Transcript Document

BJ LeJeune, CVRT, CRC
Research to Practice: Is it too big a
leap?
Research
Practice
Evidence-Based Practice
• Evidence-based practice (EBP) "is the integration of best
research evidence with clinical expertise and
[consumer] values" (Sackett, Straus, Richardson,
Rosenberg, & Haynes, 2000, p. 1). Clinical expertise
refers to the use of practice skills and past experience to
rapidly identify each [consumer's] unique circumstances
and characteristics, "their individual risks and benefits of
potential interventions, and their personal values and
expectations."
Hierarchy of Levels of Best Research
Evidence (Boothroyd,2006)
1.
2.
3.
4.
5.
6.
Literature Review of Research Findings
Randomized Controlled Experimental Research
Non-randomized Controlled Experimental Research
Single Subject (Retrospective, Replicated)
Case Studies (Retrospective)
Expert Opinion
In our field what are best levels of research
evidence?
Best Research!
• Systemized Literature Review of
Research Findings
• Single Subject (Retrospective,
Replicated)
• Pre-Post Test measure of capabilities
• Case Studies (Retrospective)
• Expert Opinion
NIDRR Commitment to Useful Research
(No, that is not an Oxymoron!)
All NIDRR grantees share a goal “to promote
the generation and effective use of
knowledge in areas of importance to
individuals with disabilities and their
families” (NIDRR Long-Range Plan for 20132017).
What is Knowledge Translation?
• The term knowledge translation (KT) is increasing in
importance and used in the fields of public health,
medicine, and now in rehabilitation research.
• KT is a relatively new term in our field to describe an old
problem – the under-utilization of evidence-based
research in systems of care and practice.
Research to Policy and Practice
Knowledge Translation
Research
Consumer
Needs
Policy
Makers and
Service
Providers
Question
• Do you use recent research findings to establish practice
or policy guidelines in serving consumers who have
visual impairments?
_____Yes
______No
???
How does research make it into practice?
• Practical, applicable and relevant
• Presented in a way that expands possibilities
• Move from “content absorption” to “conversation
utilization”
• Partnerships, Collaborations and Cooperative Activities
Levesque, P. (October, 2013). Knowledge Translation Measurement.
KT Expo Conference for NIDRR Grantees.
Common Obstacles to Research Usage
• The research is not relevant to practice.
• The research is not timely.
• The research is not communicated in ways relevant to
the user.
• Administrative pressures overwhelm research basedevidence in decision making.
Source: Allen, P., et al. (2007). Commissioning research that is used: the experience of
the NHS Services delivery and organization research development programme.
Evidence & Policy, 3 (1):119-134 as presented by Levesque, P. (October, 2013).
Knowledge Translation Measurement. KT Expo Conference for NIDRR Grantees.
Enhancing Employment Outcomes
NIDRR Research Goals
VR Agency Goals
• Short range research
outcomes – Gain
Knowledge
• Intermediate range
research outcomes –
Changes in Practice
• Long range research
outcomes – Policy
Changes
• Short range –Increase in
applicable knowledge for
direct service providers
• Intermediate – Improved
practice, procedures that
impact individual consumer
employment outcomes
• Long Range – Significant
and relevant policy
development that increase
employment outcomes for
consumers
Question
• What is the typical lag time from research findings in
health research until those findings are put into
practice?
1.
2.
3.
4.
5 years
12 years
17 years
21 years
???
Stats on Knowledge Translation for
Health-Related Research
• Eighty six percent of research never makes it into practice.
• Of the remaining 14%, there is a 17 year lag on research to
practice
• Several areas where research gets bogged down in the
translation process.
•
•
•
•
•
Establishing Research Priorities
Peer Review Process
Publication Priorities
Lack of development of Guidelines for practice
Dissemination process – is the information getting to the right
people in a viable format?
• http://jrs.sagepub.com/content/104/12/510.full
Question
• What do you think is the most effective way your direct
service providers, such as Rehabilitation Counselors,
learn about “Best Practice” or Evidence Based Practice
Guidelines?
1. Read journal articles
2. In-service training
3. On-line training
4. In their graduate training program
5. Research is not emphasized or useful
What are current resources to find research
based professional development training?
• The NRTC on Blindness and Low Vision at Mississippi State
University
• Technical Assistance Continuing Education Centers (RSA Funded)
• University Programs
• Envision
• Hadley School for the Blind
• Perkins
• The Carroll Center
• American Foundation for the Blind
• Lighthouse International
• Other private agencies and vendor-based training
NRTC Dissemination: Training Activities
• Vision Specialist Program
www.distance.msstate.edu/vision/index.html
• On-line Continuing Education Training
• Multi-Module Courses
• http://blind.msstate.edu/training/training/
• Short Courses (Free for CRC credit)
http://ntac.blind.msstate.edu/courses/
• Articles to read and digest
• (www.blind.msstate.edu)
• National Technical Assistance Website
(www.ntac.blind.msstate.edu)
NRTC Workshops with State Agencies
• Grant allowed for 2 joint funded state workshops per
year
• In the first four years we have had 9: KY, MS (2), MA (2),
ME, DC (2), WV
• Topics have included: Medical Aspects of Blindness and
Low Vision, TBI and Vision Loss, Successful Placement of
Older Blind Adults, Adjustment to Vision Loss, Transition,
Cross-Generational Communications, Job Readiness, and
Strategies to Enhance Employment Outcomes from
Current Research Activities
Other NRTC Training Activities
• Vision Specialist in Vocational Rehabilitation Graduate
Certificate (In the last 5 years we have had 36 graduates
from 22 states: GA, VA, CO, TX, AL, AL, LA, MS, ME, MI,
CA, WA, DC, OR, NC, NV, ND, TN, FL, MN, ID, MD)
• Webinars with Hadley School for the Blind, NW TACE X,
and South-Central TACE VI, Southeast TACE IV, and East
Coast TACE V
• Training Workshops with Mississippi Department of
Education, MAER, University of Southern Mississippi,
Mississippi Deaf-Blind Children and Youth,
Dissemination: Technical Assistance
• National Technical Assistance Website
(www.ntac.blind.msstate.edu)
• Email Discussion Group
• Talk with a Researcher Conference calls
• Call 662-325-2001
• Email [email protected]
Other Dissemination Activities
• Peer Reviewed Journal Articles
• Other articles and monographs
• Guidelines for Consumers and Service Providers (on
website)
• Conference Presentations
Bridging the Gap!
Research
Practice
References and Resources
• Boothroyd, A. (September, 2006). Adult aural
rehabilitation: What is it? Does it work? State of the
Science Conference on Hearing Enhancement. Gallaudet
University, Washington, DC.
Levesque, P. (October, 2013). Knowledge Translation
Measurement. KT Expo Conference for NIDRR Grantees.
Webinar.