Department of Speech-Language Pathology, SUNY Buffalo State College, NY.
Department of Communication Sciences and Disorders, University of Houston, TX.
Am J Speech Lang Pathol. 2020 May 8;29(2):688-704. doi: 10.1044/2019_AJSLP-19-00171. Epub 2020 Mar 16.
Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.
目的 本研究是对先前一项研究的后续调查,该研究旨在探讨学校言语治疗师(SLP)在儿童语言诊断决策中的作用。本研究的目的是探讨 SLP 们在临床工作中应用循证实践(EBP)的观点。
方法 对 Fulcher-Rood 等人之前参与过研究的 25 名学校 SLP 进行了半结构式电话访谈。询问 SLP 关于 EBP 的定义、研究证据的价值、在临床实践中实施科学文献的背景以及实施 EBP 的障碍。
结果 SLP 对 EBP 的定义与当前的定义不同,因为 SLP 只包括研究结果的使用。 SLP 似乎将 EBP 讨论为与治疗相关,而不是评估。报告的 EBP 实施障碍包括时间不足、资金有限以及工作环境的限制。 SLP 发现很难将研究结果转化为临床实践。 SLP 会在缺乏特定客户的临床专业知识或需要科学证据来支持他们使用的策略时,实施外部研究证据。
结论 SLP 似乎出于特定原因使用 EBP,而不是对他们做出的每一个临床决策都使用 EBP。此外,SLP 依赖 EBP 进行治疗决策,而不是评估决策。教育系统可能会带来其他需要考虑的实施 EBP 的挑战。讨论了实施科学和研究与实践之间的差距的考虑因素。