NUR 550 Topic 1 DQ 1 Identify the different levels of translational research

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research

Topic 1 DQ 1

The advancement in healthcare highly relies on translation research as it entails changing basic research into an outcome. These outcomes have a direct benefit on human health. The insights gained from the basic research always need an effective translation process to align with the health needs of humans (Banner et al., 2019). Levels of translational research include, T0, T1, T2, T3 and T4 (Choi et al., 2018). This is different from evidence-based practice. EBP is already approved and available evidence for making decisions and providing effective and efficient care for patients based on a scientific basis.

Translation research forms the basis for developing evidence-based practice. It implements interventions and contextual variables that affect the understanding of the community about health and practice. The evidence is gained from the practice as it allows the healthcare system to apply current evidence on clinical expertise and patient values that aid in directing healthcare decisions (Banner et al., 2019). Translation research goes through different stages to advance into evidence-based practice. Evidence-based practices have formed the main pillar in advancing equitable healthcare and preventive services for the longest time in healthcare.

Translation research and evidence-based practice are significant in healthcare as they focus on developing a positive outcome in healthcare management. They develop a new approach to healthcare issues that allows healthcare professionals to advance their roles in meeting the desired patient outcome (Li et al., 2018). Effective ways of managing population health is an objectives that each healthcare professional would want to meet. Focusing attention on translation research would imply that the research system in healthcare would sharpen its tools for improving healthcare.

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NUR 550 Topic 1 DQ 1 Identify the different levels of translational research References

Banner, D., Bains, M., Carroll, S., Kandola, D. K., Rolfe, D. E., Wong, C., & Graham, I. D. (2019). Patient and public engagement in integrated knowledge translation research: are we there yet? Research Involvement and Engagement, 5(1), 1-14.

Choi, P. J., Tubbs, R. S., & Oskouian, R. J. (2018). The current trend of the translational research paradigm. Cureus10(3). Doi: 10.7759/cureus.2340

Li, Y., Zhao, L., Yu, D., & Ding, G. (2018). The prevalence and risk factors of dyslipidemia in different diabetic progression stages among middle-aged and elderly populations in China. PLoS One13(10), e0205709.

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Around the year 1993, clinical research in the form of translational research first appeared. 2010 (Rubio and colleagues) As a result, in terms of research, this method of investigation is relatively new. Translational research has no precise definition, but it essentially refers to two areas of translation: the adoption of community best practices and their cost-effectiveness, as well as the information gathered in pre-clinical studies and lab research (Rubio et al, 2010). T1 is the first tier of translational research, which includes lab research, observational research, and phase I and II clinical trials. The initial study or development of an intervention is referred to as T1 (Translational Research, n.d.).

T2, or “translation to patients,” entails evaluating the efficacy of these interventions in a patient population, including through phase III clinical trials, investigating how these new interventions interact with disease processes, and developing new recommendations based on the most recent data (Translational Research, n.d.). T3, the third phase, entails integrating all research findings into daily practice as well as translating research findings into evidence-based procedures for the entire profession (Translational Research, n.d.).

According to this data, there is no distinction between translational research and evidence-based practice; rather, it serves as a means of achieving the latter. The next stage is to use all of this knowledge into evidence-based practice by following the “three T’s”. As the natural progression of translational practice ends with practice, this means the most recent treatment and knowledge for the field of public health. However, the public will suffer if no study is done in the area because there won’t be any current EPB regarding the disease process and/or its co-morbidities.

Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.

Re: Topic 1 DQ 1

Translational research is form of clinical research that was first seen around 1993 (Rubio et al, 2010). So as far as research goes this is a fairly new was to look into things. There is also no clear definition of translational research, but essentially it encompasses two areas of translation one being the information obtained in pre-clinical studies, lab research and the other being the adaptation of best practices in the community with their cost effectiveness (Rubio et al, 2010). There are three levels of translational research, starting with T1, which involves the beginning research or development of an intervention, including the lab research, observational research and phase I and II clinical trials (Translational Research, n.d.).

