Essay On Evidence Based Practice
Abstract
This paper discusses the events that led up to evidence based practice (EBP), what evidence based practices are, and how it relates to psychology today. Some topic mentioned in this paper is how EBP in psychology (EBPP) came from EBP in medicine, the three main components of evidence-based practice, and how EBP is used now to improve treatment plans for various problems. The term evidence-based practice will also be broken down into what each part means separately. Most of the information discussed below comes from a few journal articles and websites. Most of the articles defined EBP as the same thing, which will later be discussed in this paper.
Evidence based practice in fairly new in the psychology world. What most people don’t know is that EBP in psychology, and most other fields, began in medicine. According to Spring (2007), “the evidence based practice movement in medicine has a history that long predates psychology’s involvement” (p. 614). Medicine is the root for most EBP. It …show more content…
makes sense that this would be the case because medicine is very important to better us as a people.
Spring (2007) said that, “By the start of the 20th century, medical successes, like antiseptic surgery, vaccination, and public sanitation, made it possible to begin the differentiate between scientific medicine and irrational treatments. These trends encouraged the American Medical Association (AMA) to reinvigorate advocacy for greater quality control in the admission of physician candidates. Simultaneously, the AMA pressed for standardization of a curriculum based upon science and rigorous clinical training.” (615). The AMA were the ones who wanted to find rational and realistic treatments for patients. After some of medicines successes, it became somewhat easier to tell what worked and what did not. This led to the need to have better qualified candidates, which also led to a better system to allow people in the medical field to learn from. This didn’t begin until the early 1900’s, which is very interesting because I thought that EBP was around for a lot longer. So essentially, this is what led to EBP in psychology.
Evidence based practice in general is ‘the conscientious, explicit, judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). Basically, EBP is a mix of recent useful evidence, and good judgement that is used to make educational decisions about someone’s health. To be more specific, EBP in psychology “is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preference.” (APA, 2005). This specific quote is actually the policy that the American Psychological Association uses. It states that EBP in psychology has three components which consist of the use of the best available research, clinical expertise, and patient values.
Below is diagram that explains the three different components to EBP in psychology.
(Spring, 2007, p.
613)
The first point is the best available research, which is evidence that is used to answer a specific question. This also includes the type of study that is done to answer that specific question. If the study is not appropriate then you will not get the correct results to answer the question efficiently. Essentially, best available research evidence “is the highest quality (most reliable) research that is in publication, and therefore available to the practitioner for appraisal and application as the basis of clinical decision making.” (Anonymous, 2012).
The next component is the clinical expertise. This is the clinician’s interpretation of the evidence and how it should be used to treat the patient. Clinicians are trained in various components in psychology so they know how things work, what works, and what does not work. This is a very important piece because clinicians are trained at this and they know things that the patient may not
know.
The last feature is the patients’ preference. This is also a very important piece because it allows the patient to be involved in what type of treatment they receive. The point of this section is “to engage patients more fully in self-management of their own wellness and health care” (Spring, 2007, p. 614). Allowing the patient to be more involved is good because then the decision is a joint effort and not just the choice of the clinician. Overall, this is a good model because it incorporates all of the important pieces needed to decide on a good treatment.
These three components are the main focus when evidence-based practices are taught. “Teaching EBPP requires helping trainees develop skills in data mining, including how to access various secondary sources and to appraise the information obtained critically” (Collins & Leffingwell, 2007). This is one of the most important topics that is focused on when teaching EBPP. According to Collins & Leffingwell, there are at least six common myths about teaching EBPP. Some include focusing solely on randomized controlled treatments (RCT) or thinking that clinical expertise and clinical experience is the same thing. Making sure that these myths are known early in training will improve the trainee’s outcome.
To break the term down even more evidence is a body of information that is used to prove something to be true and in some cases to be false. There are different levels of evidence. Some evidence could not be representative of a population meaning it is not very useful because the results aren’t results that can be applied to just anybody. Research that is conducted using a specific population does not mean that it is a representative sample of a larger population. This means that when evidence is found for a particular problem, is still does not mean that those results can be applied to just any group of people.
