Journal [Media] Club – What actually informs practice: occupational therapists’ views of evidence.
Date: 05/11/2013 Host: @SarahMassey92 & @otgeekhannah
We are very pleased to have Sarah (@SarahMassey92) and Hannah (@OTstudentHannah) hosting this months journal club. Sarah raised the idea of a journal club during the New Years ResOTlutions chat in June 2013. As the idea of a journal club had also been suggested previously we decided to survey the community. The results of the survey indicated a resounding yes the #OTalk community felt that a journal club would be a good idea. Information about the survey results and reasoning for the chosen format was presented to the community in July 2013 : Journal (Media) Club Survey Results and Ideas.
Thank you to Sarah and Hannah for the following introduction to the article they have chosen:
As Hannah and I are embarking on our third year as OT students it is important for us to use evidence as much as possible but also to understand the role evidence has in practice.
Article:
Robertson L, Graham F, Anderson J (2013). What actually informs practice: occupational therapists’ views of evidence. British Journal of Occupational Therapy, 76(7), p.317-324.
Abstract
Introduction: This research aims to explore what New Zealand occupational therapists consider ‘evidence’ to be and how the search for evidence is accomplished in their practice.
Method: Semi-structured interviews were conducted with 14 therapists who had shown variations in comfort levels with locating and implementing evidence.
Findings: Four themes emerged from the data: (1) finding evidence to support practice: informal quick methods were favoured; (2) the nature of available evidence: evidence was considered to be of limited value in practice as the context of the research was often very different to the context of local practice; (3) the organisational influences: the culture of the work environment played a key role in the dissemination of knowledge and (4) the importance of evidence: the need to use evidence to support practice was appreciated by most therapists. In general, using reliable resources was regarded as key to evidence-based practice with availability of resources, therefore, deemed essential.
Conclusion: Therapists value trustworthy research information that is pre-digested and can be readily used in practice. Where there is limited research evidence, the focus should be on the generation and dissemination of information from critical reflections on practice.
Reasons why we chose this article:
- The purpose of a journal club is to discuss and evaluate current evidence in the context of our profession. Therefore, we thought to look at a journal, which discusses the use of evidence that will be thought provoking but also provide a building block for future journal club discussions.
- Secondly, it is a professional requirement to use evidence as stated within the College of Occupational Therapists Code of Ethics and Professional Conduct (2010) under Section 6 titled “Developing and using the profession’s evidence base”
- As students, we are curious to see how the use of evidence differs between students and practitioners. From a student perspective we are challenged to support our ideas, with current and best evidence. Does this continue during the transition from student to practitioner? Or are other influences/barriers involved?
- Finally, to see (if any) the differences between New Zealand and the UK. As based on the Occupational Therapy Board of New Zealand (OTBNZ), views of client’s experiences are used as evidence.
Questions and discussion points
- Once qualified does motivation for searching and using EBP change?
- What are your thoughts on the methodology used within this article?
- Based on the abstract alone, which theme best describes your relationship with evidence?
- Did this change as you moved through the article? Why?
- Can you identify more limitations compared to those already stated?
These are the questions and discussion points we came up with but please feel free to raise your own in the comments section below to get the ball rolling before the live chat.
Hannah and I will be using the Reading Record form based on the Learning Through Discussion structure to guide our thinking, which will posted in the comments at a later date. Please note that this will be our first time using this form and constructive criticism is welcome.
We look forward to hosting the Journal Club on the 5th Nov and hope to see you there.
Please note that the article chosen is not open source. Please be aware of copyright law.
Details and download of the Reading Record can be found on the Journal (Media) Club Resources page.
Here is the chat transcript:
bobcollinsOT | OTweek OTuesday #otalk #itsallkickingoffOTsyle | |
clissa89 | Hellooo everyone! It’s #OTalk-o’clock! Say hi, even if you’re lurking 🙂 | |
becci_haigh_ot | #OTalk with @SarahMassey92 and @OTstudentHannah – looking forward to my first ever OTalk. Hoping to follow on/off while still at work | |
clissa89 | Tonight’s chat is being run by @SarahMassey92 and @OTstudentHannah. Has anyone read the article/blog post? http://t.co/wIBvQNaIhe #OTalk | |
OTSM2011 | Hi #otalk I’m here with cuppa at the ready | |
clissa89 | @becci_haigh_ot @SarahMassey92 @OTstudentHannah glad you could join us 🙂 very special welcome for your 1st OTalk! 🙂 #OTalk | |
clissa89 | @OTSM2011 hi Sarah, welcome 🙂 #OTalk | |
clissa89 | I’ve not had a chance to read the article yet, but going to have a quick skim of the blog post http://t.co/LJz40XEWU5 #OTalk | |