The second level is T2 the translation to patients, testing these interventions and their efficacy on the patient populace, including phase III clinical trials, studying how these new interventions work with disease processes and creating new guidelines with up-to-date information (Translational Research, n.d.). The third level is T3 disseminating and implementation of all the research into daily practice, creating the research evidence found into evidence-based practices across the profession (Translational Research, n.d.).

From this information there isn’t a difference between evidence-based practice and translational research, it is just a way to get to evidence based practice. By following the ‘three T’s’, the final step is to put all of this research into practice, as evidence-based practice. For public health this means the most up to date care and information as the natural progression of translational practice ends with practice. If there is no research being done in the area however, this has a negative impact on the population, as there is not up to date EPB related to that disease process and/or its co morbidities.

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Rubio, D. M., Schoenbaum, E. E., Lee, L. S., Schteingart, D. E., Marantz, P. R., Anderson, K. E., Platt, L. D., Baez, A., & Esposito, K. (2010). Defining translational research: implications for training. Academic medicine : journal of the Association of American Medical Colleges85(3), 470–475.

Translational Research – Defining the “T’s” | Translational Cancer Research Network. (n.d.). Www.Tcrn.Unsw.Edu. Retrieved June 18, 2021, from


This is extremely intriguing. Sarah, translational research is a type of clinical research that first appeared in 1993. So, in terms of research, this is a new way of looking at things. Translational research is a type of study that aims to produce more relevant, meaningful, and valid results that can have an immediate impact on human health. The primary goal of translational research is to more quickly and efficiently translate important scientific discoveries into practices (Eske, 2020).

Translational research has been used by various researchers to improve research processes with the goal of achieving quality treatment processes and effective patient outcomes. The three major levels of translational research are T1, T2, and T3. To ensure accuracy and effective research outcomes, these levels must be incorporated into the research processes (Woolf, 2018). Level I or T1 interventions are frequently developed to ensure that the entire research process runs smoothly and in accordance with the objectives.

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research References

Woolf, S. H. (2018). The meaning of translational research and why it matters. Jama299(2), 211-213.

Eske, J. (2020, August 31). In vivo vs. in vitro: What is the difference? Medical News Today. Retrieved June 17, 2021, from

Re: Topic 1 DQ 1

Translational research is a relatively new concept in my opinion of the world; as nurses, we hear the terms evidence-based practice (EBP) and research. Translational research is frequently associated with EPB. Translational research is the study and translation of EBP interventions into practice (Melnyk & Fineout-Overholt, 2019). Translational research, as stated, translates how EBP “translates” into practice. Evidence-based practice is a guide to practice, and translation science is the translation to implement the evidence-based research into practice. Tilter (2018) Translation research includes preclinical studies, phase one small clinical trials, phase 2&3 larger clinical trials, clinical trial outcomes, and phase 5 population outcomes research. These phases provide a “bench to bedside” continuum (Tilter, 2018).

Gaps between the availability of evidence and its application in practice have been shown to contribute to poor outcomes by preventing caregivers from applying the evidence. (Tilter, 2018)Transitional research has been shown to improve in-patient outcomes and health care management by translating evidence into practice, which improves patient outcomes through the use of evidence. In my field of labor and delivery, I’ve witnessed a similar process in the abundance of research and evidence of the increased risk of hypertension in pregnancy. Nonetheless, the physicians I work with implement in a variety of ways due to a lack of translation, resulting in early inductions and increased risk to the infants. When implementing a new technology, evidence, or practice, it is critical to understand the research and evidence behind it, as well as how to do so safely. (Sung et al., 2020) Translation research is exciting and offers numerous opportunities to improve patient outcomes. As an upcoming APRN in a magnet hospital, utilizing this process with EBP will significantly improve patient care as well as nursing practice.

