EvDANCE EAsED TRACTICE IN

PiysTOTH¾RAPY. aT ||LIIO
bohal il is ? EBP ? ttoo to do?

Brainslorming
Hoso do îndervenliy wed LBP.
How to choose hick Ry wo1 ko?
Because we
have kaad abont 4hem
a. Paient Poit vien s te ,oest
9

wls what o eutdane based Paciçe ?

Fndl pratie appliafor
torvet avidenu tor a qood Pratle
Keseaneh.

Companeuts of EBP
Tndividual
Paltediy, vayes Exprkakions
clinial Anprod
6xpettise Dutlomes.
Best Available clinical Euidence.

EBP
he icoliletion, oteepretakon&apphca lon- o
Vakd
Promotes
evidence clinical deision malkcing
3Types
i The) evideuu onld be
Patiet
Reserched- deived.

rclinical Raasning - hy yo
clinikal deaioion making Discnssiou Interpekati
evideiu, knowledge Yywre eidue

HisToRY
1440's at Me Master Unive rgily Canada.
So, t is Calied Evi dence'bed Mdiae (eBM]
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 sAat ed in hysi otherapy n l9no's
9105
- Started in Neral Qo0 at kuMs.

oht is Guidente ?
Can be
-The availabletacts eumstanei etc,Supporhog
r other wiBe rlat'on ohelt
a bali propooki on
+hing
(ThompsoConiser dxford)!
what is Evidene based Modiuine ?
The Conseientiows
Lxplicit avdjndiooid |se of Cuunt
best eidenee m malabng duisions abouf the
SndiidualPaten' "
Conscienlons = oas ed, on pilplas
open Iclear unambiquÐud.

what it s Not ?
J Aseimigy Seniors |4eashen ool alrical doubte
Readuíg butdaled beokg!
+he anse ts.

en eideee o cliniial plachce.

(eout consíiderng ica Kperie nao pahiort peleven
aypulaiens]
do need EBP?
cadal dess mewn
TRadilioval Bounees of Pntotmali e books ang o
adeyale oor ap-to-date.

Tmpioved qyaliy and dalicieny of halthape

managment
classMAte PAGE
 DATE

LS
.

mvé from hil and Arrial

i melhodof Rx to Gvidene
based appioah
.To
To standandig
deliver the
4he
best
Rx.
qmality senvite -to the patie
tasiet and ba<en clbial lsion, makinA
To understand blher haalh eare profesiona desearch
atv Ceq- evidoue based Medieae) andi cormmnniate

Loaut Evidee ?
Consumkng - oest bvdcomes EBPdhslib
ckiviiavs - best ciical piadieejoiaYesponibil EBP.
Momagmend
Fu
makima Cvidme oned Poli cy
boltts- aountabi lity and st
ing
o PeDYo (2010 -)
. ione Seach 19, Seconds.
Maxi mum uilizatin - UsA C31) Austalla (12) Baail C81)
Uk(61), Spain (to), Germany Cst)
Highat wange fon (255 timo| jPhysiote apisa):
q4 (|3 timo|0)

EBP slndeuts ?
To daled huomoledge
. To
ausale dignoie test and he
the most aunate
most ellutive foterventionp. .
To bnild stong cini cal iasoning based Hhe best
availade evidonce
To de<eud the aser Viva i81 Exanm

cASSMate PAGE
 EB iti
Yeans
Souce ?

yes- qs. No-a. Lannig

+lodd yov Leasw abo nt e- leneing!?
Teaher - G
Friends
Senibri-4g. f
Internet - 321
Dtthen

> EBP uili2ation biy shudenb rom Nepd

Pabmedpebto Cothranei-N
yo ege sholas,, cINAH, Medbie hyi pe dia,
answer. Com /

) Ananeness of Souial sites as leaing Source.

