Saturday, April 12, 2014

Best Practice & Evidence-Based Practice

I recently met a lovely OT who took some time out to raise her little ones and is now looking to work as a pediatric occupational therapist outside the home again.  In truth, while my friend may have been a stay-at-home mom, I seriously doubt any of us really stop being OTs - aren't we constantly doing activity analysis about how to manage behaviors, car pools, play dates, family matters, home matters, etc.?  Truly I think OTs (OTAs included here) have activity analysis hard-wired into us by the time we're done with our educational programs and fieldworks!  ;)

At any rate, my friend was feeling insecure about re-entering the job market.  When I asked "Why?", she said she didn't know much about evidence-based practice (EBP) and thought she should learn about this before venturing into the job market.  I laughed and said: "It isn't about what you know but how you problem solve/analyze using what you know, or what you can find out, and combining that with what you know about your client."  

I know that folks are sometimes intimidated by research and using the evidence from research to help their clients/patients/students but in my opinion, there are 2 critical points to know:

1. AOTA (the American Occupational Therapy Association) has an excellent resource in which members have analyzed the various studies/articles and based on that analysis, they form recommendations as to how the evidence informs occupational therapy practice/practitioners.  The Evidence-Based Practice and Research section is an excellent resource for evidence for the practice settings of:
  • Children & Youth
  • Health & Wellness
  • Mental Health
  • Productive Aging
  • Rehabilitation & Disability
  • Work & Industry

Click on the link above and then click on the right side of the page to see specific critically appraised papers and topics for each practice area/setting. 

2. Despite #1, we still have relatively little evidence - many published research studies:
  • have small numbers of participants, which limits the applicability of that study's findings to clients/patients who are not exactly like those participants
  • use measures or assessment tools that do not effectively measure the outcomes; as a profession, we are limited in our measures and assessment tools, 
  • are poorly designed research studies; this was more true of older research studies but has greatly improved over the last 10 years.
As a result of these two critical issues, we need to rely on Best Practice, which is simply using the evidence we have but more importantly using the problem-solving/activity analysis skills we OTs are so good at, to best help our clients/patients.  Like I said to my friend: said: "It isn't about what you know but how you problem solve/analyze using what you know, or what you can find out, and combining that with what you know about your client."  :)


(c) 2014  DeLana Honaker, PhD, OTR, FAOTA

1 comment: