Since the 1990s, researchers and practitioners in health, healthcare and public health have made significant efforts to enhance practices and decision-making through the application of evidence. These efforts have been anchored in the emergence and evolution of evidence-based medicine (Wilson & Sheldon 2019). The process of moving evidence into action has been labelled with various terms: knowledge translation, knowledge mobilisation, knowledge exchange, knowledge transfer, knowledge application, to name a few. In 2006, Graham et al. (2006) described the knowledge-to-action framework to guide experts in the field and bridge misunderstandings arising from the use of several terms referring to parts of its cyclical process. Shaxson et al. (2012) reiterated the need for coherence in 2010 and introduced the letter K* to refer to the continuum of activities from the dissemination of knowledge to its integration for innovation. The process of knowledge translation has been conceptualised in three main ways, each corresponding to a different generation of thinking. In the linear model, knowledge is seen as something to be disseminated from researchers to users. The interactive model emphasises the exchange and co-production of knowledge between researchers and users. Finally, the systemic model views knowledge translation as a complex, dynamic and context-sensitive process embedded within broader systems (Boaz & Nutley 2019). However, these models are grounded in research mainly conducted in high-income countries and lack validation in other contexts, such as African health systems (Edwards, Zweigenthal & Olivier 2019).

This variety of terms and models reflects the complexity of promoting the use of evidence to inform practices or decision-making. Individuals and organisations supporting this knowledge translation (KT) process may engage in various tasks, broadly categorised as knowledge management (e.g. creating tailored KT products), linkage and exchange (connecting stakeholders) or capacity-building (supporting knowledge users) (Bornbaum et al. 2015). Knowledge translation strategies cannot be one-size-fits-all, as their success or failure is highly dependent on context (Ziam et al. 2024). In other words, acquiring the extensive set of skills necessary to bridge the gap between research and practices requires dedicated training, with high-quality mentorship being particularly important (Brownson et al. 2021). Targeting teams of students, researchers, practitioners and policymakers may also enhance the impact and sustainability of training programmes (Juckett et al. 2022). Unfortunately, quality evidence on what constitutes effective knowledge translation training is limited (Golhasany & Harvey 2023; Shewchuk, Wallace & Seibold 2023), even though building capacity in knowledge translation is a crucial global challenge (Global Commission on Evidence to Address Societal Challenges 2024).

Evaluation of knowledge translation training initiatives in low- and middle-income countries (LMICs) is particularly scarce (Murunga et al. 2020), with research focusing mainly on those deployed in high-income countries (Golhasany & Harvey 2023). Specific needs for knowledge translation training in LMIC settings include increased accessibility to courses and mentorship, covering a broad range of competencies and adapting content to diverse stakeholders (Turner et al. 2021). Indeed, although the number of such courses is on the rise, few knowledge translation courses are accessible to learners in LMICs (Brownson et al. 2024; Davis & D’Lima 2020; Viglione et al. 2023). One reason for the scarcity of training programmes may be that they require mobilising substantial resources – financial, material and human – to free people up from their usual tasks and to bring together those providing and those receiving the training in the same place for a given number of days. Interestingly, a recent scoping review identified that evaluation of knowledge translation training did not consider costs of training (Shewchuk et al. 2023). Online courses may facilitate access to training, as they represent an economy of scale, making it possible, in theory, to reach a wider audience without barriers or limitations to access. In practice, however, two major limitations persist: firstly, the vast majority of massive open online course (MOOCs) are taken by learners from high-income countries (Reich & Ruipérez-Valiente 2019), and secondly, drop-out rates remain very high (Meinert et al. 2018). Drop-out rates have typically been calculated using data from mainstream MOOC providers, mostly comparing enrolment numbers with course certifications or completion of course requirements. Researchers are increasingly advocating for a more holistic understanding of MOOC drop-out (Celik & Cagiltay 2024). In the context of learners from LMICs, a research gap lies in the lack of cohort-specific studies that provide insights into the factors that facilitate or hinder course completion (Nieder et al. 2022).

What are the optimal ways to organise knowledge translation training through MOOCs for public health professionals in LMICs? Experiments with different MOOC deployment formats are now commonplace, featuring the alternation of different learning modes (completely remote, blended or entirely face to face) (Yousef & Sumner 2021). The evaluation of an MOOC on implementation science, offered remotely to public health professionals and scientists, concluded that the initiative was useful for improving knowledge and practice (Launois et al. 2021). Our recent work has shown the added value of blended training using MOOCs, in which part of the coursework is performed at a distance and part face to face, when considering the content and context of knowledge translation training (Dagenais et al. 2024). Indeed, several studies have underscored the importance of retaining a certain degree of flexibility to offer context-sensitive teaching with MOOC that meets needs and encourages interaction (Nieder et al. 2022; Nwameme et al. 2023). Trainers should consider ways to mitigate student isolation by creating opportunities for discussions with peers or instructors (Longhini, Rossettini & Palese 2021) and providing opportunities for team-learning, hands-on learning and mentoring (Oronje et al. 2022; Osanjo et al. 2016). Finally, the lack of organisational support for applying the knowledge and skills acquired through MOOCs is a constraint to be considered (Ross et al. 2022).

