This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT.
Let’s review four references that explain this:
1. According to Carol Dollaghan (The handbook for evidence-based practice in communication disorders, 2007, Baltimore: Brook), the EBP is the conscientious, explicit, and judicious integration of best available evidence from three areas:
- External evidence from systematic research (LAB)
- Internal evidence from clinical practice (CLINIC)
- Evidence concerning the preferences of a fully-informed patient (CLIENT)
2. According to the American Speech-Language-Hearing Association (ASHA), the EBP integrates information from these same three areas:
- Current Best Evidence (LAB)
- Clinical Expertise (CLINIC)
- Client/Patient Values (CLIENT)
3. According to Laura Justice who is editor of the American Journal of Speech-Language Pathology (“Evidence-Based Terminology” AJSLP, 17, 4, November 2008), some people are confusing the term EBP with the term “empirically validated treatments,” which is a treatment that has been validated by empirical research. She wrote:
“…one’s use of an empirically validated treatment is not the same as engaging in EBP” (p. 324).
Using EBP, the clinician:
“systematically gathers and integrates information (i.e., evidence) from a variety of resources, including scientific evidence [LAB], prior knowledge [CLINIC], and client preferences [CLIENT], to arrive at a decision” (p. 324).
4. The originators of the concept of the EBP are Sacket et al (Sacket, D., & Richardson, W.S., & Rosenberg, W., & Haynes, R.B. (1997) Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone). They wrote:
“Evidence-based medicine is not ‘cook book’ medicine … It requires a bottom-up approach that integrates the best external evidence [LAB] with individual clinical expertise [CLINIC] and patient choice [CLIENT] … External clinical evidence [i.e., research] can inform, but can never replace, individual clinical expertise” (p. 3-4).