Evidence-Based Practice Quiz

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Questions and Answers

What is a limitation of a systematic review even if it is considered the highest level of evidence?

  • It may include only quantitative studies.
  • The studies may not demonstrate statistically significant outcomes. (correct)
  • It must only focus on recent studies.
  • All included studies are guaranteed to be randomized controlled trials.

What criteria would disqualify a systematic review from being considered Level I evidence?

  • If the systematic review is comprehensive.
  • If it contains studies not conducted in the last five years.
  • If it includes studies other than randomized controlled trials. (correct)
  • If the authors have conflicting interests.

What aspect of study design does internal validity primarily refer to?

  • The accuracy in establishing a causal relationship between the intervention and the outcome. (correct)
  • Consistency of the results across different studies.
  • The relevance of the study to real-world applications.
  • The number of participants involved in the trials.

Why is it important to evaluate the studies included in a systematic review?

<p>Because the overall evidence may be weakened by lower quality studies. (B)</p>
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What constitutes Level II evidence?

<p>Evidence from randomized controlled trials. (C)</p>
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What is the first step in the evidence-based practice process?

<p>Formulate a question based on a clinical problem (A)</p>
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Which of the following types of questions is LEAST likely to be addressed in evidence-based practice?

<p>General dissatisfaction with services (C)</p>
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Why is it important to formulate a specific question in evidence-based practice?

<p>To address the clinical problem effectively (A)</p>
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After formulating a question, what is the next step in the evidence-based practice process?

<p>Identify relevant evidence (D)</p>
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What factor should therapists always consider along with research evidence?

<p>Previous experience and client factors (A)</p>
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Which step in the evidence-based practice process involves assessing the findings from previous steps?

<p>Evaluate the evidence (D)</p>
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What is the ultimate goal of an intervention decision grounded in evidence-based practice?

<p>To achieve positive outcomes for the client (A)</p>
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What should be done after implementing useful findings in evidence-based practice?

<p>Evaluate the outcomes (B)</p>
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What did the orthopedic surgeon suggest after the cast was removed?

<p>To replace the cast for several more weeks (A)</p>
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What reason did the orthopedic surgeon have for wanting to keep the cast on longer?

<p>The bone was healing well, but vulnerable to refracturing (B)</p>
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How did the mother respond to the surgeon's recommendations?

<p>She requested a splint instead of a cast (C)</p>
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What was a key factor that influenced the surgeon's decision to comply with the mother's request?

<p>The importance of the parent’s opinion (C)</p>
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What aspect of decision-making was emphasized as important for best practice in the health care setting?

<p>Shared decision-making from the beginning (D)</p>
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Which of the following best describes the nature of the relationship between the orthopedic surgeon and the family?

<p>Conflicted yet respecting differences (B)</p>
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Which of the following components is NOT part of evidence-based practice?

<p>Personal intuition (A)</p>
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What defines the focus of Natalie Jones' early psychosis employment program?

<p>Support for individuals experiencing psychotic symptoms (D)</p>
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What is the primary method used by researchers to develop external scientific evidence?

<p>Employing the scientific method (D)</p>
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What foundational principle is highlighted in the development of early psychosis programs according to Natalie Jones?

<p>Utilizing evidence-based practice (B)</p>
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What is the first step of the scientific method?

<p>Asking a question (D)</p>
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What can reflective practitioners gain from the tension between research findings and clinical experience?

<p>A broader understanding of practice (C)</p>
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In the context of evidence-based practice, which of the following best illustrates the role of client's values?

<p>They are essential for comprehensive decision-making. (D)</p>
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What was the hypothesis of the researchers in the study about the technology-assisted enriched environment?

<p>An enriched environment could improve patient activity and upper arm function. (A)</p>
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Which of the following describes the outcome when comparing the intervention group to the control group in the mentioned study?

<p>The intervention group exhibited greater improvements in activity and function. (A)</p>
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What should be prioritized for the best clinical decisions in evidence-based practice?

<p>Considering all three sources of evidence (A)</p>
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What does the example of external scientific evidence in the content primarily highlight?

<p>The importance of replication in research findings (D)</p>
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What type of evidence does a systematic review provide?

<p>A summary of many studies on the same topic. (C)</p>
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According to the content, why should results from a single study be viewed with caution?

<p>No research fully captures clinical complexities (B)</p>
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Which intervention was chosen by Sam's parents to address his sleep issues?

<p>Standard extinction. (C)</p>
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How has the perspective on practitioner experience evolved in evidence-based practice?

<p>It was initially undervalued but is now viewed as complementary (A)</p>
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What is a potential short-term effect of implementing standard extinction in children with autism?

<p>Increase in tantrums and agitation. (B)</p>
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What is one of the key limitations of scientific research mentioned in the content?

