This is a workshop presented by BC RSRnet for British Columbia physiotherapists and occupational therapists on March 8, 2007 and recorded by Eugene Barsky, UBC Physiotherapy Outreach Librarian. / Qualitative Evidence in Practice - Appraising Evidence Developed Using Qualitative Inquiry

This is a workshop #6 presented by BC RSRnet for British Columbia physiotherapists and occupational therapists on April 12, 2007 and recorded by Eugene Barsky, UBC Physiotherapy Outreach Librarian. / Improving use of evidence in health care : needs, hopes and the reality

This is a workshop presented by BC RSRnet for British Columbia physiotherapists and occupational therapists on December 14, 2006 and recorded by Eugene Barsky, Physiotherapy Outreach Librarian. / EBP STEP 2 - APPRAISING THE EVIDENCE : So how do I know that this article is any good? (Quantitative Articles)

This is a workshop presented by BC RSRnet for British Columbia physiotherapists and occupational therapists on January 11, 2007 and recorded by Eugene Barsky, UBC Physiotherapy Outreach Librarian. / EBP STEP 2 - APPRAISING THE EVIDENCE - How do I know the article is any good? Step 2: How to appraise the literature (Quantitative articles – practical session).

This is a workshop presented by BC RSRnet for British Columbia physiotherapists and occupational therapists on February 8, 2007 and recorded by Eugene Barsky, UBC Physiotherapy Outreach Librarian. / How do I know the research is any good? Step 2: How to appraise the literature (Qualitative articles – theory session).

Provision of a high standard of care in addiction treatment and prevention services is dependent upon knowledge of evidence-based practice (EBP) principles, and the skills needed to apply those principles, among the substance abuse workforce (SAW). Competency profiles for Canada’s SAW define the need for skill and knowledge of EBP. Within Canada’s SAW, persons within the Occupational Cluster Senior Management are ultimately responsible for decisions and therefore must possess a high level of proficiency in EBP. This proficiency has not been assessed in this group; the objective of this study was to conduct such an assessment on Senior Management from Nova Scotia’s Addiction Services. Eighteen Senior Managers completed semi-structured qualitative interviews. Interviews were analyzed using content analysis, five main themes emerged. It appears that Senior Management possess an understanding of the principles of EBP, but that their knowledge and use of the skills required for their application requires further development.

Serious gaps between best and actual stroke rehabilitation practices continue to exist, even with the plethora of evidence and guidelines for stroke best practice management. To address this knowledge gap with an effective knowledge translation (KT) intervention, six steps of the Knowledge to Action (KTA) Model were applied to these specific research objectives: 1) to conduct a systematic review to examine evidence on the effectiveness of single/multi-component KT interventions for improving knowledge, attitudes, and rehabilitation practice behaviors of occupational therapists (OTs) and physical therapists (PTs), in order to inform the design of a KT intervention; 2) to conduct usability testing to explore factors that facilitate or hinder OTs' and PTs' use of an evidence-based, stroke rehabilitation-specific e-learning resource (Stroke Engine; www.strokengine.ca), as a preliminary step in its potential use as a KT intervention; and, 3) to conduct a KT intervention study to determine the extent of knowledge acquired regarding stroke rehabilitation best practices by OTs and PTs while using Stroke Engine as an e-learning KT intervention for three months. A sub-objective was to identify the association between knowledge acquired and factors related to the clinician, their work environment, and adherence to the KT intervention. Main findings from this research agenda suggested that use of active, multi-component KT interventions resulted in some knowledge gains among physical therapists, but additional research was needed to understand impact of these strategies on occupational therapists. During Stroke Engine testing, factors hindering its use were identified and the website was modified to maximize its usability as an e-learning KT intervention. Clinicians were satisfied with Stroke Engine as it provided them with the latest stroke evidence in a quick, user-friendly format. Finally, significant improvements in clinicians' proportion of 'evidence-based' responses on the Stroke Rehabilitation Knowledge Questionnaire were observed between baseline and following Stroke Engine use as a KT intervention. Intensity of Stroke Engine use was the most significant predictor for clinicians' improved 'evidence-based' knowledge on the Questionnaire. It was concluded that Stroke Engine has promise as an effective e-learning KT intervention for enhancing rehabilitation clinicians' knowledge of stroke best practices.

