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EBP > WEEK 1-9 > Flashcards

WEEK 1-9 Flashcards

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1
Q

What is Evidence-based health care?

A

The contentious use of current best evidence in making decisions about the care of individual patients or the delivery of health care

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2
Q

What is “current best evidence”

A

Up to date information from relevant and valid research

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3
Q

What is evidence-based medicine

A

Means integrating the clinical expertise with the best available external clinical evidence from systematic research and patient values

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4
Q

What is evidence-based clinical practice?

A

Problem based approach, whereby research is used to inform clinical decision making

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5
Q

Why is EBP important?

A

Aims to provide the most effective care available and improve patient outcomes

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6
Q

5 main steps of EBP process

A
  1. Answerable question (develop)
  2. Best evidence (find info to answer question)
  3. Critically appraise (the evidence)
  4. Integrate (evidence into practice)
  5. Evaluate (how well you did in steps 1-4)
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7
Q

What is research

A

The systematic and rigorous process of enquiry which aims to describe phenomena and develop and test explanatory concepts and theories

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8
Q

What is critical appraisal

A

Process of deciding whether a piece of research will be useful to your practice

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9
Q

What are the 3 questions you need to ask about research

A

Is it valid?
Is it important?
Is it relevant?

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10
Q

Explain the systematic review process

A
  1. Develop review protocol
  2. Ask answerable questions
  3. Finding the evidence
  4. Appraising the evidence
  5. Judging the applicability of the evidence
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11
Q

What is qualitative research?

A

Examine a particular issue in terms of people’s feelings and values etc.

Explores the human subjective experience

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12
Q

What is the aim of taking a qualitative approach?

A

Aims to understand the world of the participants from their perspectives

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13
Q

What are the types of sampling?

Non-probability

A

Convenience sampling
Purposive sampling
Snowball sampling
Theoretical sampling

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14
Q

What is convenience sampling

A

People invited to participate because of convenience

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15
Q

What is purposive sampling

A

Participants recruited due to preselected criteria

2 types: quota sampling and maximum variation sampling

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16
Q

What is snowball sampling

A

Aka chain referral or networking

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17
Q

What is theoretical sampling

A

Mostly used in grounded theory

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18
Q

What are the 3 types of sampling criteria

A

Inclusion criteria
Exclusion criteria
Sample size

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19
Q

Data collection

A

Direct data
Indirect data
Data obtained through archives or internet

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20
Q

Examples of data collection in qualitative research

A

Interviews
Focus groups
Observation
Documents

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21
Q

2 methods of data analysis (qualitative)

A

Thematic

Coding and categorising

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22
Q

Advantages if qualitative research

A

Uses subjective info
Build new theories
In-depth examination of phenomena

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23
Q

Disadvantages of qualitative research

A

Subjectivity can lead to procedural problems
Difficult the replicate
Researcher bias is unavoidable

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24
Q

What are paradigms in research

A

The set of values, beliefs and practices that are/should be shared by the people conducting and appraising/judging research

