Professional Documents
Culture Documents
The Role of Profesional Expertise in Evidnece Base - Occupational Therapy
The Role of Profesional Expertise in Evidnece Base - Occupational Therapy
don, & Thompson, 2002) and physiotherapy (Turner & Whitfield, 1997). Since
individual practitioners efforts to address
any of these barriers detract from their
direct clinical accountabilities, these barriers must be addressed at the level of the professional organization.
The neglect of qualitative research as evidence. The third, and somewhat more con-
Professional
Expertise
Clinical
Decision
Making
Client
Evidence
Research
Evidence
Stage 1
Stage 2
Client
Research
Evidence
Evidence
1. Gather and 1. Identify
appraise
research
client
question
evidence
2. Identify
2. Gather
occuparelevant
tional perevidence
formance
issues
3. Appraise
quality of
evidence
Collaborative Professional
Role
Role
Professional
Research
& Client
Expertise
Stage 3
Stage 4
Integration of
Decision
Evidence
Making
1. Establish
1. Discuss
applicabiliCEc and RE
ty of REa to
with client
C1.Eb
2. Determine 2. Develop
appropriplans for
ateness to
enablesetting
ment col3. Determine
laboratively
method,
amount,
timing
4. Identify
evaluation
criteria
5. Anticipate
outcomes
Professional Collaborative
Role
Role
Clinical
Professional
Expertise
& Client
Stage 5
Enablement
& Evaluation
1. Further
assessments as
needed
2. Undertake
processes
for enablement
3. Evaluate
outcomes
Client Outcomes
Client
Collaborative
Role
Professional
& Client
RE = Research evidence
C1.E = Client evidence
c CE = Clinical expertise
a
Professional
Expertise
Client
Evidence
Clinical
Decision
Making
Research
Evidence
professional expertise across the evidencebased practice process may persuade managers and funders to address organizational
barriers to evidence-based practice. By more
fully appreciating the centrality of professional expertise to evidence-based practices,
therapists may be inspired to become more
reflective about their clinical practices, educators may wish to reconceptualize their
curricula, and payers may reexamine their
funding mechanisms. This paper invites
both rigorous discussion and empirical
analysis of the proposed models.
Acknowledgments
I thank Nick Stitt and Janet Craik for their
thoughtful reviews of earlier drafts of this
paper and Sara McEwen for her assistance
with the figures.
References
Bennett, S., & Bennett, J. W. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy
Journal, 47, 171180.
CAOT et al.: Canadian Association of Occupational Therapists, Association of Canadian
Occupational Therapy University Programs, Association of Canadian Occupational Therapy Regulatory Organizations,
and Presidents Advisory Council. (1999).
Joint position statement on evidence-based
occupational therapy. Canadian Journal of
Occupational Therapy, 66, 267277.
Craik, J., & Rappolt, S. (in press). Theory of
research utilization enhancement. Canadian Journal of Occupational Therapy. (2003
Special edition on evidence-based practice.)
Curtin, M., & Jaramazovic, E. (2001).
Occupational therapists views and perceptions of evidence-based practice. British
Journal of Occupational Therapy, 64(5),
214222.
Dysart, A. M., & Tomlin, G. S. (2002). Factors
related to evidence-based practice among
U.S. occupational therapy clinicians.
American Journal of Occupational Therapy,
56, 275284.
Egan, M., Dubouloz, C.-J., von Zweck, C., &
Vallerand, J. (1998). The client-centered
evidence-based practice of occupational
therapy. Canadian Journal of Occupational
Therapy, 65(3), 136143.
N E W A N D N O W AVA I L A B L E AT A O TA
Evidence-Based Rehabilitation
A Guide to Practice
Mary Law, PhD, OT(C), Editor
This book is formatted into four sections: Introduction to Evidence-Based
Practice, Finding the Evidence, Assessing the Evidence, and Using the
Evidence.
Each chapter is equipped with learning objectives, take-home messages
relating the key learning points, summaries or conclusions, learning and
exploration activities, and references. Some chapters include Web links and
additional resources. 14 appendices highlighting forms, examples, key
indicators, and timelines are also included.
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