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Supporting the integration of research evidence, practitioner expertise, and client perspectives in the clinical decision-making process.
Sofia has worked in the occupational therapy department of a large metropolitan hospital for the past 15 years. She values this setting because of opportunities that have arisen over the years to learn about and then practice in new areas. Recently, the department administrator approached her about taking a leadership role in developing a driving rehabilitation program to meet the needs of the large number of older adults served by the hospital community. Sofia is eager to be involved in this opportunity but realizes that she will need to learn a great deal about driving rehabilitation for older adults.
As a first step, Sofia visited the AOTA Web site (www.aota.org) to find some introductory information about the topic. She connected to the Older Driver Safety section, and clicked on the Toolkit for Professionals. She had recently attended a day-long workshop about evidence-based practice (EBP) sponsored by her state occupational therapy association and was still intrigued by the instructor's take-home message: "there are three components of EBP-clinical judgment, client context and preferences, and the scientific evidence." Sofia was confident with her skills in the first two components of EBP, but she was less comfortable in knowing how to use the scientific evidence to inform practice and program development.
Sofia began to explore the Toolkit section and saw Driving CATs and CAPs. Although she didn't know the full scope of Critically Appraised Topics (CATs) or Critically Appraised Papers (CAPs), she did know that they were examples of the summaries of systematically appraised literature mentioned in the EBP workshop. So before proceeding, Sofia reviewed her notes.
The workshop leader had begun her presentation by acknowledging that most occupational therapists and occupational therapy assistants are interested in providing effective services that are client-centered, supported by evidence from the literature, and delivered in an efficient and costeffective manner. At the same time, many practitioners are challenged to understand how to find literature relevant to their clinical questions, and then are not comfortable evaluating the quality of the literature after it is found. These factors, along with lack of time, limited access to key electronic databases, as well as competing workplace demands and administrative...