OTSM2011 | @clissa89 #otalk I read the article and completed reading record 2 weeks ago – it will all come back to me as we go along! | |
OT4Rach89 | @clissa89 As a twitter newbie I’m ‘lurking’ tonight however looking forward to joining in another time! 🙂 #OTalk | |
clissa89 | @OTSM2011 wow, that’s efficient! 🙂 What does your reading record (template) include? Curious for my own CPD #OTalk | |
clissa89 | I’m quite excited reading the questions for tonight’s chat – interesting! http://t.co/LE6KTBbQUu #OTalk | |
OTstudentHannah | @OTSM2011 @clissa89 aw brilliant! Very productive #OTalk | |
clissa89 | @OT4Rach89 great to have you here 🙂 no pressure to join in, but if you have something to say, then please do! We don’t bite! #OTalk | |
OTstudentHannah | @OTstudentHannah: Please use the appropriate number in your tweet when answering so we can keep track 🙂 #otalk | |
SarahMassey92 | #OTalk Hello everyone. Let’s get started! 1. Firstly, did everyone understand the article and what were your first impressions? | |
OTSM2011 | @clissa89 #otalk I used the reading record from otalk occhat website and recorded that I’ve done so on my TRAMm Tracker | |
becci_haigh_ot | @clissa89 have read the blog post and skim-read the article. #OTalk | |
OTalk_Occhat | RT @SarahMassey92: #OTalk Hello everyone. Let’s get started! 1. Firstly, did everyone understand the article and what were your first imp… | |
clissa89 | @SarahMassey92 1. I’ve not read the article yet, but I’ve had a skim of the blog post & sounds like lots of potential for exploration #OTalk | |
OTstudentHannah | 1. I was attracted to the concept of understanding practitioners take on evidence #OTalk | |
bobcollinsOT | @SarahMassey92 #otalk 1. skimmed the article. makes sense. first impressions are that as a clinician it is hard to dedicate time to research | |
clissa89 | 1. Topic really interesting to me, as someone who values evidence as a concept, including generation, but having hard time finding it #OTalk | |
OTSM2011 | @SarahMassey92 #OTALK Read article, agreed with lot of it. Been qual 3 yrs, work in social services. originally no access 2 any research 1/2 | |
clissa89 | @bobcollinsOT @SarahMassey92 yes definitely difficult to dedicate the time – but also so important. Have you found strategies? #OTalk | |
SarahMassey92 | 1. I was interested to explore the differences between how students and practitioners use evidence. #otalk | |
OTstudentHannah | @bobcollinsOT 1. That was a lot of the findings which usually relates to organisational factors/barriers, quite universal #OTalk | |
clissa89 | @OTSM2011 @SarahMassey92 do you mean you didn’t have access to e.g. a database to search for articles or library service? #OTalk | |
OTSM2011 | @SarahMassey92 #otalk at least now as member of BAOT have access to some journals but no EBP culture within work. 2/2 | |
clissa89 | @OTstudentHannah @bobcollinsOT yes organisational factors are so significant. I’m fortunate to be in a service now that values EBP #OTalk | |
OTstudentHannah | @clissa89 as students we have access to it so we can imagine the difficulties being in practice & not having the tools #OTalk | |
OTstudentHannah | 2. Based on the abstract alone, which theme best describes your relationship with evidence? #OTalk | |
OTstudentHannah | 2a. Did this change as you moved through the article? Why? #otalk | |
clissa89 | @OTstudentHannah the point about nature of available evidence really stood out for me – struggle to find evidence that meets my needs #OTalk | |
clissa89 | @OTstudentHannah seeing real gaps in literature has motivated me to generate research/evidence – also to consider broader sources #OTalk | |
OTstudentHannah | RT @clissa89: @OTstudentHannah the point about nature of available evidence really stood out for me – struggle to find evidence that meets … | |
OTstudentHannah | @clissa89 I definitely agree with extending our searches to transfer the evidence into our practice effectively #otalk | |
clissa89 | @OTSM2011 @SarahMassey92 that sounds really difficult – not having that culture to support EBP. How do you manage the challenge? #OTalk | |
OTSM2011 | @OTstudentHannah #otalk all of it resonated but also, for various reasons, clients want what they think works for them not necessarily EB | |
clissa89 | @OTSM2011 @OTstudentHannah important to be flexible & critical with evidence – doesn’t always translate #OTalk | |
OTstudentHannah | 2. I feel that theme 4 best describes a students use of evidence as we’re constantly reviewing literature to support our ideas #otalk | |
OTSM2011 | @clissa89 @SarahMassey92 #otalk keep working away quietly. Make sure all my notes are comprehensive & explain reasoning. Use BAOT guidelines | |
SarahMassey92 | 2. We also believed that theme 3 (organisational influences) has the most impact on gathering evidence within practice #OTalk | |
clissa89 | @OTstudentHannah I liked your question re changing motivation for EBP. As newly qualified, evidence has become even more important #OTalk | |
OTstudentHannah | RT @OTSM2011: @OTstudentHannah #otalk all of it resonated but also, for various reasons, clients want what they think works for them not ne… | |
OTSM2011 | @SarahMassey92 #otalk current OT training teaches how to and what EBP is but people who qualified before us don’t know the skills needed | |
bobcollinsOT | @OTstudentHannah 2.all 4 themes describe my relationship with evidence. EBP needs to be used with a good dollop of clinical reasoning #otalk | |
OTstudentHannah | @clissa89 I hope evidence does remain important as we find critiquing to be interesting and enjoyable #otalk | |
clissa89 | There’s a good comment on the blog re how difficult it is to consider evidence when first in the job – so much to learn. #OTalk | |
