What is evidence based practice in clinical psychology?
An increasingly important concept relevant to the scientist-practitioner model within clinical psychology is that of evidence-based practice. The evidence-based practice movement is a rela- tively new phenomenon in psychology, which intends to improve the care given to patients by
Is the scientist-practitioner model the best approach to clinical psychology?
clinical psychology, and the scientist-practitioner approach still dominates the field. This paper has reviewed the scientist-practition er model as a n approach to clinical psychology. implementatio n. Evid ence-based practice is an important compo nent of this model, yet there number of problems with their use.
Who are the authors of evidence-based medicine and organisational change?
Ferlie E, Gabbay J, Fitzgerald L, et al. Evidence-based medicine and organisational change: an overview of some recent qualitative research. In: Ashburner L, editor. Organisational behavior and organisational studies in health care: reflections on the future. Basingstoke, UK: Palgrave; 2001. 174. Lozano P, Finkelstein JA, Carey VJ, et al.
How many trials of interventions to improve professional practice are there?
Oxman AD, Thomson MA, Davis DA, et al. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. Can Med Assoc J. 1995;153(10):1423–31. [ PMC free article 110. Schmidt KL, Alpen MA, Rakel BA. Implementation of the Agency for Health Care Policy and Research pain guidelines.
What is evidence based practice?
Evidence-based practice (EBP) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions. 12–15 Best evidence includes empirical evidence from randomized controlled trials; evidence from other scientific methods such as descriptive and qualitative research; as well as use of information from case reports, scientific principles, and expert opinion. When enough research evidence is available, the practice should be guided by research evidence in conjunction with clinical expertise and patient values. In some cases, however, a sufficient research base may not be available, and health care decision making is derived principally from nonresearch evidence sources such as expert opinion and scientific principles. 16 As more research is done in a specific area, the research evidence must be incorporated into the EBP. 15
Why do researchers need to use conceptual models?
In planning investigations, researchers must use a conceptual model to guide the research and add to the empirical and theoretical understanding of this field of inquiry. Additionally, funding is needed for implementation studies that focus on evidence-based patient safety practices as the topic of concern.
What organizational factors affect adoption of EBPs?
22, 39, 79, 134, 165–167 Vaughn and colleagues 101 demonstrated that organizational resources, physician full-time employees (FTEs) per 1,000 patient visits, organizational size, and whether the facility was located in or near a city affected use of evidence in the health care system of the Department of Veterans Affairs (VA). Large, mature, functionally differentiated organizations (e.g., divided into semiautonomous departments and units) that are specialized, with a focus of professional knowledge, slack resources to channel into new projects, decentralized decisionmaking, and low levels of formalization will more readily adopt innovations such as new practices based on evidence. Larger organizations are generally more innovative because size increases the likelihood that other predictors of innovation adoption—such as slack financial and human resources and differentiation—will be present. However, these organizational determinants account for only about 15 percent of the variation in innovation adoption between comparable organizations. 22 Adler and colleagues 168 hypothesize that while more structurally complex organizations may be more innovative and hence adopt EBPs relatively early, less structurally complex organizations may be able to diffuse EBPs more effectively. Establishing semiautonomous teams is associated with successful implementation of EBPs, and thus should be considered in managing organizational units. 168–170
How does interprofessional communication affect EBP?
Interpersonal communication channels, methods of communication, and influence among social networks of users affect adoption of EBPs. 39 Use of mass media, opinion leaders, change champions, and consultation by experts along with education are among strategies tested to promote use of EBPs. Education is necessary but not sufficient to change practice, and didactic continuing education alone does little to change practice behavior. 61, 116 There is little evidence that interprofessional education as compared to discipline-specific education improves EBP. 117 Interactive education, used in combination with other practice-reinforcing strategies, has more positive effects on improving EBP than didactic education alone. 66, 68, 71, 74, 118, 119 There is evidence that mass media messages (e.g., television, radio, newspapers, leaflets, posters and pamphlets), targeted at the health care consumer population, have some effect on use of health services for the targeted behavior (e.g., colorectal cancer screening). However, little empirical evidence is available to guide framing of messages communicated through planned mass media campaigns to achieve the intended change. 120
What is dissemination and dissemination?
