Deconstructing the Three Pillars of Evidence-Based Practice to Facilitate Social Justice Work in Speech Language and Hearing Sciences

2021 ◽  
pp. 130-150
Author(s):  
Reem Khamis-Dakwar ◽  
Melissa Randazzo
Keyword(s):  
Qualitative Research ◽  
Social Justice ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
People Of Color ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Systemic Racism ◽  
Cultural Mismatch ◽  
Communication Impairments

This chapter reviews the limitations of the evidence-based practice (EBP) framework adopted by American Speech Language Hearing Association for the field of speech, language, and hearing sciences (SLHS) in addressing systemic racism. The authors argue that a shift from a medically-based EBP model to a pluralistic EBP model would better serve the needs of black, indigenous, people of color (BIPOC) with communication impairments in the current sociopolitical landscape. The authors examine the three pillars of EBP through the lens of social justice work. They describe how the current EBP model limits the development of social justice work in SLHS. They describe the need to refine the EBP model by validating the contribution of qualitative research as scientific evidence, reevaluating the basis of clinical expertise in client-clinician cultural mismatch, and address the importance of integrating policy and culture in consideration of client and family preferences. These transformations are critical in light of the under-representation of BIPOC clinicians in the field of SLHS profession.

Modeling Evidence-Based Practice for Graduate Clinicians: Perspectives from Off-Site Clinical Supervisors in Medical Settings

2014 ◽  
Vol 24 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Sharon B. Hart ◽  
Kelly A. Kleinhans
Keyword(s):  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Fundamental Aspect ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Structured Interviews ◽  
Medical Settings ◽  
Clinical Placements

A fundamental aspect of graduate education in speech-language pathology is facilitating clinical competence. Teaching clinical decision-making within an evidence-based practice framework is necessary during both on-site and off-site clinical experiences. In this article the authors present the results of semi-structured interviews with off-site supervisors in medical settings. Interview questions addressed aspects of evidence-based practice (EBP) that are discussed or modeled for students. Supervisors also weighed the importance of each EBP element in their practice. Clinical expertise was given slightly more weight as compared to external scientific evidence and client/patient/caregiver perspective elements. However, individual responses were highly variable across participants. Suggestions for ensuring continued EBP instruction during off-site clinical placements is discussed.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

scholarly journals The PICO strategy for the research question construction and evidence search

2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Research Question ◽  
Clinical Decision ◽  
Evidence Based ◽  
Review Of The Literature

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

The Client-Centred Evidence-Based Practice of Occupational Therapy

1998 ◽  
Vol 65 (3) ◽  
pp. 136-143 ◽  
Author(s):  
Mary Egan ◽  
Claire-Jehanne Dubouloz ◽  
Claudia Von Zweck ◽  
Josée Vallerand
Keyword(s):  
Occupational Therapy ◽  
Process Model ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Treatment Decision ◽  
Population Based ◽  
Individual Characteristics ◽  
Evidence Based ◽  
Health Related ◽  
Problem Solving Process

Evidence-based practice has its roots in evidence-based medicine. This term refers to the formulation of treatment decision using the best available research evidence. While the concept has gained increased attention among health care workers in the recent past, practice based on scientific evidence has been recommended for over 300 years. However, all health-related professions continue to report difficulties adopting evidence-based practice. Notably, practitioners are often concerned that results of population-based research may not be relevant for their specific patients. This may be of particular concern for occupational therapists who aim to provide client-centred intervention, taking into consideration individual characteristics of the client, the environment and the occupation. As well, those wishing to practice evidence-based occupational therapy must determine which decisions are made during the course of therapy and what evidence may impact on these decisions. The Occupational Performance Process Model (Fearing, Law & Clark, 1997) outlines the occupational therapy problem solving process and assists therapists to integrate knowledge from both client and therapist. A framework for evidence-based occupational therapy is presented, based on this model.

scholarly journals The Use of Evidence-Based Acupuncture: Current Evidence

2022 ◽  
Author(s):  
Dedi Ardinata
Keyword(s):  
Clinical Evidence ◽  
Scientific Evidence ◽  
Current Evidence ◽  
Systematic Research ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Quality Of Evidence ◽  
Assessment Development ◽  
Evidence Quality

Evidence-based medicine (EBM), which emphasizes that medical decisions must be based on the most recent best evidence, is gaining popularity. Individual clinical expertise is combined with the best available external clinical evidence derived from systematic research in the practice of EBM. The key and core of EBM is the hierarchical system for categorizing evidence. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system divides evidence quality into four categories: high, moderate, low, and very low. GRADE is based on the lowest quality of evidence for any of the outcomes that are critical to making a decision, reducing the risk of mislabeling the overall evidence quality, when evidence for a critical outcome is lacking. This principle is also used in acupuncture as a complementary and integrative treatment modality, but incorporating scientific evidence is more difficult due to a number of factors. The goal of this chapter is to discuss how to establish a clinical evidence system for acupuncture, with a focus on the current quality of evidence for a variety of conditions or diseases.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

Evidence-based Practice: Making the Research Relevant to Your Situation—CLUE #4: Apply

2018 ◽  
Vol 33 (3) ◽  
pp. 154-157 ◽  
Author(s):  
Catherine F. Yonkaitis ◽  
Erin D. Maughan
Keyword(s):  
Evidence Based Practice ◽  
School Nurses ◽  
Venn Diagram ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Fourth Step

Evidence-based practice (EBP) is often thought to be synonymous with research and literature. This article focuses on the fourth step in the EBP process: Apply. In this step, we fully integrate the EBP Venn diagram, which illustrates that EBP occurs at the intersection of evidence and data, clinical expertise and resources, and population’s values and cultures. Only when school nurses include each component into their practice decision will true EBP occur.

Evidence-Based Practice Application: A Goal for Anaesthetic and Recovery Nurses

2011 ◽  
Vol 12 (3-4) ◽  
pp. 53-56 ◽  
Author(s):  
Joni M. Brady
Keyword(s):  
Nursing Education ◽  
Formal Education ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Nursing Process ◽  
Skilled Professional ◽  
Professional Opinion ◽  
Guided Instruction ◽  
Subsequent Addition

AbstractHistorically speaking, nursing actions were often based on opinions or habits with very little scientific evidence available to guide practice. The nursing process has been widely employed in basic nursing education programmes for several decades. The subsequent addition of the critical thinking component has enabled the practitioner to apply reasoning and formulate appropriate judgments about his/her patient's needs. Although many nurses lack formal education in research and evidence-based practice (EBP), frontline practitioners occupy a perfect position to stimulate and impact adoption of EBP in practice. Incorporation of EBP education and guided instruction in the EBP process for anaesthetic and recovery nurses can only serve to sustain its primary goal of combining the best available evidence with skilled professional opinion to achieve safe and sound practice at the bedside.

Sign in / Sign up

Export Citation Format

Share Document