OTstudentHannah | @OTSM2011 very true, sometimes practitioners reasoning is “because we’ve always done it” which can be concerning for students #otalk | |
clissa89 | @bobcollinsOT @OTstudentHannah “dollop” – what’s that, about a tablespoon? 😉 🙂 agree – clinical reasoning vital #OTalk | |
OTstudentHannah | RT @bobcollinsOT: @OTstudentHannah 2.all 4 themes describe my relationship with evidence. EBP needs to be used with a good dollop of clinic… | |
SarahMassey92 | @OTSM2011 @OTstudentHannah I have experienced this on placement. Have u found it diff. finding evidence to support what client wants? #otalk | |
OTstudentHannah | @clissa89 yes, and with some of the participants feeling the need to gain permission to review evidence (newly qual) #otalk | |
clissa89 | I’m hoping that, now that I’m working in a specialist service, it will be easier to keep up to date with evidence. #OTalk | |
SarahMassey92 | Ok question 3 guys… 3. What are your thoughts on the methodology used within this article? #otalk | |
clissa89 | @OTstudentHannah as newly qualified, I did all my evidence-reviewing in my own time – definitely no time to do it on the ward! #OTalk | |
becci_haigh_ot | @OTstudentHannah 2. agreed about theme 4 at Uni. Then graduating and feeling lost for direction. Looking forward to working and 1/2 #OTalk | |
clissa89 | @SarahMassey92 I’ve not looked at the methodology in depth – but it looks like quite a small sample. Glad they considered comfort #OTalk | |
OTstudentHannah | @clissa89 I can imagine! & some people won’t want to do that in their ‘free time’ – I know I would to make working life easier! #otalk | |
OTstudentHannah | There were a few limitations we felt with the types of questions asked, did anyone else notice? #otalk | |
clissa89 | @OTstudentHannah evidence in your spare time is difficult – especially with full life out of work. Great if culture exists in work #OTalk | |
becci_haigh_ot | @OTstudentHannah 2. hopefully bringing enthusiasm of EBP to work. though agreed i may be overwhelmed with learning experiences 2/2 #OTalk | |
Sasa_Radic | Good evening all.The topic tonight is quite interesting. Especially coming from community in which EBP is only declarative must #otalk | |
clissa89 | @OTstudentHannah can you expand on that? I didn’t see the questions they asked #OTalk | |
SarahMassey92 | @clissa89 We thought a sample of 14 OTs was small considering they invited all OT’s in New Zealand to participate. #Otalk | |
clissa89 | @Sasa_Radic can you elaborate on what you mean by that? EBP as a declarative must? #OTalk | |
OTstudentHannah | @becci_haigh_ot I definitely think enthusiasm for learning aids in EBP, without it you’re merely looking for answers #otalk | |
SarahMassey92 | @clissa89 @OTstudentHannah Do you think time within working hours should be dedicated to EPB? #otalk | |
OTstudentHannah | @clissa89 some of the questions were misleading/implying desired answers – very naughty! #otalk | |
clissa89 | @SarahMassey92 @OTstudentHannah dedicated EBP time would be very worthwhile. Difficult with time pressures. #OTalk | |
OTstudentHannah | Next question: 4. Do you believe that once qualified motivation for searching and using EBP change? #OTalk | |
clissa89 | @OTstudentHannah did the authors explore any potential bias that they might’ve brought to the research? #OTalk | |
Sasa_Radic | @clissa89 It is said “we need to use EBP in health”but if we try to elaborate the evidance show OTefficiancy then it is not important#otalk | |
clissa89 | @OTstudentHannah 4. Qualified, more important to me that use the evidence because what I do is my responsibility & decision #OTalk | |
clissa89 | @Sasa_Radic it can be so difficult to find good quality, relevant OT evidence #OTalk | |
OTstudentHannah | @clissa89 no they didn’t, their limitations section was very vague #otalk | |
OTstudentHannah | RT @clissa89: @OTstudentHannah 4. Qualified, more important to me that use the evidence because what I do is my responsibility & decision #… | |
OTstudentHannah | @clissa89 hopefully others take on a similar ethos #otalk | |
OTSM2011 | @OTstudentHannah #otalk yes, people struggle with CPD nevermind EBP. Realities are picking the cases that you reason are worth the hrs 1/2 | |
becci_haigh_ot | @OTstudentHannah 3. type of info investigated may have been attainable through questionnaires and quantitative analysis? #otalk | |
janet_folland | #OTalk EBP essential & everyones responsibility- but to be truly embedded needs to be placed at core of organisations strategy & data source | |
OTSM2011 | @OTstudentHannah #otalk 22 of research. Usually in own time. But that’s part of what makes OT fab career | |
SarahMassey92 | @becci_haigh_ot Do you try and use EPB within your current practice or do you find this difficult to do? #Otalk | |
clissa89 | Valuable asset is library service if available at workplace – I get weekly emails summarising research, literature searches, books #OTalk | |
Sasa_Radic | @clissa89 yes I agree, and as stated you need to have developed skills for critical reflection/reasoning #otalk | |
SarahMassey92 | @becci_haigh_ot That’s how the study was completed, did you find any flaws with these methods #otalk | |
becci_haigh_ot | @SarahMassey92 have just graduated and starting new real OT job soon. but looking at articles/research in preparation. #otalk | |
OTSM2011 | @Sasa_Radic @clissa89 #otalk also awareness of credible sources – only 1 person in the study mentioned this | |
sophiewearing | @clissa89 @OTstudentHannah def agree!!It affects u more directly&i feel more passionate about it&my job because of it #OTalk | |
