Current literature indicates that many healthcare practitioners – including OT practitioners – are failing to identify or utilize high-quality, up-to-date sources of evidence and are instead relying on personal experience, popular media, and outdated treatment protocols to provide intervention.
I have observed firsthand the difficulty of integrating evidence into practice during my OT education and employment experiences. During one of my fieldwork placements, a veteran fieldwork educator with 15+ years of experience gave the same home exercise program (HEP) to every client she saw, despite their diverse diagnoses and abilities. Although one could argue that upper body strengthening may be generally helpful for any person who is recovering from illness or injury, I began to wonder whether or not giving the same handout and Theraband to every client was actually benefiting them. In short, what was the evidence supporting this practice?
The fieldwork educator certainly wasn’t harming any of the clients by giving them a generic home exercise program. But not causing harm isn’t a particularly good reason to use a treatment or intervention. By that logic, you could provide any treatment whatsoever as long as you aren’t hurting your patients! It seemed to me like this supervisor had simply included “home exercise program” as part of her routine, rather than carefully considering each person’s condition, learning style, or level of health literacy and incorporating this information into her plans of care.
I don’t fault my fieldwork educator for her actions; since joining the workforce I’ve experienced firsthand how challenging it can be to ensure that the interventions I provide are evidence-based. It’s exhausting to spend all day treating patients, answering emails, talking with interdisciplinary team members, documenting, and going to meetings – some days it feels like Googling an unfamiliar diagnosis is the most than I have the time or energy to do. Despite this, I push myself every week to read an article, pick a coworker’s brain, talk with a mentor, or find another way to continue incorporating evidence into my everyday practice. And I’ve found that while it’s not always easy, it is always worth it to find evidence to support the interventions I provide and grow my knowledge base and clinical skills.
Why Is It So Hard to be an Evidence-based OT?
There are a plethora of reasons why many occupational therapists struggle to consistently utilize evidence within their daily practice, such as: