Integration Of Research Evidence Research Articles

Climate Perceptions of Small Ruminant Farmers in the Mouhoun Province of Burkina Faso

Perception is all about taking in, taking for oneself, taking hold of. Thus, a false perception of climate change can lead to a lack of adaptation or to maladaptation. Climate change represents a threat to the livestock farmers of the MP, whose main source of income is the exploitation of natural and animal resources. The problematic of this study is based on the good perception of the stockbreeders which were necessary to them to adapt to the climatic crises already occurred. The aim of this study is to analyze the perception of climate change by small ruminant breeders in the Mouhoun Province of Burkina Faso. To this end, 286 breeders, including agro-pastoralists and agro-pastoralists, i.e. 22 breeders per village, were surveyed. In addition, a focus group was held in each village, for a total of thirteen (13). Phinks software was used to process the individual survey data. The results indicate a drop in rainfall intensity (78.7%), a rise in temperatures (90.7%), a withdrawal from grazing areas (86%), a drop in milk production (81.3%) and lactation duration (86%). In summary, it appears that the population has a good perception of the climate in their locality. In addition, although it is difficult to integrate research evidence into development policy and practice, the results of this research could guide policy in making decisions about the climate perception of small ruminant farmers in the Mouhoun Province. This study leads to the conclusion that the changes perceived by farmers are relevant to the development of climate change adaptation strategies.

The Power of Rapid Reviews for Bridging the Knowledge-to-Action Gap in Evidence-Based Virtual Health Care.

Despite the surge in popularity of virtual health care services as a means of delivering health care through technology, the integration of research evidence into practice remains a challenge. Rapid reviews, a type of time-efficient evidence synthesis, offer a potential solution to bridge the gap between knowledge and action. This paper aims to highlight the experiences of the Fraser Health Authority's Virtual Health team in conducting rapid reviews. This paper discusses the experiences of the Virtual Health team in conducting 15 rapid reviews over the course of 1.5 years and the benefit of involving diverse stakeholders including researchers, project and clinical leads, and students for the creation of user-friendly knowledge products to summarize results. The Virtual Health team found rapid reviews to be a valuable tool for evidence-informed decision-making in virtual health care. Involving stakeholders and focusing on implementation considerations are crucial for maximizing the impact of rapid reviews. Health care decision makers are encouraged to consider implementing rapid review processes to improve the translation of research evidence into practice, ultimately enhancing patient outcomes and promoting a culture of evidence-informed care.

Equity-related ‘knots’ in theory of change development: Conceptualization and case illustrations

Theory of change (ToC) is an approach widely used to guide planning, implementing, and evaluating change initiatives. While there is substantial guidance, there has been little attention on equity within ToC research and practice. We propose and illustrate the metaphor of ‘knots’ to frame practical and ethical challenges that arise when centering equity within ToC processes. Drawing on our experiences using a ToC approach in two case examples, we identify and illustrate five equity-related knots: (a) clarify root causes, pathways, and success; (b) facilitate participation across power and perspective differences; (c) integrate research evidence and practitioner knowledge; (d) represent complex change visually; and (e) creatively navigate constraints. We show why framing these as knots can help practitioners make wise judgments within the circumstances and close with recommendations for including knots in ToC processes, reporting, and guidance.

Descriptive and Content Analysis of Questionnaires Used to Assess Evidence-Based Practice Among Dietitians: A Systematic Review

BackgroundEvidence-based practice (EBP) is described as the integration of the following 3 main dimensions in health professionals’ decision making: best currently available research evidence, professional expertise, and patient’s values and circumstances. Barriers to EBP at an individual level have been assessed using questionnaires. Knowing which EBP dimensions are actually explored in these questionnaires is essential to promote EBP and its adoption. ObjectiveThe aim of this review was to identify and describe questionnaires that have been used among dietitians to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP, and to perform a content analysis of these, drawn on the EBP dimensions explored. MethodsQuestionnaires were identified through a systematic review in MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (last search was November 2022). Eligibility criteria were studies using, evaluating, or developing questionnaires meant to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP among dietitians. The content analysis was conducted to identify the EBP dimensions explored (ie, research evidence, professional expertise, and/or patient’s values and circumstances). Questionnaire items were categorized as follows: 1 sole EBP dimension, a combination of dimensions, or no identifiable dimension. ResultsThirty reports (25 studies) were included. The analysis of the 847 items extracted from the 25 questionnaires used showed that the main EBP dimension explored was the integration of research evidence into decision making, found in 75% of items, solely or in combination with another dimension. Professional expertise was explored in 18% of the items, patient’s values and circumstances were found in 3%, and the combination of these 3 dimensions was found in <1%. ConclusionsThe important imbalance of explored EBP dimensions in the questionnaires used may lead to a partial and misleading evaluation that prevents efficient strategies to foster EBP. There is an important need to develop more integrative and accurate evaluations of EBP targeting dietitians to promote and develop high-quality dietetics practice.

