EBP- QUIZ 1 FINAL.pdf

Lecture 1: Summary The text focuses on Evidence-Based Practice (EBP) in the context of Speech-Language Pathology (SLP), emphasizing the importance of integrating research into clinical practice. It discusses the EBP triangle, historical misapplications of therapy, the role of the International Cla...

Lecture 1: Summary The text focuses on Evidence-Based Practice (EBP) in the context of Speech-Language Pathology (SLP), emphasizing the importance of integrating research into clinical practice. It discusses the EBP triangle, historical misapplications of therapy, the role of the International Classification of Functioning, Disability and Health (ICF), and the significance of critical thinking and skepticism in evaluating treatment methods. Highlights - 📚 1. What is EBP? - EBP guides clinical decision-making using research and client perspectives. 2. Historical Context - Past therapies like Freudian treatment lacked evidence and led to ineffective practices. 3. The EBP Triangle - The triangle includes client preferences, best available research, and clinician expertise. 4. Importance of Research - Research is essential for understanding disorders and effective treatment planning. 5. Role of ICF - Integrating ICF promotes person-centered care in SLP. 6. Critical Evaluation - Clinicians must critically evaluate research and adapt based on client needs. 7. Scientific Method - EBP relies on the scientific method for evidence and treatment efficacy. Key Insights - 🔍 1. Integration of Research - EBP emphasizes the integration of high-quality research into clinical practice, ensuring that treatments are effective and relevant. This approach helps clinicians stay updated with the latest findings while providing the best care possible. 💡 2. Historical Missteps - Understanding historical misapplications of treatment, such as Freudian therapy for stuttering, highlights the potential dangers of relying on unproven theories and practices, underscoring the need for evidence. ⚠️ 3. Client-Centered Care - EBP stresses the importance of considering client preferences and perspectives, which fosters a collaborative relationship and improves treatment outcomes. This holistic approach acknowledges that each client is unique. 🧑‍⚕️  4. Critical Thinking and Skepticism - Practicing skepticism and critical thinking allows clinicians to discern valid from invalid claims, ensuring that they do not fall prey to pseudoscience. This mindset encourages continuous questioning and analysis. 🔍 5. Value of the ICF - The ICF framework helps clinicians understand the complexities of health and disability, promoting a more comprehensive and person-centered approach to treatment that considers environmental and personal factors. 🌍 6. Continuous Learning - Clinicians must engage in lifelong learning to stay informed about current research and practices, which is vital for providing effective interventions in a rapidly evolving field. 📈 7. Balance Between Science and Practice - EBP requires a balance between scientific evidence and clinical judgment, allowing clinicians to make informed decisions while adapting to individual client needs and contexts. Booths 5-Step Process (2004) 1. Formulate the clinical question 2. Find available relevant published research evidence 3. Evaluate quality of research 4. Combine quality research findings with expertise, experience, client desires, & preferences 5. Evaluate the outcomes of treatment provided Step 1: Formulate the clinical question Will TX A work? Will TX b work? For which clients Will tx a or be more effective at achieving outcome X PICO ○ P: a type of patient or problem ○ I: intervention ○ C: a comparison or contrast to the intervention ○ O: an outcome Step 2: Find the research evidence: Systematic review, meta-analysis systematic reviews & meta-analysis: are the best; they are comprehensive, reliable, unbiased, identifies gaps, etc (best for evidence and will give evidence-based answers to clinical situations)  Do NOT depend on textbooks unless they provide a thorough systematic review of research studies Internal validity: measures how well a study is conducted & how accuractely its results reflect the studied group External validity: realtes to how applicable the findings are in the real world Step 3: Evaluate the research evidence Assess the internal validity of the studies including its basic design, and then its external validity with respect to your client Must consider client characteristics and selection of outcome measure IDEAL several well constructed RCTs (randomized control trials) with consistent results, all with clients like yours summarized in one objective and comprehensive systematic review Step 4: Combine Research evidence, expertise, and clinical references to make a decision Quality research is the starting point Step 5: Implement and monitor Implement treatment, monitor to see if it is being done accurately and systematically Obtain objective measures of effect of Tx Be prepared to change course! It’s an art: the clinician’s ability to balance multiple, constantly changing sources of information What is the point of theories?Why do they matter? Theories synthesize (integrate) the facts into a coherent framework that explains them; and Theories