Knowledge Translation in Audiology

Abstract

The origins of evidence-based practice (EBP) come largely from clinical medicine. The EBP paradigm provides techniques and procedures to critically examine the abundance of scientific evidence in order to assist clinical decision making and improve the quality, effectiveness, and efficiency of health services received by the public. The desired clinical outcome of EBP is an increase in the number of patients who get treatment of proven quality and effectiveness. The generally agreed-upon definition of EBP is that it is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." Evidence-based practice integrates "individual clinical experience with the best available external clinical evidence from systematic research" (Sackett, Rosenberg, Muir Gray, Haynes, & Richardson, 1996, p. 71). Incorporating evidence into practice is regarded as a process that begins with a search for research literature about how best to solve specific clinical problems and results in treatment decisions based on the best possible evidence (Stetler, 2001). As clinicians and their organizations learn more about EBP and the components of EBP, workshops, seminars, training kits, books, and educational opportunities have been developed to assist clinicians in developing the necessary EBP skill set that includes the ability to develop focused and appropriately structured clinical questions, search and locate high-quality evidence in the literature, evaluate the strength of the evidence, critically appraise the evidence, and implement evidence within the clinical context. Evaluating the Strength of the Evidence: Hierarchy of EvidenceIn order to provide professionals with a method for ranking the quality of research, hierarchies of evidence were intro- AbstractThe impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitat...

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