Remember Evidence-Based Practice (EBP)? I have recently been thinking about it, and about the relationship between research and clinical practice. Indeed, clinical expertise is one component of EBP, but what about the link between evidence and practice? Statistical significance is important, but what are logical (and meaningful and appropriate) ways in which clinicians can translate evidence into daily practice?
Brackenbury, Burroughs & Hewitt (2008) demonstrated the massive challenges of EBP for SLPs. The authors highlight the critical importance of EBP and provide suggestions for clinicians. Even if you are not interested in reading about EBP, I would highly recommend the article as it is a neat qualitative study. (As an aside, look out for me thinking more about qualitative methods within Speech-Language-Hearing Science, as I am super duper into them. Basically, I want to be an ethnographer.)
In my research seminar we have been discussing the very real divide between research and clinical practice. Initially, we considered the differences between inferential generality and logical generality. Inferential generality allows us to make inferences about a population based on a sampling of subjects. Logical generality is the application of information (derived from a sampling of subjects) to an individual. (See Meline, 2009) More recently, our discussions have centered about quality of evidence. Within both of these conversations, it is seems reasonable to state that researchers and clinicians consider evidence, but from arguably quite different perspectives.
For example, researchers may consider characteristics of the design, or if the statistical analyses were appropriately applied and interpreted. Clinicians consider evidence to support their understanding of a clinical population, or to support a certain intervention model or technique. Researchers consider evidence to substantiate a model. Clinicians may think about research with one specific client in mind. This divide is real, and we need to think creatively about ways to move the science of our field forward while considering how we are contributing to the clinical day-to-day system.
How can we (as researchers) produce research that is clinically meaningful? How can we (as clinical practitioners) develop better strategies for understanding and applying research in appropriate ways?