CACA guidelines for holistic integrative management of nasopharyngeal carcinoma

Abstract Purpose Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor originating in the nasopharynx and is particularly prevalent in southern China. Unfortunately, international guidelines, such as NCCN or ESMO, fail to adequately coincide with clinical practice in China, making it difficult to achieve precision personalized therapy in China. The aim of this guideline is to better promote a “Multidisciplinary Team to Holistic Integrative Medicine" (MDT to HIM) system for the prevention, screening, diagnosis, treatment, and rehabilitation of NPC. Methods The China Anti-Cancer Association (CACA) invited domestic multi-disciplinary experts, involving radiologists, oncologists, surgeons, pathologists, herbalists, physiatrists, and psychologists, to write, discuss, and revise the guidelines. Based on the integration of research evidence, clinical experience, and patient needs, the domestic experts have iteratively developed these guidelines to provide proper and feasible management of NPC. Results and conclusion The CACA Guidelines for Holistic Integrative Management of Nasopharyngeal Carcinoma are more suitable for China's clinical practice, highlight Chinese characteristics, and have important clinical significance.

Public Health Impact and Health System Preparedness within a Changing Climate in Bangladesh: A Scoping Review

Bangladesh, one of the most disaster-prone countries in the world is also severely exposed to climate change (CC) impacts with a multitude of health complexities. Health adaptation to CC is thus a serious issue in Bangladesh, but not explored properly from a health system and policy environment perspective. In order to address this gap and provide a holistic picture of the overall scenario, this scoping review explores CC impacts on the population health in Bangladesh and discusses the policy environment and health system preparedness against such climatic challenges. A total of 28 articles were reviewed following Arksey and O’Malley’s scoping review framework. A “5-point scale” was devised to assess CC integration in the health sector Operational Plans (OPs). Though the country made significant progress in different health indicators, poverty and income inequality have kept marginal communities out of many health provisions. There are four major stakeholders in the health system. The government sector is handicapped by poor governance, bureaucratic processes, and staff shortages; and primarily focuses on the public sector only. National Health Policy (NHP) governs the health system through 29 sectoral OPs, that put CC as a major cross-cutting issue. About 25% of the OPs have fully integrated CC and other OPs have significant CC co-benefits. In Bangladesh CC was linked to increased morbidity and mortality, diarrhea, cholera, skin problems, respiratory infections, malaria, dengue, kala azar, pre-eclampsia, and hypertension. Significant research gaps exist on child health, migrant health, and mental health. Integration of research evidence into policy, planning and program design is largely absent. However, prioritizing health for the National Adaptation Plan is an essential step towards establishing a climate-resilient health system.

Rapid Reviews to Support Practice: A Guide for Professional Organization Practice Networks.

Background. Occupational Therapists, among other healthcare decision makers, often need to make decisions within limited timeframes and cannot wait for the completion of large rigorous systematic reviews and meta-analyses. Rapid reviews are one method to increase the integration of research evidence into clinical decision making. Rapid reviews streamline the systematic review process to allow for the timely synthesis of evidence; however, there does not exist a single agreed upon guide for the methodology and reporting of rapid reviews. Purpose. This paper proposes a rapid review methodology that is customized to a professional organization practice which can feasibly be used by practice networks such as those of the Canadian Association for Occupational Therapy to conduct reviews. Implications. Practice networks provide a sustainable mechanism to integrate research evidence and foster communication amongst practitioners. This guide for conducting and reporting rapid reviews can be used across Occupational Therapy practice networks and similar groups to support the consistent and timely synthesis of evidence necessary to improve evidence-informed clinical decision making.

Identifying barriers and facilitators of translating research evidence into clinical practice: A systematic review of reviews.