This article presents the results of an evaluation of knowledge translation training based on two MOOCs developed by the RENARD Knowledge Translation Research Team (Quebec) in collaboration with the French National Research Institute for Sustainable Development (IRD). This series of free courses is accessible worldwide to an unlimited number of people and leads to certification. The first MOOC of the series presents an introduction to knowledge translation in eight modules, for an estimated 20 h of learning. It provides an overview of key concepts and principles in this field, as well as guidelines for developing, planning, implementing and evaluating a knowledge translation strategy. It details various products and activities for translating research results, including the policy brief. The policy brief is the subject of the second course, comprising five modules, for around 15 h of learning. This course offers a step-by-step approach, with practical exercises, to guide learners in writing a concise and convincing document summarising research results. The online courses include educational videos, testimonials, quizzes, practical exercises, summary sheets, complementary bibliographic resources and end-of-module exams.

This training was offered in French remotely to stakeholders in the Technologies Participation Citoyenne en santé (TOPICs) project. The aim of this project was to gather the opinions of users of healthcare systems in Burkina Faso, Benin and the Democratic Republic of Congo by setting up a toll-free telephone number (Ouedraogo et al. 2023). The initiative was led by a group of partners consisting of representatives from the scientific community, government agencies, non-governmental organization (NGOs) and technical service providers in the three countries (Biau et al. 2021).

Knowledge translation training was deemed important for the project, as stakeholders planned to mobilise the various players involved and circulate evidence from the citizen consultation process. In this article, we do not discuss the TOPICs project in itself but rather focus on the knowledge translation training offered to stakeholders in the Democratic Republic of Congo (DRC), with the general objective of acquiring the principles and skills needed to translate the TOPICs project results to targeted audiences, such as representatives of the Ministry of Health.

In other words, the context of this evaluation involved addressing the training needs in knowledge translation for the stakeholders of the TOPICs project. The teaching strategy included two MOOCs taken autonomously with biweekly coaching sessions and feedback via email. The development of the evaluation plan benefited from close collaboration between the research team and stakeholders of the TOPICs project. To guide future training efforts, this evaluation aimed to analyse the learning experience from the perspective of TOPICs project members from the DRC, based on their assessment of the chosen learning format, including the added value of coaching, the implementation facilitators and barriers and the effects on their practice.

The knowledge translation training consisted of taking two online courses individually and autonomously, with coaching every 2 weeks from a trainer (CD). These coaching sessions lasted between 60 min and 90 min. The courses and accompanying activities were produced in French. As the courses were completed, coaching could also include feedback by email on knowledge translation tools produced by the learners (including policy briefs). A WhatsApp group was created by the trainees to facilitate discussions during this training period. Because of technical connection problems, several meetings were postponed, and training was spread out from 17 May 2020 to 20 November 2020.

The results are first organised according to the first three levels of Kirkpatrick’s model, from the learners’ reactions to potential changes in behaviour. They are then presented in terms of the individual, technological and pedagogical factors that may represent barriers to implementation according to the TIPEC framework. A summary of results is presented in Figure 1.

This evaluation analysed the learning experience from the point of view of professionals. The learners’ assessment was generally positive. Trainees also described their experience as motivating in many ways. The majority reported a variety of learning outcomes that had been integrated into their day-to-day practice, regardless of whether this practical application was related to the field of knowledge translation.

Firstly, a major factor of success was that training was adapted to the context. From the outset, it was integrated into an action-oriented research project, with professional added value for the trainees. Thus, the relevance of the subject – knowledge translation – was obvious to these partners. The practical exercises featured in the MOOCs and the coaching provided helped to further tailor content to their needs, which is a recognised factor for success (Nwameme et al. 2023). Indeed, most found that the skills acquired could be put immediately to use. The practical application of the learning and the relevance of the course from a professional standpoint, thus emerged as motivating factors for completing the course. This is in line with the conclusion reached by other learners who had taken the course independently and whose greatest motivating factor appeared to be the prospect of professional utility (Villemin, Dagenais & Ridde 2024).

Secondly, the training was also able to build on existing collaborative networks and take on a social aspect, with videoconferencing sessions and WhatsApp interactions. In other words, trainees had the opportunity to interact with their peers as well as with an instructor, both of which are considered beneficial features for MOOCs (Longhini et al. 2021; Nieder et al. 2022).