bobcollinsOT | @OTstudentHannah #otalk 4.Maybe not the Motivation as I still thirst for the evidence. More the Habituation changes as no time to search. | |
clissa89 | @becci_haigh_ot @SarahMassey92 I think that getting your head around evidence base before starting is great foundation 🙂 #OTalk | |
sophiewearing | I remember how passionate I am abour my job when I get involved in #OTalk | |
SarahMassey92 | @becci_haigh_ot Let me know if your motivation remains or if organisational barriers/way of working get in the way in the future #otalk | |
RobWebster_LCH | RT @clissa89: Valuable asset is library service if available at workplace – I get weekly emails summarising research, literature searches, … | |
clissa89 | @sophiewearing @OTstudentHannah I agree, knowing & using evidence makes me enjoy my job more too #OTalk | |
OTstudentHannah | We felt that participants were using anything as EBP but forgetting that as a competent OT it is a core skill of ours to critique #OTalk | |
sophiewearing | @clissa89 @OTstudentHannah I just wish everyone felt the same rather than a chore! #OTalk | |
OTstudentHannah | @bobcollinsOT that’s a really interesting point #otalk | |
OTstudentHannah | @sophiewearing @clissa89 we couldn’t agree more @SarahMassey92 #otalk | |
bobcollinsOT | #otalk that should be ‘less’ time not ‘no’ time to search for evidence. | |
becci_haigh_ot | @SarahMassey92 would maye have liked a discussion of what qualitat. info brought that was not available form initial questionnaire? #otalk | |
clissa89 | From the abstract, it looks like “what is evidence” was a key question – is evidence only peer-reviewed research articles? #OTalk | |
SarahMassey92 | Question 5; Can you identify any more limitations compared to those already stated? #otalk | |
OTstudentHannah | @becci_haigh_ot there are quotations mentioned – would you have preferred full transcripts? #otalk | |
OTstudentHannah | @clissa89 it discusses that using peers/colleagues is valid for EBP which was quite shocking to us, any thoughts? #otalk | |
clissa89 | @OTstudentHannah I’ve had many conversations with service users, peers, colleagues when no ‘formal’ evidence available – valuable #OTalk | |
clissa89 | @OTstudentHannah in an ideal world, there would be robust, high-quality evidence for everything – but there are a lot of gaps #OTalk | |
OTstudentHannah | @clissa89 very interesting, we do the same as students but feel finding the actual evidence is crucial #otalk | |
SarahMassey92 | @clissa89 That was a similar theme that many practitioners brought up within the article. #otalk | |
kilner100 | @OTSM2011 as a student on placement I’ve got articles and books for my educators! Access to journals and time clearly issues! #otalk | |
clissa89 | @OTstudentHannah what if there is no “actual evidence”? #OTalk | |
clissa89 | @kilner100 @OTSM2011 time pressures is a definite reality of practice. Think for some people it’s also about skill/confidence #OTalk | |
SarahMassey92 | @kilner100 @OTSM2011 That was a theme mentioned within article and this is what we have picked up from being on placement ourselves #otalk | |
bobcollinsOT | @clissa89 #otalk Kind of what I mean by clinical reasoning.’Evidence’ can take may forms. Its up to us to decide how to use it. | |
OTstudentHannah | @clissa89 we would be looking elsewhere re for assignments but in practice I can see where peer EBP comes in handy #otalk | |
OTSM2011 | @kilner100 #otalk I did the same when I was on placement. Access an issue within SS 1/2 – | |
kilner100 | RT @sophiewearing: I remember how passionate I am about my job when I get involved in #OTalk” 🙂 sorry I’m butting in late #dissertation | |
OTSM2011 | @kilner100 #otalk 2/2 I have suggested as part of integration we get access to NHS library! | |
OTstudentHannah | @OTSM2011 we were wondering whether we’ll still have access to our uni library when we qualify, hope we do! #otalk | |
clissa89 | @kilner100 @sophiewearing glad to have you here, especially with dissertation-pressure 🙂 #OTalk | |
OTstudentHannah | Question 6. Will you now rethink the way you locate/read/use evidence within your practice setting? #otalk | |
clissa89 | @OTstudentHannah @OTSM2011 I had access to mine for a short while. Fortunately NHS has Athens, and being member of professional body #OTalk | |
OTSM2011 | @OTstudentHannah #otalk I did ask at ours but we weren’t! 😦 | |
bobcollinsOT | #otalk I agree that there are massive gaps in the evidence for the profession. There are people out there filling them though e.g @RCOMH | |
kilner100 | @OTstudentHannah @clissa89 ‘practice based evidence’ sure I’ve read about that s’where? Oops #otalk | |
Sasa_Radic | @kilner100 @OTSM2011 If we were given evidance to read it would be colored by oppinion of the person giving them to us #otalk | |
OTstudentHannah | @clissa89 @OTSM2011 defo benefit from being a student member of the @BAOTCOT #otalk | |
clissa89 | @bobcollinsOT @RCOMH I find conversations with like-minded colleagues helpful in the interim – but really feel the need to fill gaps #OTalk | |
OTSM2011 | @OTstudentHannah #otalk I have thought if I needed something major I would approach @BAOTCOT library for help. | |
OTstudentHannah | @Sasa_Radic very true, sometimes you need to be objective and look at supporting/unsupporting evidence to truly make a decision #otalk | |
bobcollinsOT | #otalk leaving uni and library resources makes access to evidence harder too. There is Athens but somehow not as comprehensive. | |
SarahMassey92 | If everyone can answer this: 7. From reading the journal and participating in the talk tonight, what is your take home message? #Otalk | |
