ACQ Vol 12 no 1 2010

clinical groups within this network include: paediatric feeding, adult swallowing, and voice. Speech pathologists who are interested in joining a clinical group must undertake a training workshop in the principles and procedures of the network. SpeechBITE™ (Speech Pathology Database for Best Interventions and Treatment Efficacy; http://www.speechbite. com) was launched in 2008 and is an internet-based resource designed to assist speech pathologists in evidence based clinical decision making. With Dr Leanne Togher as project leader and Kate Smith as project manager, SpeechBITE™ provides abstracts of speech, language, communication, and swallowing intervention papers that have been published in scientific journals and then adds an expert rating out of 10 for the paper based upon its design, statistical methodology and other factors. SpeechBITE™ is available free of charge on the internet. Look up your area of interest on the website and find abstracted empirical demonstrated by a group of Speech Pathology Australia Association members. While undertaking training in how to evaluate the evidence, the efficacy of a number of marketed child language therapy programs was considered. After devising a relevant clinical question, a search of the literature was undertaken using SpeechBITE™. A number of relevant articles were identified and downloaded from major databases for medical and educational articles: PubMed (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed), Medline (http://www.nlm.nih.gov/databases/databases_ medline.html) and Eric (http://www.eric.ed.gov/). Following evaluation of the articles it was agreed that there was no sound evidence to support the use of these child language programs. Attendees agreed that resources such as SpeechBITE™ certainly made it easier to identify and evaluate the available evidence, and thereby enabled clinicians to provide advice and professional opinion to a client that was informed by the best available evidence. Next steps To reduce the perceived gap between speech pathology practice and research underpinning practice, more research and increased numbers of researchers (especially clinical researchers) are required. If you are interested in conducting clinical research but do not have knowledge and/or experience in the area, it is important that you access the support of experienced researchers who will be able to guide you along the research path. You might even consider accessing the support of a mentor. This can be done through undertaking a postgraduate course/ degree or through enrolling in the mentoring program (http://www. speechpathologyaustralia.org.au/Content.aspx?p=234) offered through Speech Pathology Australia. By accessing appropriate support and mentoring when undertaking research, the potential for your research to be conducted in an appropriate manner will be heightened, and your research findings and recommendations will not only be robust and open to scrutiny but will contribute meaningfully to the knowledge base and scientific basis of the profession. I look forward to receiving your comments and engaging in discussion regarding the issues that impact our ability to incorporate the evidence into our clinical practice, and am excited by the prospect these discussions may have in relation to the evidence base that underpin our clinical practice. References Dollaghan, C. A. (2007). The handbook for evidence-based practice in communication disorders . Baltimore: Paul H. Brookes. scientific evidence for or against your treatments. The utility of the above resources was recently

Valuable information is also available by means other than that provided through research projects. For example, papers that describe hypotheses and theories will facilitate understanding of theoretical frameworks underpinning clinical interventions. They will also provide a first step in designing future studies that aim to investigate the efficacy of treatment interventions. Information provided in workshops and seminars will also provide relevant information, particularly when the information is underpinned by research that is robust in design and interpretation. A process for EBP in speech pathology An evidence based practice process has been described in the speech pathology literature (Gillam & Gillam, 2006). The steps in this process are defined as: 1) creating a general or specific clinical question; 2) finding external evidence that pertains to the question; 3) determining the level of evidence that the study represents and critically evaluating the study; 4) evaluating the internal evidence related to client-patient factors; 5) evaluating the internal evidence related to clinician- agency factors; 6) making a decision by integrating the evidence, and 7) evaluating the outcomes of the decision (p. 304). As an addition to the above seven steps, evaluating the evidence relating to clinician-agency factors has been added (Nelson & Steele, 2006). This extra step addresses the importance of an intervention being effective and economical. Specifically, should an intervention require a mode of service delivery that may be difficult to implement and sustain (e.g., requiring support four times a day), it will likely not be implemented. Consideration of clinician-agency factors ensures that practical aspects of the intervention program (such as frequency and duration) as well as its costs are taken into account as part of the evidence based process. Journals and websites for EBP in speech pathology There are journals devoted to systemic review of interventions in our field, such as “Evidence-Based Practice (EBP) Briefs”, published by Pearson (http://www. speechandlanguage.com). This journal has easy-to-read reviews of the literature on topics of interest to working clinicians. Another journal that is dedicated to EBP in speech pathology is Evidence-Based Communication Assessment and Intervention (Psychology Press; http://www. languagedisorderarena.com). Aside from international journals and publications, a number of more hands-on resources exist to provide information and support in relation to EBP. The NSW Evidence Based Practice Network (http://www.ciap.health. nsw.gov.au/specialties/ebp_sp_path/) was established in 2002 to provide opportunities for speech pathologists in NSW to learn about EBP and to evaluate the available evidence in relation to clinical practice. Interested speech pathologists meet to evaluate the evidence and write summaries on specific clinical questions (called Critically Appraised Topics [CATs]). For example, the child language clinical group of the NSW EBP Network has been considering the following clinical questions: 1) in school- aged children with speech language impairment (SLI), is an in-class school-based model better than a withdrawal model in managing SLI in the classroom?; 2) in school- aged children with SLI, is a school-based treatment model an effective way of managing SLI in the classroom? Other

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ACQ Volume 12, Number 1 2010

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