2. NSCA Mission Statement
⢠âAs the worldwide authority on strength and
conditioning, we support and disseminate research-
based knowledge and its practical application to
improve athletic performance and fitness.â
⢠âBridging the gap between science and
application.â
3. Objectives
⢠Define the process of evidence-based practice (EBP).
⢠Discuss the challenges to EBP or EBSC
⢠Identify some reasonable approaches to EBSC.
⢠Leave with specific strategies and tactics to
implementing EBSC.
5. JASPA =
Journal Associated Score of Personal Angst
⢠0 = outlier
⢠1-3 = normal range
⢠>3 = at risk for polythenia gravis and related
conditions
⢠Polythenia gravis: increasing sense of guilt and
inadequacy associated with an inability to keep up
with the journals.
⢠Related condition: increased fall risk associated with
tripping over piles of unread journals.
7. Leaks in the Evidence-Based Knowledge Pipeline
Aware Accept Target Doable Recall Agree Done
Valid
Research
Strauss, Richardson, Glasziou &Haynes (2005)
8. From EBP to EBSCâŚ.
⢠Consistent evidence of failure to translate research
findings into clinical practice
⍠30-40% patients do not get treatments of proven effectiveness
⍠20â25% patients get care that is not needed or potentially
harmful
⢠Whatâs happening in the strength and conditioning
realm?
Schuster, McGlynn, Brook (1998). Milbank Memorial Quarterly
Grol R (2001). Med Care
10. What is evidence worth?
Usefulness = Validity X Relevance
Work
Strauss, Richardson, Glasziou & Haynes (2005)
11. Why Bother with EBSC?
Motivation: Who are you?
⢠Client expectation ⢠Doer (researcher/teacher
⢠Competitive advantage ⢠User (coach/trainer)
⢠Lifelong learning ⢠Replicator (gurus are
⢠Satisfaction, pride good enough for you).
⢠Ethical thing to do
⢠Contribution to the
profession
⢠Professional
development
15. What questions to ask?
⢠Most common scenarios
⢠Unique situations
⢠Desire to become an expert
⢠Curiosity
⢠The more specific the question, the better.
16. Step 2: Acquiring the Evidence
⢠How much time do you want to spend?
⢠What databases to you have access to?
⍠Online versus paper
⍠PubMed
⍠Ebsco
⍠Professional membership
⢠What is your skill level at searching?
⢠Think QUALITY of evidence!
17. Evidence Pyramid
Synopses
Meta-Analysis
Systematic Review
Randomized Controlled Trial
Cohort studies
Case studies
Basic/Bench Research
Editorials/Gurus/Colleagues
18. Narrative v. Systematic Reviews
Narrative Systematic
⢠No systematic ⢠Rigorous methodology
methodology ⢠Focused research question
⢠Tend to be broad ⢠Search strategy developed
⢠Potential for authorâs bias ⢠Inclusion/exclusion criteria
⢠References gathered ad for references
hoc ⢠Quality assessment
⢠Qualitative approach ⢠Quantitative approach
Qualitative Quantitative
21. RSS Feeds + iGoogle = Efficiency
How to use RSS feeds tutorial:
http://www.youtube.com/watch?v=0klgLsSxGsU
22.
23. Step 3: Appraise
⢠Most traditional EBP training occurs at this step
⢠Yet it is time consuming/intimidating
⢠Many do not have skill or time to appraise wellâŚ
⢠Solution?
24. Let others do the first appraisal
HIGH QUALITY Pre-appraised evidence
⍠Systematic Reviews (Cochrane, PubMed)
⍠Evidence summaries
⍠Professional organization guidelines
BUT first you must ASK a good question
and ACQUIRE the summaries!
25. Then do your OWN appraisal:
⢠Is the evidence source high quality?
⢠Does it apply to my client?
⢠Is it useful?
⢠Does this fit with client goals/preferences?
26. Step 4: Apply the Evidence
âEvidence does not make decisions, you do!â
27. Step 5: Assess
⢠What worked?
⢠How did this benefit your client?
⢠What more do you want to know?
⢠Do you have information to share?
28. Summary
⢠What role can EBSC play in your career?
⢠What is your strategic plan of EBSC?
⢠What tactics can you use to achieve this plan? List 3
29. If you only haveâŚ.
⢠1 minute: Write a PICO question
⢠5 minutes: Set up an RSS feed, run a quick search.
⢠1 Hour: Read a study in depth, discuss a study with a
colleague, watch a free online tutorial, explore a new
database.
30. Objectives Reveiw
⢠Define the process of evidence-based practice or
EBSC.
⢠Discuss the challenges to EBSC.
⢠Identify some reasonable approaches to EBSC.
⢠Leave with specific strategies and tactics to
implementing EBSC.
31. Resources
No doubt I will add to these slides. Updates, additional
references, and EBP resources can be found at:
ďNSCA EBSC Pageflake:
http://www.pageflakes.com/ayork/2501555
32.
33. Selected References
⢠Davis, J. (2007). Evaluating education in evidence-based practice. JAMA:
The Journal of the American Medical Association, 297(1), 39.
⢠Guyatt, G., & Rennie, D. (Eds.). (2002). Users' guides to the medical
literature. Chicago, Ill.: AMA Press.
⢠Ho, P.M., Peterson, P.N., & Masoudi, F.A. (2008). Evaluating the evidence:
Is there a rigid hierarchy? Circulation, 118, 1675-1684.
⢠Shaneyfelt, T., Baum, K. D., Bell, D., Feldstein, D., Houston, T. K., Kaatz, S.,
et al. (2006). Instruments for evaluating education in evidence-based
practice: A systematic review. JAMA: The Journal of the American Medical
Association, 296(9), 1116-1127.
⢠Slawson, D. & Shaughnessy, A.F. (2005). Teaching EBM: Should we be
teaching information management instead? Academic Medicine, 80 (7),
685-689.
⢠Strauss, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005).
Evidence-based medicine, how to practice and teach EBM. (3rd ed.).
Edinburgh: Elsevier.
34. Contact Information
Ann M. York, PhD
Associate Professor
Master of Health Care Administration Program
College of Health Sciences
Des Moines University
3200 Grand Ave
Des Moines IA 50325
515-271-1641
ann.york@dmu.edu