Cunningham Barbara Jane, Daub Olivia May, Cardy Janis Oram
School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON N6G 1H1, Canada.
School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON N6G 1H1, Canada.
J Commun Disord. 2019 Jul-Aug;80:66-80. doi: 10.1016/j.jcomdis.2019.05.001. Epub 2019 May 8.
This practice-based research study was a collaborative effort between researchers and speech-language pathologists (SLPs). The purpose of the study was to assess SLPs' perceptions of barriers for two new evidence-based assessment procedures to be implemented in practice. Procedures were for (1) program-level outcome monitoring and (2) individual vulnerability testing for children who are deaf or hard of hearing. These procedures were summarized for clinicians in an online learning module.
After finishing the online learning module, SLPs completed electronic surveys to identify perceived barriers to implementation. Fifty-four SLPs completed an online survey specific to the program-level outcome monitoring procedures. Twenty-five also completed an online survey specific to individual vulnerability testing. Surveys were structured using the Ottawa Model of Research Use, which assesses barriers within three components: (1) the practice environment; (2) clinicians' knowledge, skills, and beliefs; and (3) the evidence-based innovation (development and content of the online learning module).
Most items specific to program-level outcome monitoring were rated positively. Some barriers were identified within the practice environment and evidence-based innovation, but clinicians' skills, knowledge, and beliefs were not barriers to implementation. For individual vulnerability testing, barriers were noted across all components of the Ottawa Model of Research Use.
This work demonstrates the value of including front-line clinicians in the development of evidence-based assessment procedures. Through practice-based research, we identified SLPs' perceived barriers to implementation, allowing for modifications to be made to the online learning module prior to wider-scale implementation. The barriers identified and methods used in our work may be useful to other researchers and programs involved in developing materials and methods for the implementation of evidence-based assessment procedures.
这项基于实践的研究是研究人员与言语语言病理学家（SLP）共同开展的合作项目。该研究的目的是评估SLP对两种新的循证评估程序在实践中实施的障碍的看法。这两种程序分别是：（1）项目层面的结果监测；（2）对聋儿或听力障碍儿童的个体易感性测试。这些程序在一个在线学习模块中向临床医生进行了总结。
完成在线学习模块后，SLP完成电子调查问卷以确定实施过程中察觉到的障碍。54名SLP完成了针对项目层面结果监测程序的在线调查。25名SLP还完成了针对个体易感性测试的在线调查。调查问卷采用渥太华研究应用模型构建，该模型从三个方面评估障碍：（1）实践环境；（2）临床医生的知识、技能和信念；（3）循证创新（在线学习模块的开发和内容）。
大多数针对项目层面结果监测的项目得到了积极评价。在实践环境和循证创新方面发现了一些障碍，但临床医生的技能、知识和信念并非实施的障碍。对于个体易感性测试，渥太华研究应用模型的所有方面都存在障碍。
这项工作证明了让一线临床医生参与循证评估程序开发的价值。通过基于实践的研究，我们确定了SLP察觉到的实施障碍，从而能够在更广泛实施之前对在线学习模块进行修改。我们工作中确定的障碍和使用的方法可能对其他参与开发循证评估程序实施材料和方法的研究人员及项目有用。