ALSO READ: NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

This is insightful Deanna, translational research is a new concept in my view of the world, it is a fairly new concept, as nurses we hear the term evidence-based practice (EBP) and research Translational research has been applied by most researchers to influence study processes and to ensure quality outcomes in different studies (Tilter, 2018). Translational research mainly involves the production of more meaningful, and applicable results in the research process that directly benefit human health. Most researchers prefers translational research because in can be applied to enhance methodologies and general research outcomes.

The application of different levels of research processes T1, T2, and T3 depend on the methodologies that have been applied as well as the research objectives (Woolf, 2018). Translation research has different components to implementation of preclinical studies, phase one small clinical trials, phase 2&3 larger clinical trials, outcomes from the clinical trials, them phase 5 population outcomes research- these phases offer a “bench to bedside” continuum.

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research References

Tilter, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing23(2). Retrieved June 16, 2021, from

Woolf, S. H. (2018). The meaning of translational research and why it matters. Jama299(2), 211-213.

Re: Topic 1 DQ 1

As nurses, we all have heard about evidence-based practice and Florence Nightingale. Although back then, the term evidence-based practice was not a common phrase, that is exactly what Florence Nightingale was doing back then. She would examine and experiment with the sanitary conditions of the facilities and look at how it affected the patient’s outcomes (Mackey & Bassendowski, 2017). Translational research is more of a newer terminology. Although it can be confused with evidence-based practice, there is a key distinction. Evidence-based practice is the act of applying the evidence into everyday practice, whereas translational research is more the act of conducting the studies to find the best evidence (Titler, 2018).

There are strict guidelines when conducting translational research or what many of us know as clinical trials. There is phase process where in order to progress to the next phase of clinical trials, they must meet certain criteria. New drugs must undergo in vitro preclinical trials where they are testing it in a laboratory setting instead of human trials. Then they can proceed to in vivo studies where they are studying it in animals and small sample size of human trials (Eske, 2020). Once it has proven to be safe, then they can progress to a phase two or three trial increasing the sample size and comparing it to common treatments or sometimes placebos. Once it has shown safety and efficacy in a phase two or three trial, it can then go for Food and Drug Administration (FDA) approval. There are also phase four and five trials that help with translating the evidence into practice and community settings (Titler, 2018).

In my specialty area of oncology, we are constantly hearing about clinical trials and new therapies coming to market. It is critical to have a good understanding of what each phase of the trial consists of and what the outcomes really mean to the patient.

NUR 550 Topic 1 DQ 1 Identify the different levels of translational research References

Eske, J. (2020, August 31). In vivo vs. in vitro: What is the difference? Medical News Today. Retrieved June 17, 2021, from

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing33(1), 51–55.

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing23(2).


This is insightful Kelli, translational research is a new concept in my view of the world, it is a fairly new concept, as nurses we hear the term evidence-based practice (EBP) and research. Translational research is critical in the research processes as they involve translation of what have been found in other studies (Eske, 2020). Most researcher prefer to apply translational research processes to influence different study outcomes. The application of different levels of research processes T1, T2, and T3 depend on the methodologies that have been applied as well as the research objectives. Translational research is a new concept in my view of the world, it is a fairly new concept, as nurses we hear the term evidence-based practice (EBP) and research (Woolf, 2018). There are three major components of translation research including T1, T2, and T3. These translational research are important in ensuring that every study outcomes are done in line with the research objectives.

I agree with you that translational research focuses on applying scientific discoveries to improve health. Translational research provides more meaningful results that impact human health.  The research involves discovering new ideas that can improve healthcare. However, for the research to make more sense, it is divided into three levels: bench-to-bedside, bedside-to-population, and population-to-bench (Jones et al., 2022). These three levels are important. For example, the population-to-bench level uses findings from study populations to suggest new hypotheses. Hypothesis is necessary in any research. Therefore, the third level enables formulation of hypothesis. The implementation of evidence-based practice in healthcare settings have mandated research. Research allows healthcare professionals to obtain accurate information (Ryder & Jacob, 2022). At the same time, research generates additional health information. Healthcare providers with effective evidence-based practice have reported improved positive patient outcomes. Evidence-based practice focuses on helping practitioners make patient care decisions.