Clinicians and hospital administrators are increasingly challenged to achieve efficient evidence-based care. Clinical decision support (CDS) tools are being introduced into the clinical setting to facilitate the bridging of knowledge gaps at the point of care. Order sets are one of the tools used to facilitate this knowledge translation. Using the realist review methodology and a focus group of interview participants, this thesis explored retrospectively some of the causal relationships that lead to effective and successful order set adoption. Findings demonstrate the need for in-depth and regular review of context and order set adoption. Technology can offer some enhancements in the form of delivery tools, but it also introduces new and complex challenges for development and implementation. Ongoing software development is needed to improve delivery formats as well as incorporate effective tools to allow for efficient continuous quality improvement supports. / Graduate / 0769 / 0566 / hallsm.77@gmail.com

Aim: This paper is a report on a study that explored the professional development of intensive care unit nurses in journal clubs. Background: Evidence-based practice is important in nursing care (Krom, Batten, & Bautista, 2010). However few nurses feel comfortable using evidence to guide their practice (Pravikoff, Tanner, & Pierce, 2005). Journal clubs are a way to establish science as conversation (Wright, 2004) and foster knowledge translation for evidence-based nursing practice (Goodfellow, 2004). Methods: Monthly journal club meetings were held with the participation of a total of 71 healthcare professionals (65 nurses, 2 physicians, 2 pharmacists, 1 physiotherapist, and 1 respiratory therapist), who worked in two intensive care units of an Ontario hospital. After six months of meetings, 21 individual interviews were conducted with nurses, physicians, pharmacists, and nurse educators. Additional data collection included two focus groups, surveys, a review of staff meeting minutes, and researcher field notes. Findings: Journal clubs provided nurses with incentive to read research articles, improved nurses’ confidence in reading research, created a community of peers who worked collaboratively to improve clinical practice, provided a structure for nurses to reflect-on-practice, and led to reported changes in clinical practice. However, the data suggests that any gains in competence of nurses with the critical appraisal of research articles were probably modest. Barriers to participating in journal clubs and evidence-based practice are also identified. Conclusion: Journal clubs can foster knowledge translation and evidence-based practice through creating a community of practice and by providing nurses with motivation, structure, and confidence to read research articles. However, nurses reported a lack of critical appraisal skills and uncertainty about how to implement evidence into practice. Journal clubs may have a greater impact when implemented alongside other knowledge translation strategies such as working with clinical nurse specialists in order to enhance evidence-based practice.

abstract: Risk assessment instruments play a significant role in correctional intervention and guide decisions about supervision and treatment. Although advances have been made in risk assessment over the past 50 years, limited attention has been given to risk assessment for domestic violence offenders. This study investigates the use of the Domestic Violence Screening Inventory (DVSI) and the Offender Screening Tool (OST) with a sample of 573 offenders convicted of domestic violence offenses and sentenced to supervised probation in Maricopa County, Arizona. The study has two purposes. The first is to assess the predictive validity of the existing assessment tools with a sample of domestic violence offenders, using a number of probation outcomes. The second is to identify the most significant predictors of probation outcomes. Predictive validity is assessed using crosstabulations, bivariate correlations, and the Receiver Operating Characteristic (ROC) curve. Logistic regression is used to identify the most significant predictors of probation outcomes. The DVSI and the OST were found to be predictive of probation outcomes and were most predictive of the outcomes petition to revoke filed, petition to revoke filed for a violation of specialized domestic violence conditions, and unsuccessful probation status. Significant predictors include demographics, criminal history, current offense, victim characteristics, static factors, supervision variables and dynamic variables. The most consistent predictors were supervision variables and dynamic risk factors. The supervision variables include being supervised on a specialized domestic violence caseload and changes in supervision, either an increase or decrease, during the probation grant. The dynamic variables include employment and substance abuse. The overall findings provide support for the continued use of the DVSI and the OST and are consistent with the literature on evidence-based practices for correctional interventions. However, the predictive validity of the assessments varied across sub-groups and the instruments were less predictive for females and offenders with non-intimate partner victims. In addition, study variables only explained a small portion of the variation in the probation outcomes. Additional research is needed, expanding beyond the psychology of criminal conduct, to continue to improve existing risk assessment tools and identify more salient predictors of probation outcomes for domestic violence offenders. / Dissertation/Thesis / Ph.D. Justice Studies 2011