EBDM MIDTERM QUESTIONS WITH 100% CORRECT SOLUTIONS!!

How does our profession promote evidence based practice? -ANS -APTA article search -APTA academy of research -conference presentations must be evidence-based -foundation for physical therapy research What are the barriers to evidence-based practice? -ANS -lack of education or skill in EBP activities (searching, critical appraisal, statistics) -low self-efficacy to perform EBP -negative perception of research -insufficient access to required resources What is the top barrier to EBP -ANS time What is evidence-based practice? -ANS the integration of the best research evidence with our clinical expertise and our patient's unique values and circumstances to make decisions about the care of individuals What are the steps involved in evidence-based practice? -ANS Ask Acquire Appraise Apply Describe the ask step in EBP -ANS ask: converting the need for information into an answerable question --identify your information needs --determine what type of information you need (clinical, background, foreground) What are the three types of questions? -ANS clinical questions background questions foreground questions What are clinical questions? -ANS -ask for information specific to the patient of interest -usually asked because of the need of more information about the patient's impairments, disability, history, goals, concerns, or attitudes -usually answered through history/interview, chart review, or examination examples of clinical questions -ANS -any pain? -how does it limit you? -what have you done before? did it work? -what are your concerns? What are background questions? -ANS -not specific to the patient -ask for general knowledge about a condition, treatment, a diagnostic test, or other aspects of care -usually asked for the need of basic information -not normally asked because of a need to make a clinical decision about a specific patient -typically answered from notes, textbooks, handbooks, narrative review, or google Examples of background questions -ANS -what causes toe walking? -what do PTs do for toe walking? What are the foreground questions? -ANS -ask for specific knowledge to inform clinical decisions or actions (PICO questions) What are the four components of PICO questions? -ANS P: patient/problem I: intervention C: comparative intervention (optional) O: outcome (clinical) example of a foreground/PICO question -ANS does stretching of the gastroc increase DF in a 5 year old toe walker? What do foreground/PICO questions arise from? -ANS the central tasks of clinical work -therapies and interventions -diagnosis and selecting diagnostic tests -prognosis (also etiology and prevention, which we aren't focusing on) What do you have to do to form a PICO question on diagnosis? -ANS stretch the format -I becomes the diagnostic test -O becomes the accurate diagnosis of a condition (i.e. in a 5y/o with toe walking can electrophysiological biopsy diagnose muscular dystrophy) How do you form a PICO question on prognosis? -ANS -I becomes time, or prognosis factor -O is what you think will happen in the future (i.e. in a 5 y/o boy with toe walking, what is the likelihood that normal gait will emerge with time) What should you ask yourself when forming a PICO question? -ANS -what central task does my question address? (treatment/intervention, prognosis, diagnosis) -should I use group or individual for my P -how much detail is required? -does it roll off the tongue Describe the Acquire step in EBP -ANS acquire: tracking down the best evidence with which to answer that question Describe the appraise step in EBP -ANS critically appraising that evidence for its validity, impact, and applicability Describe the apply step in EBP -ANS applying the evidence in clinical decision making and integrating the evidence with the patient's preferences and particular circumstances theory -ANS -description or explanation of a set of events, phenomena, or observations -represents our world view, what we believe to be true -can be used to make predictions about events -adaptable, mutable, and testable -also called a framework/model THEORY INFLUENCES ALL OUR QUESTIONS, ACTIONS, AND CARE DECISIONS What are the five steps to developing a theory? -ANS 1. what is the problem? 2. what is causing the problem? 3. What is the intervention? 4. How does the intervention work? (what is the mechanism of action) 5. explain how the intervention will affect the cause of the problem and resolve