Jones, S. L., Hall, T., Procter, R., Connolly, C., & Fazlagić, J. (2022). Conceptualising translational research in schools: A systematic literature review. International Journal of Educational Research114, 101998.

Ryder, M., & Jacob, E. (2022). A translational research framework for nurse practitioners. Journal of Nursing Management30(2), 421-427.

Healthcare providers and organizations leverage translational research to improve patient care in their settings by applying research discoveries made from laboratories in practical situations. As such translational research entails implementation of evidence into practice and offers healthcare providers the chance to leverage local evidence-based practice for optimal care provision in communities and among patient populations.

The movement of clinical and translational research allows practitioners to move scientific finding along a virtual path from the laboratory to practical situations leading to better human health. The core levels of translational research are four that include translational research type (TI) to translational research type four (T4). The T1 research focuses on testing findings from basic research for their applicability (De Maria. et al., 2021). Through T1 research, nurses and other healthcare providers get knowledge concerning human physiology and the possible interventions in different situations. At this level, the approaches include human physiology, proof of concept and human physiology. 

Translational research type two (T2) focuses on new interventions in controlled environments to establish a basis for clinical use and evidence-based guidelines. T2 also tests new interventions as the basis for application and evidence-based guidelines (Laxton et al.). The third level of translation research explores innovative way of using recommendations or guidelines. Imperatively, T3 research yields knowledge concerning the working of interventions recommended. At the core of T3 research is yielding knowledge that allow provider to offer care in real-world situations. The fourth level of translation research entails researching certain factors and interventions that influence health of populations. The results of T4 research include improved global health. 

Evidence-based practice and translation science are different. EBP entails the use of evidence in practice. However, translation research entails studying the implementation of interventions. The use of EBP in population health management entails leveraging best practices using the process and making necessary decisions in interventions (Titler, 2018). EBP is applicable to population health management as it allows the use of the most effective approaches to care provision; especially approaches that respect all stakeholders.


De Maria Marchiano, R., Di Sante, G., Piro, G., Carbone, C., Tortora, G., Boldrini, L., … & 

Scambia, G. (2021). Translational research in the era of precision medicine: Where we are and where we will go. Journal of Personalized Medicine, 11(3), 216. DOI: 10.3390/jpm11030216 

Laxton, D., Cooper, L., & Younie, S. (2021). Translational research in action: The use of 

technology to disseminate information to parents during the COVID‐19 pandemic. British Journal of Educational Technology, 52(4), 1538-1553. 

Titler, M. G. (2018). Translation research in practice: an introduction. Online Journal of Issues 

           in Nursing, 23(2). DOI: 10.3912/OJIN.Vol23No02Man01 

Translation research examines the movement of scientific work into nursing and healthcare practice. The use of translational research in nursing and healthcare aims at improving care outcomes. Translational research exists in phases. The first phase is the development process of translational research or T1 research. In this stage, the focus of the research is on the discovery of new practices in the laboratory. It may also entail discoveries made through pilot studies and field words. The focus is the determination of the potential benefits and risks that may be associated with discovery and its benefits to healthcare (CDC, 2020).  

           The second stage in translational research is testing translational research or T2 research. This entails determining the value of the new discoveries to healthcare and nursing practice. The testing provides a true picture of the need and potential of intervention in healthcare. The investigations occur in controlled environments to inform evidence-based guidelines and clinical applications. The third phase of translational research is institutionalizing the invention or T3 research. The aim of this phase is to determine the acceptability of translational research in the workplace. It also determines the safety of the intervention and its ability to promote the desired behaviors in an organization (CDC, 2020). The approaches utilized in this level of translational research include phase IV clinical studies, health services research, and clinical outcomes research. 

The last phase of translational research is an evaluation or T4 translational research. The evaluation examines the real-world benefits of the discovery and its associated risks. It provides insights into the effectiveness of an intervention on large scale. Interventions such as surveillance are utilized in this phase (CDC, 2020). The approaches utilized in T4 translational research include social determinants of health and population-level outcome studies. Translation research differs from evidence-based practice. evidence-based practice entails the selection and use of the best research evidence in practice. translational research focuses on the study of implementing interventions, contextual variables, and factors that affect knowledge acquisition in practice (Rubio et al., 2019).  


CDC. (2020, February 24). Translation Research | NIOSH | CDC. 

Rubio, I., Osuchowski, M. F., Shankar-Hari, M., Skirecki, T., Winkler, M. S., Lachmann, G., La Rosée, P., Monneret, G., Venet, F., Bauer, M., Brunkhorst, F. M., Kox, M., Cavaillon, J.-M., Uhle, F., Weigand, M. A., Flohé, S. B., Wiersinga, W. J., Martin-Fernandez, M., Almansa, R., … Bermejo-Martín, J. F. (2019). Current gaps in sepsis immunology: New opportunities for translational research. The Lancet Infectious Diseases, 19(12), e422–e436.

It was not until the other day after reading about evidence-based practice and translational research how much as a nurse I was unaware. I understand there is always ongoing research to determine best evidence for different interventions, but it was not until this class I was able to identify how conclusions are drawn and rolled out to the public for improvement of health.  

 For instance, I currently work in a wound center and often times we are trialing different modalities to heal wounds to determine which we would like to adopt into practice. For instance, one topic I find interesting to learn more about is if debridement in diabetics is the best option to improve healing and patient quality of life. In a white paper done by Ennis and Sheridan (2021) mechanical, biological, adjunctive modalities, and sharp debridement’s were compared to see which would have the most benefit and if increased frequency improves healing.

Each debridement has already been rolled out to the public based on the research and intervention done, the T4 phase of translational research. After Ennis and Sheridan (2021) did a comparative review, it was determined sharp debridement can improve healing in complex wounds when they are being applied on a regular basis. When Ennis and Sheridan (2021) compared frequent visits and debridement with less frequent visits showed patients who were seen more frequent had higher healing rates. Therefore, they followed the four phases of the translational research to determine the appropriate intervention for faster healing which leads to better patient quality outcomes.  


After looking more into research articles, it is easier to understand translational research, because as a nurse I forgot about the beginning process of the research and how interventions/conclusion are made and brought into healthcare.  


 Ennis, W. & Sheridan, M. (2021). The use of Modalities in Wound Care Part 1: Debridement. Healogics. 

 Nice discussion on the approaches utilized in T4 translational research including social determinants of health and population-level outcome studies. Translation research differs from evidence-based practice. evidence-based practice entails the selection and use of the best research evidence in practice. translational research focuses on the study of implementing interventions, contextual variables, and factors that affect knowledge acquisition in practice. 

In addition, translation science is a relatively young area of investigation that is rapidly growing. Although several healthcare practices have an evidence base to guide care delivery, their use is not part of routine practice (Titler, M.G May 31, 2018) The gap between the availability of evidence-based practice (EBP) recommendations and application to improve patient care and population health is linked to poor health outcomes (Titler, M.G May 31, 2018) Translation science, also known as implementation science, is testing implementation interventions to improve the uptake and use of evidence to improve patient outcomes and population health.

It also helps clarify what implementation strategies work for whom, in what settings, and why. This scientific field emerged to investigate which implementation strategies work to promote the use of EBPs and uncover the mechanisms by which they work. Advancements in translation science can expedite and sustain the successful integration of evidence in practice to improve care delivery, population health, and health outcomes (Titler, M.G. May 31, 2018). Keywords:  Translation science, models and theories, terminology, implementation science 


Titler, M.G., (May 31, 2018) “Translation Research in Practice: An Introduction” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 2, Manuscript 1. 

