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INTRODUCTION

QUESTIONS TO CONSIDER

  1. Why is it important to construct a searchable clinical question?

  2. Give an example of a background question and a foreground question.

  3. Describe the difference between a database and a search engine.

  4. Name a search engine that anyone can access for free on the Internet. What are this tool’s strengths and weaknesses for helping therapists find research evidence?

  5. Name three important techniques for narrowing a search in the PubMed search engine. Do the same for expanding a search.

  6. Where could you locate a repository of full-text research articles mandated by the U.S. Congress?

CHAPTER-AT-A-GLANCE

This chapter will help you understand the following:

  • Searchable clinical questions

  • Searching for research evidence

  • Accessing the full text of research articles

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This chapter develops your knowledge and skills in the first two steps of evidence based practice (EBP):

  • Step 1: Identify a need for information, and develop a focused and searchable clinical question.

  • Step 2: Conduct a search to find the best possible research evidence to answer your question.

These steps take you through the process of obtaining research evidence. Most therapists find that research evidence is the most difficult type of evidence to obtain. This chapter helps you learn to obtain it quickly and efficiently.

HOW DO I KNOW IF I NEED INFORMATION?

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Step 1 can be divided into two parts—identifying a need for information and then constructing a focused, searchable clinical question. How do you identify a need for information? During your physical therapy education, you are flooded with information about how to care for patients. As an evidence based therapist and lifelong learner, you will constantly add to your knowledge. Every patient is different, and many present in ways that push you to find new information to optimize their care. Also, scientific evidence rapidly changes. There are now over 3,500 new clinical trials published every year related to physical therapy (Fig. 2.1). You cannot know the answer to every clinical question that arises. The key is to identify important knowledge gaps and know how to fill them with the best available evidence.

FIGURE 2.1

Number of physical therapy-related clinical trials published each year from 2000 to 2014.

Identification of your information needs may occur before you see a patient and throughout a patient’s course of care. The American Physical Therapy Association1 defines patient management as having six components (Fig. 2.2):

  1. Examination

  2. Evaluation

  3. Diagnosis

  4. Prognosis

  5. Intervention

  6. Outcomes measurement

FIGURE 2.2

Elements of patient/client management. From: American Physical Therapy Association. Guide to Physical Therapist Practice. 2nd ed. Alexandria, VA: American Physical Therapy Association; 2001; with permission.

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