Title

A Cultural Analysis of “Evidence” Emerging from Research and Practice Contexts: An Occupation of Evidence-Building?

Location

New River Room A

Start Time

3-10-2015 10:45 AM

End Time

3-10-2015 11:15 AM

Session Type

Theoretical Paper

Abstract

The intention of this paper is to provide preliminary support for and stimulate discussion of “evidence-building” as a legitimate occupation, with its form, function and meaning influenced by the values of the builder and the cultural aspects of the context in which it is built. It seeks to expand present conceptualizations of evidence-based practice.

Though strides have been made since evidence-based practice was introduced, more remains to be done. The use of a uni-paradigm pyramid for literature critique is being questioned (Tomlin & Borgetto, 2011). A scoping review of the literature finds that “evidence” is defined differently in research and practice (Thomas and Law, 2013). Correspondingly, Gabbay and le May (2004) identify the use of “mindlines,” (guidelines that are socially constructed by practitioners through the use of research and practice guidelines/outcomes) rather than research alone, as guiding everyday practice decisions.

Through focus groups and qualitative content analysis, a recent study described how evidence was defined, generated and used in the everyday practice of six school-based occupational therapists. Findings pointed to two major categories of evidence, and an almost constant “reasoning in action” process where evidence was gathered through observation, oral reports and artifacts, and then used to make everyday intervention decisions in service of the client (Dougherty et al, 2015). This process of “building evidence” seemed different than the process mirrored in pyramids that critique research literature where evidence is valued more highly as it moves from qualitative research/expert opinion (lower level) to meta-analyses of randomized controlled trials (higher level). For the purpose of this inquiry, research and practice were viewed as two different cultures, and, given that occupations are defined in relation to their own culture, this question emerged: Will “evidence-building as an occupation” emerge differently from the cultures of practice and research? If so: 1) what might be the differences in form, function and meaning; and, 2) what might be the implications of such a concept?

A model shared by Bonder et al, 2004, describes three aspects of an emergent culture, namely embedded values, locales, and patterns of behavior (“talk” and “action”). These aspects guided a preliminary analysis of evidence and its processes from the perspectives of both research and practice, with results suggesting an occupation of evidence-building that is specific to its respective cultural aspects. The results of the cultural analysis, a proposed definition of evidence-building, and possible implications of such an occupation will be shared for discussion and vetting, and as possible first steps toward answering Hinojosa’s call for the creation of an evidence-based philosophy that is reflective of our profession (Hinojosa, J., 2013).

This paper supports the mission of SSO in that it views evidence and evidence-based practice through an occupational lens. In doing so, it is informed by several bodies of literature: evidence-based practice; clinical reasoning; expertise; and, knowledge translation. This comprehensive, occupational view of evidence has the potential to build bridges of understanding between practice and research, and inform educational approaches for future students.

References

Bonder, B., Martin, L. & Miracle, A. W. (2004). Culture emergent in occupation.

American Journal of Occupational Therapy, 58, 159-168.

Dougherty, D. A., Toth-Cohen, S. E. & Tomlin, G.S. (2015). Beyond research

literature: Practitioners’ perspectives of evidence in everyday practice.

Manuscript submitted March, 2015.

Hinojosa, J. (2013). The Issue Is – The evidence-based paradox. American

Journal of Occupational Therapy, 67, e18-e23.

http://dx.doi.org/10.5014/ajot.2013.005587.

Thomas, A., & Law, M. (2013). Research utilization and evidence-based practice

in occupational therapy: A scoping study. American Journal of Occupational

Therapy, 67, e-55-e65. http://dx.doi.org/10.5014/ajot.2013.006395.

Tomlin, G., & Borgetto, B. (2011). Research pyramid: A new evidence-based

practice model of occupational therapy. American Journal of Occupational

Therapy, 65, 189-196.

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Oct 3rd, 10:45 AM Oct 3rd, 11:15 AM

A Cultural Analysis of “Evidence” Emerging from Research and Practice Contexts: An Occupation of Evidence-Building?

New River Room A

The intention of this paper is to provide preliminary support for and stimulate discussion of “evidence-building” as a legitimate occupation, with its form, function and meaning influenced by the values of the builder and the cultural aspects of the context in which it is built. It seeks to expand present conceptualizations of evidence-based practice.

Though strides have been made since evidence-based practice was introduced, more remains to be done. The use of a uni-paradigm pyramid for literature critique is being questioned (Tomlin & Borgetto, 2011). A scoping review of the literature finds that “evidence” is defined differently in research and practice (Thomas and Law, 2013). Correspondingly, Gabbay and le May (2004) identify the use of “mindlines,” (guidelines that are socially constructed by practitioners through the use of research and practice guidelines/outcomes) rather than research alone, as guiding everyday practice decisions.

Through focus groups and qualitative content analysis, a recent study described how evidence was defined, generated and used in the everyday practice of six school-based occupational therapists. Findings pointed to two major categories of evidence, and an almost constant “reasoning in action” process where evidence was gathered through observation, oral reports and artifacts, and then used to make everyday intervention decisions in service of the client (Dougherty et al, 2015). This process of “building evidence” seemed different than the process mirrored in pyramids that critique research literature where evidence is valued more highly as it moves from qualitative research/expert opinion (lower level) to meta-analyses of randomized controlled trials (higher level). For the purpose of this inquiry, research and practice were viewed as two different cultures, and, given that occupations are defined in relation to their own culture, this question emerged: Will “evidence-building as an occupation” emerge differently from the cultures of practice and research? If so: 1) what might be the differences in form, function and meaning; and, 2) what might be the implications of such a concept?

A model shared by Bonder et al, 2004, describes three aspects of an emergent culture, namely embedded values, locales, and patterns of behavior (“talk” and “action”). These aspects guided a preliminary analysis of evidence and its processes from the perspectives of both research and practice, with results suggesting an occupation of evidence-building that is specific to its respective cultural aspects. The results of the cultural analysis, a proposed definition of evidence-building, and possible implications of such an occupation will be shared for discussion and vetting, and as possible first steps toward answering Hinojosa’s call for the creation of an evidence-based philosophy that is reflective of our profession (Hinojosa, J., 2013).

This paper supports the mission of SSO in that it views evidence and evidence-based practice through an occupational lens. In doing so, it is informed by several bodies of literature: evidence-based practice; clinical reasoning; expertise; and, knowledge translation. This comprehensive, occupational view of evidence has the potential to build bridges of understanding between practice and research, and inform educational approaches for future students.