Another component to EBP in psychology is empirically supported treatments. “ESTs start with a treatment and ask whether it works for a certain disorder or problem under specified circumstances. EBPP starts with the patient and ask what research evidence will assist the psychologist in achieving the best outcome. In addition, ESTs are specific psychological treatments that have been shown to be efficacious in controlled clinical trials, whereas EBPP encompasses a broader range of clinical activities.” (273). The difference between EST and EPP is that EST works in the opposite direction of EBP. Empirically supported treatments begin with the treatment and decides if that treatment works for that specific problem. Whereas, ESPP starts with the patient and their problem and based on that they find the best treatment based off the evidence that is most useful. ESTs are a portion of EBPs and EBPs are the broader picture.
EBP has helped to explore how things work such as the brain. Without the help of EBP a lot of what we know now would not have been discovered. This is another reason why EBPs are important and why they are such a useful instrument to improve health care and even encourage more people to seek help when needed.
In order to conduct an EBP you need to do five things. The first thing is to ask a question, which is where you find out the problem. The next step is to use that problem to find the best research to find the answer to that question. The third step is to look through the evidence is actually useful for the problem, and decide if it will be helpful or not. The fourth step to combine the analysis of the evidence with your clinical expertise, and with the information known about the patient. The fifth and final step is to evaluate steps one through four and find ways to improve them for the next time they are used (Evidence-Based Practice).
There was a study conducted to see what type of involvement people with PTSD want when it comes to finding the right treatment. The researchers wanted to know if the patients with PTSD wanted to be active, active-shared, collaborative, passive-shared, or passive in the involvement of finding the right treatment. The article stated that “clinical guidelines for improving the quality and patient centeredness of health care recommend shared decisions making approaches” (Harik et al, 2016). This shows that patients who are more involved in deciding their treatment can improve the nature of health care and its quality. The hypothesis is “involving patients in treatment decisions for PTSD symptoms can enhance treatment engagement and outcomes” (Harik et al, 2016). This specifically ties into the part of clinical decision-making model that focuses on what the patient wants and thinks.
The sample used in this specific study was representative of the U.S population. The sample was gathered from a large online survey panel. The article states that “the panel included a nationally representative sample of approximately 55,000 adult members recruited through probability sampling” (Harik et al, 2016). The sample included men and women who were both veterans and non-veterans. There were no reports of any reliability or consistency in this article. This is another important piece because it shows how a sample that is representative of a specific population could be applied to multiple kinds of people.
The statistical analyses used were appropriate and useful in understand the information that was found in this study. The sample size used in this study was large enough to gather meaningful results. The results showed that 44.2% of the participants wanted the active-shared approach for involvement in finding treatment, only 1 in 4 participants wanted to have the final say in their treatment decision, and about 2.7% chose the passive option. The results also showed that preferred decisional control was not significantly related to demographic factors.
Overall the results found is good evidence that a clinician could use when trying to incorporate the patient, specifically with PTSD, in the treatment. It informs the clinician, on average how many patients with PTSD want to be involved in finding the best treatment possible. This ties into EBP because this is evidence that was found in a research study about patient involvement in their treatment decision.
Evidence-based practices has changed the outcome for health care. Not just for psychology but other health professions also. Having EBP now makes it so much easier to find the appropriate treatment for various issues. It has also helped to rule out things that don’t work or that are not effective. EBP continues to grow and improve which helps find better treatment. EBP has helped psychology today to improve as a whole. It has been a very useful tool that will continue to impact the way psychologist conduct their everyday work.
In conclusion, the main point of EBP is to “improve the quality of health care services” (Spring, 2007, p. 616). In order for EBPP in improve and develop over the next few years, more people need to be trained to effectively conduct EBP and they also need to be able to interpret evidence and apply to whatever situation it fits.
