Finding Evidence for Your Practice
Evidence-based practice (EBP) and evidence-informed practice (EIP) have become commonly used terms in our current healthcare environment. This construct is critical to the sustainability and future development of all health professions. The literature suggests that these terms can be defined as the integration of the best research, sound clinical expertise and the values of clients in the provision of an optimal healthcare outcome.
Although literature reviews (especially of randomized control studies) and critical appraisals of research articles are the cornerstones of evidence-based practice, there are a number of strategies that can assist in informing your practice, including;
- Published research is found in numerous data bases such as MEDLINE, the Cochrane Library, CINAHL, OTD Base and PsycINFO. The Allied Health Professional Development Electronic Health Library provides a complimentary, comprehensive literature search tool for occupational therapists registered to practice in Ontario.
Journal clubs - consider establishing a commitment amongst peers to share coffee or lunch while discussing a current article of relevance to your practice. Why not use OSOT's resource for Establishing an OT Journal Club!
OT Interest Groups
Assessment tools and outcome measures provide useful evidence.
Checking the “gray” literature through internet searches.
Problem-solving with your colleagues.
Client-centered care is evidence in itself as the evidence demonstrates that clients involved in decision-making have better health outcomes.
Joint Position Statement on Evidence Based Occupational Therapy (Canada)
Authored by the Canadian Association of Occupational Therapists (CAOT), the Association of Canadian Occupational Therapy University Programs (ACOTUP), the Association of Canadian Occupational Therapy Regulatory Organizations (ACOTRO), and the Professional Alliance of Canada (PAC), this joint position statement reviews the background, information, responsibilities and challenges required for evidence-based occupational therapy. It is hoped that this will be of use to those who require knowledge of how evidence is used by occupational therapists. Those interested may be occupational therapy students, practitioners, educators, researchers and regulators, as well as clients, administrators, payers and other health, social service or education workers. View the Joint Position Statement on Evidence Based Occupational Therapy (Canada).
The Ontario Allied Health Electronic Health Library
Supported by the Ontario government the Electronic Health Library
(EHL) gives registered members of the allied health professionals complimentary access to the most recent health care literature to help determine the best approach to evidence-based practice by providing access to the databases of MEDLINE, DynaMed and CINAHL. The Electronic Health Library also provides access to PUBMED, which comprises more than 22 million citations for biomedical literature from MEDLINE, life science journals, and online books. Whenever available from the publisher, full text articles are available through the EHL. Registered Ontario occupational therapists can register an account for the library at any time. Introductory and advanced search webinars are also available free of charge.
OTseeker is a database that contains abstracts of systematic reviews and randomized controlled trials relevant to occupational therapy. Trials have been critically appraised and rated to assist you to evaluate their validity and interpretability. These ratings will help you to judge the quality and usefulness of trials for informing clinical interventions. In one database, OTseeker provides you with fast and easy access to trials from a wide range of sources. The OT Seeker Links page also provides a number of other resources that are valuable to specific areas of practice.
Occupational Therapy Critically Appraised Topics (OT CATS)
OT CATS is a site which contains CATs and CAPs focusing on occupational therapy interventions. The earlier topics were completed by Australian occupational therapists participating in a year-long research project between 2002 and 2003. Completion of a CAT or CAP was the major assignment for the study, and resulted in the development of the website. Participants in that study identified a common clinical problem, wrote a focused clinical question, conducted a search for the best available evidence, then appraised and summarized the evidence. Studies on the effectiveness of an intervention were sought. The aim was to locate current best evidence, such as systematic reviews and randomized controlled trials. However, in the absence of such research, lower level studies were found and appraised. See the OT CATS Critical Appraisal Template
The Cochrane Collaboration
The Cochrane Collaboration is an international non-profit and independent organization, dedicated to making up-to-date, accurate information about the effects of healthcare readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. The Cochrane Library is a collection of six databases that contain different types of high-quality, independent evidence to inform healthcare decision-making, and a seventh database that provides information about groups in The Cochrane Collaboration. Of particular interest to clinicians is the Database of Systematic Reviews. Individuals can subscribe to receive email updates, join a Cochrane Journal Club, etc.
The Centre for Evidence-Based Rehabilitation
The Centre for Evidence-Based Rehabilitation provides links to evidence based learning resources, steps for the evidence-based practice process and contact information for research themes within the School of Rehabilitation Science at McMaster University, Hamilton, Ontario, Canada. Follow the links to The McMaster University Occupational Therapy Evidence-Based Practice Research Group which aims to focus on research that critically reviews evidence regarding the effectiveness of occupational therapy interventions. This group have developed tools to use in the evaluation of occupational therapy programmes and guidelines for critical appraisal. This site gives online access to the group's critical appraisal forms and guidelines (quantitative and qualitative) as well as to 2 systematic reviews.
The Open Journal of Occupational Therapy
The Open Journal of Occupational Therapy is a peer-reviewed, open-access journal with a mission to publish high quality articles that focus on applied research, practice, and education in the occupational therapy profession. Specifically, the categories of articles published in OJOT include Applied Research, Guidelines for Practice and Technological Guidelines, Opinions in the Profession, Topics in Education, and Letters to the Editor.
Keeping up with the medical literature is increasingly difficult. At the current pace, over 1.2 million citations will be added to PubMed this year, which breaks down to more than 304 per hour in an 80-hour work week. To be knowledgeable about recent studies and innovations requires a two-part pull and push strategy: you not only need to be able to dive into the literature and pull what you need when you need it, but you will also benefit from the most relevant information being pushed to you for overall current awareness. Docphin can be a useful resource for all OTs.