Despite a substantial body of evidence on effective interventions for neglected tropical diseases (NTDs), a significant "know-do" gap persists between research findings and their application in LMICs. This gap is exacerbated by a lack of capacity to adapt interventions to diverse health systems. Implementation research (IR) aims to bridge this gap by investigating why interventions work (or fail) and how to improve implementation, scaling, and sustainability. This study focuses on improving IR training modalities in LMICs to enhance knowledge translation, recognizing the complex interplay of various types of knowledge, levels of practice, and stakeholder engagement inherent in the process. The research explores how current training falls short and proposes solutions to better prepare researchers and other stakeholders to translate research into action.

A literature review of peer-reviewed and grey literature (Scopus database and Google search) identified existing IR training efforts globally, focusing on actors involved, training modalities (academic courses, project-embedded training, short online courses), and training needs in LMICs. The review revealed a relative scarcity of accessible IR training opportunities in LMICs, despite a growing number of programs offered primarily by institutions in high-income countries. One exception is the Special Programme for Research and Training in Tropical Diseases (TDR)'s resources, including a successful Massive Open Online Course (MOOC). The review informed the subsequent phases of the study, guiding the interviews and virtual dialogues.

The study employed a four-phase modified Delphi method: 1. **Literature Review:** A systematic review of the literature identified actors, modalities, and training needs in IR. 2. **Individual, Semi-structured, Expert Interviews:** Ten interviews with key stakeholders explored strengths and weaknesses of existing training programs. Three main IR training modalities were identified: academic courses, project-embedded training, and short online/face-to-face courses. 3. **Virtual Dialogues:** Two rounds of virtual dialogues (four sessions) with 66 IR experts, practitioners, and learners from 18 countries (40 from LMICs) validated the findings from the previous phases and identified further gaps in IR training. The discussions covered successes, challenges, gaps in IR training, and potential solutions. 4. **Synthesis of Findings and Peer Review:** The findings were synthesized into a report, which underwent peer review by four experts in implementation research, health intervention delivery, health policy, monitoring and evaluation, and IR training.

The study identified pedagogical challenges hindering knowledge translation in IR training: 1. **Multidisciplinary Collaboration:** Existing training modalities inadequately address the diversity of learners' backgrounds and lack opportunities for experiential, team-based learning. They also fail to support the different roles within IR teams (researchers, implementers, decision-makers, community members). 2. **Stakeholder and Community Engagement:** IR training often overlooks the skills needed to engage effectively with external stakeholders, including decision-makers (at various levels) and communities. The ability to understand and navigate power dynamics, particularly relevant in community engagement, is crucial but often neglected. 3. **Translating Results into Action:** Curricula lack sufficient focus on translating research findings into actionable recommendations for different audiences (policymakers, implementers, communities). The ability to communicate complex information clearly and effectively to non-technical audiences is a significant gap.

The study's findings highlight significant shortcomings in existing IR training modalities that impede effective knowledge translation. The lack of attention to multidisciplinary teamwork, stakeholder engagement, and the translation of research into actionable recommendations limits the impact of IR. Addressing these challenges requires a shift in training approaches, moving toward more experiential and team-based learning, incorporating diverse perspectives, and providing explicit training in communication and stakeholder engagement skills. The modular approach to training, allowing learners to select modules relevant to their roles and backgrounds is also proposed.

This study emphasizes the need for a transformative approach to IR training in LMICs. The proposed solutions – modularized curricula, experiential team-based learning, enhanced stakeholder engagement training, and focused instruction on policy translation – are crucial to improving knowledge translation capacity and bridging the "know-do" gap. Future research should focus on evaluating the effectiveness of these recommended changes and exploring innovative methods for delivering high-quality, accessible IR training to a wider audience in LMICs.

The study's focus on a progressive series of activities rather than a formal empirical research design might affect the generalizability of the findings. The reliance on online dialogues might have excluded the perspectives of individuals with limited access to technology. The study also did not include a formal evaluation of the training framework's effectiveness after implementation.