OTstudentHannah | RT @bobcollinsOT: #otalk leaving uni and library resources makes access to evidence harder too. There is Athens but somehow not as compreh… | |
clissa89 | My take-home message is finding & using evidence can be challenging, but very important. & I want to generate more. #OTalk | |
Sasa_Radic | @clissa89 @bobcollinsOT @RCOMH #otalk Ithink we should also talk/exchange ideas/evidance with people having different oppinions then yours | |
bobcollinsOT | #otalk The hospital librarians have been fantastic though. They have the time to find relevant articles and send a regular bulletin. | |
clissa89 | @Sasa_Radic @bobcollinsOT @RCOMH oh yes! Considering different views definitely important. By “likeminded”,meant curious, reflective #OTalk | |
OTSM2011 | @SarahMassey92 #otalk to keep trying! | |
Sasa_Radic | #otalk No of participants in the study can be an issue, but sometimes single case stud can be a good evidance to base our therapy | |
SarahMassey92 | @bobcollinsOT In your experience have you found this different between settings? #otalk | |
kilner100 | @Sasa_Radic @OTSM2011 usually at their request! All research / evidence has opinions and bias in it. We just need to assess how much #otalk | |
clissa89 | @bobcollinsOT this has been the same in my experience – librarians such a valuable resource, if have access to them #OTalk | |
OTstudentHannah | @Sasa_Radic in the whole of NZ only 14 recruited, very peculiar! #otalk | |
kilner100 | RT @OTSM2011: @SarahMassey92 #otalk to keep trying! | |
OTstudentHannah | @clissa89 @bobcollinsOT this is very good to know for the future! #otalk | |
becci_haigh_ot | @SarahMassey92 7. we’re all in the same (baot) boat. think journal clubs are time efficient for OT/MDT teams to keep up to date #otalk | |
clissa89 | Wow, where’s the hour gone? 2 minutes to go! But keep on chatting if you like, & comment on the blog too! 🙂 #OTalk | |
bobcollinsOT | @SarahMassey92 I think my attitude to libraries have changed rather than there not being the resource there! #otalk | |
OTstudentHannah | @becci_haigh_ot couldn’t agree more #otalk | |
OTstudentHannah | RT @clissa89: Wow, where’s the hour gone? 2 minutes to go! But keep on chatting if you like, & comment on the blog too! 🙂 #OTalk | |
clissa89 | Next month’s journal club article will be about the experience of living with psychosis – we’ll tweet/blog details soon #OTalk | |
kilner100 | RT @clissa89: My take-home message is finding & using evidence can be challenging, but very important. & I want to generate more. #OTalk | |
SarahMassey92 | @becci_haigh_ot Oh I like the pun there! I agree with you and why we actually came up with an online journal club. #otalk | |
clissa89 | Thank you so much to @OTStudentHannah and @SarahMassey92 for choosing this article, hosting the chat, & all the preparation! #OTalk | |
Sasa_Radic | @kilner100 @OTSM2011 I can understand, as educator I have given research to students/newOTs #otalk | |
OTstudentHannah | @bobcollinsOT would you feel confident locating the evidence yourself after having their help? #otalk | |
CroftVictoria | Looks like it’s been a good discussion. Sorry I’m late. Boys Bedtime routine ran on #otalk | |
Sasa_Radic | @kilner100 @OTSM2011 But I have realized that impact and critical reasoning was better when they found it by themselves #otalk | |
kilner100 | #OTalk @OTstudentHannah @SarahMassey92 great chat, and very well prepared, thank you and well done! | |
clissa89 | @CroftVictoria glad you could pop in 🙂 feel free to keep tweeting for next 24 hours, or comment on the blog: http://t.co/xhbiU568fv #OTalk | |
bobcollinsOT | #otalk take home message: Link with others to gather, consider and produce evidence. Use the librarians and students. Use clinical reasoning | |
SarahMassey92 | @CroftVictoria You’ll have to read what’s been discussed but please leave your comments on the blog 🙂 #otalk | |
OTstudentHannah | @kilner100 thank you very much! #otalk | |
OTSM2011 | RT @clissa89: Thank you so much to @OTStudentHannah and @SarahMassey92 for choosing this article, hosting the chat, & all the preparation! … | |
OTstudentHannah | @clissa89 glad you enjoyed it and we’re so pleased everything went smoothly! We’ve spent a long time preparing for this haha #otalk | |
Sasa_Radic | @OTstudentHannah Yes I agree, I would send an e-mail to them asking why just 14 #otalk | |
OTstudentHannah | RT @bobcollinsOT: #otalk take home message: Link with others to gather, consider and produce evidence. Use the librarians and students. Use… | |
SarahMassey92 | @kilner100 @OTstudentHannah Glad it has gone well, we’ve been prepared for roughly a month #OTGeek #otalk | |
CroftVictoria | @CroftVictoria running my eye down the thread. Love #otalk | |
clissa89 | @OTstudentHannah @SarahMassey92 remember to record all that preparation as CPD! 🙂 #OTalk | |
OTstudentHannah | @bobcollinsOT you’ve been my favourite tweeter this evening, thank you! #otalk | |
gillyflower78 | RT @bobcollinsOT: #otalk take home message: Link with others to gather, consider and produce evidence. Use the librarians and students. Use… | |
SarahMassey92 | RT @bobcollinsOT: #otalk take home message: Link with others to gather, consider and produce evidence. Use the librarians and students. Use… | |
OTstudentHannah | @Sasa_Radic good idea! #otalk | |
gillyflower78 | @clissa89 @OTstudentHannah @SarahMassey92 Sorry I missed out on this! Will follow what was discussed on the blog #otalk | |
clissa89 | @CroftVictoria thank you – we love it too! It’s great to have this amazing community as a resource to support EBP/reflective practice #OTalk | |
