1. Evidence Based Practice
Law, Policy and Practice Guidelines
Practice Communities
Professional Goals

2. “The best way to predict the future of health care is to create it.”
(Otternbacher, Tickle-Denen & Hasselkus, 2002)

3. Objectives
At the end of this presentation, the participant will be able to:
Define evidence-based practice and knowledge transition
Discriminate between scholarly and popular articles
Identify three databases from which to gather information
Demonstrate ability to retrieve one scholarly, peer reviewed article regarding collaborative consultation in schools.

4. American Occupational Therapy Association Centennial Vision
We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society’s occupational needs.

5. Top Ten Reasons… It sounds impressive. Your team will be impressed.
Your patients will be impressed.
Everyone is doing it.
You want to know what your students are talking about.
You want to be reimbursed.
You want to be a competent practitioner.
You want to be a scientific practitioner.
You want to be an ethical practitioner.
You want the best outcomes for your clients.
Use article for ideas of each.
Study that indicates approximately 50% of participants received recommended care. Success in health care?
As compared to airline industry that can boast 99.9% safe travel.
Reference: McGlynn, Elizabeth A., Asch, Steven M., Adams, John, Keesey, Joan, Hicks, Jennifer, DeCristofaro, Alison, & Kerr, Eve A. (2003). The Quality of Health Care Delivered to Adults in the United States. New England Journal of Medicine, 348(26),
Margo B. Holm, PHD, OTR/L, FAOTA, ABDA: “OT PRACTICE online”

6. Evidence-based Practice
Ask the question
Look for the answers
Assess the information
Use clinical reasoning
Plan an action
Re-evaluate
Evidence-based Practice
Use strong clinical reasoning = client centered, problem solving and adaptive approach, experience, occupation based.

7. What is evidenced-based medicine?
Evidenced-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best external clinical evidence from systematic research. (Sackett et al.,1996)
Sackett is generally acknowledged to be the originator of evidence based practice. EBP is the integration of current best evidence with the client’s priorities & goals as well as the occupational therapist’s clinical expertise (practice based evidence).

8. Knowledge Translation
Closing the gap between research and practice.
Buzz word in the process of evidence based practice
The way we, as occupational therapists use knowledge is different than other professions. We must use our experience, our client centered approach and occupational based practices to determine our care. This is the process of transitioning knowledge into practice. Questions?

9. Scholarly vs. Popular Articles
Primary sources are: professional journals, edited books, and internet databases
Most often peer reviewed
Well cited and referenced
At least research based
Primary sources are magazines, books, internet search engines
Written to be easy to read for general public
Not well cited

10. Research Literature Quantitative Studies
Levels I – V (highest are randomly controlled trials)
Qualitative Studies
Phenomenological
Ethnographic
Grounded Theory
Participatory
Others specific to theoretical disciplines
Phenomenological – describes an experience
Ethnographic – answers what is the culture of a group in a particular setting
Grounded Theory – what is the theory or core social processes
Participatory – participants are researching their own personal beings and experiences
Others specific to theoretical disciplines
Others specific to theoretical disciplines, p. 365 Law

11. Critical Appraisals
Structured approach to assessing scholarly information
Individual and systematic reviews
Available through AOTA and through specific databases such as Cochrane Review, PubMed and MEDLINE
Metaanalysis vs systematic review that synthesizes the conclusions.

12. Let’s give it a try…
Determine question: “What effect does collaborative consultation have in the school system?”
Choose Database
Identify key words and put in search box.
Refine search words or limit results function to manage amount of results.
Review abstracts and choose articles.

13. Searching Using a Database
ERIC
PubMed Central
Google Scholar
Chatham University
AJOT (BJOT and CJOT)

14. Citing Literature Always track your resources
Start a citation manager on your computer
Become familiar with American Psychological Association (APA) formats
Beware of plagarism

15. "Never doubt that a small group of thoughtful, concerned citizens can change the world. Indeed it is the only thing that ever has."
Margaret Mead

16. References
American Occupational Therapy Association, [AOTA]. (2007). Centennial Vision. American Journal of Occupational Therapy, 61(6). Retrieved from
AOTA’s Centennial Vision and Executive Summary. (2007). American Journal of Occupational Therapy, 61(6), 613–614.
Eckel, E. (2014). Introduction to EBP OTH 690. Chatham University.
Law, M., & MacDermid, J. C. (2014). Evidence-Based Rehabilitation: A Guide to Practice (3rd Edition). Thorofare, NJ: Slack Incorporated.
McGlynn, Elizabeth A., Asch, Steven M., Adams, John, Keesey, Joan, Hicks, Jennifer, DeCristofaro, Alison, & Kerr, Eve A. (2003). The Quality of Health Care Delivered to Adults in the United States. New England Journal of Medicine, 348(26),
Ottenbacher, K. J., Tickle-Degnen, L., & Hasselkus, B. R. (2002). Therapists Awake! The challenge of evidence-based occupational therapy. American Journal of Occupational Therapy, 56(3), 247–249
Reder, R. D. (2015, April). Changing the way we practice: A roadmap to transforming care. Presented at the AOTA Conference, Nashville, TN.
Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn’t. BMJ : British Medical Journal, 312(7023), 71–72.
Taylor, M. C. (2007). Evidence-Based Practice for Occupational therapists (2nd ed.). Oxford, UK: Blackwell Publishing, Ltd.