Translating research into clinical practice is a global priority because of its potential impact on health services delivery and outcomes. Despite the ever-increasing depth and breadth of health research, most areas across the globe seem to be slow to translate relevant research evidence into clinical practice. Thus, this review sought to synthesise existing literature to elucidate the barriers and facilitators to the translation of health research into clinical practice. A systematic review of reviews approach was utilised. Review studies were identified across PubMed, Scopus, Embase, CINAHL and Web of Science databases, from their inception to 15 March 2021. Searching was updated on 30 March 2022. All retrieved articles were screened by two authors; reviews meeting the inclusion criteria were retained. Based on the review type, two validated tools were employed to ascertain their quality: A Measurement Tool to Assess Systematic Reviews-2 and International Narrative Systematic assessment. The framework synthesis method was adopted to guide the analysis and narrative synthesis of data from selected articles. Ten reviews met the inclusion criteria. The study revealed that the translation of new evidence was limited predominantly by individual-level issues and less frequently by organisational factors. Inadequate knowledge and skills of individuals to conduct, organise, utilise and appraise research literature were the primary individual-level barriers. Limited access to research evidence and lack of equipment were the key organisational challenges. To circumvent these barriers, it is critical to establish collaborations and partnerships between policy makers and health professionals at all levels and stages of the research process. The study concluded that recognising barriers and facilitators could help set key priorities that aid in translating and integrating research evidence into practice. Effective stakeholder collaboration and co-operation should improve the translation of research findings into clinical practice.

CACA guidelines for holistic integrative management of gastric cancer

According to statistics, the rates of incidence and death of gastric cancer in China have risen to the fourth worldwide, resulting in huge social burden. Regrettably, international guidelines, such as NCCN or ESMO, could not provide enough consideration to Chinese clinical practice, making it difficult to achieve individual therapy in China. In 2020, China Anti-Cancer Association (CACA) invited domestic multi-disciplinary experts and made the guideline of gastric cancer, involving surgeon, oncologist, pathologist, radiologist, herbalist, physiatrist and psychologist. This gastric cancer guideline recommends comprehensive treatment scheme with high-evidence and well-feasibility, which is mainly based on evidence-based medicine, Chinese experience and expert consensus. We provided MDT to HIM system of “prevention, screening, diagnosis, treatment, rehabilitation” for gastric cancer, which embodied the integration of research evidence, clinical experience and patient needs. The CACA guideline is more suitable for China’s clinical practice, reflecting scientificity, accessibility and Chinese characteristics, highlights the concept of integrated medicine, and has guiding value of clinical practice.

The ecological approach to construct entrepreneurship education: a systematic literature review

PurposeThe research effort on entrepreneurship education has been mainly for the higher education settings and on the individual level of analysis. On the contrary, this research urges scholars to expedite attention to the secondary education settings, especially in the emerging economies in Asia and Africa. This paper aims to reveal the existing landscape of literature development on the topic and promote ecological approaches of constructing entrepreneurship education programs in schools. It advocates the “incubator” role of schools for students and the necessity of establishing socially embedded entrepreneurship education as the playground for future entrepreneurs.Design/methodology/approachThis study followed the systematic literature review as its research design. It obtained 1,555 publications from six academic databases and 60 more publications from expert consulting and backward snowballing technique. Data screening resulted in a total of 101 relevant publications with the upper secondary education as their research context. The qualitative integrative synthesis method was then applied to integrate research evidence to the five circles of systems according to Urie Bronfenbrenner’s ecological systems theory.FindingsThis study contributes to the entrepreneurship education and youth career development literature, especially in the developing countries. Results discovered that entrepreneurship education programs, when interacting with ecological systems, resulted in training success. The most frequently studied systems were microsystems; here, there was a dominant focus on program-level reporting and analyzing. There was less focus on other systems such as mesosystems, exosystems or macrosystems. Moreover, only one study was associated with chronosystems, suggesting a significant research gap regarding the longitudinal studies. However, this review validated the different approaches to delivering entrepreneurship education in emerging and developed economies.Research limitations/implicationsOne limitation of this research lies in the methodology. The inclusion criteria limited the studies to the context of upper secondary education and excluded those of secondary education in general. The sampling method limited the power of this research to analyze and discuss policy-level studies because policies most likely embrace the whole secondary education level as its target. Another limitation is associated with the lack of experimental studies in assessing the comparative advantages of following the ecological approach when constructing entrepreneurship education. It, therefore, remains an undiscussed matter within this study regarding whether following the ecological approach means empirically a better educational choice or not.Practical implicationsThis study discusses the implications for policymakers, especially in emerging economies, and suggests that awareness, attention and funding are needed to empower youth entrepreneurship education from an ecological systems view.Originality/valueTo the best of the authors’ knowledge, this research is one of few studies that use the ecological systems theory in the context of entrepreneurship education with the purpose of focusing on environment-level analysis instead of individual-level analysis. Through the systematic literature review, this study proposes an ecological approach to comprehend, guide, evaluate and improve the design and implementation of entrepreneurship education programs in schools based on well-articulated research evidence. The research can inform both researchers and educators by offering a holistic perspective to observe and evaluate entrepreneurship education programs and their levels of social connectedness.

