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Master of Occupational Therapy Program: Evidence-Based Practice

WHAT IS EVIDENCE-BASED PRACTICE

Sackett states, 

“EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology” (as cited in Duke University, 2016a) .

ebp diagram 

Image from: http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021

 

Why is EBP Important in Occupational Therapy?

"Implementing evidence in clinical practice is a process of closing the gap between research and practice so that research findings are used more routinely. This process is crucial to promote the efficacy, efficiency, and justification of reimbursement/funding of OT services necessary to maintain our position as a valued member within the future of healthcare"                          (OT Seeker, n.d.)​.

CLINICAL APPLICATION OF EVIDENCE-BASED PRACTICE

Evaluating Resources (Western Libraries, 2012):

  • This video offers a short tutorial explaining an overview on how to evaluate evidence resources

 OT Seeker:

  • This resource provides a comprehensive tutorial overview for the systematic evaluation of evidence within occupational therapy

CAT's:  Occupational Therapy Critically Appraised Topics :

  • This site is funded by Occupational Therapy Australia (Anne McCluskey, 2003), and contains CAT's (critically appraised topics) and CAP's (critically appraised papers) focusing on occupational therapy interventions.  Files in the list can be downloaded in a PDF format.     

Levels of Evidence Hierarchy

The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence​ provides a ranking system reflecting the quality/rigor of the research and strength of the results, and associated confidence in applying the results into clinical decision-making with OT clients. 

Click the following link to watch a short video explaining the levels of evidence: 

Levels of Evidence Pyramid

Clinicians must also understand the types of evidence and their relative quality in the hierarchy of research evidence.  The Evidence Pyramid below represents the relative quality of types of evidence with the least clinically relevant at the bottom and the most clinically relevant at the top.

                                                                                                                                                                                                                                                     

Image retrieved  from https://nursetopia.files.wordpress.com/2011/03/levels-of-evidence1.jpg

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Please review the following link for a description of the "Types of Design Types" (American University of Beirut Saab Memorial Medical University Library, n.d.).   

Types of Study Designs

Review the following links for a description of study designs included in the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence:

With so much available on the internet, it is easy to find information on just about every topic, but it is appropriate information to support graduate level work?  To help understand the expectations for appropriate scholarly literature, review the following video and resources: 

EVIDENCE-BASED PRACTICE RESOURCES

Evidence-Based Practice Databases 

  • Cochrane Library:  (2016)
  • Cochrane Evidence: (Cochrane Collaboration, 2016)
    • This database site offers summaries of evidence-based systematic reviews of studies that "... investigate the effects of interventions for prevention, treatment, and rehabilitation"
  • Health People 2020: (U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, 2016) 
    • This database site offers access to professional information resources related to a broad range of community/population health topics 
  • OT Search: AOTA:  (AOTA, 2016)
    • AOTA provides a search function to locate databases of bibliographic information for occupational thearpy and related areas of professional literature.  **A Member Login Is Required**
  • OT Seeker:  (n.d.b)
    • This resource assists occupational therapists access and integrate existing research evidence for generating informed clinical decision-making and developing evidence-based practice.  It's database site of abstracts for systematic reviews, randomized controlled trials and other resources relevant to occupational therapy interventions.
  • PEDro: The Physiotherapy Evidence Database:   (Physiotherapy Evidence Database, 2016)
  • Rehabilitation Measures Database: (2010)
    • This site offers "reliable and valid instruments used to assess patient outcomes during all phases of rehabilitation ... [including], evidence-based summaries that include concise descriptions of each instrument’s psychometric properties, instructions for administering and scoring each assessment as well as a representative bibliography with citations"

Evidence-Based Practice Search Engines

  • ClinicalKey: (Elsevier Inc., 2016)
    • This clinical search engine includes books, journals, clinical guidelines, patient education evidence sources to support informed clinical decision making and justification for the efficacious application of clinical interventions
  • Google Scholar: (Google, n.d.)
    • This publicly accessible web search engine allows you to perform broad searches across diverse interprofessional scholarly literature and research sources

Evidence-Based Clinical Practice Guidelines

  • The following sources provide public access to peer-reviewed evidence  from a broad range of interdisciplinary sources synthesized into clinical guidelines/recommendations to support informed clinical-decision making and the provision of  safe, effective, and quality driven healthcare services across a broad range of conditions 

Evidence-Based Practice Glossaries

The following glossaries offer comprehensive reference lists of evidence-based practice terminology: 

  • Centre for Evidence-Based Rehabilitation:  (2016b)
  • OT Critically Appraised Topics (CATS): (2003)
    • This site, funded by Occupational Therapy Australia, contains CATs and CAPs focusing on occupational therapy interventions. CATs are also increasingly being used as a university assignment to assess student's skill and knowledge, and many of the more recent topics were completed by final year, Australian undergraduate occupational therapy students. Files in the list can be downloaded in PDF. 
  • Introduction to Evidence-Based Practice:  (Duke University Medical Center Library, 2016b)
    • This tutorial, from Duke University Medical Library, offers a a "... basic introduction to the principles of evidence-based practice". 
  • MOHO (Model of Human Occupation) Web:
    • ​This site is "a confidential online resource ... [facilitating] access and use of all the MOHO assessments and interventions that are supported for distribution through the University of Illinois at Chicago" (University of Illinois Board of Trustees, 2016a)
    • References and evidence for the MOHO assessments are accessible within the Scholarship Section (University of Illinois Board of Trustees, 2016b)

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