The past three decades have produced a surge of interest in the role of evidence-based practice (EBP) in the clinical decision-making of speech-language pathologists and other healthcare professionals in delivering optimally effective patient care. A review of the literature revealed several studies investigating potential barriers to EBP implementation and attitudes toward EBP. However, few studies have been designed to probe what treatment approaches to neurogenic communication disorders clinicians are currently implementing and the rationales behind their use. Furthermore, a review of the literature failed to reveal any surveys designed to probe the correlation between what clinicians perceive to be evidence based and what truly is evidence based as outlined in current practice guidelines. The primary aim of this study was to examine potential trends within the field of speech-language pathology relating to the role of EBP in the clinical decision-making of aphasia therapy and the quality of evidentiary support for these decisions. Launching both Web-based and hard copy versions of an 18-question survey, questions probed clinicians' perceptions of the evidence level, primary sources of information, and timeframe of implementation related to various traditional treatment approaches for aphasia. Analysis of the 104 survey responses revealed a disconnect between the implementation of aphasia treatments and the research behind their use. Results indicate that many of the common treatment approaches for aphasia currently in practice are evidence based. However, a research-to-practice gap exists as many treatment approaches that clinicians are not reportedly using are also supported by evidence. Similarly, clinicians' perceptions of what is evidence based are not always in accordance with current practice guidelines. Clinicians appear to rely on professional journals, graduate school training, and professional conferences as their primary sources of evidence-based information. It does not appear as though advertising significantly affects clinicians' decision making in treatment selection. Furthermore, clinicians tend to implement new or alternative treatment approaches rather quickly after exposure to the treatment. Although participants reportedly acknowledge the importance of EBP, further research is needed to investigate causes of and ways to eliminate the research-to-practice gap in the treatment of neurological communication disorders.

Radiography has seen most development over the last 30 years with the evolution of new technologies, but perhaps more significantly changes in education models and radiographer roles. The development of advanced and consultant posts has facilitated the growth of the profession, although the evidence base is still evolving. Through a number of research projects this thesis will explore the growth in the radiography evidence base with specific reference to the extending role of the radiographer in image interpretation. Parallel clinical and academic developments have provided evidence of a scholarly profession which is slowly establishing its place through publication and a growing research base.

A critical review of evidence-based literature addressing screening, barriers to treatment, treatment modalities and programs of care for posttraumatic stress disorder and depression in active duty military members was conducted using the Galvan method. The ONS levels of evidence and the ONS weight of evidence scale were used to critique and analyze extant research. Programs of care and their evaluation were reviewed. Gaps in research were identified and suggestions for evidence-based treatment and program evaluation of evidence-based treatment of PTSD and depression in military members are proposed.

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.

This randomized-controlled pilot study explored the impact of a pretreatment, telephone engagement intervention on adolescents’ (ages 13-19) initial mental health service attendance (i.e., the first 3 counseling sessions) and four secondary outcome variables (i.e., autonomous/ controlled treatment motivation, self-efficacy, and working alliance). Twenty-seven adolescents received the engagement intervention and completed assessments and 24 adolescents completed assessments only. Both groups completed follow-up assessments 6 weeks after study enrollment. Associations between the outcome variables and initial treatment attendance were explored. The extent to which demographic variables (i.e., age, gender, race, immigration status, and residence in low income neighbourhoods), psychological distress, and self-reported barriers (i.e., mismatched treatment expectations and external demands) were associated with treatment attendance was also explored. The primary findings from this pilot study indicated that adolescents who received the engagement intervention had greater initial treatment attendance (M=2.11, SD=1.01) than the assessment only group (M=1.54, SD=1.22), but the difference only approached significance. Moreover, no significant between-group differences in the secondary outcome variables were found. Paired samples t-tests were used to examine changes in autonomous/controlled treatment motivation and self-efficacy within groups between baseline and follow-up. The results of the paired samples t-tests indicated that that the experimental and control groups both demonstrated a significant decrease in controlled motivation at follow-up. In addition, the control group demonstrated a significant decrease in autonomous treatment motivation at follow-up. Post hoc analyses, using correlation and linear regression analyses, explored the associations between initial attendance and the secondary outcome variables, psychological distress, self-reported barriers, and demographic variables. A negative association between age, self-reported barriers and initial attendance was found. A positive association was found between working alliance and initial attendance. While the majority of adolescents who participated in this research lived in low income neighbourhoods and nearly half were second generation immigrants, these demographic variables were not associated with initial treatment attendance. Although the engagement intervention had a medium effect on initial treatment attendance, this difference was not statistically significant. Future research with a larger sample size and longer follow-up is needed to determine the effectiveness of the engagement intervention.

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).