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Pre-Test

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  1. Can you explain to someone else what evidence based practice (EBP) is and why it is important?

  2. Can you describe the three primary sources of evidence for EBP?

  3. What are the five steps of EBP?

  4. What is known about EBP in the real world?

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Introduction

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What is EBP and Why is it Important?

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Evidence based practice (EBP) is a method of clinical decision making and practice that integrates the best available scientific research evidence with clinical expertise and a patient's unique values and circumstances.1,2 For the evidence based therapist, these three sources of evidence (scientific research, clinical expertise, and patient values and circumstances) form a foundation on which you and your patients will work together to determine the best course of physical therapy care in any given circumstance (Fig. 1.1). The goal of evidence based therapists is to ensure that the best available evidence informs patient care to optimize the benefit that patients gain from therapy.

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FIGURE 1.1

The three pillars of evidence that support optimal outcomes for patients. The patient and the therapist contribute evidence to the decision-making process. As the evidence is collected, the therapist and the patient engage in a dynamic process using evidence to make a shared-informed decision.

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As an evidence based therapist, you will provide care that is grounded in scientific research, guided by clinical expertise, and ultimately directed by your patients' individual values and circumstances. Third-party payers, patients, and the general health-care community have a steadily increasing expectation that physical therapists will be evidence based. The effort that you put into EBP will not only fulfill the expectations of others, it will also enhance the quality and credibility of your services. This will lead to enhanced confidence and ability to assist patients in choosing their best options for physical therapy care. EBP moves the physical therapy profession away from practice based on habit and toward a careful, systematic assessment of the best available evidence to inform patient care. By carefully appraising what is known from multiple reference points, you will be better prepared to provide your patients with the best care that physical therapy has to offer.

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Image not available. CASE STUDY 1.1 June Wilson

Consider June Wilson, a 17-year-old swimmer referred to your outpatient clinic for neck pain 3 days before the state high school swimming championships in which she is scheduled to compete. June and her parents will expect you, the movement expert, to be able to answer their questions. June might ask you:

"Why does my neck hurt?"

"What are the chances that I will be able to swim without pain in 3 days?"

"What will you be able to do to help me get better?"

As an evidence based therapist, you will be able to give June and ...

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