One thing I really want to remember about evidence-based practice is the proper use of coding. Coding is a common feature of research and all qualitative analysis and synthesis. Coding is sorting all data sets according to topics, themes, and issues important to the study. Coding is for interpretation and storage more than for organizing the final report. It is important to appropriately sort data for a research study. Coding is not intended to be used for the final report, but rather, is a great tool for interpreting and storing data. Organizing information through microresearch helps synthesis and analysis of information for the final research findings (Stake, 2010).
Another important thing I learned about research were the different types of validity: predictive validity helps to determine how well a test predicts future outcomes; concurrent validity forecasts the present performance. I learned about the hierarchy of research: expert opinion, case-controlled studies, cohort studies, randomized controlled trials (RTCs), critically individual articles, critically appraised topics and systematic reviews. (Sackett, Straus & Richardson, 2000)
When I entered the occupational therapy program, I believed evidence-based practice was important to some degree, but I didn’t realize how important it is to provide evidence for the interventions you provide to clients. When I took some time to think through what it would be like if I were receiving therapy, I realized that I would want my therapist to have evidence to support that what they are doing to is effective. There are many treatments, but if my therapist could show me the research to back it up, I would be far more likely to try a treatment. My attitude changed and I began trying to back up everything I was doing in class or in fieldwork. It was a habit that Touro instilled in me and I will continue to use this skill. I have more confidence in my ability to understand research articles after completing a systematic review; I had to learn to understand the intervention used, outcomes, and clinical significance verses statistical significance. I can extract what I need from articles when interventions are being compared.
I still have room to grow when it comes to transcribing interviews and coding the information from the interviews. I need to work on identifying and understanding bias in articles that don’t specifically discuss it. I still find it difficult to understand the outcome measure in some articles because I am not yet familiar with a broad enough range of assessment tests and measurement scales; I am a novice and am familiarizing myself with assessment tests.
Applying knowledge to actual practice situations is a struggle for me. It is hard to perfectly apply evidence-based practice in every situation, but you can get an idea of the effectiveness of different interventions based on systematic reviews and other studies. I think to truly apply evidence-based practice, you would need to do this with every treatment session; this seems unrealistic to me. It also seems that there is a severe lack of occupational therapists in research; it was rare to see an occupational therapist giving the treatment in research studies I read. This was unnerving to me; how can we be do doing evidence-based practice if there is there a lack of evidence-based research being conducted by occupational therapists? We need more occupational therapists to determine the outcomes of occupation-based interventions.
References
- Stake, R. E. (2010). Qualitative research: Analysis and Synthesis: How things work. New York, NY: Guilford Press.
- Sackett, D. L.Straus S., E. Richardson, W., S. (2000). Evidence-based medicine: how to practice and teach EBM (2nd Ed.). Edinburgh: Churchill Livingstone.