Enhancing Evidence-Based Practice in Rehabilitation Education

 
Educating Future Scholarly Practitioners:
Converging Paradigms
 
 
 
Aliki Thomas, PhD, OT(c), erg.
Assistant Professor
School of Physical and Occupational Therapy
 
Research Scientist
Centre for Medical Education
Faculty of Medicine
 
 
 
1
st
 National Knowledge Translation Conference in Rehabilitation
May 4, 2016
 
Key Questions and Messages
 
Entry-level instruction on evidence-based practice (EBP)
in “isolation”: a disservice to our graduates ?
 
Limited knowledge translation (KT) content in entry-level
rehabilitation programs ?
 
Promising strategies and educational initiatives ?
The Scholarly Practitioner
OCCUPATIONAL THERAPY
PHYSICAL
 THERAPY
Profile of OT practice  in Canada (2012) 
Essential competency profile for physiotherapy in Canada (2012
Characteristics of the Scholarly Practitioner
 
Uses a reflective approach to practice, lifelong learning
 
Engages in scholarly inquiry
 
Bases work on the best evidence from research, best practices, experiential knowledge
 
Maintains/enhances competence through ongoing learning
 
Designs/implements systems to support competency, ongoing professional development
 
Evaluates information to support client, service, practice decisions with ease and efficiency
 
Supports  use of best evidence, and the distribution and translation of new knowledge
into practice
 
Committed to facilitate learning, contribute to the creation, dissemination, application,
and translation of knowledge
 
KT
Profile of OT practice  in Canada (2012), Essential competency profile for physiotherapy in Canada (2012)
 
Canadian OT and PT Educational Programs
 
EBP as a focal point in all curricula
 
Increased emphasis with move to Master’ entry-level
research methods courses
research projects
 
Instructional design and assessment of EBP
 
Effectiveness of Teaching EBP in Health
Sciences Programs
 
“Know how” to ask a PICO question, search and appraise
      the literature
 
Attitudes towards EBP generally favorable
Self-efficacy +
 
Decision making stage
Variability in performance function of experience
 
Impact of fieldwork placements… generally negative
 
(Crabtree et al., 2012; Dizon et al., 2012; Hecht et al., 2016; 
Thomas et al., 2013;
 Young et al., 2014; Wong et al., 2013)
 
Local Context
 
Perceptions towards the teaching practices and
assessment of EBP within the curriculum and impact
of curriculum on EBP self-efficacy
 
 
Mixed methods study
Cross sectional survey of 4 student cohorts and new grads
OT students (n=
115, 56%)
Focus group with senior students
 
(Thomas, Lu, Osler, Turnbull & Douglas, submitted)
 
Results
 
 
Thematic analysis
Mixed feelings about the value of EBP
Barriers to the application of EBP
Opposing worlds: EBP contrasts
Vital and imperfect role of the curriculum
Potential Interpretation
 
Students and new graduates unprepared to:
 
Understand and analyze research-practice gaps
Contribute to reducing research-practice gaps
 
 
 
Disempowered and disillusioned students
and young clinicians?
 
Is there a disconnect?
 
Professional programs focus primarily on EBP
 
Insufficient attention to KT
 
Most KT courses, content, training:
graduate programs
targeting graduate students, post docs, junior faculty
KT Canada summer institutes, seminar series, Sick Kids KT
certificates:
build capacity in KT and KT research
 
A Disconnect…
 
Solution: Converging paradigms?
 
Strategies for Educational Programs
 
Prepare them early, often!
Instruction on EBP 
and
 KT
explicit links between EBP and KT
beyond searching and appraising evidence
recognize gaps, reasons for gaps
 
Integrative approach
 KT is contextualized (e.g. pediatrics course)
 
KT courses during professional education
mandatory content
electives
 
 
 
 
Leveraging Other Competencies
 
Curricula designed to promote 
change agent and advocate
 
as “vehicles” for the scholar
 
Provide evidence of successful implementation efforts,
changes in practice, impact on patient outcomes
 
“Lighting a fire”
Champions
Exemplars
 
New graduates and seasoned clinicians
 
Back to the Local Context
-educational initiatives-
 
1.
Curricular mapping
 of scholar role in our programs
2.
Professional electives redesigned with KT  as a cross cutting theme
3.
Professional master’s research projects
4.
Graduate course in 
KT
 
 
5. Scholarship of Practice
School of Physical and Occupational Therapy
 
…built 
meaningful partnerships between our educators, researchers,
the students, clinicians, decision-makers and health service
consumers
. 
These partnerships enable us to interweave theory,
education, research and practice such that each element informs the
other….ensures that our 
teaching is evidence-informed and clinically
meaningful, that our scientific discoveries are clinically relevant and
that our practitioners are scholarly agents of change
.
Collectively we aim to improve the health and participation of all
members of Quebec society through a scholarship of practice model.
Finalyson et al., 2005; Forsyth et al; 2005; Kielhofner, 2005 a,b; Melton et al., 2010; Taylor et al., 2005; Wimpenny e tal., 2010;
A new “generation” of scholarly practitioners?
 