Sasa_Radic | @OTstudentHannah 4 example – if I would ask the research questions in my community (Croatia), I would get an answer from aprox 25 OTs #otalk | |
sophiewearing | @OTstudentHannah @clissa89 where I work we have a journal club in1 lunchbreak so newly qualifieds&varying senior levels can analyse..#OTalk | |
clissa89 | @gillyflower78 @OTstudentHannah @SarahMassey92 thanks for popping in – yes check out the blog post and leave a comment #OTalk | |
kilner100 | @Sasa_Radic I’m sure that’s true. Sometimes i was asked as educator cldn’t access the article and I cld get from uni library! #OTalk | |
SarahMassey92 | #otalk final point. Do you agree the findings are appropriate for the UK considering this was a study completed in New Zealand? | |
becci_haigh_ot | @clissa89 yes have been working hard on the next JC. As discussed, it takes so much time! 🙂 hope people will enjoy the topic #Otalk | |
OTstudentHannah | @Sasa_Radic we’re really considering asking their reasoning #otalk | |
sophiewearing | @OTstudentHannah @clissa89 them together,thus skill sharing&learning at the same time as well as service improvement. #OTalk | |
clissa89 | @becci_haigh_ot it sounds like a fascinating topic, and I’m really looking forward to discussing it with you next month 🙂 #OTalk | |
bobcollinsOT | @clissa89 @OTstudentHannah @SarahMassey92 Yeah, thanks for a great #otalk | |
SarahMassey92 | RT @OTstudentHannah: @Sasa_Radic we’re really considering asking their reasoning #otalk | |
OTstudentHannah | @sophiewearing @clissa89 that would make my working environment very pleasant!! #otalk #otgeek | |
Sasa_Radic | @OTstudentHannah People who would answer would be proactive OTs, some of the best Croatian ones, with good EBP use skills #otalk | |
SarahMassey92 | @bobcollinsOT @clissa89 @OTstudentHannah No problem! We have really enjoyed it. #otalk | |
clissa89 | Thanks to everyone who joined in tonight. For a little group, we’ve generated a lot of discussion! CPD record: http://t.co/ix4GjUmdo1 #OTalk | |
OTSM2011 | @OTstudentHannah @SarahMassey92 thanks for interesting #otalk got to leave now. Well done | |
OTstudentHannah | RT @clissa89: Thanks to everyone who joined in tonight. For a little group, we’ve generated a lot of discussion! CPD record: http://t.co/ix… | |
Sasa_Radic | Thank you @OTstudentHannah @SarahMassey92 for tonight #otalk You have given me some new ideas | |
sophiewearing | @OTstudentHannah @clissa89 it does I think!Also inspirea me! #Otalk #otgeek too!! | |
sophiewearing | @clissa89 looking forward to this #Otalk | |
OTstudentHannah | Thanks everyone, we’ve had such a good evening with you. Don’t forget to read some ground breaking literature 😉 #otalk | |
SarahMassey92 | Thank you to everyone who has participated. Comment on the blog with any last thoughts. If you write a reflection please do share it. #otalk | |
sophiewearing | @clissa89 ohmygoodness thank u for that post! #Otalk | |
OTwilsher | @clissa89 @OTstudentHannah @SarahMassey92 apologies I missed out on the #otalk tonight but I will defo read the blog and retweet info | |
clissa89 | @OTwilsher @OTstudentHannah @SarahMassey92 no worries – look forward to your thoughts 🙂 #OTalk | |
clissa89 | @sophiewearing hope you find it useful. Would love to hear any feedback/additional ideas about how we can support CPD #OTalk | |
sophiewearing | @clissa89 Im on mat leave@the mo so a bit rusty but ill have a think! #OTalk | |
Abbie_Mowbray | RT @kirstyOT: OT week 2013 Nov 3rd-7th What is OT to you? #OTweek #otalk http://t.co/PmlMIDxrmd | |
OTAshleyP | Sorry to miss tonight’s #otalk busy getting ready for #sotls! Excited to meet you all, live or virtually, on Saturday! | |
otnotes | Oh, is it Tuesday? Another missed #otalk 😦 sigh | |
OTstudentHannah | I am shattered! Had a lovely evening with @SarahMassey92 for our #otalk journal discussion, I’ll be uploading a reflection soon #otgeek | |
SarahMassey92 | @DawnFraser_OT Thank you for writing on the blog earlier Dawn. Hope you can catch up on the discussion we had tonight. #otuesday #OTalk | |
clissa89 | #otalk mt “@Heatheryb2: @OTstudentHannah peers/colleagues valid for EBP esp when working in collab w/other prof. or w/OT w/cert or exp” | |
BoothRach | RT @clissa89: @OTstudentHannah 4. Qualified, more important to me that use the evidence because what I do is my responsibility & decision #… | |
BoothRach | @OTstudentHannah no, still every group Iteam gets a EBP & risk ass before it starts, we do sometimes use students to do this! #otalk | |
BoothRach | @SarahMassey92 @clissa89 @OTstudentHannah it’s part of your job you should find time! Time is very precious tho! #otalk | |
Icepop1902 | RT @clissa89: @OTstudentHannah 4. Qualified, more important to me that use the evidence because what I do is my responsibility & decision #… | |
Helen_otuk | RT @OTstudentHannah: Thanks everyone, we’ve had such a good evening with you. Don’t forget to read some ground breaking literature 😉 #otalk | |
LabmedOT | RT @kirstyOT: OT week 2013 Nov 3rd-7th What is OT to you? #OTweek #otalk http://t.co/PmlMIDxrmd | |
RCOMH | @bobcollinsOT #otalk Thank you for recognising RCOMH’s work | |
OTstudentHannah | I should have my reflection from last nights #otalk ready at the end of the day, going for a walk now to relax and refresh myself! | |
OTstudentHannah | RT @OTwilsher: @clissa89 @OTstudentHannah @SarahMassey92 apologies I missed out on the #otalk tonight but I will defo read the blog and ret… | |
SarahMassey92 | I’m thinking of creating a blog to store my reflections etc. What blogs do people use now i.e. blogspot/wordpress…. why? #otalk #otgeek | |
OTstudentHannah | RT @SarahMassey92: I’m thinking of creating a blog to store my reflections etc. What blogs do people use now i.e. blogspot/wordpress…. wh… | |