suggest hypotheses/conjectures/predictions that can be tested Example 1: a theory about the cause of a problem may suggest how to treat it Example 2: a theory about how the various symptoms of a problem are related may suggest the best targets for intervention PBE Step 1: Develop/ FormulateLemoncello & Fanning, 2011 ASHA presentation Develop/ Formulate Define the clinical question/ target Functional, measureable Long-term and short-term goals Select and define the intervention (see next slide) Data collection plan Consider data types Quantitative, qualitative, continuous, probe, percent correct, rate, duration, interval… Consider data collection methods Important: Evidence-based practice has become fundamental to clinical (and medical) practice Research is what moves us forward! A stagnant clinician should be a retired clinician… We will examine multiple ways to integrate research into clinical practice from a practical perspective Practice-based evidence Complements EBP Must be used when intervention approaches are not cut-and-dry Uses some of the same approaches Pseudoscience “Quackery” Any practice or remedy without compelling scientific basis for how or why it works Pseudoscience Includes questionable ideas, products and services Regardless of sincerity of promoters Does not adhere to appropriate scientific methodologies even if made to look scientific What’s a charlatan? Someone who pretends or claims to have more knowledge or skill than s/he possesses Knows their skills are not real Uses deception (Usually) motivated by money, fame or other advantages You know it is pseudoscience when….. Disconfirming evidence is ignored and practice continues When approach is disconnected from well-established scientific theories. The only “evidence” is anecdotal Inadequate evidence is accepted. Printed materials are not peer-reviewed. Presented directly to public (CEU event, self-published website/books, etc.) Accessible only for pay Grandiose outcomes are proclaimed. Too good to be true? Lecture 2: Summary Lecture 2 by Mattison focuses on locating scientific evidence effectively, highlighting reliable sources and methodologies for research appraisal. It emphasizes the importance of critical thinking in evaluating research quality and making informed therapeutic decisions. The session includes specific assignments related to speech therapy, encouraging the application of evidence-based practice while ensuring compliance with HIPAA. Highlights - 📚 1. Identify reliable sources for scientific evidence. 2. Avoid poor-quality research like outdated textbooks. 3. Use electronic databases and library privileges. 4. Understand research alignment with patient preferences. 5. Emphasize critical thinking in evaluating claims. 6. Group research topics for targeted investigation. 7. Upcoming assignments to apply learned concepts. Key Insights - 🔍 1. Source Evaluation - 🏫 Reliable sources such as PubMed and Cochrane are crucial for quality research. Understanding where to look ensures better therapeutic outcomes. 2. Research Order Importance - 📊 Following a hierarchy of evidence, from summaries to individual studies, aids in finding the most relevant information quickly. 3. Bias and Conflict of Interest - ⚖️ Recognizing potential biases in research helps in critically appraising the relevance and trustworthiness of findings. 4. Validity and Reproducibility - ✅ Validity in research design and reproducibility of results are critical for establishing reliable treatment methods. 5. Critical Thinking Application - 💡 Employing critical thinking skills enhances the ability to assess the credibility of research claims and their applicability to clinical situations. 6. Patient-Centric Research - 👥 Aligning research outcomes with patient values increases the likelihood of successful therapeutic interventions. 7. Assignment Integration - 📅 The outlined assignments encourage practical application of research skills, reinforcing the importance of evidence-based practice in therapy. Good Quality Research Examples: - www.pubmed.org www.guideline.gov  www.Cochrane.org www.asha.org www.theinformedslp.com Evidence Maps (asha.org) Poor Quality Research Examples: Textbooks Look at research in the right order... 1. Evidence summaries from panels Out of date sources 2. Evidence summaries from indiviuals 3. Critically appraised individual research Presentations Workshops Small non-reviewed research studies Integrate Critical Thinking 1. What Is critical thinking? a. The ability to assess claims and make objective judgements for well supported reason 2. Critical Thinking involves three steps… a. Identification of argument b. Identify rationale c. Assess available information 3. Qualities linked with strong critical thinking: a. Open-mindedness, Fairmindedness, Reflectiveness, Counterfactual thinking Critical thinking pitfalls We are more likely to be persuaded by incidents than objective statistical evidence We prefer evidence that supports our opinion We assign meaning to even chance events We don't acknowledge how we can be deceived Oversimplify our thinking Lecture 3: Summary The text discusses the fundamentals of evaluating research validity in speech-language pathology, focusing on internal and external validity, study design threats, and practical implications for treatment approaches across various topics including child language, adult language, articulation, swallowing, voice, AAC, and fluency. It emphasizes the balance between internal and external validity, the importance of clear operational definitions, and the impact of participant selection and measurement methods on research outcomes. Highlights - 📚 1. 