<p>It cannot answer all specific clinical questions faced by practitioners (B)</p>
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What role does clinical experience play in the decision-making process?

<p>It provides context when scientific evidence is not adequate (C)</p>
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Which research design level is generally considered to provide the strongest evidence?

<p>Systematic reviews. (B)</p>
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What major finding did the Cuomo et al (2017) systematic review report regarding sleep interventions for children with autism?

<p>The studies on sleep interventions were limited. (C)</p>
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What aspect of the scientific method is emphasized in the content?

<p>The gradual accumulation of results through replication (A)</p>
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What criticism did early models of evidence-based practice face?

<p>They ignored the contributions of clinical experience (A)</p>
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Which among the following approaches is mentioned in the review as a method for addressing sleep issues?

<p>Stimulus fading. (B)</p>
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What was the parents' belief about starting the bedtime intervention during a long weekend?

<p>It would help them adjust to a new routine. (B)</p>
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What is a core concept emphasized regarding scientific evidence and practitioner practice?

<p>Best practices integrate both scientific evidence and clinical expertise (B)</p>
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What outcome did Sam's parents report after one week of using the extinction technique?

<p>Significant reduction in night awakenings. (C)</p>
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Flashcards

Replication

The process of repeating a study to verify its findings.

Accumulation of Evidence

The consistent findings from multiple studies across different contexts and populations.

External Scientific Evidence

Evidence obtained from research studies, such as randomized controlled trials, that investigates the effectiveness of interventions.

Practitioner Experience

Knowledge and skills gained through years of practice and experience as a therapist.

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Evidence-Based Practice

An approach that balances scientific evidence and practitioner experience in clinical decision-making.

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Practice Knowledge

Knowledge acquired through professional practice that complements external scientific evidence

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Insufficient Scientific Evidence

A limitation of external scientific evidence where research may not address all the specific questions that arise in day-to-day practice.

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Translating Research into Practice

The ability to translate research findings into real-world clinical settings and apply them to diverse clients.

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Scientific Method

A method used by researchers to minimize bias, involving controlled experiments, objective data collection, and statistical analysis.

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Clinician Experience

A practitioner’s experience and knowledge gained through clinical practice.

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Client/Family Situation and Values

Clients', caregivers', and family's perspectives, values, and experiences that contribute to clinical decision-making.

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Three Components of Evidence-Based Practice

The core principles of evidence-based practice that guide clinical decision-making.

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Reflective Practice

A crucial aspect of evidence-based practice that involves analyzing and interpreting research findings to apply them to clinical settings.

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Steps of the Scientific Method

Using the scientific method to answer research questions and reduce bias in research findings.

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Shared Decision-Making

A healthcare approach where the healthcare provider and the patient work together to make decisions based on shared information and understanding.

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Systematic Review

A systematic review summarizing multiple studies on a topic, often used to assess the effectiveness of interventions.

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Efficacy Study

A research design that aims to determine if an intervention causes a specific change, often using a control group for comparison.

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Extinction

A type of behavior therapy for sleep problems where parents gradually decrease their responses to nighttime awakenings, helping the child learn to self-soothe.

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Levels of Evidence

A hierarchy used to assess the strength of evidence from different types of research studies, with randomized controlled trials generally considered the highest level.

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Generalizability

The ability of a research study's findings to apply to different contexts and populations.

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Validity

The extent to which a study's findings are accurate and reflect reality.

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Randomized Controlled Trial (RCT)

A study design that aims to determine if an intervention causes a specific outcome. It randomly assigns participants to groups to minimize bias and control for confounding variables.

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Internal Validity

The ability of a study to demonstrate that the intervention, rather than other factors, caused the observed outcome. It's about confidently attributing the result to the specific intervention.

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External Validity

This refers to how well the findings of a study can be generalized to the real world and applied to other settings, populations, or interventions. It's about ensuring that the study's results are applicable beyond the specific study participants and context.

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Level I Evidence

A systematic review that includes only randomized controlled trials (RCTs) is considered the highest level of evidence in evidence-based practice.

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Level I Evidence: Importance of RCTs

The evidence level of a systematic review is determined by the quality of the studies included. If the review doesn't include RCTs, it might not be considered Level I evidence.

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What is evidence-based practice?

A decision-making approach that combines scientific evidence, clinical expertise, and client values to achieve the best possible outcomes.

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How is evidence-based practice like the scientific method?

The process of evidence-based practice follows the steps of the scientific method, but instead of creating new evidence, it applies existing evidence to answer clinical questions.

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Why is formulating a good question important in evidence-based practice?

A well-defined question about a clinical problem helps guide the search for relevant evidence and focuses the research effort.

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What are some sources of evidence in evidence-based practice?

