When I first heard the words, “evidence-based practice,” I was intrigued by the concept. In OT school we spent time examining the knowledge-to-practice gap, knowledge translation, and the establishment of best practices in of occupational therapy, but I was eager to learn more. From exploring the AOTA website, I discovered the opportunity to complete a fieldwork opportunity within the association, sent in my application, and before I knew it, dates were coordinated and my experience within the Knowledge division at AOTA was set to begin.
Evidence-based practice (EBP) is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research... and in the more thoughtful identification and compassionate use of individual patients’ predicaments, rights, and preferences in making clinical decisions about their care.” (Sackett et al., 1996, p. 71).” Best clinical practice should integrate clinical expertise, research evidence, and client values. Studies demonstrate that practitioners consider EBP as an ideal; however, many practitioners do not know how to get started (Hull et al., 2019). AOTA provides members with various resources to assist in this process and has ongoing efforts to develop additional resources to meet this need. Some of the resources I’ve found most helpful include:
Access to Occupational Therapy Journals: As an AOTA member you receive access to a variety of peer-reviewed occupational therapy journals. These include the American Journal of Occupational Therapy (AJOT), the Canadian Journal of Occupational Therapy, the British Journal of Occupational Therapy, and the Australian Occupational Therapy Journal. Each of these publications provides a myriad of articles related to occupational therapy in various content areas and can serve as excellent resources.
Systematic Reviews: Systematic literature searches aim to identify, appraise, and synthesize all relevant research on a specific, focused topic (“Study Designs”, 2019). The methods to conduct a systematic review are rigorous, consisting of an explicit search strategy, thorough critical appraisal, evaluation of level of evidence and risk of bias, as well as clearly defined methods that are supportive of future replication. AOTA follows the level of evidence guidelines set by the Oxford Centre for Evidence-Based Medicine to ensure critique is standardized and universally accepted. The quality and rigor of these methods should reassure the practitioner that presented research is the best available evidence within the scope of occupational therapy.
Critically Appraised Topics (CATs): After the development of the systematic reviews, Critically Appraised Topics (CATs) present a synthesis of the research findings on each specific, focused question. Each CAT provides a concise summary of research findings and a clinical bottom line specific to each question and relevant subthemes. This resource is available and discoverable by content area on the Evidence-Based Practice page of the AOTA website.
Practice Guidelines: Informed by the findings of systematic reviews, the Practice Guidelines provide the gold standard and most comprehensive view of the current research related to specific content areas (e.g., Adults Living with Serious Mental Illness, Productive Aging, and Traumatic Brain Injury). These resources provide case studies, clinical implications, and evidence tables to inform your practice. Beginning in 2020, the Practice Guidelines will be available through publication in AJOT, in order to reach a wider audience.
Choosing Wisely® Campaign: One of the most exciting aspects of AOTA’s involvement within the Choosing Wisely® campaign is that every step of the process was informed by AOTA members. This campaign is an initiative of the American Board of Internal Medicine (ABIM) Foundation to “ensure interventions and assessments are supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary” (“Our Mission”, 2019). AOTA chose to partner with ABIM to create OT-specific Choosing Wisely® recommendations that encourage practitioners to ensure interventions and assessments are necessary, effective, safe, occupation-based, and client-centered, in alignment with the core tenets of our profession. AOTA has also developed a toolbox of resources, including Q&As and clinical application guides for practitioners to use as they implement these recommendations within their clinical practice or academic program. Check out the website to learn more!
Journal Club Toolkit: The Journal Club Toolkit is a compendium of the resources necessary to conduct a journal club, designed to make implementing a Journal Club as seamless as possible. These resources include tips on how to get started, a guide to choosing articles, information on options for journal club formats, a guide to conducting a critical appraisal of the research, a reference to statistical tests, and handouts for journal club promotion.
One of the most exciting aspects of my fieldwork experience at AOTA was to have had the unique opportunity to see how hard the AOTA staff members work to protect our scope of practice, provide practitioners with tools to inform their practice, and develop initiatives and resources to better serve AOTA members and their clients. There are various opportunities and resources available on AOTA.org that I encourage you to take advantage of. This could range from joining the conversations on CommunOT to share ideas with your colleagues, visiting the value webpage to learn about the resources available to you amidst new payment changes, voicing your concerns at the Legislative Action Center, and more!
Hull, L., Goulding, L., Khadjesari, Z., Davis, R., Healey, A., Bakolis, I., & Sevdalis, N. (2019). Designing high- quality implementation research: development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide. Implementation Science 14(80), 1-20. doi: 10.1186/s13012-019-0897-z
Our Mission. (2019). Retrieved from Choosing Wisely® an initiative of the ABIM Foundation: http://www.choosingwisely.org/our-mission/
Sackett, D., Rosenberg, W., Gray , M., Haynes, R., & Richardson, S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(71), 71-72. doi:10.1136/bmj.312.7023.71
Study Designs. (2019). Retrieved from the Centre for Evidence-Based Medicine:https://www.cebm.net/2014/04/study-designs/