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Occupational Therapy Assistant Resources - Penn Valley

What is Evidence Based Practice?

Evidence based practice (EBP) is the conscientious use of current best evidence in making decisions about patient care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). 

It is a problem-solving approach to clinical practice and administrative issues that integrates: 

  • A systematic search for and critical appraisal of the most relevant evidence to answer a burning clinical question 

  • One's own clinical expertise 

  • Patient preferences and values (Melnyk & Fineout-Overholt, 2014) 

The EBP process is a method that allows the practitioner to assess research, clinical guidelines, and other information resources based on high quality findings and apply the results to practice. 

EBP is an evolving, ongoing, systematic process of applying relevant research to clinical problem-solving, using the following steps: 

  1. Transform your information need into a focused research question (PICO process) 

  1. Search for evidence in the literature using reliable resources 

  1. Critically assess the evidence for validity and usefulness 

  1. Apply the results in clinical practice 

  1. Evaluate the performance of that evidence in clinical use 

PICO

Understanding PICO

The first stage of any evidence-based practice process is formulating an answerable question. This forms the foundation for quality searching. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question. 

An answerable question has a format that follows the PICO format. The acronym translates to: 

 

 

Example PICO Questions 

  • What interventions reduce the incidence and severity of bed sores in residents of aged care facilities? 

  • What method for assessing temperature in children who come to the Emergency Department is most useful for an accurate assessment? 

  • Does hand washing among healthcare workers reduce hospital acquired infections?

 

*Image from https://research.lib.buffalo.edu/dnp/evidence-based-practice

Evaluating Research

 

It is important to understand the types of research available when you search for scientific studies. Not all studies are the same. They may differ for a number of reasons including: the purpose of the research study, the funding of the study, the methods used in the study, the population being studied, or the intended use of the study findings. As a researcher, you are responsible for understanding the difference between strong and week scientific evidence. The above hierarchy is a starting point for understanding what makes scientific evidence strong or weak, and how to evaluate studies that you find in your research. Focusing your search on meta-analyses and systematic reviews, or studies that use randomized controlled trials will help ensure that you are using strong evidence.


Key Questions to Reveal an Article's Strengths & Weaknesses:

  1. Is the article peer reviewed?
  2. Are there any conflicts of interest based on the author's affiliation or the funding source of the research?
  3. Are the research questions or objectives clearly defined?
  4. Is the study a systematic review or meta analysis?
  5. Is the study design appropriate for the research question?
  6. Is the sample size justified? Do the authors explain how it is representative of the wider population?
  7. Do the researchers describe the setting of data collection?
  8. Does the paper clearly describe the measurements used?
  9. Did the researchers use appropriate statistical measures?
  10. Are the research questions or objectives answered?
  11. Did the researchers account for confounding factors?
  12. Have the researchers only drawn conclusions about the groups represented in the research?
  13. Have the authors declared any conflicts of interest?

Answering "yes" to most of these questions should indicate that the article conveys quality research. Answering an equal number of "yes" and "no" to these questions will require that you make a decision about whether the quality of the article meets your needs. If it doesn't, keep looking.

Source credit: Massachusetts General Hospital

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