EBP in SP Test 1 Flashcards
Speech
Physical act (planning and execution) of producing sounds using articulators for communication.
Language
Symbolic use of phonemes (and graphemes), and gestures with set rules, used for communication.
Communication
3 Phases
The primary function of speech/language.
Encoding
Transmitting
Decoding
Communication as a Human Right
Universal Declaration of Human Rights:
right to freedom of opinion and expression
right to seek, receive and impart information and ideas
Professional Standards
Speech Pathology Australia:
3 Domains
- Professional Conduct
- Reflective Practice and Lifelong Learning
- Speech Pathology Practice
Clinical Decisions
Clinical Assessment
Diagnosis
Treatment
Based on evidence
Evidence Based Practice
Simple Definition
The conscientious, explicit and judicious use of current data from high quality research and the integration of the data to make clinical decisions.
Dolloghan Triangle:
E3BP
External Scientific Evidence:
Best available external evidence from systematic research
Client Preferences:
Best available evidence concerning client preferences
Clinical Expertise:
Best available evidence internal to clinical practice
Best Evidence is___________
and may be focused on ____________ __________ _____________
clinically relevant (patient-centred)
accuracy of assessments
power of prognostic markers
efficacy and safety of treatments
4 EBP Components
Research Evidence
Clinical Expertise
Client Perspectives
+
Contextual Factors (Employer Policies)
Evaluating Sources Frameworks
Currency
Relevancy
Authority
Clarity
OR
Currency
Relevancy
Authority
Accuracy
Purpose
EBP: 5 Step Process
Question
Search
Evaluate
Integrate
Self-Evaluate
- Clinical Questions and Knowledge Gaps
Clinical Questions are client driven but NOT client specific.
Identify knowledge gaps:
EBP (research/clinician knowledge) gaps = form clinical questions
Client Specific (case-history, assessment result) gaps = communication/assessment with client/families
- Clinical Questions PICO
Patient Population/Problem:
patient demographic, problem type
Intervention:
Treatment being considered
Comparison/Control:
Other treatments to be considered (or no treatment)
Outcome:
Desired effects and side effects
- Searching for Evidence
Books, Journals, Databases, Websites (associations, government)
- Evaluating Evidence
Appraise for______ x3
Consider ___________________x8
Appraise for:
validity, reliability and bias
Consider:
currency, publisher, authors, affiliations, purpose, study type, journal rankings and peer-review
- Evaluating Evidence:
Bias examples x3
Reducing bias x4
Selection Bias
Withdrawal Bias
Measurement Bias
Randomisation
Blinding
Declaring author bias/interests
Declaring funding sources
- Levels of Evidence (Pyramid)
1 (Best) to 6 (Worst)
- Systematic Review
- Randomised Control Trial
- Quasi-Experimental Study
- Observational/Qualitative Study
- Expert Opinion/Consensus, Lab Research
- Individual Studies
- Integration ___+____
E3BP + Contextual Factors
Context:
money/funding, resources, employer policies, time
- Self-Evaluation x 2
1.Evaluate own performance of EBP process steps
- Ongoing evaluation of client progress, self performance, adjust as necessary
Randomised Control Trial Groups x 2
Random group allocation:
Experimental (treatment)
Control (no treatment)
Barriers to EBP x 3
Limited access to research
Workload/Lack of time (locate, read, train, practice implementation)
Inadequate workplace support (training and resources)