This paper discusses the events that led up to evidence based practice (EBP), what evidence based practices are, and how it relates to psychology today. Some topic mentioned in this paper is how EBP in psychology (EBPP) came from EBP in medicine, the three main components of evidence-based practice, and how EBP is used now to improve treatment plans for various problems. The term evidence-based practice will also be broken down into what each part means separately. Most of the information discussed below comes from a few journal articles and websites. Most of the articles defined EBP as the same thing, which will later be discussed in this paper.
Evidence based practice in fairly new in the psychology world. What most people don’t know is that EBP in psychology, and most other fields, began in medicine. According to Spring (2007), “the evidence based practice movement in medicine has a history that long predates psychology’s involvement” (p. 614). Medicine is the root for most EBP. It …show more content…
makes sense that this would be the case because medicine is very important to better us as a people.
Spring (2007) said that, “By the start of the 20th century, medical successes, like antiseptic surgery, vaccination, and public sanitation, made it possible to begin the differentiate between scientific medicine and irrational treatments. These trends encouraged the American Medical Association (AMA) to reinvigorate advocacy for greater quality control in the admission of physician candidates. Simultaneously, the AMA pressed for standardization of a curriculum based upon science and rigorous clinical training.” (615). The AMA were the ones who wanted to find rational and realistic treatments for patients. After some of medicines successes, it became somewhat easier to tell what worked and what did not. This led to the need to have better qualified candidates, which also led to a better system to allow people in the medical field to learn from. This didn’t begin until the early 1900’s, which is very interesting because I thought that EBP was around for a lot longer. So essentially, this is what led to EBP in psychology.
Evidence based practice in general is ‘the conscientious, explicit, judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). Basically, EBP is a mix of recent useful evidence, and good judgement that is used to make educational decisions about someone’s health. To be more specific, EBP in psychology “is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preference.” (APA, 2005). This specific quote is actually the policy that the American Psychological Association uses. It states that EBP in psychology has three components which consist of the use of the best available research, clinical expertise, and patient values.
Below is diagram that explains the three different components to EBP in psychology.
(Spring, 2007, p.
613)
The first point is the best available research, which is evidence that is used to answer a specific question. This also includes the type of study that is done to answer that specific question. If the study is not appropriate then you will not get the correct results to answer the question efficiently. Essentially, best available research evidence “is the highest quality (most reliable) research that is in publication, and therefore available to the practitioner for appraisal and application as the basis of clinical decision making.” (Anonymous, 2012).
The next component is the clinical expertise. This is the clinician’s interpretation of the evidence and how it should be used to treat the patient. Clinicians are trained in various components in psychology so they know how things work, what works, and what does not work. This is a very important piece because clinicians are trained at this and they know things that the patient may not
know.
The last feature is the patients’ preference. This is also a very important piece because it allows the patient to be involved in what type of treatment they receive. The point of this section is “to engage patients more fully in self-management of their own wellness and health care” (Spring, 2007, p. 614). Allowing the patient to be more involved is good because then the decision is a joint effort and not just the choice of the clinician. Overall, this is a good model because it incorporates all of the important pieces needed to decide on a good treatment.
These three components are the main focus when evidence-based practices are taught. “Teaching EBPP requires helping trainees develop skills in data mining, including how to access various secondary sources and to appraise the information obtained critically” (Collins & Leffingwell, 2007). This is one of the most important topics that is focused on when teaching EBPP. According to Collins & Leffingwell, there are at least six common myths about teaching EBPP. Some include focusing solely on randomized controlled treatments (RCT) or thinking that clinical expertise and clinical experience is the same thing. Making sure that these myths are known early in training will improve the trainee’s outcome.
To break the term down even more evidence is a body of information that is used to prove something to be true and in some cases to be false. There are different levels of evidence. Some evidence could not be representative of a population meaning it is not very useful because the results aren’t results that can be applied to just anybody. Research that is conducted using a specific population does not mean that it is a representative sample of a larger population. This means that when evidence is found for a particular problem, is still does not mean that those results can be applied to just any group of people.
