Designed for Learning Sampler

cover

table of contents

introduction

activities

perspectives

resources

Objectives

  • Identify important clinical questions and search a body of literature for evidence that might provide a partial answer;
  • Manage time effectively so that tasks are completed as scheduled; and,
  • Give and receive observations and feedback openly and objectively.

Course Description

This course provides an overview of occupational therapy, its scope of practice and basic principles, and the roles of an occupational therapy assistant. Course activities include practice in basic craft skills, analysis and instruction of functional activities and games and small crafts, development of communication skills, and field visits. The effects of environmental and cultural differences in shaping activity behaviors and preference are emphasized.

Evidence-Based Practice Activities Mary Beth Early

I use this activity beginning in the seventh or eighth week of the introductory course in the major, after students have a basic understanding of occupational therapy concepts. The activity is designed to help students formulate clinical questions and seek best evidence for the answers. I want to awaken in students an appreciation for the levels of evidence that might be considered in making a decision related to patient care. Using the web and Blackboard facilitates this since we have access to many excellent resources and can create a record of the learning process, the students' work and the feedback loop involving the other students and the professor.

I have used this activity three times in three sections over the past two years. The opportunity for students to access online occupational therapy databases and identify key words to conduct focused web searches involves students directly in the process of knowledge construction. Online discussions have been critical for sharing and developing ideas.

Having taught this material in other ways before, I think exposure to external links and the Discussion Board prompts helped move students to more independent thinking and a broader perspective on course material. There was less of the "only one right answer" thinking and more of the "many perspectives" thinking than I had seen in past sections of this course. Students did not have time to master the process of Evidence-Based Practice (EBP) research, an evolving trend in occupational therapy patient care. However, they did gain some insight into how it might work by attempting to engage in it and reporting on the process they went through.

Let me first describe some of things that lead up to this activity. Students are already familiar with Blackboard, having used it every week since the beginning of the term. I let students know the expectations they need to meet when writing a response on the Discussion Board. Here are suggestions I give my students for their postings:

  • Feel free to state your ideas in as much detail as you wish.
  • Remember to write in standard English (sentences, full words instead of abbreviations, etc.). This will get you in the habit of professional writing and thinking.
  • It may help to compose a longer post first in Word or another word processing program, then cut and paste the text to the Discussion Board.
  • Don't worry about stating things perfectly...learning is a process!

During the weeks preceding the EBP project, students learn how to use Google and have a library session focusing on locating peer-reviewed articles in the various electronic databases. They have had the experience of finding a peer-reviewed article related to a field visit, and writing a report on the visit and a summary of the article. By showing them how to conduct a search, Librarian Marie Spina has been a great resource for students.

Activity Overview

In this project, students investigate the theory and implementation of Evidence-Based Practice (EBP). After a lecture on the topic, students break into small groups to formulate questions for continued research. Students put theory into practice by applying what they have learned about EBP to a hypothetical case question developed during their small group discussions.

Before beginning the first Blackboard assignment, students have heard a lecture presentation on the topic of Evidence-Based Practice. A folder on the External Links section of the course Blackboard site has been loaded with the links to be used, the assignment has been posted in the Assignment section, and the Discussion Board has been created. For the first Blackboard session, the assignment reads as follows:

Blackboard Assignment #1

  1. Go to the External Links section, and click on the "Evidence-Based Practice" link.
  2. Click on "OT Seeker" (http://www.otseeker.com/). This website is designed for EBP searches related to occupational therapy. Included is a tutorial about EBP and how to conduct a search.
  3. In OT Seeker, click on the tutorial and complete it.
  4. Go to the Discussion Board on Evidence-Based Practice and report on what you learned. Emphasize anything that constituted new learning for you.
  5. In the remaining time, explore the other external links in the Evidence-Based Practice folder AND respond to at least one classmate's posting on the Discussion Board for Evidence-Based Practice.

The Discussion Board prompt is: "Use this board to post your responses to the assignments on Evidence- Based Practice. See Assignments section for details." (The same Discussion Board will be used for all three Blackboard assignments on EBP. I use a very open prompt to indicate that this is an ongoing project and that all sorts of responses will fit here.)

For the second Blackboard session, the assignment reads as follows:

Blackboard Assignment #2

  1. Choose a partner and together go to the External Links section, and click on the "Evidence-Based Practice" link.
  2. Together look BRIEFLY at the other links (not "OT Seeker").
  3. Partners must choose ONE link and explore it in detail (you can each explore it separately) for 20 minutes.
  4. Partners discuss what they found on the link.
  5. Each of you goes to the Discussion Board on Evidence-Based Practice and reports on what you learned, emphasizing anything that constituted new learning for you. Each student posts his/her comments separately.
  6. Include any questions you would like addressed in the lectures on EBP.

Before the third Blackboard assignment, students experience another lecture presentation on "Searching for Evidence." The PICO model, explained in one of the external links stands for Problem, Intervention, Comparison, Outcome.

Blackboard Assignment #3

Following the lecture/presentation on Evidence-Based Practice, do the following:

  1. Talk in a small group (two-four people) and together develop a question that you think could be addressed by a search of the clinical literature. Use the PICO model to format your question.
  2. Title your post with the names of the members of your small group.
  3. Go to the Discussion Board on Evidence-Based Practice. Create a group post, stating the question your group developed.
  4. Also, in your post, identify any questions or concerns you had as you worked on this activity.
  5. In the remaining time, look at questions posted by other groups and offer feedback.

Sample student group response from Class Session Three:

The question we formulated has to do with an individual who has had an amputation of the left wrist. The question is: What would be the best type of prosthesis to suit that particular individual? Student Team Process: We began our search in EBSCO HOST using the Medline database. We used various searches regarding hand and prosthesis; however, under the [key word] search of "hand" and "prosthesis" we finally found an article named "The design and development of a gloveless endoskeletal prosthetic hand." We enjoyed working together while conducting our research. It was a new experience that we all extensively learned from. And at the same time we learned during the research and also learned the benefit of socializing within our group.

Materials and Resources

Evidence-Based Practice Group at McMaster University (OT): Mary Law and colleagues at McMaster University (Canada) are working to collect evidence for best practice in OT. If you go to this link, scroll down to the highlighted link "activity.pdf". Clicking on the link will bring you to a PDF file of a review of activity interventions for persons with dementia. The file will be slow to load and you must have Acrobat Reader on the computer you are using. http://www-fhs.mcmaster.ca/rehab/ebp

Centre for Evidence-Based Medicine, Oxford University: This site gives more information about EBM. It is worth exploring if you have the time. It is not a database. http://www.cebm.net

Agency for Healthcare Research and Quality: A United States government site that provides links to Evidence-Based Practice centers (EPCs). No site is listed for OT or rehabilitation medicine, but relevant links that ARE listed include: health care services, musculoskeletal, psychiatry and substance abuse. http://www.ahcpr.gov/clinic/epcix.htm

OT Seeker: This website is designed for EBP searches related to occupational therapy. Included is a tutorial about EBP and how to conduct a search. http://www.otseeker.com

Simple Probability and Statistics: Using simple examples, this site explains statistics and probability. http://www.sportsci.org/resource/stats/summarize.html

PICO: Elements of a Question for EBP Search: This page explains the PICO elements that help in formulating questions for EBP. Other links on the page take you to other parts of the site with rich information on EBP. http://www.uic.edu/depts/lib/lhsp/resources/pico.shtml

PubMed: This public site, available from any computer with Internet access, is more comprehensive than Medline. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi