Knowledge, Power, and Technology: A Narrative Review of Knowledge-Sharing in Project ECHO (Extension for Community Health Care Outcomes).

Abstract

Introduction: This narrative review joins an ongoing scholarly conversation about Project ECHO, a virtual educational innovation, with an aim to understand it as a technology-enabled interface that facilitates knowledge-sharing. Critical attention is paid to how dynamics of power are accounted for in the deployment of Project ECHO, and sociomaterial attention is paid to how communication technology is described. The review is relevant to those who wish to establish, understand, or further develop virtual multiprovider knowledge-sharing interfaces.

Methods: Data collection followed processes set out by a narrative review methodology, a review methodology that provides a comprehensive and balanced critical analysis of the published literature. Analysis was informed by thematic analysis. Forty-five articles and one book chapter published between 2015 and 2024 were selected for inclusion. This review was contained to studies of Project ECHO in Canada.

Results: Our data set captures an implied awareness of dynamics of power and a desire to counter such dynamics. This is visible in the desire to mitigate a hierarchical differentiation between participants by using teaching and learning theories, a pedagogical design and processes of interaction that favour participation, and by using technology that allows participants to join from across vast geography.

Discussion: Emerging scholarly attention to how knowledge is shared and developed in Project ECHO will help develop an understanding of how technology-enabled educational innovations facilitate knowledge sharing in spaces that are imbued with complex power dynamics. Future explicit inclusion of a critical gaze and sociomaterial lens will deepen understandings of technology-enabled educational innovations.