Sbedi, Mohajam, shama S/, 201s4 uñder sevigu
Fodbook - q11.,Twitet- 3o|!

t,

How ctenyo
Hardly ever st.
ocasionally
Somelimes 331
- H01. 4
Fieamenthy
Does internet help i ltanig ?

what aie |he baui

Slow in terneb
Sites not available.

clAssMate PAGE
 ytenit Revieo.
DATE

5 steps to
EBP (torthncd atee
Convert a chnical
kel malions)y
Fnd the besl piobemm into answelable clinical usthion
3 Cilically Ppaie
evideue (literature Beanch).
Ond
appicabi hy
4 reanb clnical piadice
s Evalate he
<jyclivess and
7 Step 1 - Convert clinical Problemi into ansuJ erab le cliicat
quslions.
Palient
populahion (p) Compafson Cc).
Intervention (I) butome (o)
Houw to ask cliica qmestion ? p
Patient or Ipopulatin P)- adutt, childiern,preg nag wornen,
Trderventon
Compatfson ()
)-Cayoiheray
ont come (o) - Pam Jtiasound
moion

>etep 2 Seanch for +the best evidence .

Recent evidenes tl
" Tntecnet i-try to 4inc artides ohichi have alady ben
an
cpptaisad pious
q :Cochrane' Peoto.
. Some databases: Pabmed l Medline ScopusEmbasc, CiniAHL
pfoqm est
>step 3- citically ppíajso the evidenei
Levd o Evidences - SAcKETTNHMAC loxford -
siade
PeDro Scale

qualilgAqudelns
Adopt
(htp|| eamatot
alassMate
or eheklisb.
neloork Orq)
PAGE
 the rasuly.
clinial

Appliablity
o Evidence

Experi mental Studies . Sysiernatle Yeuitws

Randonised tontelled Tials
(Rclct

Cohort

observalioval studies Case conol

Cvoss,- Be}ional,
Ji,

Caser fepprt iy )

the Resvdty to
clinial
Step 4 Arphy
" To ame yow Rx protolols
qaestions nd
*To qenejate tnture hesench tieat men
To deeimi ne 4he

> Step 5- Evanate

. Evamate the eHgeiveness Ricieny ohich sleps
1-4 Careied out

. Evawnate the inervemion

Steps EBP 5 A's#

(ctent tornunnk
Analyge
PAGE
clAsSMAte
follous
 Main.
EBA Aquide Lay
to Pucice
DATE
ohat is
. Best optimal
availae
. Current | Apglicasle
Lateat " Cost -allecive
valid aud lleade
Relevant
4he best relevant Areatnent ora penson T
\ast
but is not ade o hs
gling,
hand
ansat tons
above ha but abe
Ahen
Fnd ont a
1evant Rpost lovid patient Go
haung daby aud bicasking issnes yeals
3.
Fnd the louditon
on te persbe ho hast stoke CTe)
4heSan side
ide avd todeeky Maten hdolopd poraysy
Lelt side. vomte 4he best ever irtteatoent Hemiasu
Gvi dene
Based raiee EBP
. Thene

tou, no a
mtbudes.aundunekonàing
piacice it
EBP ause
can be
the
Sden iiosa

a
fne balane Hw c'mica sxp cdis e externa
elenical evscl ence
¬BP is bused ses - dhetel model
GBP can
clial
Suppol a shongy clent cihed uapp1ak to teha
Axpeise Remalns Cwaial toz
nonlodgable toill

clAsSMAte PAGE
 DATJL
Cvide
Conepla
Aaeness
Covs nltatioy
Tudgneut
Cteaiy

Me
Mater Usivesi vohidh stcde tat Gvidaue
Based ciieaPralice CGecp)
evì dece
Ahat chial (plaatiee and
that ovidunce
cliian must be aore he avicdano
telateitow the) praciee and 8nould be np tot date t wha
naus regeach
Fouued annemesp
From iournal onlme diseussion ehat igrum
OvOn atura
" Gach praci tiongr imast
p- to- date.