OTstudentHannah | I’ve done a little informal reflection from last nights #OTalk, posted on the blog: http://t.co/kGvLQ47wo5 | |
Helen_otuk | @AllisulliOTProf @subu_ot @BridgettPiernik Facebook & pinterest popular here too. But we do love Twitter also. #OTalk #OccupationalTherapy | |
SarahMassey92 | See @OTstudentHannah reflection about hosting last nights journal club on #otalk. http://t.co/eecKmshxHn | |
Helen_otuk | RT @SarahMassey92: See @OTstudentHannah reflection about hosting last nights journal club on #otalk. http://t.co/eecKmshxHn | |
NaomiMcVey | @JanetThomas47 @RobYeldham @thecsp …#wenurses chats have included DH, @NHSLeadership & tweeting NHS CEOs, #Otalk the HCPC | |
munchknmunch | @clissa89 @DrieCulturen how did I miss this??? Yes, I’d love to. Feeling a tad guilty I’ve let my OT side go! #otalk #tcks | |
MediconnectRec | RT @SarahMassey92: See @OTstudentHannah reflection about hosting last nights journal club on #otalk. http://t.co/eecKmshxHn |
Content from Twitter
Hello all, we both hope you have had chance to read the article in preparation for the journal club? Here is the reading record Hannah and I have completed, it is our first attempt at using the form so please feel free to add your own comments, discussion points and any constructive criticism you have is very welcome.
We look forward to reading your comments.
Name: Sarah Massey & Hannah Webster
Date Record Completed: 20/10/13
Full Harvard Reference:
Robertson, L., Graham, F. and Anderson, J (2013) What actually informs practice; occupational therapists’ views of evidence. British Journal of Occupational Therapy, 76(7), 317- 324.
Definitions of terms and concepts:
Culture of evidence based practice (EPB) – use of journal clubs (McQueen et al, 2006, Stern, 2008); internships (Sabus 2008); group education (Hammond and Klompenhouwer 2005) and employing a clinical research leader role to facilitate the process (Horner et al 2007).
Critical thinking – “About integrating individual clinical expertise and the best external evidence” (Sackett et al, 1996, p.71).
Thematic analysis – The process involves the identification of themes through “careful reading and re-reading of the data” (Rice & Ezzy, 1999, p.258). It is a form of pattern recognition within data, where emerging themes become the categories for analysis. (Fereday, J. and Muir-Cochrane, E. (2006).
Identification of the author’s main message:
What occupational therapy practitioners in New Zealand are considering as evidence and how they are using it within practice.
Identification of major themes:
1. Finding evidence to support practice
2. The nature of available evidence
3. The organisational influences
4. The importance of evidence
Discussion of major themes and sub-themes:
1. Finding evidence to support practice – Professional development time wasn’t allocated within workloads so talking to experienced colleagues was favoured as it was quicker and easier to find information. Many considered it’s only essential to read literature when there is no other way of finding out the information. Consulting colleagues for confirmation on practice added opportunities for peer support and professional dialogue and articles that were quick to read were favoured, such as abstracts of story-form literature as they were easy to read.
2. The nature of available evidence – A randomised controlled trial was not considered the “OT way of working” as it’s not individualised. Qualitative research was thought to be better suited for individualised practice as it addresses individualised practice however it was a concern that EPB wasn’t capturing the importance of this. Some commented that is was hard to find peer-reviewed journals that were relevant to New Zealand practice. Some suggested that evidence could be more appropriate to certain clinical settings within the same practicing sector than others.
3. The organisational Influences – Policies and cultural aspects influenced the use of EBP within working practitioners and it was not high on their priority list. A graduate with skills related to EBP felt they needed permission to use evidence. Competition amongst practitioners discouraged the sharing of information and time wasn’t allocated within the working day to contribute to EBP. Having to pay for articles or just read abstracts is a frustration amongst practitioners, as they didn’t have access to databases or libraries. However the use of journal clubs within settings was seen as helpful as it ‘forced’ someone to read the information.
4. The importance of evidence – Therapists see the use of evidence as ‘core to their practice’, part of professional responsibility and ‘key…to being competent’. Many examples were given stating the importance of justifying evidence and practice is ‘sound and robust’. Evidence outside of own practice provides confidence when justifying to funders, defending approaches, working within a multi-disciplinary team and to support work with clients.
Integration of material with other work:
This article has been a very beneficial one to read in the eyes of a student, even to the degree of critiquing the methodology. Integrating what we’ve read from this article will be in the eyes of guiding fellow students to think “has this been evidenced?” but also using the new understandings of evidence to aid in our university studies and placement practices, such as using our core skills as OTs to effectively utilise the evidence and promoting our educators on their evidence of practice, which will in turn positively impact our learning and theirs.
