EBP: Class 1

  1. What is Evidence-Based Practice (EBP)?
    • integration of best research evidence with our clinical expertise and patient's unique values and circumstances
    • when elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance which optimizes clinical outcomes and quality of life
  2. What are the sources of evidence?
    • 1. patient's unique values and circumstances
    • 2. best research evidence
    • 3. clinical expertise
  3. Define "patient's unique values and circumstances" as a source of evidence:
    • values, preferences, expectations
    • clinical state and circumstances
  4. Define "best research evidence" as a source of evidence:
    results of scientific research
  5. Define "clinical expertise" as a source of evidence:
    • personal knowledge, expertise, and expectations
    • established experts
  6. KEY POINT: The best research evidence, our clinical expertise, and our patient's unique values and circumstances should INFORM our practice.
    • As therapists, we make the decisions about patient care (It's our license)
    • These decisions should be well-informed/intelligent ones
  7. What type of question is "What is subacromial impingement syndrome?"
    background question
  8. Name the 5 Steps for EBP:
    • 1. Ask a focused clinical question
    • 2. Search for the best research evidence
    • 3. Appraise the quality of the research evidence
    • 4. Integrate the research evidence with information about the patient and clinical expertise
    • 5. Reflect on the process to improve the future
  9. In step 1 for EBP, what type of clinical questions should be asked?
    background and foreground questions
  10. What makes a clinical question well-built?
    • the question should be directly relevant to the problem at hand
    • the question should be pharsed to facilitate searching for a precise answer
  11. What are the 3 parts of making a well-built clinical question for step 1 of EBP?
    • 1. the patient or problem being addressed
    • 2. The exposure/intervention being considered and/or the comparision intervention or exposure
    • 3. clinical outcomes of interest
  12. What is the PECO (PICO) approach?
    • an approach to formatting your clinical question
    • P: patient/problem
    • E: exposure (I: intervention)
    • C: comparison group
    • O: outcome
  13. Name the levels of the USC "Evidence Pyramid" from top to bottom (better to less good):
    • Level 1a: systematic reviews
    • Level 1b: randomized clinical trials
    • Level 2b: cohort studies
    • Level 3b: case-control studies
    • Level 4: case series and case studies
    • Level 5: narrative review, expert opinion, textbooks
  14. KEY POINT: We must critically appraise the integrity of each source of evidence:
    • clinical expertise
    • best research evidence
    • patient's unique values and circumstances
  15. KEY POINT: Truth
    • There is no perfect article
    • Every article can teach us something
  16. What are some things to consider when you reach step 5 (reflect on process to improve the future)?
    • patient outcomes
    • reimbursement
    • image
    • respect
    • confidence
    • influence
    • program development
    • conflict resolution
    • personal/patient/staff motivation
  17. Important Reminders...
    • Information on its own doesn't change practice.
    • We must learn more about how we move from evidence to change, but we know that change is not always easy
Card Set
EBP: Class 1
review of lecture 1 from EBP