Living and Role Modelling Evidence-Based Practice

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Introduction

Evidence-based practice (EBP) is an integral part of healthcare and has become a key part of clinical training, research and rehabilitation practices. It is a problem-based approach where research evidence is applied to clinical reasoning and decision-making.[1] Each element of the evidence-based practice model is important - it is imperative to realise that these concepts are to be applied together rather than divided into parts or categories to justify a clinical decision.[1] Hoffman

The definition of evidence-based practice has evolved over time. Along with the integration of research, clinical expertise and patient values and circumstances, it is also necessary for the healthcare professional "to consider characteristics of the local and broader practice context.”[1] Thus, it is not only about the research but also about the skills, education and experience of a clinician as well as the patient and their values, circumstances, preferences and clinical status. Furthermore, the clinician needs to consider the availability of resources, policies, and cultural and socioeconomic factors in the decision-making process. Hoffman et al.[1] explain this eloquently: “This requires judgment and artistry, as well as science and logic.”

Since then, various models and frameworks have been proposed in the healthcare setting that apply to more fields than just medicine.[3]

Review of the Evidence-Based Practice Steps

Step 1: Determining the patient’s needs to formulate a clinical question

• You can review this step here: Evidence-Based Practice and Patient Needs
• Make use of the PICOT mnemonic to formulate your clinical question:

PICOT Mnemonic to use in formulating a clinical question

P (Patient / Population)	I (Intervention)	C (Comparator)	O (Outcome)	T (Type)

Step 2: Locating the knowledge resources

• If you'd like to review this step, you can have a look at Locating the Knowledge Sources in Evidence-Based Practice
• Suggested order for locating knowledge resources:
  1. Look for information on a synthesised, evidence-based platform
  2. Look for a clinical practice guideline
  3. Look for a systematic review
  4. Look for primary studies

Note: Remember to download and save the relevant papers in a safe place so that you can easily find them again.

Step 3: Appraising the quality of the knowledge resources

• If you'd like to review this step in detail you can have a look at Appraising the Quality of Knowledge Resources.
• Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Table
• Process of how to determine which study type was used: Downloadable PDF by Jeremy Howick about study designs

Step 4: Discussing the options with the patient

Step 5: Formulating the treatment plan

Step 6: Implementing the treatment plan

Step 7: Evaluating the effectiveness of the treatment plan and the evidence-based practice process

Evidence based practice steps- link to steps

Making Evidence Based Practice Part of Your Life

Implementing evidence-based practice

Get the skills – you know best where you lack the necessary skills

Make time – time is a big barrier to EBP – Try and overcome this barrier in a creative and innovative way that works for you

Remind yourself of the evidence-based practice process – put it up where you can see it daily, make it a habit

Live evidence-based practice – find opportunities to share the evidence-based practice model with others

Empowering Others

Share what you have learned with others. Here are some examples of ways to do this:

Organise journal clubs or case discussions

Join in these if they already exist at your specific setting

Actively contribute to these sessions

If there are no journal clubs – start one – be the change. It can be online or in-person

Write blog posts

Suggestions for blog posts:

Share some of the valuable website that you discovered

What have you learned from the EBP process

Highlight how you followed the EBP process with a specific case

Share some of the new skills that you gained

Make videos

Find platforms where you can be interviewed, record techniques, share outcome measures, showcase the brilliant new skills that you acquired

Podcasts

Contribute to podcasts as an expert or as an interviewer

Contribute to courses – webinars, partner with organisations or associations and share your knowledge

Publish case studies

Summary

Resources

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• x

or

1. numbered list
2. x