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An introduction to evidence-based practice

Evidence-based practice (EBP) is the integration of best available evidence, clinical expertise and service-user preferences and values. All three elements are critical to the process of evidence-based clinical decision making.

Clinical expertise

This refers to clinical knowledge, skills, experience and education. Clinical expertise is always evolving through day-to-day practice and the process of EBP. Furthermore, professional consensus statements and position statements can be sources of published clinical expertise / expert opinion

Service-user preferences & values

This is the viewpoint of the service-user and their caregivers. A clinician should consider the service-user’s preferences, environment, culture and values regarding health and well-being. Published research studies, guidelines and reviews can also provide evidence of clients’ perspectives, in addition to those of the clients you are directly working with

External scientific evidence

This refers to published research evidence, both qualitative and quantitative. Research evidence should be interpreted by the clinician to judge how trustworthy or robust it is, and how applicable it is to their specific question / situation.

Critical appraisals

It’s natural to make judgements about what we read. Critical appraisal helps us become more systematic, thorough and questioning about the quality of what we read and how we might decide to apply it.

"Having just finished my post-graduate certificate in health research, I think one of the most useful things I’ve learnt is to be able to interpret statistics better. I always used to skip over the results section. I didn’t really understand it. To actually understand relative risks, odds, ratios and confidence intervals, plus know if they’ve been used correctly is really important for the critical appraisal of a paper."

- Louise Kelly, Cambridgeshire

"I’ve recently discovered the checklists on the CASP website. They're a really helpful way of making sure you’ve considered everything when appraising papers. It makes you not just take research at face value and deem it as good evidence, just because it’s been published."
- Vanessa Rogers, Oxfordshire

"I’d recommend courses on literature search and critical appraisal. They are offered by your NHS trust or as part of the Clinical Academic Pathway. The Centre for Evidence Based Medicine offers great online resources."
- Mark Jayes, Sheffield

"Leeds University Library website has helped me to devise a PICO question and start my literature search."

- Abi Davies, Hampshire

"Join or set up a journal club. When constructing one it can be really useful to attend a workshop on critical appraisal to get some initial background knowledge. Use a framework like the one featured in Speech and Language Therapy in Practice, based on formal frameworks but nicer and with pictures.

Our journal club has been running for two years now and I feel I am reading papers much more efficiently, not just swallowing it whole and believing everything I read. How to read a paper by Tricia Greenhalgh is a fantastic resource."

- Claire Rowland, Leeds

RCSLT evidence-based practice resources

RCSTL evidence-based decision making tool

To find out more about the Evidence-based approach to practice, use our e-learning tool. This should take around 30-45 minutes to complete and help you:

  • understand what it means to use an EBP approach, including understanding of the three component parts of EBP
  • understand the value of using an EBP approach
  • develop a basic understanding of the main research designs
  • consider a number of practical ways to start/continue developing an EBP approach to your practice
  • know where to go for more information.

Launch An introduction to evidence-based practice for busy clinicians

rcslt evidence based practice toolkit front page  

The RCSLT evidence-based clinical decision-making tool supports SLTs at all stages of their careers, to make evidence-based intervention choices.

The tool provides a step-by-step guide to the clinical decision-making process; taking you from assessment, through to the selection and evaluation of interventions for individual clients.

We hope that you find this tool helpful and that it will encourage you to develop clinical practice and the evidence-base.

Background information and advice about how the tool will support SLTs. 

Launch the RCSLT Clinical evidence-based decision-making tool 

RCSLT Research Under the Spotlight elearning

One part of the evidence-based practice model is using external, scientific evidence. The RCSLT have produced an e-learning tool to help you with one aspect of this: navigating and understanding a research paper. The Research Under the Spotlight course takes you through the process of breaking down research articles and shows you how to decide whether it’s worth your time reading the whole paper. With top tips from experts and self-assessment quizzes, it’s a quick way to develop your confidence in understanding research papers and signposts you to even more resources, to develop your skills further.

RCSLT Research Publications

The RCSLT produces a range of publications to support evidence-based practice.

  • The International Journal of Language and Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.
  • The Research & Development forum in the Bulletin discusses a wide range of topics around evidence-based practice and research.
  • The In the Journals page in the Bulletin presents members reviews of recent research in our field
  • Our bi-monthly research newsletter is essential reading for anyone with an interest in speech and language therapy research.

Other RCSLT resources

  • Up to the minute information about research news, networks, resources, and papers is also provided by our RCSLT Research RCSLT Research Facebook page and Twitter handle.
  • All our Clinical guidance contains an Evidence section where you can find key research evidence within that clinical area.
  • Your RCSLT membership also allowsyou access to over 1,800 online journals in the RCSLT Journals Collection.

See also RCSLT guidance on the use of novel interventions

Other evidence-based practice resources

Below are some other websites which can support your evidence-based practice.

Please note, unless specified these websites are not endorsed by the RCSLT.

