Activity 1: Evidence-based practice—An introduction

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Introduction

The purpose of this activity is to provide a strong introduction, hopefully without overwhelming you, on evidence-based practice (EBP) and the evidence-based decision making process (EBDM). The web sites and readings will be used for all of the activities associated with this lesson (and the next), as well as for Assignment 3: Evidence-Based Decision Making.

Begin this activity by looking at the Glasner-Edwards & Rawson (2010) article and viewing the Canadian Institutes of Health Research and the Centre for Evidence-Based Medicine websites. We will be returning to these resources in subsequent activities in order to help you to begin to develop the skills associated with EBP.

The Canadian Institutes of Health Research (CIHR) web site provides a clear process for undertaking EBP. It is highly recommended that you take the time to work through their practice exercises. Take note of their framework—Ask, Acquire, Appraise, Integrate, Adapt, Apply, and Analyze—since we will continue to refer to it throughout the course. In addition, take note of their Population, Intervention, Comparators, Outcome (PICO) questions in the “Ask” section, since this framework will be used in Activity 3.

The Centre for Evidence-Based Medicine also has a wealth of resources on their web site, including some useful YouTube videos. Although this site is international, it is highly influenced by research from Canada. In fact Canada has been the world leader in evidence-based practice since its creation in 1993.

We recommend that you spend considerable time on these web sites, reviewing the EBDM tools and associated tutorials. These sites are recommended because 1) they are primers for the activities in this lesson and the next one, and 2) developing your competency in the EBDM process will be the standard for all subsequent work in this and other courses of the certificate program.

After you look at the web sites, read the Glasner-Edwards (2010) article, which provides a good overview of the history and process of EBP (which by now may feel more familiar). The description of the levels of evidence and how to evaluate the strength of evidence will assist you in Activity 3. In addition, Glasner-Edwards’ discussion about how to evaluate and include clinical expertise and practice-based evidence into the decision making process is not discussed in some of the other readings. Since this paper focuses on substance use treatment, it is well worthwhile to become familiar with the list of contraindicated treatments, as well interventions and core evidence-based skills that have been shown to improve clinical outcomes. This article may help you to identify practice situations or research questions that you may have.

You also may want to peruse the Forrest and Miller (2009) and Miller and Forrest (2009) articles at this time. You will more closely review the first article in Activity 3, and the second one in Lesson 6. Both of these articles are peer reviewed, and although written for a dental hygiene audience, the practices and knowledge they present are universal.

At this time, it is important to get a strong overview and feel comfortable with the core concepts of EBP and EBDM.

Instructions

  1. Read: Glasner-Edwards, S. & Rawson, R. (2010). Evidence-based practices in addiction treatment: Review and recommendations for public policy. Health Policy, 97(2–3), 93–104.
  2. View: Canadian Institutes of Health Research (CIHR) web site at http://www.cihr-irsc.gc.ca/e/45245.html
  3. View: Centre for Evidence Based Medicine web site at http://www.cebm.net/?o=1014 or access the EBM resources directly at http://www.cebm.net/category/ebm-resources/
  4. Write a summary of 300–500 words outlining your understanding of the core principles of evidence-based practice.
  5. Write out five questions you may have about your effective clinical practice, or start thinking about five situations you have been exposed to that you want to apply evidence-based decision making to. You don’t have to write these questions in any particular format, since we will develop them in Activity 3. One of the situations you think about now may be useful to you in Assignment 4. If you are not currently in practice, think of situations you have been exposed to either in previous substance use-related jobs or in practicums/preceptorships during your academic studies. If you are unable to think of any situations from your professional career to which you want to apply evidence-based decision making, think about situations in the public media and/or related to family/friends.
  6. These questions will set the stage for subsequent activities and are one component of Assignment 4.