Specific cognitive aptitudes and gifted samples

This paper explores the way in which the literatures on gifted education and specific cognitive aptitudes can be better integrated and inform one another to advance scientific knowledge. We first briefly review evidence accumulated to date on specific cognitive aptitudes and gifted samples and then explore what might be usefully investigated in the future. We consider measurement issues, value for applied uses of tests, specific cognitive aptitudes beyond what has been focused on to date and conclude with a discussion surrounding cross-field integration using the totality of evidence and consideration of policy. Continued research and better integration of research evidence across domains and translation to policy and practice might correspondingly improve basic scientific understanding of cognitive aptitudes.

Engaging with research: practical advice for nurses at every level.

Nurses at every level can reflect on their active engagement with clinical research. This article aims to support nurses to understand how they can facilitate and lead research. It provides practical advice to support the integration of research evidence into care delivery and increase the opportunities for patients to participate in clinical research. This is important because patients can benefit from nurses who are knowledgeable, confident and supported in applying research evidence. Furthermore, nurses can support and inform patient choice through increased confidence and competence in engaging with research and implementing research findings. Organisational culture and leadership are also important elements in fostering environments where evidence and research are promoted throughout the nursing workforce.

Integrating research into policy sphere: evidence from Tanzania

ABSTRACT This article explores lessons on integrating research evidence into policy through public-private dialogue for the purpose of enhancing evidence-based policy making. Based on a qualitative analysis of the engagement of researchers and policy actors in Tanzania, it is evident that collaborative arrangements of researchers, the private sector, media and policy makers promote the use of research findings in the policy-making process. Accordingly, we suggest a multi-disciplinary network of academia and policy actors as a tool to bring about effective utilisation of research findings in policy decisions.

Evidence-based practice and clinical reasoning in occupational therapy: A cross-sectional survey in Chile.

Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making. A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis. Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making. Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP.

Important implementation constructs for federal agencies in health and human service settings that are selecting, monitoring, and supporting grantees

Background:Federal agencies and other funders seeking to maximise their impact aim to understand factors associated with implementing evidence-based interventions (EBIs) to address health problems. Challenges exist, however, in synthesising information from different disciplines and reaching agreement about these factors due to different terminology, frameworks, and measures being used in different fields. Methods:A mixed-methods approach was used to identifying a set of implementation constructs helpful for selecting, monitoring, and supporting federal grantees in health and human service settings. Three phases of research were conducted: a literature review, structured expert interviews, and consensus building. Interviews with implementation experts were used to validate a set of implementation constructs identified in the literature review as strongly and consistently related to successful implementation of EBIs in international contexts. A modified Delphi approach was used with a technical working group (TWG) of federal staff to agree on the constructs most relevant for federally funded EBIs. Findings:This process yielded 11 constructs related to either the intervention, the intersection between the invention and context, or the implementation process. These constructs are areas of interest when integrating research evidence into routine practice. Expert interviewees recommended establishing clear, consistent construct definitions before developing valid, feasible measures of the constructs. In contrast to the numerous and specific constructs advanced by researchers, federal TWG members favoured fewer constructs with more generalisability. Discussion and conclusions:This article demonstrates the translation work required for policy contexts and highlights a successful approach to translate evidence from implementation science research for federal staff.

Integrating evidence from research into decision-making for controlling endemic tropical diseases in South East Nigeria: perceptions of producers and users of evidence on barriers and solutions

