L1 Introduction

Question 1

what is evidence based practice

Answer 1

the integration of 3 components to provide best possible care for clients and patients

Question 2

what are the 3 components of EBP

Answer 2

clinical expertise/expert opinion
evidence - internal and external
client/patient/caregiver perspectives

Question 3

what is clinical expertise/expert opinion

Answer 3

the knowledge, judgement and critical reasoning acquired through your training and professional experiences

Question 4

what is evidence - internal and external

Answer 4

the best available information gathered from scientific literature (external evidence) and from data and observations collected on your individual client (internal evidence)

Question 5

what is client/patient/caregiver perspectives

Answer 5

the unique set of personal and cultural circumstances, values, priorities and expectations identified by your client and their caregivers

Question 6

why is it important to stay current on EBP

Answer 6

research grows and changes - what was best practice two years ago may not be best practice today

Question 7

advantage of being aware of the evidence base

Answer 7

optimisation of clinical load planning
rather than wasting time on interventions which have no evidence behind them eg. NSOMES, we can use that time wisely to provide evidence-backed interventions (eg. Van Riper’s articulation therapy)

Question 8

one resason why a clinician may not provide gold standard care

Answer 8

lack of available resources eg. LSVT is gold standard for hypokinetic dysarthria - however it is very time intensive and may not be feasible for a clinic to provide

Question 9

cochrane reviews

Answer 9

named after EBP founder Archie Cochrane, these are reviews which are considered to be very high quality evidnce, they must be updated every few years and have very strict criteria for research inclusion

Question 10

challenges associated with EPB

Answer 10

1. evidence changes quickly
2. people have their own agendas in desseminating information and influencing the acceptance of EPB
3. finding credible sources
4. discerning what is good evidence and what is bad evidence
5. Where to find the evidence
6. how to keep up with the evidence
7. sometimes there is no evidence

Question 11

key steps in EBP

Answer 11

step 1: ask a clinical question
step 2: acquire the best evidence
step 3: appraise the evidence
step 4: apply the evidence
step 5: assess your performance

Question 12

types of evidence

Answer 12

• clinical state and circumstance
• research evidence
• systematic review
• randomised control trial
• meta analysis
• patient preference and actions

Question 13

what is clinical state and circumstance evidence

Answer 13

epidemiology studies - nature, risk, prevalence, course of the acquisition

Question 14

why is clinical state and circumstance evidence useful

Answer 14

helps us understand conditions and plan services

Question 15

what is research evidence

Answer 15

focused on experimental design, carefully controlled interventions and measurable outcomes

Question 16

why is research evidence useful

Answer 16

helps us understand efficacy of interventions and diagnostic accuracy of tests

Question 17

what is a systematic review

Answer 17

a summary of all the available primary research or evidence in response to a research question. A systematic review uses all the existing research and is sometimes called ‘secondary research’ (research on research). They are often required by research funders to establish the state of existing knowledge and are frequently used in guideline development. (Clarke 2011)

Question 18

what is a randomised control trial

Answer 18

• a study design that randomly assigns participants into an experimental group and/or a control group.
• The only expected difference between the control and experimental groups in a randomized controlled trial (RCT) is the outcome variable being studied.

Question 19

what is a meta analysis

Answer 19

a combination of a group of studies to reach a conclusion statistically about the effect of an intervention. the results are depicted on a forest plot

Question 20

issue with meta-analyses

Answer 20

researchers often use different outcome measures and tests eg. Frenchay and AIDS

Question 21

what is a core outcome set

Answer 21

the solution to the meta-analysis issue - they are international standards where researchers use a specific test/outcome measure so that a meta analysis can encompass them all

Question 22

what is patient preference and action evidence

Answer 22

qualitative studies - interviews, surveys, quality of life instruments, autobiographical accounts

Question 23

how is patient preference and actions evidence useful

Answer 23

it helps us understand the perspectives of key stakeholders, impact of conditions on lives, tolerance of procedures etc.

Question 24

PICO formula

Answer 24

• Patient or Problem
• Intervention (cause, prognostic factor, treatment) - what intervention am I considering
• Comparison intervention (if necessary) - is this intervention Y better than intervention X
• Outcomes - what can I hope to achieve, can this be measured