Evidence Based Practice- MIDTERM

single group threats to internal validity

-history, maturation, testing, instrumentation, mortality, regression to the mean

First five steps of evidence based practice

1. Answerable question 2. Find evidence 3. Appraise Evidence 4. Integrate appraisal & evidence 5. Evaluate steps

Please choose the correct in-text citation format for the journal article referenced below: Johnson, B., Horsley, T. L., Reed, T., Balasubramanian, N., Siddall, V. J., & Ruland S. (2019). Interprofessional simulation to deliver stroke management and TeamSTEPPS content. Journal of Interprofessional Education & Practice, 17. https://doi.org/10.1016/j.xjep.2019.100288

According to Johnson et al., (2019)...

In APA citation style/format, how should references be organized in the reference list?

Alphabetically by authors' last names

Please select the correct APA reference list format for the following journal article.

Angelaki D. E. & DeAngelis, G. C. (2011). Visual and vestibular cue integration for heading perception in extrastriate visual cortex. The Journal of Physiology, 589(4), 825-833. doi:10.1113/jphysiol.2010.194720

Evidence-based practice consists of the following:

Current best evidence, patient/client values, clinician expertise

One benefit of a large sample that exceeds the minimum power analysis size is that it...

Enhances the external validity of the study.

Level III Evidence

Evidence provided by expert opinions, case series, case reports and studies with historical controls

Level 1 evidence

Evidence provided by one or more well-designed, randomized, controlled clinical trial, including overviews (meta-analyses) of such trials

Level II evidence

Evidence provided by well-designed observational studies with concurrent controls (e.g., case control or cohort studies)

Evidence-based practice does not take into account the experience of the clinician.

FALSE

Evidence-based practice rejects any evidence that is not a randomized controlled trial?

FALSE

Expert opinions are considered a high level of evidence?

FALSE

The reliability of a research study is related to the truthfulness or accuracy of a study's results.

FALSE

You should spend hours searching the literature for pieces of evidence "gold".

FALSE

A research study that involves studying social skills in children with Autism Spectrum Disorder would require what level of review from the IRB?

Full

Identify the threat to Internal validity in the following research study: During a study to compare a group weight loss program with a self-monitoring weight loss program, the local TV news channel does a series on Keys to Success in Losing Weight.

History

Prior to evidence-based medicine/practice, physicians made medical decisions based on

Intuition

Identify the threat to Internal validity in the following research study: In a research study, the researcher selects twenty 2 1/2-year-old children who will be placed in the experimental group and receive a new treatment for play skills. At the end of 6 months, the 20 children's play skills improved.

Maturation

narrative reviews

Narrative reviews are non-systematic. They are a descriptive, broad overview of a topic. They do not tend to address a specific question.

PICO stands for

Patient, Intervention, Comparison, Outcome

Principle of Autonomy

People have the right to make decisions about their own life

Please select the correct APA reference list format for the following text book.

Portney, L . G. (2020). Foundations of clinical research: Applications to evidence-based practice (4th ed.). F.A. Davis.

Primary sources are:

Randomized Control Trial (RCT) Controlled Clinical Trial (CCT) Experiments Surveys Case-control or a cohort study Case study Case reports or case series

Which step in the process for reading and analyzing a research article is detailed below? "Read the article's title, abstract and discussion sections to understand the basic conclusions of the study. Then determine, based on the conclusions, if this study is relevant and appropriate for a more thorough review."

Step 1

Steps to analyzing research article

Step 1: Identify the Conclusions (what are the key conclusions of the study? do they help answer my research question?) Step 2: Determine the Purpose and Rationale (what is the research problem? what is the research question or hypothesis?) Step 3: Understand Methods and Materials (what procedures were followed? how were participants selected? what variables are being measured?) Step 4: Understand Results and Data Analysis (do the results make sense? what are the important outcomes? are the results valid and reliable?) Step 5: Interpret Outcomes and Draw Conclusions (are the outcomes reasonable and logical? are the results useful in clinical practice? what are the strengths and limitations of this study?)

Systematic literature review

Systematic literature reviews use systematic methods to collect secondary data, critically appraise research studies, and synthesize findings either qualitatively or quantitatively.

One way to focus your approach to searching the literature is by asking a question using PICO to find relevant research.

TRUE

The highest level of evidence is systematic reviews.

TRUE

In the following scenario, which principle of ethics is violated? A client is referred to therapy in the home health setting after suffering a stroke. After evaluating the client, the therapist determined that the client had recovered and regained the levels of function that he/she had enjoyed before the stroke. The Home Health company indicated that the client was authorized for 6 visits. Since the therapist had just discharged two other patients and had time on his/her schedule, the therapist wrote up a Plan of Care that included seeing the client for the 6 visits that had been previously authorized.

The Principle of Beneficence

In the following scenario, which principle of ethics is violated? A research project is studying a drug that may decrease spasticity in individuals who have suffered a Traumatic Brain Injury. The researchers stated in the participant exclusion criteria in the IRB that individuals with a TBI that DO NOT have spasticity should not participate. They had difficulty recruiting an adequate number of participants and therefore admitted some participants with TBI that DID NOT have spasticity in order to increase the number of participants.

