scholarly journals Developing a research framework to inform an evidence base for person-centered medicine: keeping the person at the centre

2013 ◽  
Vol 1 (2) ◽  
pp. 336 ◽  
Author(s):  
Corinne Reid
Keyword(s):  
Clinical Practice ◽  
Evidence Based Practice ◽  
Evidence Base ◽  
Evidence Based ◽  
Research Framework ◽  
Humanistic Medicine ◽  
A Priority ◽  
Person Centered Approach ◽  
Evidence Generation

Person-centered medicine exists at the intersect of science and humanism and has the dual goals of relational and evidence-based practice. In the operationalization of humanistic medicine the development of a sympathetic and facilitative research framework is, then, a priority. The person-centric research framework is proffered as one such model and will be described in this paper with a view to eliciting discussion about the essential qualities of a person-centered approach to evidence generation. This framework has been emergent from the clinical practice of the author and builds upon other pioneering work in this field. It is operationalized as a practitioner-informed philosophy of the conceptualisation, practice and interpretation of research.

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.

The Distinct Value of OT: Examination of Person-Centered Care in Practice

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510251p1-7512510251p1
Author(s):  
Elizabeth Jayne Braun ◽  
Erin Casey Phillips ◽  
Hannah Corner ◽  
Shayla Murphy ◽  
Alayna Pullara ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Capacity Building ◽  
Evidence Based ◽  
Person Centered Care ◽  
Centered Care ◽  
Person Centered Approach ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Health care is shifting from volume to value, and there is a need to define the distinct value of services. OT is founded on the principles of person-centered care, and the intentional use of these strategies must be part of evidence-based outcomes in order to solidify the value of OT services. This study examined the use of person-centered care in clinical practice, and results were used to develop capacity-building strategies for implementation of a person-centered approach. Primary Author and Speaker: Elizabeth Jayne Braun Additional Authors and Speakers: Erin Casey Phillips, Hannah Corner Contributing Authors: Shayla Murphy, Alayna Pullara, and Nathan Kies

scholarly journals Evidence-based practice of stereotactic radiosurgery: Outcomes from an educational course for neurosurgery and radiation oncology residents

2021 ◽  
Vol 12 ◽  
pp. 77
Author(s):  
Swathi Chidambaram ◽  
Sergio W. Guadix ◽  
John Kwon ◽  
Justin Tang ◽  
Amanda Rivera ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Stereotactic Radiosurgery ◽  
Radiation Oncology ◽  
Evidence Based Practice ◽  
Evidence Base ◽  
Comfort Level ◽  
Evidence Based ◽  
Senior Faculty ◽  
Exact Test ◽  
Before And After

Background: As the field of brain and spine stereotactic radiosurgery (SRS) continues to grow, so will the need for a comprehensive evidence base. However, it is unclear to what degree trainees feel properly equipped to use SRS. We assess the perceptions and comfort level reported by neurosurgery and radiation oncology residents concerning the evidence-based practice of SRS. Methods: A continuing medical education (CME) course provided peer-reviewed updates regarding treatment with intracranial and spinal SRS. Presentations were given by neurosurgery and radiation oncology residents with mentorship by senior faculty. To gauge perceptions regarding SRS, attendees were surveyed. Responses before and after the course were analyzed using the Fisher’s exact test in R statistical software. Results: Participants reported the greatest knowledge improvements concerning data registries (P < 0.001) and clinical trials (P = 0.026). About 82% of all (n = 17) radiation oncology and neurosurgery residents either agreed or strongly agreed that a brain and spine SRS rotation would be beneficial in their training. However, only 47% agreed or strongly agreed that one was currently part of their training. In addition, knowledge gains in SRS indications (P = 0.084) and ability to seek collaboration with colleagues (P = 0.084) showed notable trends. Conclusion: There are clear knowledge gaps shared by potential future practitioners of SRS. Specifically, knowledge regarding SRS data registries, indications, and clinical trials offer potential areas for increased educational focus. Furthermore, the gap between enthusiasm for increased SRS training and the current availability of such training at medical institutions must be addressed.

scholarly journals Supervision of clinical practice indicators: evidence-based practice in the context of the surgical patient

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Leonor Teixeira ◽  
Cristina Barroso Pinto ◽  
António Luís Carvalho ◽  
Ana Isabel Carvalho Teixeira ◽  
Maria Cristina Bompastor Augusto
Keyword(s):  
Clinical Practice ◽  
Evidence Based Practice ◽  
Surgical Patient ◽  
Evidence Based

scholarly journals Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice?