Consullakon-JA Muir Guiay'a (j943)Ece is an,

deision mh img ohichthe cme £p ses best euse
availayen Consntalion voth the patint to detde upoo
opion oich that patien but.
. Piattonen have 'a stils, krauedo
and essertial part o Hhêr been to be.
ommuncatór
Role is Hhe c'ent to as (estain the problern
cnd hoo t Can be fesowe easiet posie terms.
toqe then CTeam hootk)
Ednafiaing the cient
Paciionei Bhod adatly snglain
to theîv cliert, hov hey have cti cal
data they and hat ne dong
clAsSMAte PAGE
 DATL
oi be most proussnpto
elient Can Beel what -Ine piatithonen
"tBP 4urns
e <ouu tovoanda 4he he
prato ne, is educato( uhy Sewice
providen
> Judqe Ment
goal of duiion 4
makig clsnical dasions
Sens:e lovellOns
loncnsions ooul
bout Ibe Rx.
|-The
hoo -do
Ralitioyer
apply
muy t
he
poss
qood cliaicad indmen
leLommencdion
-Io
mut
cVent 8itnalion.
eieo
Qiaice qwike eadne based piatice
Crealvity '
4he vbes ortio cmical devoion naing
be sAratghtoiuond andpratithnen. ou hare to we
4heu ereabi skill Meet
challng
e es
feal ye
EBP is ooth asSienee iad and as Bue
must be melded i to already fsing body skilla.
EviduncenN based tehaliRtaio Þ may Fnd ike a "tcokieCull
pratfcebnt tealhy atuaty, giat deal
crakily and oigt
y
 DATE

EviDENCE BASED
3:DgvÆ LOPMENT 0F

Conrents
> Introdaction
>he mdividmal Protessio mal
Phass of Profosional Davelopmeot Iv
Protesslonal witin A, Disei plne

INTRODUCTION
atl toletton otlid eau akout a opic
kvowledge devdo at
>knoroled¡ Pntreted
and a.,ohen plme
Bimilar ideas
lhat malt ey a lonelusi
Evidene isa mnfo maton
Pparent, advdnw the
know ledqe' m atalar larua
Put pose

hnowledg e dovelops Tin a disci_ lwinel x

1. Tue ndividnal profesidral avels torongh
mental pfouss o Seuviee o adnationalprepaiain
and Coriwme swpert phase o proÇeysinna) easeet

path
olhen
2. Profesieval davlops Shave Rntormation Qaeh

their diihine
3. Patess ional docdlapd

THE tNOIVI0UAL PROFGSs1ONAL

> Tndividual professionals Qye Responsible
doadopment
RespoNGIBILITIGS
pahe

Aofessi oal Mit anateness their oon

clAsSMAte PAGE
 DATE
> Bdin
fon shose we
Cq' hornp's may
melaiy
henblils padie exper'e neg. 4 an nwar 4he
yeasons r
unielmed, profusowa) ana
hei choicy m plo dict malkig oll hate
evaluatig to
venea
qwiion Curent nformation Zeek

an coillingnes Ao nomaltom to , abindon nkie meld

fonos ideas
meet nedevelopberi EeP professqmal l shar e
4heir tdeas and T ohers
mwst
feview and
pautipa[e ini formal data lolletion

91

PHASES OF PROF ESsNAL DEVELo PMENT ;

s1: PRESERV iCe
" Leano he
knouolawailab)e
he edge basedevidenee the discipline and ne
ot arrept terv gntiom
Prafesstoval lean hovs cto e he (avalaale evidenu to
Consttntiprliminany cinieal and detson
Äeosonig
Beome

belieg
PROFG S6ONAL PERIOD Cen experianud vir6tnation)
. Novit proBessi ova! tny eideas andl evalate
ndidl
Prof esioval beqvo 1 to geuwalize Sdeas alosS People and iny
deter ming feative and
Rnesfatiye methads or piaipe

or pladise elarihy aid

qeneralfzabikg knowedg
elassmate PAGE
 DATE
3.

Gstablish melhod
shane
eal?vemess tolloou
on heir
parsonal dababase
The professiomal shone thein peroonaevi deues
-rhe knevaledg Can beishaned oher
md orotuioal cen<eroree
tonBerone
t Ex pe RT
Profesai a panteipate formal melhods
Colleadfng data, cnnd evalnaling eettveness
terventtou shae hnooledg4
Crithqmes olhet
Londut reseaneh dntheBersc e Sehng
Ppalation
professigna.) posrtspate ReT to determin e
rtervention method is mast eetive.

