September/October 2001 Table of Contents
In this Article
Publish journal articles that are relevant and easy to read
Help therapists find the information they need
By Joyce Magill-Evans and Kerrie Pain
Therapists want to base their practice on current, relevant evidence and have excellent suggestions for professional associations to help them do this. This article outlines what 165 randomly selected Alberta therapists told our multidisciplinary research team during interviews examining the transfer and uptake of research knowledge by rehabilitation professionals (OTs, PTs, and SLPs- speech language pathologists). At the recent CAOT conference in Calgary Alberta, the thought-provoking results were discussed with the 60 extended session attendees. The discussion underscored the recommendations for professional associations which are summarized below.
I. Publish journal articles that are relevant and easy to read
One of the first steps in evidence-based practice is knowing the evidence. On average, the therapists in our study spent less than an hour a week of unpaid and paid time in work-related reading. Almost all of them read the journal that is mailed to them (usually by their professional association). Because available time is short and occupational therapists report only a moderate understanding of statistics (2.7 on a 5 point scale), they want journal articles to be clinically relevant and easy to read.
" you know practical things. Things that we can use in our practice, not things that are fancy in a research setting" or "So specific as to have almost no relevance to what I might be doing."
"Some studies have too many statistics and you get lost in the numbers of this and that…"
The Canadian Journal of Occupational Therapy (CJOT) and Occupational Therapy Now (OT Now), publications of our professional association, are mailed to all CAOT members. Their editors and editorial boards can address these concerns by including front-line clinicians as reviewers and considering alternative formats. Therapists wanted researchers to take studies and create "bite-sized" messages for clinicians to take into practice. Some therapists commented on how easy it is to read OT Now. Perhaps CJOT could create an on-line version of accepted journal articles that are peer-reviewed, clinician- friendly, bite-sized (less than 500 words) and linked to web-sites of the provincial and national associations. Could CAOT hire someone who creates bite-sized versions of articles that are published in other relevant publications?
II. Help therapists find the information they need
Incorporating research evidence into practice is a lengthy process. Therapists reported that getting and using information involves a number of steps.
1. Learn how to do a search. Search skills need to be re-learned periodically because of changes in technology.
2. Find the best sources of information. Again, new learning is involved as databases evolve. Access to databases may be limited outside of a university environment making information difficult to find.
3. Sift through the results of the search and choose appropriate articles.
4. Find a way to get the articles. The cost of article reprints can be a significant deterrent in some work settings. Some articles are now available through the Internet, but this is still rare.
5. Read the articles carefully to try and make sense of them and synthesize conflicting ideas.
6. Think and talk about the ideas.
Only after step 6, can therapists make a plan for implementing research-based changes into their practice.
Therapists made a number of suggestions to make the process of finding information easier. They wanted their professional associations to be a hub of information about how to navigate the Web and find prime OT sites, how to effectively find evidence and do searches, and to publicize the research that is being done. They also wanted information about funding sources for research. They wanted to have someone to gather information from the library and provide regular updates on selected topics. In addition, therapists wanted the table of contents of relevant journals available through provincial web sites and access to on-line journals. Our professional association has heard some of these messages as OT Now is addressing these needs through articles and columns that include useful web sites, evidence for practice, the research updates and the COTF column. Therapists clearly wanted more of this type of information.
III. Ensure that clinically-relevant research exists
Before evidence can be located and incorporated into practice, there must be clinically-relevant evidence available. Occupational therapists rated the amount of research available in their area of practice significantly lower (3.4 on a 7-point scale) than did the SLPs (4.9). OTs' ratings were not significantly different from the PTs' (3.9). It is not clear whether the research is truly lacking or whether therapists were just unable to locate it. To begin to address this perceived lack of research support, they suggested that professional associations hire someone to do research for the profession in targeted areas. Some of the research granting agencies are also addressing this need through the promotion of research teams that include both university and applied expertise.
Where to from here?
The therapists in our study have invested time in carefully thinking about how to ensure that their practice is evidence-based. In order to make this information readily available to association decision-makers and to front-line clinicians wishing to lobby associations for change, we have included a member of the provincial association on the advisory panel for this project, presented information at conferences, and published brief articles such as this one in national and provincial association newsletters even before we publish in more scholarly journals. The question now becomes one of how this information will be used. Will therapists use this information to talk to representatives of their provincial and national associations? Will our associations listen and respond by truly becoming the hub of information to promote evidence-based practice?
Joyce Magill-Evans, PhD, OT(C) is a Professor at the University of Alberta. Kerrie Pain, PhD is Rehabilitation Research Coordinator for the Calgary Health Region. This study was funded by Health Canada. For more information, e-mail: joyce.magill-evans@ualberta.ca or call (780) 492-0402.
September/October 2001 Table of Contents
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