2018 ◽  
Vol 32 (9) ◽  
pp. 751-761 ◽  
Author(s):  
Elizabeth A. Lynch ◽  
Brigit M. Chesworth ◽  
Louise A. Connell
Keyword(s):  
Clinical Practice ◽  
Stroke Rehabilitation ◽  
Evaluation Research ◽  
Well Being ◽  
Professional Associations ◽  
Evidence Base ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Rehabilitation Research

Despite the exponential growth in the evidence base for stroke rehabilitation, there is still a paucity of knowledge about how to consistently and sustainably deliver evidence-based stroke rehabilitation therapies in clinical practice. This means that people with stroke will not consistently benefit from research breakthroughs, simply because clinicians do not always have the skills, authority, knowledge or resources to be able to translate the findings from a research trial and apply these in clinical practice. This “point of view” article by an interdisciplinary, international team illustrates the lack of available evidence to guide the translation of evidence to practice in rehabilitation, by presenting a comprehensive and systematic content analysis of articles that were published in 2016 in leading clinical stroke rehabilitation journals commonly read by clinicians. Our review confirms that only a small fraction (2.5%) of published stroke rehabilitation research in these journals evaluate the implementation of evidence-based interventions into health care practice. We argue that in order for stroke rehabilitation research to contribute to enhanced health and well-being of people with stroke, journals, funders, policy makers, researchers, clinicians, and professional associations alike need to actively support and promote (through funding, conducting, or disseminating) implementation and evaluation research.

The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

2021 ◽  
Author(s):  
Alaine E Reschke-Hernández
Keyword(s):  
Clinical Practice ◽  
Music Therapy ◽  
Behavioral Interventions ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Intervention Development ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

Using a Critical Appraisal Assignment to Infuse Evidence-Based Practice into a Therapeutic Modality Course

2014 ◽  
Vol 9 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Mary Beth Zwart ◽  
Bernadette Olson
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Clinical Findings ◽  
Therapeutic Modality ◽  
Future Research ◽  
Evidence Based ◽  
Clinical Question ◽  
Starting Point

Context It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding EBP concepts across the curriculum, a modified critical appraisal assignment was developed to teach therapeutic modality concepts. Objective The purpose of this action research project was to demonstrate how a modified critical appraisal assignment can be used to introduce the process and aspects of critical appraisal and begin scaffolding the development of critical appraisal skills over time. The objectives of this study were to evaluate the students' ability to (1) successfully locate relevant research needed to answer clinical questions and (2) successfully appraise the literature according to basic EBP strategy. From a program perspective, the modified critical appraisal assignment was a starting point from which to include EBP principles into didactic coursework. Design Seventeen athletic training students completed 3 modified critical appraisal assignments pertaining to the use of therapeutic modalities. Each paper included 5 sections: (1) clinical question, (2) key clinical findings, (3) clinical applicability based on information from the appraisal and significance of results, (4) article comparison table, and (5) implications for clinical practice, patient education, and future research. The instructor evaluated the assignments blind. Conclusions Students were generally able to complete the critical appraisal assignment; however, students had difficulty locating research that answered the clinical question. Students struggled to relate the key clinical findings of the research articles and implications for clinical practice to the given clinical question. Findings from this study have informed faculty teaching, including introducing EBP skills earlier in the curriculum and inserting assignments that stress various aspects of the critical appraisal process.

Building the house of evaluation: Reconsidering the blueprints and bricks for knowledge accumulation in evaluation

Evaluation ◽  
2018 ◽  
Vol 24 (2) ◽  
pp. 185-201 ◽  
Author(s):  
Sebastian Lemire ◽  
Christina A. Christie
Keyword(s):  
Evidence Based Practice ◽  
Knowledge Building ◽  
Meta Analysis ◽  
Evidence Base ◽  
Evidence Based ◽  
The Public ◽  
Body Of Knowledge ◽  
What Works ◽  
Alternative Approaches ◽  
Cumulative Knowledge

The push for evidence-based practice is persistent in the public sector—what counts is what works. One central premise for evidence-based practice is the existence of an evidence base; that is, an accumulated and generalizable body of knowledge. Informed by a recent systematic review, we examine the promises and pitfalls of meta-analysis (the statistical workhorse of systematic reviews) as the primary blueprint for cumulative knowledge building in evaluation. This analysis suggests that the statistical assumptions underlying the meta-analytic framework raise issues that, at least in regards to producing generalizable knowledge, may cut even deeper than is suggested by common criticisms. Advancing beyond meta-analysis, we consider alternative approaches for knowledge building and reflect on the implications of these for individual evaluations.

Sign in / Sign up

Export Citation Format

Share Document