Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Lisa M. D. Archibald

Affiliation

Health and Rehabilitation Sciences

Abstract

Evidence-based practice refers to an integration between one’s clinical expertise developed through professional development and previous experience, the most current and valid scientific evidence and the unique needs of a particular clinical setting. Recently, there has been a growing expectation of speech-language pathologists to engage in the evidence-based practice process despite awareness that real-world implementation is a complex task. Implementation strategies may be helpful in moving complicated research findings into clinical practice, but there is little research examining the practical use of these strategies. The current dissertation examines how four different implementation strategies, explored through two case studies, can be used to bolster clinical practice and aid in the evidence-based practice uptake process in the field of speech language pathology.

In chapter 2, collaborative relationships between speech-language pathologists and educators, in the implementation of an evidence-based language and literacy program for early-years students in an educational setting, were qualitatively examined. By investigating the complexities of this collaborative effort, barriers and facilitators to interprofessional collaboration were identified and explored. In chapter 3, the same language and literacy program allowed for the quantitative examination of changes in professional knowledge and confidence, and subsequent student language and literacy performance outcomes, following its implementation. This program involved investigating two approaches to moving evidence into practice: professional development sessions aimed at providing current evidence-based language and literacy education strategies and in-the-field coaching opportunities between speech-language pathologists and educators. In chapter 4, clinician readiness for real-world implementation of the evidence-based diagnostic label of developmental language disorder was investigated across practice settings. By examining current knowledge and practice, important future steps for adoption of this evidence-based practice could be acknowledged. Chapter 5 summarized the findings from these three empirical chapters, discussed the implications of this work, acknowledged the limitations of the current work and outlined considerations for future research regarding the use of implementation strategies in improving evidence-based practice in this field. Overall, this research will help to illuminate several ways in which implementation strategies can be used to improve current practice and contribute to the successful uptake of EBP in the clinical world of speech-language pathology.

Summary for Lay Audience

Evidence-based practice is the combination of one’s previous clinical knowledge and experience, the most current and accurate research findings and the needs of a particular clinical location. Recently, speech-language pathologists have been required to participate in evidence-based practice despite the known fact that it is difficult to do. Implementation strategies may be helpful in moving complicated research findings into practice, but there is little research looking at actual use of these strategies. The current thesis looks at how four different implementation strategies, in two case studies, can be used to improve clinical practice and help clinicians to use evidence in their work in the field of speech language pathology.

In chapter 2, collaboration between speech-language pathologists and teachers, in an evidence-based language and literacy program for grade one students across several schools, was examined. By investigating the challenges of these collaborations, barriers and facilitators could be identified and explored. In chapter 3, the same language and literacy program allowed for the opportunity to look at changes in speech-language pathologist and teacher knowledge and confidence, as well as student language and literacy scores, following its implementation. This program involved looking at two approaches to moving evidence into practice: professional development sessions aimed at teaching current evidence-based language and literacy education strategies and in-the-field coaching opportunities between speech-language pathologists and educators. In chapter 4, how ready clinicians were to implement the label of developmental language disorder was investigated across the field of speech-language pathology. By examining current knowledge and practice, important future steps for consistently using this label could be acknowledged. Chapter 5 summarized the findings from these three chapters, discussed the effects of this work, acknowledged the limitations of the current thesis and outlined considerations for future research regarding the use of implementation strategies in improving evidence-based practice in this field. Overall, this research will help to show several ways in which implementation strategies can be used to improve current practice and encourage successful use of evidence-based practice in the clinical world of speech-language pathology.

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