The Principle of Beneficence

In the following scenario, which principle of ethics is violated? A therapist needs to get a non-ambulatory patient into their wheelchair in order for them to be positioned optimally to participate in a feeding intervention. The patient's records indicate that this is a maximum assist 2-person transfer due to the inability of the patient to weight bear in their lower extremity. The therapist can't find another person to help them with the transfer, but the patient is adamant that they want to start therapy right now and the therapist has a full schedule so they really need to start the session. The therapist sees that there is a slide board in the room and decides to transfer the patient by themselves using the slide board. During the transfer the slide board slips and the patient suffers a ground level fall.

The Principle of Nonmaleficence

external validity

The degree to which results of a study can be generalized to persons or settings outside the experimental situation.

internal validity

The degree to which the relationship between the independent and dependent variables is free from the effects of extraneous factors.

In the following scenario, which principle of ethics is violated? A research project is being conducted on the effectiveness of an intervention for adults with intellectual disabilities. The researchers had a letter of consent that they had the participants sign themselves, even though the individuals were clearly not competent to understand the details of the study and the risks involved.

The principle of autonomy

In the following scenario, which principle of ethics is violated? You have an elderly client who is in the very early stages of dementia. Her children come to you and request that you tell their mother that she can't drive anymore. You have determined that she is still safe to drive, although that will be a concern to address in the future. However, her children are not backing down and are inundating your voicemail with multiple requests to write a letter to the DMV recommending she not be able to drive to see if they can get her driver's license revoked. You are tired of all of the voicemails and give in to the children's request rather than honoring the patient's wishes that are in line with your clinical judgment for safety.

The principle of autonomy

In the following scenario, which principle of ethics is violated? In a research study, they were looking to see the effectiveness of a drug on decreasing morning sickness in pregnant women. During the study, the researchers observed that a disproportionate number of women in the experimental group who took the drug were giving birth to children with severe birth defects. Despite this observation, they did not discontinue the study and the use of this drug.

The principle of nonmaleficence

In the following scenario, which principle of ethics is violated? An outpatient clinic has a long waiting list of clients who are in need of therapy services. One of the therapists suggests to the clinic manager that they go through and prioritize the clients according to which clients would benefit the most from immediate therapy and those that would be harmed the least in delaying treatment. The clinic manager instead decides to prioritize the clients based on their mode of payment, and those with the highest reimbursement rates would be seen first because the administration has indicated they will have to cutback on salaries if the clinic does not increase its revenue flow.

The principle of utility

The following scenario is an example of which principle of ethics? The grant committee is reviewing applications for a grant to support research studies at the University. There are a large number of applications for a limited amount of funding. The committee decides to prioritize studies addressing programming for treating diabetes over proposals for treating less prevalent health problems.

The principle of utility

patient values

Unique preferences, concerns, and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient

"A really great way to understand a research article isn't to read it from beginning to end, that's a total example of an incredible waste of time." This statement is a poor example of scholarly writing due to:

Use of contractions and colloquialisms

"The introduction section of research articles provide a stated purpose about the study and what there reasons are to perform the study for." This statement is a poor example of scholarly writing due to:

Use of poor grammar

Please select the correct APA reference list format for the following journal article.

Wallace, M. T., Carriere, B. N., Perrault, T. J. Jr., Vaughan, J. W., & Stein, B. E. (2006). The development of cortical multisensory integration. The Journal of Neuroscience, 26(46), 11844-11849.

n Step 5 of reading and analyzing a research article you are to interpret outcomes and draw conclusions. During this step you are answering all of the following questions EXCEPT:

What are the variables that are being measured?

principle of beneficence

action of helping others and performing actions that result in benefit to another person

Which of the following threats to internal validity would be a situation whereby an elderly subject drops out of an aerobic exercise study when she develops angina while exercising?

attrition

evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Best research evidence

clinically relevant research, which includes outcomes and effectiveness patient care

Institutional Review Boards (IRB) were established to ensure that human participants in research projects were adequately protected from the following EXCEPT:

financial benefit

Principle of Nonmaleficence

is the moral obligation to protect from harm, specifically physical or mental danger. This principle also indicates that you should not expose people to unnecessary risk.

Principle of Utility

moral principle that actions and behaviors are right if they promote happiness and pleasure.actions are wrong if they promote unhappiness or pain. Another way to think of this is to consider usefulness of the action or behavior to achieve happiness.

If you have a choice between a treatment that has no evidence and one that has been proven to work, which one would be considered evidence-based practice?

proven intervention

clinical expertise

the ability to use clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis, individual risks and benefits of potential interventions, and personal values and expectations

word-for-word plagiarism

when you directly copy someone else's words or ideas without acknowledging the source. Using 7 or more words in the same sequence from an original source without appropriately quoting the words and citing the source is considered plagiarism.

paraphrasing plagiarism

when you summarize, synthesize or reword something written or spoken by others in your own words, which means quotation marks are not used. Occurs when you rephrase the words or ideas of another without acknowledging the source.