A Critical review of the research literature

1. A Critical review of the research literature Qualitative research design

2. Evidence based practice • Not doing research, using research • Critical thinking - utilising up to date best evidence to inform us • Links with clinical reasoning and reflective practice • Vital in today's political environment • Ensures that OT practice is effective and relevant In essence: “am I doing the right thing in the right way with the right person at the right time in the right place for the right result – and am I the right person to be doing it” (Cusick 2001, cited in Duncan, E. Eds. 2009, p.212)

3. Challenges for OTs • Start asking the questions: who, what, why, where, when • Develop skills in locating and evaluating evidence • Implement the changes based on the evidence...courage to change something that is in-grained • Evaluate our performance: critically • Spread the word! Vital for the survival of our profession

4. Incorporated into practice • Journal club: structured formal sessions, come prepared OR electronically (posting researched articles on wiki for others to read/ create discussion • Critical reflection and case study: Present an evidence based case at supervision of forum following a period of reflection on action (of your experiential knowledge) and an exploration of the evidence • Develop critical appraisal skills: today's focus

5. Critical review of research articles Critical appraisal is: “the ability to read original and summarised research, to make judgements on its scientific value and to consider how its results can be applied in practice” (Taylor 2003, cited in Duncan., E. Eds. 2009, p.222) • Assess the value and trustworthiness of a piece of research within the context of practice. • Review the whole research process, not just the findings. • Identify the strengths and the weaknesses, and weighed up in view of the context. • Skipping over “complicated parts” may lead to misinterpretation by the reader • Positive, open minded experience. Challenge your own and the authors assumptions. • Guidelines and form developed by the McMaster University Occupational Therapy EBP Research Group, available for quantitative and qualitative research • Available at http://www.srs-mcmaster.ca/Default.aspx?tabid=630

6. Cont. Key question to ask self: • How rigorous/valid/trustworthy is the research? 2. What are the findings? 3. Can the findings be applied to my particular practice context and my evidence based question? • What are the consequences, and to whom if my practice is not EBP? Tip: Critical appraisal of evidence and self reflection is a skill that can only be learned through practice!

7. Some further reading on EBP & critical reading Any core OT textbook e.g. Duncan A.S. Eds. (2009). Skills for practice in occupational therapy. Edinburgh: Churchill Livingstone Turner, Foster Johnson; Creek; Pedretti; Hagedorn; Law; Taylor ........ Journals e.g. Bennett, S. & Bennett, J.W. (2000).The process of evidence based practice in occupational therapy: informing clinical decisions. Australian Journal of Occupational Therapy (47) 635-638. Rappolt, S. (2003). The role of professional expertise in evidence based occupational therapy. American Journal of Occupational Therapy 57(5), 589-593. Bannigan, K. & Hooper, L. (2002). How journal club can overcome barriers to research utilisation. British Journal of Therapy and rehabilitation 9(8), 229-303.

8. Qualitative research – very Briefly • Refers to the design of the research. Think words/open ended questions • Concerned with exploring and understanding the meaning individuals or groups ascribe to a social or human problem. • Recognises that the clients/participants are the experts/ hold the knowledge. Similar to client centred practice. • Facilitates participation in the research process for the client/participant, and explores their experience. • Within qualitative research there are different types of research methodologies (strategies), and different methods used to collect data. • Take particular attention to trustworthiness: of the methods used to collect, analyse and interpret the data.

9. Further readings on critical reviews & qualitative research Cook, J. V., Ed. (2001). Qualitative Research in Occupational Therapy. New York, Delmar. Conneeley, A.L. (2002). Methodological issues in qualitative research for the researcher/practitioner. British Journal of Occupational Therapy, 65(4), 185-190. Curtin, M., & Fossey, E. (2007). Appraising the trustworthiness of qualitative studies: guidelines for occupational therapists. Australian Occupational Therapy Journal, 54(2), 88-94. Finlay, L. (2006). 'Rigour', 'ethical integrity' or 'artistry'? Reflexively reviewing criteria for evaluating qualitative research. British Journal of Occupational Therapy, 69(7), 319-326. Hammell, K. W. (2004). Using qualitative evidence to inform theories of occupation. In K.W. Hammell & C. Carpenter (Eds.), Qualitative research in evidence-based rehabilitation. Edinburgh: Churchill Livingstone. Rebeiro, K. (2004). How qualitative research evidence can inform and challenge occupational therapy practice. In K. W. Hammell & C. Carpenter (Eds.), Qualitative research in evidence-based rehabilitation (pp. 89-102). Edinburgh: Churchill Livingstone.