Thank you
Merci
 
aliki.thomas@mcgill.ca
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This presentation by Dr. Aliki Thomas highlights the importance of integrating evidence-based practice (EBP) into rehabilitation education. It discusses the need for better knowledge translation in entry-level programs, promising strategies, and the characteristics of scholarly practitioners in occupational and physical therapy. The focus is on equipping graduates with the skills to apply research evidence in practice effectively.

  • Rehabilitation education
  • Evidence-based practice
  • Knowledge translation
  • Scholarly practitioners
  • Occupational therapy

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  1. Educating Future Scholarly Practitioners: Converging Paradigms Aliki Thomas, PhD, OT(c), erg. Assistant Professor School of Physical and Occupational Therapy Research Scientist Centre for Medical Education Faculty of Medicine 1st National Knowledge Translation Conference in Rehabilitation May 4, 2016

  2. Key Questions and Messages Entry-level instruction on evidence-based practice (EBP) in isolation : a disservice to our graduates ? Limited knowledge translation (KT) content in entry-level rehabilitation programs ? Promising strategies and educational initiatives ?

  3. The Scholarly Practitioner OCCUPATIONAL THERAPY PHYSICAL THERAPY Profile of OT practice in Canada (2012) Essential competency profile for physiotherapy in Canada (2012

  4. Characteristics of the Scholarly Practitioner Profile of OT practice in Canada (2012), Essential competency profile for physiotherapy in Canada (2012) Uses a reflective approach to practice, lifelong learning Engages in scholarly inquiry Bases work on the best evidence from research, best practices, experiential knowledge Maintains/enhances competence through ongoing learning Designs/implements systems to support competency, ongoing professional development Evaluates information to support client, service, practice decisions with ease and efficiency Supports use of best evidence, and the distribution and translation of new knowledge into practice KT Committed to facilitate learning, contribute to the creation, dissemination, application, and translation of knowledge

  5. Canadian OT and PT Educational Programs EBP as a focal point in all curricula Increased emphasis with move to Master entry-level research methods courses research projects Instructional design and assessment of EBP

  6. Effectiveness of Teaching EBP in Health Sciences Programs Know how to ask a PICO question, search and appraise the literature Attitudes towards EBP generally favorable Self-efficacy + Decision making stage Variability in performance function of experience Impact of fieldwork placements generally negative (Crabtree et al., 2012; Dizon et al., 2012; Hecht et al., 2016; Thomas et al., 2013; Young et al., 2014; Wong et al., 2013)

  7. Local Context Perceptions towards the teaching practices and assessment of EBP within the curriculum and impact of curriculum on EBP self-efficacy Mixed methods study Cross sectional survey of 4 student cohorts and new grads OT students (n=115, 56%) Focus group with senior students (Thomas, Lu, Osler, Turnbull & Douglas, submitted)

  8. Results Thematic analysis Mixed feelings about the value of EBP Barriers to the application of EBP Opposing worlds: EBP contrasts Vital and imperfect role of the curriculum

  9. Potential Interpretation Students and new graduates unprepared to: Understand and analyze research-practice gaps Contribute to reducing research-practice gaps

  10. Disempowered and disillusioned students and young clinicians?

  11. Is there a disconnect?

  12. A Disconnect Professional programs focus primarily on EBP Insufficient attention to KT Most KT courses, content, training: graduate programs targeting graduate students, post docs, junior faculty KT Canada summer institutes, seminar series, Sick Kids KT certificates: build capacity in KT and KT research

  13. Solution: Converging paradigms?

  14. Strategies for Educational Programs Prepare them early, often! Instruction on EBP and KT explicit links between EBP and KT beyond searching and appraising evidence recognize gaps, reasons for gaps Integrative approach KT is contextualized (e.g. pediatrics course) KT courses during professional education mandatory content electives

  15. Leveraging Other Competencies Curricula designed to promote change agent and advocate as vehicles for the scholar Provide evidence of successful implementation efforts, changes in practice, impact on patient outcomes Lighting a fire Champions Exemplars New graduates and seasoned clinicians

  16. Back to the Local Context -educational initiatives- 1. Curricular mapping of scholar role in our programs 2. Professional electives redesigned with KT as a cross cutting theme 3. Professional master s research projects 4. Graduate course in KT

  17. 5. Scholarship of Practice School of Physical and Occupational Therapy built meaningful partnerships between our educators, researchers, the students, clinicians, decision-makers and health service consumers. These partnerships enable us to interweave theory, education, research and practice such that each element informs the other .ensures that our teaching is evidence-informed and clinically meaningful, that our scientific discoveries are clinically relevant and that our practitioners are scholarly agents of change. Collectively we aim to improve the health and participation of all members of Quebec society through a scholarship of practice model. Finalyson et al., 2005; Forsyth et al; 2005; Kielhofner, 2005 a,b; Melton et al., 2010; Taylor et al., 2005; Wimpenny e tal., 2010;

  18. A new generation of scholarly practitioners?

  19. Thank you Merci aliki.thomas@mcgill.ca

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