The Bench to Practice to Bench Cycle of Evidence-based PracticeSpeech Science and Orofacial Disorders (2006)
AbstractEvidence based clinical practice (EBCP) is a concept that has been discussed in various iterations by healthcare scientists and practitioners over the past half-century. EBCP refers generally to the use of empirical data combined with clinical expertise and end-user (i.e., patient) values to inform and to change clinical activities (Sackett et al., 2000). EBCP originated within the field of medicine, and as result its practice is heavily steeped in medical research paradigms. Over the past two decades, however, it has risen to prominence in both speech science and the profession of speech-language pathology. The emerging emphasis on EBCP seems to be fueled by the mounting importance placed on healthcare accountability by administrators, policy-makers, researchers, clinicians, clients/patients, and other interested groups such as professional associations, drug and assistive device manufacturers and representatives of disease-based organizations (e.g., Heart and Stroke Foundation). As we will discuss, however, EBCP also provides a framework for the evaluation of scientific evidence within clinical practice, and within a complex and rapidly changing professional landscape. The concept of knowledge transfer (KT); also known by other (albeit not necessarily interchangeable) terms such as knowledge exchange, knowledge uptake, and knowledge implementation, has grown in parallel with EBCP within our discipline. EBCP and KT are philosophically and conceptually linked in that scientific data must guide reasoned clinical decisions that are based on valid, reliable, available, and accessible knowledge – and in turn, empirically-driven clinical activities must inform the development of refined or new research hypotheses and questions that re-engage the EBCP process. The purpose of this paper is to provide a framework that illustrates the utility of the ‘bench to practice to bench’ cycle that should form the foundation of EBCP and which clearly integrates EBCP with KT. We begin with a brief overview of EBCP and its processes. We then address the different ‘ways of knowing’ that are employed by clinical practitioners, and the psychological factors mediating the conflict that results from our internal comparisons between ‘what we think is effective’ and ‘what has been demonstrated to be effective’. We then discuss methods by which practitioners might evaluate sources of evidence, along with potential biases that might hamper valid decision-making. Finally, we end with a brief discussion of an example of implementing EBCP and KT into graduate-level curriculum for speech-language pathology and audiology.
Citation InformationJB Orange and Andrew M. Johnson. "The Bench to Practice to Bench Cycle of Evidence-based Practice" Speech Science and Orofacial Disorders Vol. 16 Iss. 1 (2006)
Available at: http://works.bepress.com/andrewjohnson/43/