Application of material to own experience:
As students, understanding the clinical reasoning behind particular interventions and assessments is almost second nature. Therefore, out on placement it is always a major topic of discussion with our educators, however little emphasis is on the why they do what they do: assessment tools, outcome measures and interventions are used because it’s what they do and how long they’ve been doing it for, not EBP. Hence why we can relate to the recently qualified issues with having to gain permission to use evidence (p.321, Organisational Influences). A further comment was made regarding the limited time and resources to locate and evaluate evidence, this we can relate to and we feel is a universal barrier to EBP, however to us as students using evidence proves our worth as OTs and we have the constant worry of not being able to say “we’re doing this because… however we delved into other options such as…” – which we’re sure that a lot of qualified OTs also worry about regarding maintaining their CPD and portfolio for the HCPC potential audits, not to mention the drive we all have as OTs to be continuously creative and resourceful.
Evaluation of author’s presentation:
For an article written about evidence and how it is used within practice, we were surprised that the authors didn’t comment on the importance EBP has within OT practice, as we all know how important it really is. Questions can also be raised about the article and the approach the authors took, for example, did you feel any of the telephone questions were leading? How did they purposively select the participants from those that replied to the survey? And are 14 participants enough for this type of study?
We felt more emphasis could have been put on the importance of EBP (especially as this is what we have been used to) and some suggestions on how evidence can be used in a more productive manner within practice for current practitioners who can relate to these themes, and students who are about to embark in employment settings who may themselves face the same barriers.
Application of learning to practice:
Many strong points were made within this article that made us think about EBP and what actually constitutes as it, in a very positive manner. For instance, on the first page there is emphasis on utilising our clients’ knowledge of their own occupational concerns as a part of our evidence, noting that we do this on a regular basis with the OT process/information gathering it was quite interesting to read such a powerful statement, that does make you think twice about how many different ways there are to understanding the use of evidence in practice. Delving further into the article, there were some points that focus on using our core skills as OTs to utilise evidence effectively, and regardless of how ‘good’ the evidence may seem, it can be pretty worthless if it is not utilised effectively by someone with the appropriate skills – this applies perfectly to understanding why, at university, EBP is in our minds at all times, however it politely raises the issue of continuing this within practice – which is an ideal learning opportunity for students and practitioners as we can focus our individual learning needs on expanding our evidence within and without the prompts of university lecturers.
Relationship to Practice/KSF Competencies:
EBP is core to our speciality practice – with other health professionals questioning our practice, knowing we have this evidence not only expands our creative field but empowers those of our colleagues, whether they be other health professional students or those on your MDT, to understand occupational therapy. In addition, this helps create an effective therapeutic relationship with our clients: when we spend the time to explain why we’re there to see them and what we aim to achieve with them, we are ensuring they have a positive experience within our care which is tailored to a client-centered, occupational-based intervention which has been critically evaluated and reflected upon – we ensure our clients’ know that “one-size” doesn’t fit all when it comes to occupational therapy.
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Initially after qualifying there was so much to learn ‘on the job’ that how it linked to the latest evidence wasn’t at the forefront of my mind. However, once this level of learning was established, EBP became a key focus as part of the drive to continually improve services. This was driven through engaging in journal clubs and reading BJOT but specific searches weren’t conducted on my area of expertise. As a more experienced clinician this changed but access to searching the literature was more difficult and by this stage I was out of practice. In the current climate we need to be able to prove our effectiveness and justify our actions more so than ever before so we need to embrace research, it’s findings and not be afraid of being critical of our practice in our quest to continuously improve! Our service users deserve to be treated by upto date professionals and employers need to recognise this and provide protected time for clinicians to do this.
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My reflection (informal, no tool used):
My prior experience to hosting a journal club was very limited, I’d failed to participate in the previous months’ journal club however I did make a note to go through the transcript and I did participate in my first #OTalk session on twitter so I felt I had an idea of how our journal club would plan out. I’d never been a part of an online journal club before, however I have been a part of journals clubs within the university and out in placement with other occupational therapists and their students. My experience of journals clubs is very vast and it is something I would consider to be enthusiastic about it, so this experience was almost like taking it to a new level.
Preparation for this journal club was very early on: what I felt was one of our best tools was actually selecting the journal without pre-reading it. We’d read the title and made the decision the use the article immediately, which I feel aided in our journal club evaluations and topic discussions. We didn’t pick it because it was easy or for any other superficial reason, we chose it because of its relevancy: it relates to student OTs, OTs in practice, qualified OTs not in the working profession and retired OTs.
Sarah and I had gotten together MANY times to discuss our individual notes and to create notes/questions ourselves that we could both agree on and felt that were appropriate. Working with another person was actually quite a weight off my shoulders, we could depend on one another for help and support as well as creating discussion pointed based on each other’s thought processes: Sarah had thought of points/made conclusions that I had not and vice versa. Even doing the online discussion was so much easier with another person. We would branch off each other’s tweets as well as dip in and out of discussions so that we both had equal input.
I must admit, the wait beforehand was nerve wrecking: there weren’t many people tweeting which panicked me in particular. However once the ball was rolling, I think we had nice steady flow of conversations, which again I am grateful for a second person as the flow may have been too much to handle on my own.
Journal clubs are definitely a leisurely pass time for myself and it would be a pleasure to do more of these, especially with Sarah as we do get on extremely well personally, academically and professionally. I feel that the entire experience enhanced my use of twitter as a professional tool as well as increasing rapport with other students and practising OTs out in the big working world, which is so beneficial for networking and making those vital connections. – Hannah Webster. 06/11/2013
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Great stuff. Is there a journal club on 12yh November? If so, what is the article to read up on? Thanks, Bri
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Hi Bri – the journal club is only on the first Tuesday of every month though we do meet weekly to discuss other things. You can find out topics from the google calendar at the top of the page and we normally post an introductory blog about what will guide the discussion at least a few days before. Hope that helps.
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Thanks, Kirstye- look forward to getting involved . Bri
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