity Sciences for Health (ISSCSH), Waitsfield, VT, USA


The systemic failure of organisational learning should not come as a surprise – after all every system delivers exactly what it is designed for. Knowledge management/transfer is a property of the organisational system rather than a particular technique. Hence, knowledge management/transfer is about the contextual framing in which learning focused on understanding can occur. Looking through a system lens any research field can be defined as a complex adaptive organisation, and its culture determines if and how learning and knowledge transfer (or shared learning) can occur. Creating and maintain a learning culture requires leadership that perpetuates continuous dialogues to achieve tacit and explicit knowledge exchange.


We’ll get to the truth quicker if we don’t worry about logic.

Louise Erdrich - American author

The health policy and systems research literature increasingly observes that knowledge translation (KT) practices are difficult to sustain. An important issue is that it remains unclear what sustainability of KT practices means and how it can be improved1 Borst, Wehrens and Bal’s, based on an extensive literature search and thematic synthesis, describe the systemic failures (or at a minimum difficulties) of organisational learning. That should not come as a surprise as every system always delivers exactly what it is designed to deliver.2 Put differently, failure of KT is an inherent property of the system (the organisation people work at) that fails to achieve KT (and thus not a problem of the people themselves).3

The core argument of this short commentary is that knowledge management/transfer, rather than being a technique (in Ackoff’s terms instructions4), in the first instance is one of contextual framing and thus the creation of understanding.4

Knowledge Transfer = Systemic Organisational Learning

Borst et al also tacitly acknowledges that health policy and systems research is a heterogeneous field that lacks a clear definition of purpose. Any research field reflects an organisational frame, and thus can be defined – looking through a systems lens – as a complex adaptive organisation. It is the organisational context that provides the environment in which learning and knowledge transfer (or shared learning) occurs. Learning, broadly speaking, is the acquisition of new understandings, knowledge, behaviours, skills, values and attitudes.

Not all organisations foster shared learning, and some indeed prevent it from occurring based on a command-and-control philosophy where information and knowledge is only shared on an at-needs basis. Such organisation have a bias towards success (paying lip-service to learning from failure) and action (resulting in exhaustion and lack of time to reflect), and tacitly demand people to fit in (diminishing creativity).5

In contrast, complex adaptive organisations have a set of key characteristics that explain the why, what and how of the organisation’s approaches to achieve its tasks. Such organisation:

  1. Understand their purpose/focus – WHY are we here? WHAT do we want to achieve?

  2. Define specific goals to achieve – WHAT exactly do we want to deliver within a given time frame?

  3. Understand their core values – WHAT are the values that do not change even if our circumstances change? They must be consistent with the purpose of the organisation; and

  4. Articulate their ‘core operational rules’ (aka “simple rules”) – How do we interact? What are the key ways (or what are – typically – the 3-5 principles) that define ‘how we do business’ in this organisation?6

By implication, complex adaptive organisations are learning organisations – they have a collaborative purpose-focused approach, facilitate a continuous dialogue between tacit and explicit knowledge exchanges,7 and embrace a collective and collaborative problem-solving approach. The free flow of information and knowledge amongst all its members regardless of their role within the organisation is valued as the sine-qua-non for success, and constantly reinforced and upheld by its leadership (for more detail see Heifetz8,9) (Box 1).


Box 1. Perspectives on Organisational Learning and Learning Organisations

Definitions of Organisational Learning/Learning Organisation

Organizational learning is a process of detecting and correcting error.10

Organizational learning means the process of improving actions through better knowledge and understanding.11

Organizational learning occurs through shared insights, knowledge, and mental models…[and] builds on past knowledge and experience—that is, on memory.12

Learning organizations [are] organizations where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning to see the whole together.13

Learning organizations are characterized by total employee involvement in a process of collaboratively conducted, collectively accountable change directed towards shared values or principles.14

The Learning Company is a vision of what might be possible. It is not brought about simply by training individuals; it can only happen as a result of learning at the whole organization level. A Learning Company is an organization that facilitates the learning of all its members and continuously transforms itself.15

Knowledge Transfer – “Work” or “Absorption/Integration

This ‘sustaining work’ is an interplay of three processes: ( i ) translating, (ii) contexting, and (iii) institutionalising. Translating refers to activities aimed at constructing and extending networks. Contexting emphasises the activities needed to create contexts that support KT practices. Institutionalising addresses how actors create, maintain, and disrupt institutions with the aim of sustaining KT practices.”1 Borst, Wehrens and Bal’s observation of knowledge transfer as ‘work’ describes why most organisations are ‘non-learning organisations.’5 They are dysfunctional organisations whose key flaw is the failure to define its purpose. It should be unsurprising that it becomes necessary to ‘enforce’ processes for knowledge transfer in the hope that these will achieve the desired outcomes – they may, but more like they do not, and not in a sustainable way.