Critical Appraisal

  • Understanding Health Research is designed to help people understand and review published health research to decide how dependable and relevant a piece of research is. The tool guides users through a series of questions to ask about specific types of health research, helping users to understand what their answers say about the quality of the research they are reading.
  • The Best Evidence Encyclopedia presents reliable unbiased reviews of research-proven educational programmes for primary and secondary education.
  • The PEDro-P scale(Perdices et al 2009) is designed to appraise the methodological quality of randomised and non‐randomised controlled trials. Scores for the PEDro-P range from 0 to 9. The higher the figure, the greater the quality of the methodology applied and reported within the study.
  • The SCED tool is designed to appraise studies using single-case experimental designs (Tate et al 2008). Scores for SCED range from 0 to 10. The higher the figure, the greater the quality of the methodology applied and reported within the study.
  • The Critical Appraisal Skills Programme (CASP) The initiative includes checklists to help clinicians to appraise systematic reviews, randomised controlled trials, cohort studies, case control studies and qualitative research.
  • The Social Care Institute for Excellence provides online resources focusing on conducting a review of the literature. It will help you to think about what to look for, where to find it and how to assess its quality in relation to the aim of your search, since different types of research are more appropriate for different kinds of questions.
  • Ben Goldacre’s Bad Science website contains articles and information on the topic of evidence-based medicine.

The Evidence Base

SpeechBITE™ is a database that provides open-access to a catalogue of best interventions and treatment efficacy across the scope of speech and language therapy. This is an evidence-based practice initiative between The University of Sydney and Speech Pathology Australia. You can also sign up to their newsletter.

  • The Early Intervention Foundations Interactive Guidebook helps to show what works in early intervention to improve childrens outcomes. It combines a search tool to filter through programmes, with guidance on implementation. This ensures early intervention is delivered in a way that most improves the lives and future chances of babies, children and families.
  • NHS Evidence provides access to selected, quality health and social care evidence and best practice. NHS staff with an Athens account can use fee-accessed journals and databases for free.
  • The Library of the Cochrane Collaboration has a database of open-access systematic reviews.
  • The NIHR Dissemination Centre and the Signals initiative identifies reliable, relevant and significant health research findings and summarises them in a range of helpful formats for you to use.
  • The What Works database is a moderated online library of evidenced interventions that aim to support children's speech, language and communication. What Works helps find the most appropriate interventions for children and young people by providing a free and easily accessible overview of the evidence base for each intervention. This includes a What Works Training Database which brings together evaluated speech, language and communication training programmes to enable you to find out more about their evidence.
  • A new section for speech, language and communication training packages has been added to What Works including evaluations on the training itself (rather than effectiveness of the intervention). Sign up here.
  • You can share your experience of using an intervention on What Works. The website contains a template and guidance, and other examples. Case studies for What Works neednt be a piece of academic research; rather they are an opportunity to recount your experience of an intervention, providing a clear and objective description that may help colleagues. For more information please visit the interventions in practice page. Please send your completed form and any supporting materials to enquiries@thecommunicationtrust.org.uk.

Finding research evidence

The RCSLT Journal’s Collection gives members access to over 1,600 titles. There are lots of useful tools and resources available to help with searching these and other journals, and to help you to find the evidence you need:

Systematic Reviews

Databases

  • AACknowledge – Communication Matters’ database of Augmentative and Alternative Communication (AAC) research.
  • Allied Health Evidence search tool – allows you to locate research across four databases at once: PEDro, OTseeker, SpeechBITE and PsycBITE.
  • Google Scholar – a simple way to broadly search for academic literature.
  • NHS Evidence – NICE hosted online database of published evidence.
  • PsycBITE – online database cataloging studies of cognitive, behavioural and other treatments for psychological problems and issues occurring as a consequence of acquired brain impairment (ABI).
  • PubMed – online database comprising more than 24 million citations for biomedical literature from MEDLINE, life science journals and online books.
  • Social Care Online - is the UK’s largest database of information and research on all aspects of social care and social work.
  • Trip Database – simple to use tool to find and use high-quality clinical research evidence.

Intervention databases

  • What works – The Communication Trust’s database of evidenced interventions to support children’s speech, language and communication needs.
  • speechBITE – online database of speech and language therapy intervention studies with methodological ratings. Download the speechBITE search guide to help you search the evidence.
  • The Campbell Collaboration produces systematic reviews of the effects of social interventions in crime and justice, education and social welfare.
  • Child Trends’ What Works/LINKS database is a searchable register of over 700 programs. It has at least one randomised, intent-to-treat evaluation to assess child or youth outcomes related to education, life skills and social/emotional, mental, physical, behavioural, or reproductive health.
  • The educational endowment foundation teaching & learning toolkit and the Early years toolkit are accessible summaries of educational research.
  • The early intervention guidebook includes early intervention programmes that can be searched by child outcome, age and evidence rating.
  • Interventions for literacy helps practitioners weigh up the choices between interventions targeted directly on literacy.
  • Research Autism rates interventions for autism according to the amount and quality of scientific evidence.
  • What works Clearing House disseminates summary information on credible and reliable evidence of the effectiveness of a given education practice, program or policy.