Evidence-Based Practice in Speech-Language Pathology: Where Are We Now?

Abstract

Purpose In 2004, American Speech-Language-Hearing Association established its position statement on evidence-based practice (EBP). Since 2008, the Council on Academic Accreditation has required accredited graduate education programs in speech-language pathology to incorporate research methodology and EBP principles into their curricula and clinical practicums. Over the past 15 years, access to EBP resources and employer-led EBP training opportunities have increased. The purpose of this study is to provide an update of how increased exposure to EBP principles affects reported use of EBP and perceived barriers to providing EBP in clinical decision making. Method Three hundred seventeen speech-language pathologists completed an online questionnaire querying their perceptions about EBP, use of EBP in clinical practice, and perceived barriers to incorporating EBP. Participants' responses were analyzed using descriptive and inferential statistics. We used multiple linear regression to examine whether years of practice, degree, EBP exposure during graduate program and clinical fellowship (CF), EBP career training, and average barrier score predicted EBP use. Results Exposure to EBP in graduate school and during the CF, perception of barriers, and EBP career training significantly predicted the use of EBP in clinical practice. Speech-language pathologists identified the three major components of EBP: client preferences, external evidence, and clinical experience as the most frequently turned to sources of EBP. Inadequate time for research and workload/caseload size remain the most significant barriers to EBP implementation. Respondents who indicated time was a barrier were more likely to cite other barriers to implementing EBP. An increase in EBP career training was associated with a decrease in the perception of time as a barrier. Conclusions These findings suggest that explicit training in graduate school and during the CF lays a foundation for EBP principles that is shaped through continued learning opportunities. We documented positive attitudes toward EBP and consistent application of the three components of EBP in clinical practice. Nevertheless, long-standing barriers remain. We suggest that accessible, time-saving resources, a consistent process for posing and answering clinical questions, and on the job support and guidance from employers/organizations are essential to implementing clinical practices that are evidence based. The implications of our findings and suggestions for future research to bridge the research-to-practice gap are discussed.