Bridging the Divide Between EBP and Practice

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How well does your program integrate clinical practice and research education? It’s a question definitely worth asking. Today, clinicians are expected to use evidence-based practice in all of their clinical encounters, but does it ever seem as though research evidence is pulling clinicians in one direction while clinical experience is pulling the other way?

EBP requires you to consider current best research evidence, clinical expertise, and patient perspectives in your clinical decision-making. Clinicians who did not receive a proper balance and integration of research and clinical practice in their graduate classes may be feeling thinly stretched to meet these demands. In an ASHA survey fielded in 2011, 24 percent of respondents indicated that EBP created unrealistic demands on clinicians.  CSD programs need to provide students with the knowledge and tools to evaluate and apply research. Additionally, faculty members need to think about how well they model a fusion of research and clinical practice in their own teaching.

Some help

To help, ASHA has updated a tool, the Academic Program Self-Assessment: Quality Indicators for Integrating Research and Clinical Practice in Communication Sciences and Disorders (CSD) Programs. The Quality Indicators (QIs) were developed originally in 2007 and were updated in 2014. They can act as a tool to stimulate discussion among academic and clinical faculty members and students about the program’s strengths and needs in integrating clinical practice and research education. The QIs are divided into five sections:

1) Curriculum and Department Goals

2) Course Work

3) Faculty

4) Students

5) Clinical Practica

They are designed to be flexible in their application–some programs may choose to formally survey a broad group of faculty and students using the tool, while others may choose to use the QIs to guide discussion during a faculty meeting.

A test drive, if you will

Beginning in November of 2013, ASHA asked several academic programs to try out the updated QIs and report back on how they used the tool. Here’s what they said…

It took most responders about one hour to complete the QIs, and most programs judged the length, appropriateness, and comprehensiveness of the tool to be “good.” Most of the programs (82 percent, 9/11) had academic faculty, clinical faculty, and the program director/administrator complete the QIs individually and then discussed the results in a meeting. Alternatively, one program provided time for faculty members to complete the QIs during a faculty meeting rather than asking that the QIs be completed on their own time. A few programs (27 percent, 3/11) also included students in the process.

A handful of challenges also were reported. Some faculty members did not have time to complete the QIs, and some students and faculty were not familiar enough with certain aspects of the department to respond to all items. ASHA is currently working to address these challenges; for example, revising the QIs to include a “Don’t know” response option and providing additional online resources.

The QIs did reveal areas of need and areas of poor knowledge exchange between clinical and academic faculty for some pilot programs. Roughly half of the pilot programs used the QIs to develop department goals for further integration of research and clinical practice. Southern Connecticut State University developed and shared with us three of their goals:

  1. To provide opportunities for discussion of contemporary research and clinical topics, faculty will rotate presenting their research and related topics to faculty/staff/students each semester.
  2. The department curriculum committee (DCC) will conduct annual reviews to ensure that EBP concepts are included in syllabi in accordance with the department mission and vision.
  3. NSSLHA will host monthly meetings to discuss research topics of interest.

Jayne Brandel of Fort Hays State University stated that following completion of the QIs, “We are reviewing our curriculum at the undergraduate and graduate level. In addition, we are exploring new clinical opportunities and having clinical instructors participate in courses.”

ASHA plans to follow up with several of the participating CSD programs after 6 to8 months to gain more insight into the longer-term role of the QIs for these programs.

Whether you are a program director, faculty member, or student, the QIs are a great resource to check out to get your program thinking about and talking about the integration of research and clinical practice. It is imperative that new clinicians are adequately prepared for the changing healthcare landscape with knowledge and application of EBP as soon as they enter the workforce. Thus, Academic programs need to be focused on both providing and modeling the foundations of EBP consistently throughout CSD education. The QIs are freely available for download.

 

Rebecca Venediktov, MS, CCC-SLP, is a Clinical Research Associate for ASHA.