Another component to EBP in psychology is empirically supported treatments. “ESTs start with a treatment and ask whether it works for a certain disorder or problem under specified circumstances. EBPP starts with the patient and ask what research evidence will assist the psychologist in achieving the best outcome. In addition, ESTs are specific psychological treatments that have been shown to be efficacious in controlled clinical trials, whereas EBPP encompasses a broader range of clinical activities.” (273). The difference between EST and EPP is that EST works in the opposite direction of EBP. Empirically supported treatments begin with the treatment and decides if that treatment works for that specific problem. Whereas, ESPP starts with the patient and their problem and based on that they find the best treatment based off the evidence that is most useful. ESTs are a portion of EBPs and EBPs are the broader picture.
EBP has helped to explore how things work such as the brain. Without the help of EBP a lot of what we know now would not have been discovered. This is another reason why EBPs are important and why they are such a useful instrument to improve health care and even encourage more people to seek help when needed.
In order to conduct an EBP you need to do five things. The first thing is to ask a question, which is where you find out the problem. The next step is to use that problem to find the best research to find the answer to that question. The third step is to look through the evidence is actually useful for the problem, and decide if it will be helpful or not. The fourth step to combine the analysis of the evidence with your clinical expertise, and with the information known about the patient. The fifth and final step is to evaluate steps one through four and find ways to improve them for the next time they are used (Evidence-Based Practice).
There was a study conducted to see what type of involvement people with PTSD want when it comes to finding the right treatment. The researchers wanted to know if the patients with PTSD wanted to be active, active-shared, collaborative, passive-shared, or passive in the involvement of finding the right treatment. The article stated that “clinical guidelines for improving the quality and patient centeredness of health care recommend shared decisions making approaches” (Harik et al, 2016). This shows that patients who are more involved in deciding their treatment can improve the nature of health care and its quality. The hypothesis is “involving patients in treatment decisions for PTSD symptoms can enhance treatment engagement and outcomes” (Harik et al, 2016). This specifically ties into the part of clinical decision-making model that focuses on what the patient wants and thinks.
The sample used in this specific study was representative of the U.S population. The sample was gathered from a large online survey panel. The article states that “the panel included a nationally representative sample of approximately 55,000 adult members recruited through probability sampling” (Harik et al, 2016). The sample included men and women who were both veterans and non-veterans. There were no reports of any reliability or consistency in this article. This is another important piece because it shows how a sample that is representative of a specific population could be applied to multiple kinds of people.
The statistical analyses used were appropriate and useful in understand the information that was found in this study. The sample size used in this study was large enough to gather meaningful results. The results showed that 44.2% of the participants wanted the active-shared approach for involvement in finding treatment, only 1 in 4 participants wanted to have the final say in their treatment decision, and about 2.7% chose the passive option. The results also showed that preferred decisional control was not significantly related to demographic factors.
Overall the results found is good evidence that a clinician could use when trying to incorporate the patient, specifically with PTSD, in the treatment. It informs the clinician, on average how many patients with PTSD want to be involved in finding the best treatment possible. This ties into EBP because this is evidence that was found in a research study about patient involvement in their treatment decision.
Evidence-based practices has changed the outcome for health care. Not just for psychology but other health professions also. Having EBP now makes it so much easier to find the appropriate treatment for various issues. It has also helped to rule out things that don’t work or that are not effective. EBP continues to grow and improve which helps find better treatment. EBP has helped psychology today to improve as a whole. It has been a very useful tool that will continue to impact the way psychologist conduct their everyday work.
In conclusion, the main point of EBP is to “improve the quality of health care services” (Spring, 2007, p. 616). In order for EBPP in improve and develop over the next few years, more people need to be trained to effectively conduct EBP and they also need to be able to interpret evidence and apply to whatever situation it fits.