The Model of Occupational Therapy Utilization of Evidence-Based Practice

SIGNIFICANCE: A key challenge to occupational therapy professionals identified in the professional literature and that guided this research is how to best incorporate evidence-based practice (EBP) into intervention planning (Sudsawad, 2005; Tickle-Degnen & Bedell, 2004).

INNOVATION: This paper will present the Model of Occupational Therapy Utilization of Evidence-Based Practice (MOTUEBP) as a means to explain how occupational therapists (OTs) integrate EBP into practice and can utilize it as means for continued professional growth and development.

METHOD: This study is a collective analysis of quantitative and qualitative research studies. Quantitative data were obtained utilizing a survey administered to 400 registered OTs nationwide that was proportionally distributed among practice areas defined by the American Occupational Therapy Association (AOTA). Qualitative data were obtained from 15 registered OTs nationally selected across practice areas for use of EBP and identified as so by others.

Quantitative data were obtained examining EBP and revolving around three factors: overall use, promotions/limitations to EBP use, and professional benefit/limit. Statistical analyses were performed, including measures of central tendency, analysis of variance (ANOVA), correlations, and predictive statistics.

Qualitative data further explored and probed findings of the quantitative study with specific exploration of patterns of EBP use; benefits to self, clients, institution, and profession; challenges/barriers to use; as well as considerations and needs to promote integration. Data were analyzed utilizing grounded theory methodology; methods to ensure trustworthiness included triangulation with use of a negative evidence search, key informant, and expert review.

RESULTS: Collective analyses were completed, drawing inferences and conclusions from both studies to develop the results. The MOTUEBP was developed from the analysis and synthesis of the body of qualitative and quantitative data collected. The MOTUEBP identified factors of meaningfulness and value as well as opportunities and outcomes that promoted the development of the identity of EBP within the MOTUEBP. The key finding was that for EBP to succeed, OTs need to create a professional persona of “best client-centered OT” that includes ongoing integration of EBP as a component of evolutionary foundational knowledge and the clinical reasoning process. The research findings further led to the creation of the Model to Promote the Persona of “Best Client-Centered OT,” to be presented as a means to aid OTs in the development of the key factors instrumental in their use of EBP and as a framework to develop practical skills in the application and integration of evidence as part of the OT process. This model can be used in conjunction with a four-tiered approach for EBP integration into occupational therapy as a profession, incorporating meaningfulness and value of EBP to individual and professional practice as well as the reinforcement that EBP values experience and clinical reasoning. The occupational therapy profession can use these models as a means to target areas for professional development, define professional identity, and advance EBP utilization within the profession, thus aiding it in achieving its Centennial Vision (Sudsawad, 2005; Tickle-Degnen & Bedell, 2004).

References

Sudsawad, P. (2005). A conceptual framework to increase usability of outcome research for evidence-based practice. American Journal of Occupational Therapy, 59, 351–355. http://dx.doi.org/10.5014/ajot.59.3.351

Tickle-Degnen, L., & Bedell, G. (2004). Heterarchy and hierarchy: A critical appraisal of the “levels of evidence” as a tool for clinical decision making. American Journal of Occupational Therapy, 57, 234–237. http://dx.doi.org/10.5014/ajot.57.2.234