16-Week Course: Transition from a 2-credit to a 16-week class format. 2. Research Topics: Focus on specific areas: Child Language, Adult Language, Articulation, Swallowing, Voice, AAC, and Fluency. 3. Validity Types: Distinction between internal and external validity in research. 4. Study Design: Importance of study design to mitigate threats to validity. 5. Measurement Issues: Considerations for testing effects and instrumentation changes. 6. Treatment Fidelity: Relation of treatment fidelity to generalizability and internal validity. 7. Quality Indicators: Emphasis on quality indicators in evaluating experimental studies. Key Insights - 🔍 1. Balancing Validity: Achieving a balance between internal and external validity is crucial for meaningful research outcomes. Internal validity focuses on the integrity of the study, while external validity addresses the applicability of findings to real-world settings. ⚖️ 2. Threats to Internal Validity: Factors like maturation, history, and selection bias can significantly affect study results. Understanding these threats helps researchers design more robust studies. 🧠 3. Selection Bias: Careful participant selection is essential to avoid biases that can skew results. Researchers must ensure that their sample is representative of the population for generalizable findings. 👥  4. Measurement Challenges: Instrumentation and testing effects can introduce variability in results. Clear operational definitions and consistent measurement methods are vital for reliable data. 📏 5. Treatment Fidelity: Ensuring that interventions are delivered consistently is key to internal validity. This affects how findings can be generalized to broader populations. 🔄 6. Experimental Context: The setting of the study (lab vs. real-world) can limit the generalizability of findings. Understanding this context is important for applying research to clinical practice. 🏢 7. Quality Indicators: Evaluating studies based on quality indicators, such as effect size and repeated measures, enhances the understanding of their credibility and relevance in clinical practice. ⭐ Internal Validity: truth in the study External Validity: truth in real life Threats to Internal Validity Threats to External Validity Lecture 4: Summary null Highlights - 📊 1. Operational Definitions: Clear descriptions of constructs being measured. 2. Measurement Methods: Various approaches include tests, surveys, and observations. 3. Types of Measures: Nominal, ordinal, interval, and ratio levels define data complexity. 4. Reliability: Consistency of measurement is crucial for credibility. 5. Validity: Ensures the right constructs are being assessed accurately. 6. Statistical Analyses: Different measurement types support various statistical methods. 7. Limitations: All measurement methods have inherent flaws and biases. Key Insights - 🔍 1. Operational Definitions Matter: Clear operational definitions are essential to avoid ambiguity in research. They guide how constructs like “articulation” or “receptive language” are quantified, ensuring consistency across studies. 📏 2. Diverse Measurement Methods: The choice of measurement method (tests, surveys, observational methods) affects data quality and relevance. Each method has distinct advantages and limitations, making it crucial to select the right one for the research question. 🧪 3. Understanding Measurement Types: Different levels of measurement (nominal, ordinal, interval, ratio) influence the type of statistical analysis that can be conducted. For example, interval data allows for more complex statistical operations than nominal data. 📈 4. Reliability is Key: For measures to be valid, they must demonstrate reliability. This means repeated measures should yield consistent results, highlighting the importance of rigorous testing conditions and observer training. ⚖️ 5. Validity Ensures Construct Accuracy: Validity examines whether the measure accurately reflects the construct it is intended to assess. Issues arise when there’s a disconnect between what is measured and the theoretical framework, leading to potential misinterpretations. ✅ 6. Statistical Analysis Insights: The way data is represented (descriptive vs. inferential) impacts how we interpret findings. Understanding these differences is vital for drawing accurate conclusions from research data. 📉 7. Awareness of Limitations: Every measurement method has limitations, which researchers must acknowledge. Recognizing these shortcomings helps improve the rigor of studies and enhances the credibility of findings in the field of communication sciences. 🚧 Reliability & Validity of Measures Need reliability for validity, but not sufficient -A scale tells me the same weight every day? Is it reliable? Do I know it is valid? - My weight hasn’t changed in reality but my scale tells me 5-10 lbs difference each day; reliable? Valid? Measurement