Rita P. Fleming-Castaldy, Glen Gillen; Ensuring That Education, Certification, and Practice Are Evidence Based. Am J Occup Ther 2013;67(3):364-369. doi: 10.5014/ajot.2013.006973.
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© 2019 American Occupational Therapy Association
The occupational therapy profession has put forth a vision for evidence-based practice. Although many practitioners express a commitment to the provision of services informed by evidence, the reality that tradition still determines much of our education, certification, and practice cannot be ignored. In this article, we highlight the disconnect between the profession’s aspirations and actual practices using neurophysiological models as an example. We describe actions to actualize the shift from traditional interventions to evidence-based approaches. We challenge readers to become agents of change and facilitate a culture shift to a profession informed by evidence. It is our hope that this article will provoke critical discourse among educators, practitioners, authors, and editors about why a reluctance to let go of unsubstantiated traditions and a hesitancy to embrace scientific evidence exist. A shift to providing evidence-based occupational therapy will enable us to meet the objectives of the Centennial Vision.
Provoke critical discourse among educators, practitioners, authors, and editors about why a reluctance to let go of tradition and embrace evidence exists;
Use the example of motor control intervention to illustrate that it is time to assertively critique professional textbook, curriculum, and certification examination content;
Describe actions to actualize the shift from traditional interventions to evidence-based approaches; and
Embolden readers to become agents of change to facilitate a culture shift to a profession informed by evidence.
Although this is typical during paradigm shifts, the amalgamation of old techniques with new theoretic knowledge is not useful either theoretically (since established Bobath techniques are not consistent within the new paradigm of motor control and learning) or for clinical practice (since numerous studies have demonstrated that there is indeed little evidence). The challenge for us as therapists is to design and evaluate techniques within the newly emerging paradigm of task-oriented training. (p. 124)
Meaningful activity is essential to occupational therapy intervention because occupation is the power of intervention. If occupational therapists believe in the use of occupation-based activities, it is contradictory for them to use pre-functional activities more often than functional activities. (Smallfield & Karges, 2009, p. 411)
the obsolete and constantly changing assumptions used to explain the Bobath Concept [and the adoption of] a new approach based on evidence-based guidelines and the improved understanding of mechanisms underlying adaptive motor relearning and mechanisms of functional recovery after stroke. (Kollen et al., 2009, p. e95)
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