Podiatry Study Guide Study Guide: Keenan, A.M.,

Podiatry Study Guide

Study Guide:

Keenan, A.M., and Redmond, A.C. (2002). Integrating research into the clinic: What evidence-based practice means to the practising podiatrist. Journal of the American Podiatric Medical Association 92(2), pp. 115-122.

Podiatrists must be discerning as they keep current with the literature to best meet the needs of their patients as well as requirements by administering bodies such as private health insurance agencies; recent initiatives have attempted to integrate research with clinical practice since many practitioners often felt that research was too academic with little practical application to patient care.

Evidence-based practice (EBP) requires practitioners to develop skills needed to critically evaluate information presented in journals and make intelligent decisions about whether the new information should inform one's practice.

Traditionally, practice has been informed by:

life experience, medical education, clinical experience, and a combination of anecdotal and data-oriented evidence.

This eclectic base forms a foundation for tradition and custom, not necessarily adoption of best practices.

Clinical decision-making is a complex process that includes knowledge, guidelines and ethics.

Within these three categories are additional factors entering into clinical decisions, including:

evidence (patient data, basic research, randomized clinical trials, and systematic reviews),

patient and clinician factors (cultural beliefs, personal values, experiences and education) and constraints (formal policies, community standards, time and reimbursement).

Decision-making skills are enhanced with experience, diagnostic accuracy, personal development (e.g., development and enhancement of technical and communications skills, development of personal characteristics such as empathy, and critical reasoning and reflective reasoning skills), access to and interpretation of knowledge, and consideration of the individual needs of patients.

Current trends in practice may assist with clinical decision-making, including increased familiarity with the research process, awareness of the hierarchy of research methods, development of basic strategies for reviewing the literature, regular reading of relevant journals, avoiding trends, continual evaluation and enhancement of one's own clinical decision-making, and reflection and monitoring of one's own practices.