EBP is the actual application of evidence in practice (the “doing of” EBP), whereas translation science is the study of implementation interventions, factors, and contextual variables that effect knowledge uptake and use in practices and communities. 

translational Research can seem very confusing. There are many steps along the translational research continuum that are labeled as “transitional research”. Please take a look at the attachment. You will see that the term “translational research” can be applied to different points along the way.   

To help clear up some of the confusion, let me try an analogy between Translational Research and Pat Benner’s “From Novice to Expert” theory. It’s not an exact parallel but it might help. 

It takes years for you to learn and deliver the best nursing care to all your patients; it takes years for you to deliver the right nursing care to the right patient. Let me elaborate.  

You began your nursing career by studying basic nursing (basic research – “bench”).  You might consider that your initial “research”. Your behavior in the clinical setting was very limited and inflexible. You had a very limited ability to predict what might happen in particular patient situations.  

After a few years of experience (basic research – bench) you could “TRANSLATE” your experience (research) into better patient care. You could think of this as T1, translating what you initially learned in nursing school to improved patient benefits (bedside). You had more experiences that enabled you to recognize recurrent, meaningful components of a situation. And you had the knowledge and the know-how but not enough in-depth experience.  

You continued your with your nursing experiences (research – bedside to practiceT2). 

You have some mastery and can rely on advanced planning; you have learned from your previous experiences (research). 

 Now, with your years of experiences (research) you are capable to see situations as “wholes” rather than parts, you can modify plans in response to different events; you can deliver more meaningful appropriate patient care. At this stage you must translate your experiences (research) to expert grasps of clinical situations (T2 & T3) 

 “Translation Research”:  

 “Translation Research” T1 = Takes benchbasic science research (animals research studies, preclinical/drug research) and “TRANSLATES” the research to bedsidehuman clinical research (controlled observation Phase 3). This “translation” is T1 (phase 1 & 2 clinical trials). 

– develop the drug then research the drug on humans.


“Translation Research” T2 = Takes bedsidehuman clinical research (from T1) and “TRANSLATES” the research to practice – clinical practice (delivery of recommended care to the right pt at the right time; identify new clinical questions and gaps in care). This “translation” is T2.  

appropriately deliver the drug in the real clinical environment.


“Translation Research” T2 & T3 = Takes practice – “clinical practice” ( T2)  to practice-based research (T2, T3). Translation to Practice (T3) – eg. dissemination research & Translation to Patients (T2)-  eg. guideline development.  

Westfall et al, 2007 

 You see Translational Research has many stops along the way. It’s not just ONE thing. :o) 🙂 




Translational research has a long history in public health. Decades ago, the research that identified evidence-based health behaviors (e.g., smoking cessation, physical activity), screening tests (e.g., mammography), and immunizations spawned its own form of implementation science: behavioral science research on how to help people adopt healthier behaviors; health services research on how health systems can improve uptake of clinical preventive services; and policy research on how to help communities adopt evidence-based policies. But in public health as in medicine, uptake of research evidence has often been disappointingly slow and incomplete. For example, rates of physical inactivity and obesity remain high, and many Americans are not acting on the evidence of life-saving forms of cancer screening. Research does not leap from the pages of journals into daily behavior. 

Woolf et al 2015. 

agree with your opinion that “research does not leap from the pages of journals into daily behavior” yet I do believe with emerging technologies, research may begin to leap from our smartphones into our daily lives and behavior. Perhaps through emerging technologies, like applications on our smartphones or watches, we may begin to create changes in behavior more quickly.  Translational research and evidence-based practices with known behavior change theories are now available right at our fingertips through apps.  Apps will help providers in healthcare take advantage of the integrated role of smartphones within our lives to gather data and interact actively with their patients in ways that could not be done before (Rhea, Felsberg, & Mayer, 2018).  

