Mapping similarities and differences to progress mutual understanding and dialogue: A comparison and contrast of evidence-based practice and person-centered healthcare

2018 ◽  
Vol 6 (3) ◽  
pp. 462
Author(s):  
James Marcum
Keyword(s):  
Medical Education ◽  
Clinical Practice ◽  
Common Ground ◽  
Evidence Based Practice ◽  
Integrated Approach ◽  
Mutual Understanding ◽  
Evidence Based ◽  
Quality Healthcare ◽  
Starting Point ◽  
Similarities And Differences

Evidence-based practice and person-centered healthcare are often seen as opposing approaches to clinical practice. And yet both offer advantages to providing quality healthcare. In this paper, both approaches to clinical practice are analyzed and mapped philosophically by comparing and contrasting their key foundational principles. The goal is to progress the dialogue between them in order to determine whether a common ground exists in which they might be integrated and how best to operationalize, both clinically and pedagogically, an integrated approach. To that end, key principles undergirding them are enumerated and then integrated by shifting the focus from evidence to the person - whether patient or clinician - for the delivery of quality healthcare. In this way, person-centered healthcare provides the optimal starting point for framing evidence-based practice. Next, operationalizing the integrated approach to clinical practice and medical education is addressed. Finally, the root of modern healthcare must be a person’s, whether patient’s or clinician’s, dignity. For the goal of healthcare is to relieve suffering associated with illness, whether that involves curing a disease or not and not adding to the suffering associated with illness.

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.

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 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

Abstract 127: Cardiovascular Risk and Outcomes in Patients with Diabetes: Using Medical Education to Improve Care

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Amy Larkin ◽  
Colleen Healy
Keyword(s):  
Risk Factors ◽  
Medical Education ◽  
High Risk ◽  
Effect Size ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Glucose Lowering ◽  
Multi Media ◽  
And Performance ◽  
Selection Of

Introduction: Mortality rates due to cardiovascular disease (CVD) are 2-4 times higher among people with diabetes than in those without. Glucose control reduces the risk of any CVD event by 42% and the risk of heart attack, stroke, or death from CVD by 57%. We assessed the hypothesis that continuing medical education (CME) improves knowledge and performance of cardiologists in managing glycemic control and other CV risk factors in patients with type 2 diabetes (T2D). Methods: Cardiologists who treat patients with coronary artery disease participated in at least 1 of 2 online CME activities within a curriculum on CV risks and outcomes in patients with T2D. Participant responses to a case-based survey after activity completion were compared with responses from demographically similar control groups of nonparticipants. Educational effect size was calculated using Cohen’s d formula, with a value of <0.4 representing a small effect, 0.4-0.8 a medium effect, and >0.8 a large effect. Results: Participating cardiologists (n = 151) were more likely to make evidence-based practice choices than were nonparticipating cardiologists. Activity 1: Improving CV Outcomes in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 33.5% Effect Size: 0.51 (N = 78) Activity 1: Assessing CV Risk in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 50.3% Effect Size: 0.87 (N = 73) Domain 1: Managing Glycemic Control and Other CV Risk Factors in Patients with CVD and T2D. Participating cardiologists significantly improved their consideration of comorbid conditions when deciding on a glucose management strategy (73% pre vs. 85% post) and selection of treatment for early intervention (85% pre vs. 96% post). Domain 2: Identification of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in the recognition of antihyperglycemic agents shown in clinical trials to be safe for high risk CV patients (36% pre vs. 79% post) and in identification of the effect of saxagliptin on CV events in high risk CV patients with T2D (SAVOR TIMI 53 trial) (55% pre vs. 86% post). Domain 3: Application of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in their selection of a DPP-4 inhibitor as the most appropriate antihyperglycemic agent for patients with T2D and CV risk factors or previous CV events (59% pre vs. 81% post and 53% pre vs. 73% post, respectively). Conclusion: This study demonstrated the success of a curriculum-style educational intervention using multimedia technology on improving knowledge and performance of cardiologists which can lead to enhanced management of CV risks and, thus, improved outcomes in patients with T2D and CVD.

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.

scholarly journals Indian nurses’ views on a collaborative model of best practices: Evidence-based practice, job satisfaction, learning environment, and nursing quality

2018 ◽  
Vol 8 (9) ◽  
pp. 87
Author(s):  
Kaisa Bjuresäter ◽  
Sister Tessy Sebastian ◽  
Bhalchandra Kulkarni ◽  
Elsy Athlin
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Nursing Students ◽  
Learning Environment ◽  
Evidence Based Practice ◽  
Positive Impact ◽  
Evidence Based ◽  
Collaborative Model

Introduction: This study is a part of a project aimed at implementing and evaluating the Collaborative Model of Best Practice, (CMBP) to promoting evidence-based practice (EBP) in health care contexts. The aim of the study was to assess nurses’ interest, attitudes, utilisation, and views on promotors of and resources related to EBP before and after taking part in the CMBP project, and to investigate their views on the CMBP in relation to collaboration between the academy and clinical practice, the earning environment, job satisfaction, and nursing quality.Methods: A descriptive, comparative design was used with pre- and post-test measurements. The Research Utilization Questionnaire (RUQ) and study-specific questions were distributed to ward nurses (n = 67) in a rural Indian hospital.Results: Most of the nurses thought that the CMBP had a positive impact on quality of care, on their attitudes to, interest in, and knowledge EBP, and on their job satisfaction. They also considered that the collaboration between the nursing college and clinical practice had a positive impact on the learning environment and that more resources were available at the end of the project.Conclusions: The CMBP project was an attempt to improve the quality of care for patients and the learning environment for nursing students and nurses on the project wards. The results indicated fulfilment of these goals, which strengthens the usability of the model. Implementation of EBP is challenging and requires long-lasting activities and comprehensive support from leaders and facilitators. More studies are needed in which EBP is systematically implemented, accomplished, evaluated, and reported.

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