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25
What is quantitative research?
Measuring 'stuff' | Using numbers and stats the can be used to describe, compare and correlate aspects of the issue
26
Examples of quantitative research data collection
Observation Questionnaire Physiological/biological measurement
27
What is a sample
Subset of the population that participate in a study
28
What are descriptive stats
Allow the researcher to describe, organise and summarise raw data
29
4 main measures of quantitative data
Mode - occurs most frequently Median - middle Mean - average Normal distribution
30
What are inferential stats
Enable inferences and conclusions to be drawn from the data | Based on probability theory
31
Role of quantitative research in health care
Describes the size of issues Describes relationships (causal links) Compares and contrasts populations
32
Advantages of quantitative research
Objective Ability to determine causality Easy to replicate
33
Disadvantages of quantitative research
Doesn’t allow in-depth examination Test theories rather than building new ones Objectivity - di3snt allow for further examination of feelings etc.
34
Why is triangulation used
To provide data from two or more perspectives to increase understanding of topic of interest
35
What is a mixed methods study
Mixing two approaches within a study (qualitative and quantitative) Provides greater depth of understanding
36
Why do we use mixed method studies
To achieve a deeper understanding
37
Limitation of mixed method studies
Time consuming | Resource intensive
38
What is a PICO question
Describes the elements of a well-formed clinical question | Works with experimental studies
39
What does PICO stand for
``` P = patient/problem I = intervention of interest C = comparison O = outcome ```
40
What is a PIO question
Describes the elements for a well formed question for qualitative studies
41
What does PIO stand for
``` P = population/patient I = intervention/exposure O = outcome OR Co = context ```
42
What is literature
Total body of writing the deals with the topic being researched
43
What is a literature review?
The act of reading, sorting and analysing the literature and putting it into some kind of order
44
Why review the literature?
Develop a comprehensive understanding of the topic Narrow the scope of the topic for the study Find out if it has been investigated in the past
45
Types of literature sources
Primary - written by the author | Secondary - referred to by another author
46
What is a systematic review
A high level overview of primary research on a particular question that trie to identify, select, synthesise and appraise all high quality research evidence relevant to that question in order to answer it
47
What is a population
All of the individuals the researchers are interested in studying
48
What is a sample
A subset of the overall population | Representation of the population
49
Possible problems with sampling process and outcomes
Subjects may fail to follow up or withdraw Participants rate may be too low Excluding/including criteria may narrow down the sample too much Incomplete info may be collected
50
How do we measure/access rigor
``` Quantitative = reliability and validity Qualitative = different measures ```
51
What are the 2 types of validity (explain)
Internal validity - related to participants and research design External validity - related to sampling plan and data collection instrument
52
What is reliability
Has to do with the accuracy and consistency of the measurement technique
53
What is a pilot study
A way to test the data collection tool on a small sample prior to the research
54
What is confirmability
Reflects objectivity in the study | Congruence between 2 or more independent people in terms of accuracy of data, relevance or meaning
55
What is authenticity
The extent to which researchers fairly and faithfully show a range of different realities
56
Qualitative research measures of rigor
Reliability Validity Objectivity
57
Research measure of Qualitative rigor (aka: trustworthiness)
``` Credibility Confirmability Authenticity Dependability Transferability ```
58
What are ethics
A branch of philosophy concerned with moral principles and values, with what ought to be the case and how people ought to live their lives
59
What is the framework for ethical research
Non-maleficence (do no harm) Beneficence (do only good) Respect for human dignity Justice
60
UNESCO core principles
- Respect for autonomy and individual responsibility (informed consent) - Respect for privacy, anonymity and confidentiality - Respect for human vulnerability and personal integrity - Respect for cultural diversity
61
What is anonymity
Mean that no person (not even the researchers) will be able to identify a on individual participating in the study
62
What is confidentiality
This means that the identities of the participants will not be linked to the information they provide
63
Ethics committees - what do they do
Consider research proposals prior to commencement
64
What are some codes and policies for research ethics in general?
``` Honesty Integrity Openness Legality Confidentiality Carefulness ```
65
What is clinical governance
A systematic and integrated approach to assurance and review of clinical responsibility and accountability that improves quality and safety resulting in optimal patient outcomes
66
Characteristics of high quality health care
``` Safe Efficient Person centred Evidence based Effective Accessible ```
67
4 pillars of clinical governance
Consumer value Clinical performance and evaluation Clinical risk Professional development and management
68
Biggest impact of clinical governance
Positive change in people’s attitudes | Move towards a culture of enquiry
69
Critical requirements for successful clinical governance
Suppotive, open and inclusive culture Active involvement from patients, carers and the public Multidisciplinary teamwork
70
What are clinical audits
Method of evaluating and improving clinical practice
71
What is the aim of a clinical audit
To identify how close the current practice is to best practice
72
What are the steps in a clinical audit
Identify issue/problem 1. Set criteria, define standards to be reviewed 2. Collect data 3. Compare performance against criteria and standards 4. Implement change 5. Repeat cycle
73
Barriers to dissemination and publication
``` Lack of confidence and experience Organisational restraints Fear of scrutiny Lack of time Structure Interactions ```
74
How to overcome barriers
``` Be confident Start small & work your way up Work with others Be patient Keep it simple and brief ```
75
What is inquiry
Rigorous and systematic thinking about professional practice, and the context in which it occurs
76
Three types of reflective practice
Reflect-for-practice Reflect-in-practice Reflect-on-practice
77
What is inquiry based health care
Involves a commitment to personal professional development | Includes developing and refining an inquiry toolbox. Of approaches and skills
78
What is a culture of inquiry
A culture that supports individuals in making decisions that are based upon finding and using the best available evidence and combining that with their clinical expertise and knowledge of the patient to guide decision making in health care
79
What is needed to build a culture of inquiry
Removal of well identified barriers Capacity/resources Structures, process and policies and are consistent with inquiry

EBP (1 decks)

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