JCPSLP Vol 23 No 3

Creative clinical education

What’s the evidence? The four components of contemporary evidence-based practice, Part 1: Practice contexts Nicole McGill, Speech Pathology Australia

Evidence-based practice in speech pathology EBP underpins the provision of quality, safe, and effective services for individuals, families, and communities (SPA, 2021). Speech pathologists in Australia are required to engage in continuous, lifelong learning and EBP (SPA, 2020). Definitions or models of EBP have evolved over time, with three examples being: evidence-based medicine (Sackett et al., 1996), evidence-based practice “E3BP” (Dollaghan, 2007), and evidence-based practice (Hoffmann et al., 2017). The expansion and refinement of these definitions over time to include additional sources of evidence are summarised in Table 1. The definition which may be most familiar in the speech pathology field is E 3 BP (Dollaghan, 2007), which outlines three sources of evidence to integrate in decision-making: (a) external evidence from systematic research, (b) internal evidence from clinical expertise and experience, and (c) informed client values and preferences (individual, family, or community). Hoffmann et al. (2017) extended upon the E3BP framework by highlighting another important source of evidence for consideration: the practice context . Contemporary EBP in speech pathology therefore calls for consideration and integration of four sources of evidence (Figure 1).

T his column is the first in a four-part series exploring the four sources of evidence to consider and implement in evidence-based speech pathology practice. You may expect Part I to focus on external evidence , given it is generally listed first in EBP definitions. However, I have decided to start by focusing on evidence from the practice context to draw your attention to the most recent (and potentially least familiar) addition to the definition of EBP, and because most of my research to date has been undertaken in this area. The following sections will briefly summarise the evolution of EBP and four sources of evidence to consider, discuss the practice context in more detail, and then outline considerations for implementing EBP. sectors. I have also been a researcher at Charles Sturt University and the University of Melbourne. An area of focus for me throughout my career has been exploring and addressing challenges and constraints faced in practice and enhancing access to services for individuals and communities. My most recent research has been in the areas of waiting lists, service delivery, and rural health. It is my privilege to have taken on the role as Senior Advisor Evidence-Based Practice (EBP) and Research at Speech Pathology Australia (SPA) and have the opportunity to write this column. I would like to thank Dr Cori Williams, who held the role since early 2012, for her valued contributions to promoting and supporting implementation of EBP among the speech pathology profession in Australia. Thanks also to Cori for her valuable insights shared in the “What’s the evidence?” column in JCPSLP over many years. Cori’s work has laid a solid foundation regarding EBP and research and I hope to continue to build speech pathologists’ knowledge, capacity, and engagement with research and EBP in this role. My previous roles include working as a speech pathologist across a range of contexts including private practice and public health, disability, and education

Nicole McGill Photo used with

permission from Kellie Crosier Photography.

External evidence from systematic research

Information from practice contexts

Values, circumstances, and preferences of informed client

Internal evidence from clinical expertise

Figure 1. Sources of evidence to consider in evidence-based practice (Adapted from Hoffmann et al., 2017, p. 4). The current paper focuses on practice contexts (shaded).

Table 1. Overview of evidence-based practice definitions and sources of evidence

Source of evidence

Definition

Author

Systematic research (External evidence)

Clinical expertise (Internal evidence)

Client preferences and values

Practice contexts

Evidence-based medicine

Sackett et al. (1996)

4

4

Evidence-based practice (E3BP)

Dollaghan (2007)

4

4

4

Evidence-based practice

Hoffmann et al. (2017)

4

4

4

4

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JCPSLP Volume 23, Number 3 2021

www.speechpathologyaustralia.org.au