Diffusion and dissemination involves partnering with professional opinion leaders and health care organizations to disseminate knowledge that can form the basis of action (e.g., essential elements for discharge teaching for hospitalized patient with heart failure) to potential users. Dissemination partnerships link researchers with intermediaries that can function as knowledge brokers and connectors to the practitioners and health care delivery organizations. Intermediaries can be professional organizations such as the National Patient Safety Foundation or multidisciplinary knowledge transfer teams such as those that are effective in disseminating research-based cancer prevention programs. In this model, dissemination partnerships provide an authoritative seal of approval for new knowledge and help identify influential groups and communities that can create a demand for application of the evidence in practice. Both mass communication and targeted dissemination are used to reach audiences with the anticipation that early users will influence the latter adopters of the new usable, evidence-based research findings. Targeted dissemination efforts must use multifaceted dissemination strategies, with an emphasis on channels and media that are most effective for particular user segments (e.g., nurses, physicians, pharmacists).
How long does it take to implement evidence based change?
Implementing the change will take several weeks to months, depending on the nature of the practice change.
What is knowledge distillation?
Knowledge creation and distillation is conducting research (with expected variation in readiness for use in health care delivery systems) and then packaging relevant research findings into products that can be put into action—such as specific practice recommendations—thereby increasing the likelihood that research evidence will find its way into practice. 37 It is essential that the knowledge distillation process be informed and guided by end users for research findings to be implemented in care delivery. The criteria used in knowledge distillation should include perspectives of the end users (e.g., transportability to the real-world health care setting, feasibility, volume of evidence needed by health care organizations and clinicians), as well as traditional knowledge generation considerations (e.g., strength of the evidence, generalizability).
Who suggested evidence based practice can enhance the ability to learn?
Woolf, 1993). Lucock et al. (2003) suggest that evidence-based practice can enhance the ability
When did T ask for force on promotion and dissemination of psychological procedures?
1995; T ask Force on Promotion and Dissemination of Psychological Procedures, 1995). As a
What is EBP in psychology?
Evidence-Based Practice (EBP) represents the gold standard for effective clinical psychological practice. In this review, we examine ways in which EBP tenets are being neglected by correctional psychologists worldwide. We examine three key aspects of EBP currently being neglected: (a) individualized and flexible client focus, (b) the therapeutic alliance, and (c) psychological expertise. We also highlight two highly related issues responsible for correctional psychologists’ neglect of EBP. The first relates to policy makers’ and correctional psychologists’ overreliance on the Risk-Need-Responsivity Model to guide correctional practice. We argue that the narrow focus and implementation of this model has resulted in a severe identity problem for correctional psychologists that has severely exacerbated the dual relationship problem. That is, the tension psychologists experience as a result of engaging in psychological practice while also obliging the risk and security policies of correctional systems. The second issue concerns psychologists’ response to the dual relationship problem. In short, psychology, as a discipline appears to have acquiesced to the dual-relationship problem. In our view, this constitutes a ‘crisis’ for the discipline of correctional psychology. We offer several recommendations for injecting EBP back into correctional psychology for the individual, psychology as a discipline, and correctional policy makers.
What is a PRN in mental health?
Practice Research Networks (PRNs) are introduced in the context of the need of mental health services to deliver on the effectiveness agenda. PRNs provide the infrastructure to enable discrete services within a geographical region to collaborate on audit and evaluation ventures. The provision of such an infrastructure yields potentially large data bases that provide the foundation for delivering 'practicebased evidence' as a natural complement to 'evidence-based practice'. Accordingly, PRNs help to provide a bridge for delivering high quality research in the post-Culyer NHS. An example of a UK PRN is provided. The potential for clinicians to address the effectiveness agenda is addressed according to the following issues: cost-efficiency; research, development and dissemination; research-practice gap; resistance to effectiveness evaluation; and policy implementation and development.
What are the components of a therapeutic process?
This commentary focuses on the three components involved in the therapeutic process, the therapist, the treatment process, and the consumer, and addresses the impact of manual-based treatment on all three from the perspective of the managed care industry. The issues of concern in managed care include reducing the variation in practice, addressing the need to have effective case-mix adjustment, increasing accountability to the consumer, recognizing that not all care and not all practitioners achieve therapeutic objectives, and responding to accreditation initiatives. The implications for training new practitioners are examined.
When did therapeutic treatment manuals start?
1997). T echnical developments have led to the introduction of therapeutic treatment manuals
Is there evidence supporting a claim of expertise in counseling?
Despite the documented efficacy of counseling, evidence supporting a claim of “expertise” among counseling practitioners is found to be lacking. A review of selected literature finds that counselors frequently hold inacurate or biased cognitive schemata concerning clients and engage in faulty reasoning regarding clients' concerns—producing clinical judgments that appear no better than those of less experienced individuals (novices). The concept of “expertise” in counseling may be justified if clinical judgment is viewed as an ill-structured problem and the criterion for judging expertise is changed from enhanced clinical accuracy to one of enhanced clinical certainty.