PROFEGS0NAL WTHN A

Responsi bii ies 9iy

Cuuent beli
the

ohen
knonled in
memlbers chalenge
at ndiseipbine
Curent
balid
posslle
chall oi dispme ensute and pfomote
fuisher ent

sharing
3Inro dine n deas J

Nu tdeas Senwe to funther developignt. gf kaonedge

hy potnasufor nes tdeatidead.
Proteastnal disclphine vs pons ible o
dugning and oplementfng formal mdhods fo
hypolheste
clAssMAte PAGE
 PROFE SSi0 NL
Evidenu
collabo fa lioy kioroled doNopnent
Bimi lan
oher drsciple
Ahe hno vole d g disepline is phadt
Canbe Jneratod.
"Responsibi iies
ohe pornt vius
Kecive neio (deas
how deroiovs
Alociplies madeib Jarioy
Berved
3. R og and aulitate asteness aboutthe simlanhe
derences ors Cppioachea o to problem and
Lknowo le dges devdopr ent qot eah sdpiho,
Advaneg
dRsei phe
SCoedfve'vdenutroastd
Rs Lamdn

To plan omten (disiplinay aPpYoa

ideas tt iohertessional
avd makegood plans
 DArE

BIsety PonrtioneR
Rertettvg PROtITo NER

Re,ledie artihouet.
"Raledeepthetatmet, 'as deenbel b
i's oho Cn a ctión

Our
pladvy, d. tatdy 4he
letcions
/a
or adDn,

ariong Hont best ptadice,

PTouss leation Can be pouoe |u
R4leslow pfouss (he, oe
dont
p'atitioei' Botne ove ohg, at
ioterval loelu bate at 4he hoorks do, and
prouss nnd Coss ders ho no an

nipiovd They elet vooikthey have

Thei EModel
The g. Model detston malkiny franuwo rk wed
to deuteion maleny and on 'deisions
The'fators Aision
onaknig s ed mto
6 cadeegories
Expeekakovs
3 environ ment
Gpesience
S- Evidene

|1. Expectaionp.
The oret steps o xpetatf os to take into (owsderatton
ne those o the chent
he allent bringi the Apertise about hâ hen
lje sihalion, Vanes and belielo, Aoles and
Sxpaet atio, therayore he of she mmst be the
clasSMate PAGE
 DATE
to alinlate he
Aherapat qpala
" The
Cootlk wpett isg about hoy to
toqelhen Ao bnti he dalinaln
In 7he
he clieot
toola and measures hav beon
dvdlopcd nd'enlend eteb axpe aions
These them -4hei!
clgan namMeh emablest h e thenapis to get a
he
eomes
Hrom therapeutie oderventioD
4he client aspeding
qmestionuai
meaS we!
amother ham ple fof, dieni - (ented
Thes e
oadivdnalged aggestmen
therapísuoond mderstand o hat AhecWenl
Rmlosmatf
More
paânes hép hel
the centa padatione a Kuy
delson.c
lone fdere
txpecdoiooy oua káo oledqe hog
heoes Can appeany
cbielavs
to Ones o bser valiong do enban
undet
event
Rataton ahips opredtt ture
helo to planbehavbin a pradit oltome
to tomate la Be xpetatiang that
altorovig
Can ations*Hll,) N

a Environment
6The eyifonm ent exets ur blio
and ations.
therap oute Yelaios hip enyi ronmetal ators
at mao lev.

PAGE
clAsSMate
 DATE

vaheu i/oil Pne

Cultena Borial rom
Rulommedabón
plans very audplable coilhia
mam

Cullar e in ton uiva

senvíc e
lotati
hyial Aole o hoiaga
RaLomendatou
the Tealily me
R Lomimindation wiloly be agpropote
loutent
-to uvent

3. xpetiènee eans 1s
The Axperienu one over tne
desio
poedorce adhuatio.
Experi enu may momps
protessioal ndengaduate
pkduatelev and Jieatio
tonial txperi onwet ne Votugo devdozma
Nodeas cununt kioualedg md mlorpate
mto Aupetoi ol

botaty
vootle ! Then oe
dient
begn patei d based o

enLounter Bunprig expated Otumé hat

assunphons and amate
elallovgkuowledg
e

perspeatlves -mat o4 at

net woik lled Aownds disuss

Case a Bnal! leanning. tol hat o')
Valme

Sigiiad Aool to emabte he

ihness leanninq iomidxperienu, but i y
linailod Bubijeutive
mone Means

PAGE
classMate
 Ix petiena DATET
w a
rtome
and
we (an bun p1achee

. The Asle

henlheae,
4he p o f i nal ssned a imore Cerita)
Popdan
In fehab
more hster
doiy mvowe
hion r,dien