The purpose-focused and purpose-driven approach of complex adaptive organisations fosters constant translation of observations and insights – learning (or the creation of understanding) is emergent and occurs by absorption and integration within the well-known context of the organisation. Knowledge transfer, new knowledge creation, and KT16 all enhance understanding4 and are a defining characteristic of the culture of these organisations.7,17

The Way Forward – Embrace Complex Adaptive Systems Approaches

Rather than needing more studies we need more pragmatism. Logically understanding the difficulties of achieving and sustaining knowledge transfer is unlikely to achieve our desired goal. We already know that the systemic – and by implication – cultural characteristics of an organisation determine failure and success.17 We need leadership that can facilitate the necessary organisational change required to create an environment for continuous dialogues to achieve tacit and explicit knowledge exchanges that ultimately result in new knowledge creation (Figure).7,8,17 The Cynefin framework offers a useful frame to achieve greater understandings4 and to meaningfully transfer of these understandings across organisations.18


Figure. Differences in Knowledge Management.


Ethical issues

Not applicable.

Competing interests

Author declares that he has no competing interests.

Author’s contribution

JPS is the single author of the paper.


  1. Borst RAJ, Wehrens R, Bal R. Sustaining knowledge translation practices: a critical interpretive synthesis. Int J Health Policy Manag 2022; 11(12):2793-804. doi: 10.34172/ijhpm.2022.6424 [Crossref] [ Google Scholar]
  2. Conway E, Batalden P. Like Magic? (“Every System is Perfectly Designed…”). Institute for Healthcare Improvement; 2015.
  3. Ackoff RL, Gharajedaghi J. Reflections on systems and their models. Syst Res 1996; 13(1):13-23. doi: 10.1002/(sici)1099-1735(199603)13:1<13::aidsres66>;2-o [Crossref] [ Google Scholar]
  4. Allio RJ. Russell L Ackoff, iconoclastic management authority, advocates a “systemic” approach to innovation. Strategy Leadersh 2003; 31(3):19-26. doi: 10.1108/10878570310472728 [Crossref] [ Google Scholar]
  5. Gino F, Staats B. Why organizations don’t learn?. Harv Bus Rev 2015; 93(11):110-118. [ Google Scholar]
  6. Sturmberg JP. Health System Redesign. How to Make Health Care Person-Centered, Equitable, and Sustainable. Cham, Switzerland: Springer; 2018.
  7. Nonaka I. A dynamic theory of organizational knowledge creation. Organ Sci 1994; 5(1):14-37. doi: 10.1287/orsc.5.1.14 [Crossref] [ Google Scholar]
  8. Heifetz RA. Leadership Without Easy Answers. Cambridge, MA: Harvard University Press; 1994.
  9. Heifetz R, Grashow A, Linsky M. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Boston, MA: Harvard Business Press 2009.
  10. Argyris C. Double loop learning in organizations. Harv Bus Rev 1977; 55(5):115-25. [ Google Scholar]
  11. Fiol CM, Lyles MA. Organizational learning. Acad Manage Rev 1985; 10(4):803-813. doi: 10.5465/amr.1985.4279103 [Crossref] [ Google Scholar]
  12. Stata R. Organizational learning-the key to management innovation. MIT Sloan Manag Rev 1989; 30(3):63. [ Google Scholar]
  13. Senge PM. The Fifth Discipline: The Art & Practice of The Learning Organization. New York: Doubleday/Currency; 1990.
  14. Watkms KE, Marsick VJ. Sculpting the Learning Organization: Lessons in the Art and Science of Systemic Change. San Fransisco: Jossey-Bass; 1993.
  15. Pedler M, Burgoyne JG, Boydell T. The Learning Company: A Strategy for Sustainable Development. London: McGraw-Hill; 1996.
  16. Sturmberg JP. Knowledge translation in healthcare - towards understanding its true complexities comment on “using complexity and network concepts to inform healthcare knowledge translation”. Int J Health Policy Manag 2018; 7(5):455-458. doi: 10.15171/ijhpm.2017.111 [Crossref] [ Google Scholar]
  17. Zheng W, Yang B, McLean GN. Linking organizational culture, structure, strategy, and organizational effectiveness: Mediating role of knowledge management. J Bus Res 2010; 63(7):763-771. doi: 10.1016/j.jbusres.2009.06.005 [Crossref] [ Google Scholar]
  18. Kurtz CF, Snowden DJ. The new dynamics of strategy: sense-making in a complex and complicated world. IBM Syst J 2003; 42(3):462-83. doi: 10.1147/sj.423.0462 [Crossref] [ Google Scholar]
  • Receive Date: 20 July 2022
  • Revise Date: 01 September 2022
  • Accept Date: 07 September 2022
  • First Publish Date: 11 September 2022