BackgroundEndemic tropical diseases (ETDs) constitute a significant health burden in resource-poor countries. Weak integration of research evidence into policy and practice poses a major challenge to the control of ETDs. This study was undertaken to explore barriers to the use of research evidence in decision-making for controlling ETDs. It also highlights potential strategies for addressing these barriers, including the gaps in research generation and utilisation in the context of endemic disease control.MethodsInformation on barriers and solutions to integrating research evidence into decision-making for controlling ETDs in Anambra State, Nigeria, was collected from 68 participants (producers and users of evidence) during structured discussions in a workshop. Participants were purposively selected and allocated to groups based on their current involvement in endemic disease control and expertise. Discussions were facilitated with a topic guide and detailed notes were taken by an appointed recorder. Outputs from the discussions were synthesised and analysed manually.ResultsCross-cutting barriers include a weak research linkage between producers and users of evidence and weak capacity to undertake health policy and systems research (HPSR). Producers of evidence were purported to conceptualise and frame their research questions based on their academic interests and funders’ focus without recourse to the decision-makers. Conversely, poor demand for research evidence was reported among users of evidence. Another user barrier identified was moribund research units of the Department of Planning Research and Statistics within the State Ministry of Health. Potential solutions for addressing these barriers include creation of knowledge networks and partnerships between producers and users of evidence, institutionalisation of sustainable capacity-building of both parties in HPSR and revival of State research units.ConclusionsEvidence-informed decision-making for controlling ETDs is limited by constraints in the interactions of some factors between the users (supply side) and producers (demand side) of evidence. These constraints could be solved through stronger research collaborations, institutionalisation of HPSR, and frameworks for getting research into policy and practice.

Psychology in executive coaching: an integrated literature review

PurposeThe purpose of this paper is to identify essential psychological-informed executive coaching approaches that enhance the organisational learning and development process and outcomes through integrating existing research evidence. Since coaching has been widely used in leadership development related areas and previous studies confirmed that this generates positive effects on individual-level learning in the organisational setting. The identified frameworks and influential factors outlined in this paper can serve as explicit guidelines for the organisation and management team when setting selection and evaluation benchmarks for employing executive coaches.Design/methodology/approachAn integrated review approach was applied to narratively synthesise 234 (k=234) identified peer-review articles between 1995 and 2018. This review followed a rigorous protocol that the authors consulted ten (n=10) experts in the field. Both qualitative and quantitative psychological-focused research evidence was included in this study.FindingsFirst, certain psychological approaches, such as cognitive behavioural, solution-focused, GROW and strength-based approaches, were highlighted in current research evidence. Second, the essential factors and skills, for instance, building trust, transparency and rapport, and facilitating learning were identified. Third, the main organisational learning and development outcome evaluation methods were outlined in this review, such as the self-efficacy scale, organisational commitment, workplace psychological well-being, 360-degree feedback and the Multifactor Leadership Questionnaire.Research limitations/implicationsIt is always challenging to integrate research evidence on coaching because of the diversity of theoretical disciplines upon which coaching interventions draw. Therefore, it is difficult to generate a meta-analytic review which can generate statistical results. This review also reveals room for improvement in the quality of existing coaching evidence in accordance with the criteria for evidence-based management or practice (Brineret al., 2009), such as research methodology and evaluation design. Moreover, there is a lack of evidence on this reflective process which helps professional coaches to ensure the quality of their practice and organisational support.Practical implicationsThis review offers a new perspective on the role psychology plays in the organisational learning and development practices. The identified coaching approaches, influential interpersonal skills and outcome evaluation methods can serve as practical guidelines when applying external coaching to facilitate a better organisational learning and development process and outcome.Originality/valueThis is the first literature review to focus on contemporary psychological-informed coaching evidence (between 1995 and 2018) in the workplace setting. Despite the rapid growth in demand for professional coaching practitioners (International Coach Federation, 2016), there is a lack of research-informed evidence to overcome the challenges faced by organisations when employing external coaches, such as what selection criteria or evaluation benchmarks to use. This review takes a practical perspective to identify essential body of knowledge and behavioural indicators required for an executive coach to facilitate an effective learning and development outcome.

Health professions digital education on clinical practice guidelines: a systematic review by Digital Health Education collaboration