Thirdly, the selected approach, distance learning with coaching, had clear advantages given the context of learners spread over a vast territory, located up to 5 h apart by car. The formula avoided problems of security and arduous travel and is thus an interesting choice for similar contexts. Trainees benefited from their involvement in the TOPICs project, which even took the form of additional resources (mobile data) and the ability to attend courses during their working hours. Training was accessible and flexible, as is recommended for similar settings (Turner et al. 2021).

However, technological factors did impede the training process, and the interviewees emphasised the determination they had applied to complete the course. These barriers remained because of unequal access to electricity and mobile data, especially during the rainy season, and solutions should be anticipated for similar training courses. Technological, Internet access and bandwidth limitations are recognised as factors in MOOC abandonment (Goopio & Cheung 2021; Nieder et al. 2022).

As for the influence of coaching, while it encouraged the application of learning, its added value in terms of completing the training was not clearly established. Coaching made it possible to produce knowledge translation tools right to the end (in this case, policy briefs and a knowledge translation plan) and certainly contributed to the perceived utility of this training, without necessarily being deemed indispensable for all. The pedagogical design of the MOOCs, their clarity, easy-to-follow structure and activities, such as relevant examples, appeared to have encouraged self-directed learning. The fact that the training content was relevant to their professional context may also have contributed to better self-regulated learning strategies (Kizilcec, Pérez-Sanagustín & Maldonado 2017).

As discussed elsewhere, whether coaching is provided in a blended format (Dagenais et al. 2024) or only online, as in the experience described here, only a minority of trainees consider coaching to be essential for completing these MOOCs. Nevertheless, according to the trainees, coaching provides opportunities for interaction, reinforces the collaborative dynamic and also, as in this case, introduces deadlines for meeting and completing the various training activities planned. All these factors contribute to creating a learning community, which is described as promoting the effectiveness of MOOCs for professionals (Longhini et al. 2021).

In conclusion, the people whose interviews are presented here seem to correspond to a wholly engaged learner profile, from the behavioural, social and cognitive standpoints (Deng, Benckendorff & Gannaway 2020). This engagement is influenced by both internal and external factors, which include, on one hand, the satisfaction that the trainees appeared to have derived from their learning, and on the other hand, a context in which they benefited from relevant activities such as policy briefs, feedback and certification (Wang et al. 2022). However, the sustainability of these new practices remains to be verified. Institutional support is an important facilitating factor for any knowledge translation capacity-building initiative (Golhasany & Harvey 2023) and may include organisational incentives or the development of KT structures (Murunga et al. 2020). Integrating KT training into existing programmes or projects may also both facilitate implementation and ensure sustainability (Oronje, Murunga & Zulu 2019; Oronje et al. 2022).

Recently, our work has evaluated other KT learning experiences using these MOOCs, but in different modalities, either with totally autonomous learning (Villemin et al. 2024) or in a blended format with in-person learning sessions (Dagenais et al. 2024). This article is original in that it analyses another form of distance support, one adapted to the context. Thus, coaching and opportunities to put learning into practice emerged as two themes of interest to better understand learners’ motivation and perseverance in completing these knowledge translation MOOCs. With regard to future research, comparing different coaching formats would help shed light on the optimal modes of learner support, as well as their specific benefits in different contexts. The benefits of the training at the individual level appear proven, but it was not possible from the assessment carried out here to measure the sustainability of the new practices or their integration into organisational routines. This is an avenue to be explored. Future research should also focus on the impacts of practice changes on services provided by the learners and on evidence-based decision-making. Finally, given the benefits of distance learning, we should continue to propose and evaluate solutions to overcome disparities in technological access.

Despite significant technological hurdles, participants in the knowledge translation training offered as part of the TOPICs project in the DRC described a satisfactory and collaborative learning experience and affirmed the relevance of the subject matter and the learning to their work context. The coaching they received was appreciated and contributed to both the social dimension of the training and the immediate application of what they had learned, although most of them did not consider it essential for completing the course. The majority of the trainees interviewed had put the knowledge translation principles and their learning into practice by the time of the evaluation. Massive open online courses-based knowledge translation training met the needs of these professionals and was deemed effective from an individual standpoint. Our study confirms the importance of tailoring the training to learners’ professional contexts, which helped foster engagement.

This qualitative research analysed the experience of professionals and helped identify facilitating factors for implementing MOOC-based training in their context. From this evaluation, several lessons can be drawn that could help to gain full advantage from the potential of MOOC-based training. These include maximising the collaborative networks already in place and providing adequate support to trainees, whether from a pedagogical, organisational or technological standpoint.