An example of such an app is how my smart watch encourages me to increase my steps each day. If I am not on pace, my watch will encourage me to get up and move. “Whether a health-related smartphone app is marketed as an assessment, monitoring, or intervention app, the desired outcome is typically the same—a change in behavior”(Rhea, Felsberg, & Mayer, 2018). It is essentially encouraging me to have a healthier lifestyle and adopt a behavior change. For me, it has worked too. I now share my steps with other nurses and family members and we all encourage each other. I have created an entire support system of like-minded individuals who want to increase their movement throughout the day.  


Rhea, C. K., Felsberg, D. T., & Mayer, J. P. (2018, Jul/Aug). Toward Evidence-Based Smartphone Apps to Enhance Human Health: Adoption of Behavior Change Techniques. American Journal of Health Education, 49(4), 210-213. Retrieved from 

According to the article by Singaram et al. (2022)., “the translational research objective is to produce meaningful and applicable results that directly benefit the community” (para.1). It involves the translation of research into practice and how it influences population health. An important aspect of translational research is the promotion of multidisciplinary collaboration between clinicians, researchers, industry, policy makers, and other stakeholders (Singaram et al., 2022). These groups of people from different disciplines work together to utilize their skills and knowledge to develop interventions to help influence population health management. Hence, it’s important to understand the development of diseases and illnesses within human populations in order to use translational research results to enhance care delivery. With translational research, the interventions that have been proven to be effective during research are applied into clinical practice. 

 The phases of translational research includes: 
  • T1 – translation to humans: finding the use of basic scientific discovery in human health 
  • T2 – translation to clinical settings: determining its value and developing evidence-based guidelines 
  • T3 – translation to practice: aiming to apply evidence-based guidelines into health care practice 
  • T4 – translation to populations: evaluating the outcomes of its application (Penn State Clinical and Translational Science Institute, 2023).  

Meanwhile, evidence-based practice (EBP) is described as a “problem-solving approach to delivering health care that integrates the best evidence from well-delineated studies and care data, and matches patient preferences with values expertise of the health professional” (Camargo et al., 2018, p. 2031). EBP promotes applying evidence into practice supported by health care professionals’ evidence-informed decisions and patient-decision making.  


 Camargo, F. C., Iwamoto, H. H., Galvão, C. M., Pereira, G. A., Andrade, R. B., & Masso, G. C. (2018). Competences and Barriers for the Evidence-Based Practice in Nursing: an integrative review. Revista brasileira de enfermagem, 71(4), 2030–2038. 

 Penn State Clinical and Translational Science Institute. 2023. About translational research. 

 Singaram, M., Muraleedhran, V., & Sivaprakasam, M. (2022). Translational Research in Health Care: A Paradigm Shift from Traditional Research. MAMC Journal of Medical Sciences, 8(3), 0. 

 can you  give a specific, concrete example of what has been a specific focus outcome of translational research at T3 or T4?  

An example of T3 and T4 translational research outcomes is vaccine development. A vaccine is authorized for use by the US Food and Drug Administration at the T3 level, while continuing to monitor its effectiveness occurs at the T4 level (Vukotich, 2016). In this example, after the vaccine is developed and studied, it will be released to be used on a large scale which is the public. After its release, ongoing surveillance and evaluation will occur to examine its benefits and effects in the real world. Hence, this an example of how translational research findings can help improve population health management.  



Vukotich, C. (2016). Challenges of T3 and T4 Translational Research. Journal of Research Practice. 12(2), 

I agree with you. Translational research discoveries are moved along a virtual path from the laboratory into real-world practice, leading to improved human health. 

T1 research tests findings from basic research for clinical effect and/or applicability. T1 research uses knowledge about human physiology and the potential for intervention. 

The approaches include: 
  •       Preclinical and Animal Studies
  •       Human Physiology
  •       First in Humans (FIH) (healthy volunteers)
  •       Proof of Concept (POC)
  •       Phase I Clinical Trials: Tests a new biomedical intervention in a small group of people (e.g. 20-80) for the first time to determine efficacy and evaluate safety (e.g., determine a safe dosage range and identify side effects).