"henapiels qen find yemsalves S the ppsition o

advoaling
As
on A
behaly
thind
elents
1,

phessions has evoted and mgtured resoceg

hawe been
making
d'yiatt deisions
Rovinaal State iandntio nal bodis
assoations ave od es oethig that scidate priná ples
for elhial decision maki
Lody
Lonpdl s to at an hic
and "ghtnass puting ithe needs o pac| eieotst and
+he boundoriu
kroaledge
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petsonal philosophypaie e
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ons Kole
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every eraction
dients and delsiso.
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he ovldena' clinical detion malkmg
he factot E Model tha bxrienes
probebly
elassMate PAGE
 DATE

L e thatiome
mas vaunon
(an y
and pleNpunakien bu praciee
pn
wse

elhics
heallhcane, hos
4he
assumed a nore (ewrlra) 4ole
Popalanoieratue
boh m
professional erature
In kehalo deistons
dually
more
mvowe i'ssne
deteimintion
nividval etienty a
odvoal
ana ing
0n Abehall
thid
and mgtur ed w mOne resouCEg
As phi<ess?ong evoN
have been., devlopd tp hei ide theragit; making
diyiutt deisions
bedius
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at ,elucidate. pfinó pls
as5oations haevtodestt
clhfcal decision naki
s to at ehic
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and ghtrassi puuing ithelj needs
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pralie ethlu haty a ol Aejletie pratitione
Another auped aod
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untustanding
These Core
dients and
valnes
ons
\ oill
delsoos dake
oflee de vry îteration
everg.

he Wse ovidenu n ceical deton malkmg

he actot the E model, tha
probablg PAGE
clasSMAte
 DATE

he uatat chang paut detade

ovielemu
ihe lea o a mot
dea wpit m

deisla
bsad hyediciMe
elmical deision
the plactitioner oducation ond b
idea EBM dammd edat
ov helatyt

Aes eaneh etden a

+hei duelsons'
EBM
spread to other healew discpihed u no
aLcpted as praice.
kay pant poss le now becaue
Gvidene tous ed prat'ce
Seieral advae tilde availade evidunce
SeLond he
evidewu' nt the needl to uitHal appraisa)
the eidenu
Veronne
6ytematico Reviews, the
Aseanch evidene

Models oRellective praditionel id

ane t o models for RP.

Gibbs 1188

kolb yde
Experienc e
Test Kolb'o Rele ct 're
cyyele
Loneplnalic
clAsSmate PAGE
 DATE

-Davidkolb pnblt shad, hi Lenyrmy lbtyles modet

1984
shich he developed vhis, laaging ayle
ioventory
kolbs Xpeii menlial lianing thuty worko, On Hwo Leues
a fown
Concened
(eanning aeo Much of Kollitheory
the learnes intenal Caynive processes
- Kolb Stat es he arqmisition
of abelract
4hat
leanning
Concepts 4hat Can be
applid tleidg
Aange of pituations kolbstheovy
Concepts
mpetvom tor the develspment of new

provid ed 2Yopetiences

eibbs 1488

(Description)

(Aaion plan
Gibbs
nallecive
onmion Cyle (vanatio)

(Analysi

Io Am eiCan jouiole qist and

poychologt Graham Caibbo pwblished hs Rel ledive
Cyde modl Lcang
peopley 4oDong
book w

thiok
hibb Re<lede cowrag o peopl
Sylenaitly abont 4he
Lxperinu hey Sad duinm
ppeie ilnation, event adivi ty:
dwningivele Lelleeti on Mose ld periemies
be Slmtued phase
PAGE
elassMAte
 DATE
about
-This olen Mkes eople
horelt detail
autioit CountEn
alo beter able t6 adjut
Zhauge aud posilive
boh
peop
Can Lean