BackgroundClinical practice guidelines are an important source of information, designed to help clinicians integrate research evidence into their clinical practice. Digital education is increasingly used for clinical practice guideline dissemination and adoption. Our aim was to evaluate the effectiveness of digital education in improving the adoption of clinical practice guidelines.MethodsWe performed a systematic review and searched seven electronic databases from January 1990 to September 2018. Two reviewers independently screened studies, extracted data and assessed risk of bias. We included studies in any language evaluating the effectiveness of digital education on clinical practice guidelines compared to other forms of education or no intervention in healthcare professionals. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to assess the quality of the body of evidence.ResultsSeventeen trials involving 2382 participants were included. The included studies were diverse with a largely unclear or high risk of bias. They mostly focused on physicians, evaluated computer-based interventions with limited interactivity and measured participants’ knowledge and behaviour. With regard to knowledge, studies comparing the effect of digital education with no intervention showed a moderate, statistically significant difference in favour of digital education intervention (SMD = 0.85, 95% CI 0.16, 1.54; I2 = 83%, n = 3, moderate quality of evidence). Studies comparing the effect of digital education with traditional learning on knowledge showed a small, statistically non-significant difference in favour of digital education (SMD = 0.23, 95% CI − 0.12, 0.59; I2 = 34%, n = 3, moderate quality of evidence). Three studies measured participants’ skills and reported mixed results. Of four studies measuring satisfaction, three studies favoured digital education over traditional learning. Of nine studies evaluating healthcare professionals’ behaviour change, only one study comparing email-delivered, spaced education intervention to no intervention reported improvement in the intervention group. Of three studies reporting patient outcomes, only one study comparing email-delivered, spaced education games to non-interactive online resources reported modest improvement in the intervention group. The quality of evidence for outcomes other than knowledge was mostly judged as low due to risk of bias, imprecision and/or inconsistency.ConclusionsHealth professions digital education on clinical practice guidelines is at least as effective as traditional learning and more effective than no intervention in terms of knowledge. Most studies report little or no difference in healthcare professionals’ behaviours and patient outcomes. The only intervention shown to improve healthcare professionals’ behaviour and modestly patient outcomes was email-delivered, spaced education. Future research should evaluate interactive, simulation-based and spaced forms of digital education and report on outcomes such as skills, behaviour, patient outcomes and cost.

Challenges Facing New Educators: Expanding Teaching Strategies for Clinical Reasoning and Evidence-Based Medicine

Context:It is the educator's responsibility to prepare the students to be clinicians who think and reason critically while integrating research evidence into practice. Those new to the role of faculty member, who lack clinical and teaching experience, face challenges in the classroom application of those concepts.Objective:To discuss the challenges facing new faculty members and present strategies for addressing them. Specific faculty challenges addressed include learning their roles as educators and teaching multifaceted concepts, such as clinical reasoning and evidence-based medicine.Background:Experience provides a framework for a professional to balance multiple demands, whether as a new instructor teaching or a clinician synthesizing information to determine a course of action. Many new educators do not have extensive experience either clinically or in the classroom. This can cause anxiety as educators are confounded by their roles and responsibilities. Students likewise lack experience and may not possess the ability to systematically analyze patient encounters or research evidence. Constructivist learning theory paired with adult learning principles can address the learning needs of faculty members and students alike.Recommendation(s):Programs must provide assistance for new faculty and implement strategies for students to learn reasoning skills. Use of constructivist learning theory and application of the adult learning model are ways to address these deficiencies. Integrating concepts of active learning and self-direction while aligning expectations and creating overlap between classroom and clinical domains can assist in addressing the challenges faced by new faculty and students.Conclusion(s):The systematic process of evidence-based decision making is grounded in utilizing evidence. Strategies must be identified and implemented throughout curricula to target and enhance students' abilities to organize and synthesize information. Educators must use new methods in their own learning and teaching to enhance their students' abilities. New faculty members in particular require assistance in negotiating their roles.

A thematic analysis assessing clinical decision-making in antipsychotic prescribing for schizophrenia

BackgroundIn recent decades atypical antipsychotics have increased treatment options available for schizophrenia, however there is conflicting evidence concerning the trade-off between clinical efficacy and side effects for the different classes of antipsychotics. There has been a consistent increase in atypical antipsychotic prescribing compared to typical, despite evidence showing that neither class is superior. This leads to the question of whether prescribers are selective in their uptake of research evidence and clinical guidelines and if so, what influences their choice.. This study aims to identify the factors that contribute to the prescribing choice and how these can be used to aid knowledge translation and guideline implementation.MethodsA thematic analysis study was conducted using data from 11 semi-structured interviews with clinicians with experience in prescribing for schizophrenia.ResultsThe analysis identified five themes underpinning prescribing behaviour: (1) ownership and collaboration; (2) compromise; (3) patient involvement; (4) integrating research evidence; and (5) experience.ConclusionThe themes mapped to various degrees onto current models of evidence-based decision making and suggest that there is scope to re-think the guideline implementation frameworks to incorporate recurring themes salient to clinicians who ultimately use the guidelines. This will further translation of future evidence into clinical practice, accelerating clinical progress.