laura Braun, Laura VanDenheuvel, Heather Westling, and Margery M' Whites

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Factors Affecting the Use of Evidence-Based
Practice by Speech-Language Pathologists

• laura Braun, Laura VanDenheuvel, Heather
  Westling, and Margery M. Whites
• cOmmunication Sciences and Disorders
• St. Cloud State University
• St. Cloud, Minnesota
• Contact last author mwhites_at_stcloudstate.edu
• American Speech-Language-Hearing Association
  National Convention
• Chicago, IL - November 2008

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Abstract

• Evidence Based Practice (EBP) is vital for
  providing optimal clinical services. It is
  unclear how consistently speech-language
  pathologists (SLPs) are using EBP. The purpose
  was to find out rewards for using EBP, job
  factors affecting its use, and factors that
  increase SLP knowledge and skills. The thirty-six
  SLPs stated that the top reward for using EBP was
  client progress. The number one job factor
  affecting the use of EBP is lack of sufficient
  on-the-job research time. Most SLPs received no
  financial incentives for using EBP. Continuing
  education and collaboration were the most helpful
  in increasing knowledge and skills of EBP.

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Introduction

• The American Speech-Language-Hearing Association
  (Asha) promotes using Evidence Based Practice
  (EBP) as a vital part of providing the best
  service possible to clients and their caregivers
  (see Trilateral Model).
• Yet, a number of factors may affect its use,
  including workplace factors, speech-language
  pathologist (SLP) knowledge about EBP, and
  perceptions about rewards and consequences of
  using EBP as vital parts of their jobs.

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Research Questions

• What do SLPs perceive as rewards for using and
  consequences of not using EBP?
• What job factors may affect the use of EBP by
  SLPs (e.g., financial incentives, supervisor
  knowledge and requirements, performance
  appraisal, time, insurance reporting)?
• What do SLPs perceive as most helpful in
  increasing knowledge and skills in EBP?

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Trilateral Model of Evidence Based Practice (Asha
2004)
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Method Participants

• 36 practicing speech-language pathologists
• Work experience ranged from one to thirty-three
  years with a mean of 11.8 years.
• 24 worked in the school setting.
• 12 worked in medical/other settings.
• Nearly all worked in the Midwestern U.S.

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Method Procedures

• Student researchers developed interview and
  survey questions.
• Prior to the interviews, each student researcher
  was trained in the observation-interview method.
• Interview questions were sent to participants
  prior to the interview.
• On the day of the interview, student researchers
  asked the open-ended interview questions and
  wrote down notes or tape-recorded the responses.
• After the interviews, participants completed
  surveys .

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Methods Procedures

• When the interviews were complete, the open-ended
  answers were grouped into logical categories.
• Two researchers rated and categorized two
  randomly chosen surveys to determine inter-rater
  reliability (0.90).
• Survey responses were categorized into agree,
  disagree, neutral or not applicable.

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Results - Interviews

• What Are Rewards For Using EBP?

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Results - Interviews

• What Are Consequences For NOT Using EBP?

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Results - Interviews

• Who do you need to report to about your use of
  EBP?
• No One - 17/36 (47)
• Third-Party Payers/Insurance 16/36 (44)
• Supervisor/Boss 8/36 (22)
• School District/IEP 6/36 (17)
• Why?
• Only if Legal Matter 5/36 (14)
• No Child Left Behind (NCLB) 2/35 (6)
• Because Doctors/Parents Wanted to Know 5/36
  (14)

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Results - Survey
I would consistently use EBP if I were provided
time on-the-job to do research.
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Results -Survey
I receive additional financial incentives to use
EBP.
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Results -Survey

• My supervisor is very knowledgeable about EBP.

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Results -Survey

• My supervisor requires the use of EBP.

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Results -Survey

• The use of EBP is part of my performance
  evaluation.

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Results -Survey

• EBP promotes the advancement of the profession.
• Agree 34/36 (94)
• Neutral 1/36 (3)
• Disagree 1/36 (3)

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Survey Results

• What do SLPs perceive as most helpful in
  increasing knowledge and skills in EBP?
• Top Results
• Continuing education 69 of participants
• Collaboration with other SLPs 61 of
  participants
• Other Results
• Professional journals 14
• Resource lists 14
• Professional Listserv 11
• Job Experience 8
• Internet 3

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Conclusions

• Benefits of using EBP appear to be client-based
  and intrinsic in nature helping others is a
  primary motivation.
• Results were mixed for supervisor knowledge and
  requirements for using EBP, thus SLPs may need to
  educate their supervisors on its value.
• Even though the SLPs believed that EBP was
  valuable to the profession, it appears that few
  extrinsic motivators are in place for its use on
  the job. These include financial incentives,
  time-on-the-job to do research, and recognizing
  efforts for using EBP through performance
  reviews.

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What Factors Affect Your Use of Evidence-Based
Practice?
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References

• American Speech-Language-Hearing Association
  (2004). Report of the Joint Coordinating
  Committee on the Definition of Evidence-Based
  Practice.  
• Levine, E.L. (1983). Everything You Always
  Wanted to Know About Job Analysis. Tampa, FL
  Mariner Publishing.
• McCormick, E.J. (1979). Job Analysis Methods
  and Applications. New York AMACOM.
• U.S. Department of Labor (1972). Handbook for
  Analyzing Jobs. Washington, D.C. U.S.
  Government Printing Office.

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Acknowledgments

• We would like to thank the graduate research
  class of 2007 and all the willing participants
  who were involved in this research study.
• We would also like to give a special thanks to
  Dr. Margery M. Whites, whose efforts made this
  research project possible.
• Thank you to the following for their financial
  support SCSU Office of Sponsored Programs, Dean
  of Fine Arts and Humanities, SCSU Student
  Association, Westside Sertoma, and SCSU CSD
  Department.