T2 research tests new interventions in controlled environments to form the basis for clinical application and evidence-based guidelines. This research uses the knowledge about the efficacy of the interventions in optimal settings. 

The approaches include: 
  •       Phase II Clinical Trials: Studies the biomedical or behavioral intervention in a larger group of people (several hundred) to determine efficacy and further evaluate safety.
  •       Phase III Clinical Trials: A broad clinical investigation (usually involving several hundred or more human subjects) to evaluate an experimental intervention in comparison with a standard or control intervention or to compare two or more existing treatments. The definition includes pharmacologic, non-pharmacologic, and behavioral interventions given for disease prevention, prophylaxis, diagnosis, or therapy. Community trials and other population-based intervention trials also are included.

T3 research explores the ways of applying recommendations or guidelines in general practice. T3 research yields knowledge about how interventions work in real-life settings. 

The approaches include: 
  •       Phase IV Clinical Trials: Studies conducted after the intervention has been marketed. These studies are designed to monitor the effectiveness of the approved intervention in the general population and to collect information about any adverse effects associated with widespread use.
  •       Health Services Research

o  Dissemination 

o  Communication 

o  Implementation 

  •       Clinical Outcomes Research

T4 research studies factors and interventions that influence the health of populations. T4 research ultimately results in improved global health. 

The approaches include: 
  •       Population-level Outcome Studies
  •       Social Determinants of Health

Translational research is a vibrant and vigorous scope encompassing basic research through use of research discoveries in practice, communities, and public health sites to enhance health and health outcomes. But EBP is the diligent and cautious use of current finest evidence combined with clinical expertise and patient ideals to direct healthcare decisions (Titler, 2018).

According to the National Institute for Occupational Safety and Health (NIOSH), translation research has four stages/phases – stages/phases 1-4. There may be a stage 0 that describes basic or applied research result that becomes the emphasis of study in Stages 1–4 of the translation research structure. It is not considered a part of the study framework (NIOSH, 2018).

Phase T1 translational research consist of work that creates ideas and developments from basic research through initial phase clinical trials in humans. Example, use of artificial intelligence to detect ocular or systemic disease employing ocular imaging technology (Zarbin, 2020).

Phase T2 translational research describes work that determines efficacy in humans, in addition to clinical guidelines. Example, establishing clinical guidelines, and evaluation of whether treatments that have proven effectiveness in the vastly controlled trials conditions are effective in less controlled environments (external validity). Phase it has been called “bedside to practice” (Zarbin, 2020).

Phase T3 translational research denotes work that centers on application and distribution of phase T2 research results. Phase T3 research involves studies that aim to disseminate knowledge about evidence-based interventions (dissemination research) and incorporate interventions into prevailing programs (implementation research) (Zarbin, 2020).

Phase T4 translational research centers on results and effectiveness in populations and includes studies that evaluate the benefit of public health policies and programs on interventions to populations and the adoption of established best practices of interventions in communities (diffusion research). Examples are cost-benefit analyses, surveillance studies, and program evaluations (Zarbin, 2020).

Example, if occupational noise–induced hearing loss (T0) is identified in an organization, protocols are developed for testing hearing protection devices in use (T1), a hearing protector effectiveness study is conducted (T2), assessment of attitude and behaviors associated with wearing hearing protection is made (T3), and finally evaluation of the impact of hearing conservation on incidence of hearing loss (T4) will be done (NIOSH, 2018).


NIOSH. (2018, May 1). Translation research. Retrieved from

Titler, M. G. (2018, May 31). Translation research in practice: An introduction. OJIN: The Online Journal of Issues in Nursing, 23(2), 1. doi:10.3912/OJIN.Vol23No02Man01

Zarbin, M. (2020). What constitutes translational research? Implications for the scope of translational vision science and technology. Translational Vision Science & Technology, 9(8), 22. doi:

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