Evidence can be found in research articles, professional guidelines, practitioners' experiences, and client preferences.

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Why is evaluating evidence important in evidence-based practice?

Evidence-based practitioners critically evaluate the quality, relevance, and applicability of the evidence they find.

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How do evidence-based practitioners use evidence in practice?

Evidence-based practitioners implement the findings from their research into their practice, but they also monitor the outcomes and modify their approach if needed.

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What is the cyclical nature of evidence-based practice?

The steps of evidence-based practice involving identifying a problem, finding evidence, evaluating it, implementing findings, and evaluating outcomes, create a continuous cycle.

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What are some key aspects of evidence-based practice?

Evidence-based practice is a dynamic process that requires practitioners to be open to new evidence, reflect on their practice, and be responsive to client needs.

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Study Notes

Defining Evidence-Based Practice

  • Trust science, believe that innovation and discoveries are good for us, and make decisions based in data and evidence.
  • Quote by Julie Payette, astronaut and Governor General of Canada.
  • Evidence-based practice combines external scientific evidence, practitioner experience, and client/family values to inform clinical decisions.

What is Evidence-Based Practice?

  • External Scientific Evidence: research from scientific journals, offering objective information applicable to clinical problems.
  • Practitioner Experience: practitioners' experiences and knowledge relevant to specific practice situations.
  • Client Situation and Values: clients' experiences, values, and preferences.

Why Evidence-Based Practice?

  • Essential when scientific evidence is insufficient.
  • Ensures clinical decisions are made within the context of client's situation.

Writing an Evidence-Based Question

  • Questions regarding intervention efficacy, assessment usefulness, condition description, outcome prediction, and the client's lived experience.
  • Different research designs used for each type of question.

Learning Outcomes

  • Identify components of evidence-based decision-making.
  • Apply an evidence-based hierarchy to specific research studies.
  • Describe types of research questions and the clinical information they provide.
  • Explain the purpose of critically appraised topics and papers.

External Scientific Evidence

  • Scientific approach is critical for evidence gathering in research.
  • Method involves asking questions, gathering information, formulating hypotheses, testing those hypotheses, examining the evidence, and reporting the evidence.
  • Randomized controlled trials are strong evidence for efficacy studies.

Practitioner Experience

  • Clinical experience and expertise are important components of evidence-based practice.
  • Reflection on experience is crucial to knowledge building in practice.
  • Theory plays a role in explaining the rationale behind an intervention.

Client/Family Situation and Values

  • Client preferences and values should be factored into the treatment planning process.
  • Shared decision making involves a collaborative process where practitioners share information from research and client experiences.
  • Decision-making process depends on client, family, and caregiver values.

Evidence-Based Practice in Rehabilitation

  • Stems from evidence-based medicine.
  • Defined by David Sackett and colleagues as conscientious and judicious use of current best evidence.
  • Evidence-based practice requires an active exchange between researchers and clinicians. Clients' values and experience are also relevant factors.

Evidence in the Real World: Applying Evidence-Based Practice to Early Psychosis Programming

  • Program developed using evidence-based practice principles.
  • Focused on increasing client independence and addressing the needs identified in the research.
  • Encompasses external scientific evidence, practitioner experiences, and clients' values and preferences.

Why Evidence-Based Practice?

  • Acknowledges that current best evidence is essential for professional practice.

The Process of Evidence-Based Practice

  • A cyclical process, mirroring the scientific method.
  • Steps include: formulating a question, identifying relevant evidence, evaluating the evidence, implementing useful findings, and evaluating outcomes.

Questions for the Usefulness of an Assessment

  • Psychometric methods assess reliability (consistency) and validity (accuracy) of assessment tools for consistency of scoring, agreement of scoring by different testers, and stability of scoring across different forms.
  • Validity assesses if an instrument measures what it is supposed to measure.

Research Designs Used in Descriptive Studies

  • Aim to describe a phenomenon as it occurs.
  • Examples include prevalence and incidence studies.
  • Survey methods are frequently used to collect data.

Research Designs Used in Predictive Studies

  • Focuses on identifying predictors of outcomes, conditions, responses, etc.
  • Strongest evidence often comes from longitudinal studies where factors are studied over multiple time points.

Questions About the Client's Lived Experience

  • Qualitative research methods are suitable for these nuanced questions.
  • Explores lived experiences and interpretations of conditions through interviews, observations, and subjective data.

Critically Appraised Topics and Critically Appraised Papers

  • CATs summarize and synthesize multiple studies relating to a topic.
  • CAPs critically appraise individual studies.
  • Important resources in evidence-based clinical practice.

Evidence-Based Clinical Questions

  • PICO format (Population, Intervention, Comparison, Outcome) is critical for precisely formulating research questions about intervention efficacy.

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