EBP and ethics

Question 1

What is evidence based practice ?

Answer 1

‘‘a commitment to use the best available evidence to inform decision-making about the care of individuals that involves integrating physiotherapist practitioners and individual professional judgement with evidence gained through systematic research” (world confederation of physical therapy)

«The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient.»

Question 2

What are the components of evidence based practice ?

Answer 2

• Best available evidence :
  Person’s condition
  Person’s environnement
• Clinical expertise
  Professionnalisme
  Training
  Continuous professional development
• Client value and preferences
  Person centered care
  Respect for the individual
  Client’s social context

Question 3

What question can you ask to critically appraise a study ?

Answer 3

Was the purpose stated clearly?
Was relevant background literature reviewed?
What is study design?
Was the sample described in detail?
Was sample size justified?
Were the outcome measures reliable/valid?
Intervention was described in detail?
Contamination was avoided? Cointervention was avoided? Results were reported in terms of statistical significance? Were the analysis method(s) appropriate?
Clinical importance was reported?
Conclusions were appropriate given study methods and results

Question 4

What sources can you use to find toolbox to critically appraise ?

Answer 4

• quantitative study : Macmaster critical review form

- qualitative study : Critical Appraisal Skills Programm

Question 5

What are the barriers to Evidence Based Practice ?

Answer 5

• lack of support from the employer
• lack of time
• lack of resources
• inability to understand statistics
• lack of interest
• limited research in some areas

Question 6

What are the facilitators of EBP ?

Answer 6

• non conformity
• post graduate degree
• access to research articles
• feasibility belief
• self directed learning

Question 7

Why are ethics important ?

Answer 7

To protect research participants from physical and psychological harm.
Study has to be in accordance with the declaration of Helsinki. It ensures the moral responsibility of the researchers. Insurance for researchers.

Question 8

Cite the 6 basic ethic principles

Answer 8

1) autonomy
2) beneficence
3) non-maleficence
4) justice
5) confidentiality
6) dissipassions of knowledge

Question 9

Describe Autonomy

Answer 9

Participation is voluntary
Valid consent must be collected
Withdrawal is possible at any time for any reason

Participation is informed

Question 10

Explain beneficence

Answer 10

The intention of a study is to do good, and to not waste participant’s time. The rights of the individual are superior to the «greater good»

Question 11

Explain non-maleficence

Answer 11

The study mustn’t cause danger nor emotional distress. Thorough risk assessment has been lead to ensure everybody’s safety.

Question 12

Explain justice

Answer 12

All study participant must be treated equally and with respect

Question 13

Explain confidentiality

Answer 13

• Aspects of the patient
• Aspects of the treatment in a confidential atmosphere without using the patient’s name
• do not involve anyone who cannot contribute to the enhancement of care of your patient
• not deposited in places where access is public

Question 14

Explain dissipation of knowledge

Answer 14

• right to information pertaining to the condition

- right to make an informed choice of treatment options available

Question 15

What are the requirements for ethical approval ?

Answer 15

• a detailed study outline
• participant information sheet
• informed consent form
• participant debrief
• secondary informations such as outcome measures
• budget planning