Download - Why and what is it EBP for Therapist
WHY AND WHAT IS IT
Evidence-informed Health (Physiotherapy) Care
K Hariohm MPTProfessor in PT
MSAJ College of PTICEBNR
objective
1. What is evidence informed practice2. What is the need for EIP3. Learning the rudiments of of evidence
informed practice
IS MED
ICINE A SCIEN
CEWhat is science
“Knowledge covering general truths of the operation of general laws, esp. as obtained and tested through scientific method [and] concerned with the physical world."
What is faith
Faith is belief with strong conviction; firm belief in something for which there may be no tangible proof; complete trust in or devotion to. Faith is the opposite of doubt.
WHAT CONSTITUTES A SCIENTIFIC METHOD
What is the first step in a scientific method
MED
ICINE IS SCIEN
CE
•Science starts with a problem or a question
•Evidence based practice – no question or no problem
REALLY DID
THE APPLE FALL O
N N
EWTO
NFormulate a question
Ask the right question Apple falls on Newton
No science without problem or questionEBP cannot happen if you don’t have a problem
What are the question in physio-therapeutic science
Question should be related to our patient care.1. Which treatment to follow for a particular
patient or condition2. Which is method of treatment is better3. Which test to perform to help in diagnosis 4. Can it lead to worsening of the patient
(harm).5. Will my patient achieve a goal can he/she
achieve
OTH
ERWISE TH
E QU
ESTION
HAS N
O VALU
E Questions related to our patient care
WH
EN AM
I GO
ING
TO FIN
ISH LEARN
ING
ALL THESE AN
D
START PRACTICING
Professional question
IF YOU
'RE NO
T PART OF TH
E SOLU
TION
, YOU
'RE PART OF TH
E PRECIPITATE!
Next step -Find solution
• Who do we usually ask-• Expert• Teacher• Social media- peers
• Refer what? • Books• Journal (really)
• Infer from • Physiological and other rationale• discuss and infer (peer discussion)
DO
ES IT MEAN
I NEED
NO
T LISTEN TO
MY PRO
FESSOR
Can I take ideas and treatment on the face value of the expert
Don't go “according to Mr. ” to every treatment method and statement
WH
AT IF MY PEERS ARE ALL D
UM
B OR SU
PER SMART
Discussion with peers
Remember they can or may also come to the conclusion it is an elephant.
We go and read
•What are we reading•When was it published•Was it referred properly•Is there confirmation bias
Remember medicine is science
•It has to be proved•Is there a physiological validity for what is said •Experimented•Repeatability•Ideal homogeneity in the answer ?!
What is evidence based practice
Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (From BMJ 1996;312:71-72)
Why evidence informed practice
Well its how science is doneMakes the practice better- better outcomes for your patient
How to practice EBM
Physiological sense
So how do I practice EBP or intelligently
1. Formulate a proper question 2. Search for answer3. Critically look at the answer for “truth”4. Put it into practice using you experience
and expertise 5. Re-evaluate