Graduation Year

2010

Document Type

Thesis

Degree

M.S.

Degree Granting Department

Communication Sciences and Disorders

Major Professor

Jacqueline Hinckley, Ph.D.

Keywords

Evidence-based practice, Neurogenics, Survey, Perceptions, Implementation

Abstract

The past three decades have produced a surge of interest in the role of evidence-based practice (EBP) in the clinical decision-making of speech-language pathologists and other healthcare professionals in delivering optimally effective patient care. A review of the literature revealed several studies investigating potential barriers to EBP implementation and attitudes toward EBP. However, few studies have been designed to probe what treatment approaches to neurogenic communication disorders clinicians are currently implementing and the rationales behind their use. Furthermore, a review of the literature failed to reveal any surveys designed to probe the correlation between what clinicians perceive to be evidence based and what truly is evidence based as outlined in current practice guidelines.

The primary aim of this study was to examine potential trends within the field of speech-language pathology relating to the role of EBP in the clinical decision-making of aphasia therapy and the quality of evidentiary support for these decisions. Launching both Web-based and hard copy versions of an 18-question survey, questions probed clinicians' perceptions of the evidence level, primary sources of information, and timeframe of implementation related to various traditional treatment approaches for aphasia. Analysis of the 104 survey responses revealed a disconnect between the implementation of aphasia treatments and the research behind their use. Results indicate that many of the common treatment approaches for aphasia currently in practice are evidence based. However, a research-to-practice gap exists as many treatment approaches that clinicians are not reportedly using are also supported by evidence.

Similarly, clinicians' perceptions of what is evidence based are not always in accordance with current practice guidelines. Clinicians appear to rely on professional journals, graduate school training, and professional conferences as their primary sources of evidence-based information. It does not appear as though advertising significantly affects clinicians' decision making in treatment selection. Furthermore, clinicians tend to implement new or alternative treatment approaches rather quickly after exposure to the treatment. Although participants reportedly acknowledge the importance of EBP, further research is needed to investigate causes of and ways to eliminate the research-to-practice gap in the treatment of neurological communication disorders.

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