Recommendations for Infusing Evidence Into Continuing Education Course Content

Evidence-based practice (EBP) is the process of applying current, best available evidence (external and internal scientific evidence), client/patient/student/consumer/care partner perspectives (referred to as “client perspectives” throughout the rest of this document), and clinical expertise to the decisions that you make about the care of the individuals you treat.

Continuing education (CE) events are the primary source for professionals to obtain information about current theory, methods, and practice. Therefore, ASHA Approved CE Providers—and other course presenters and planners—are encouraged to incorporate current, best available evidence (external and internal scientific evidence), client perspectives, and clinical expertise into CE course content. In this way, CE providers can further the growth, awareness, and inclusion of EBP in the professions of audiology and speech-language pathology.

What Is Evidence-Based Continuing Education?

In evidence-based continuing education sessions, the presenter provides

• the current, best available scientific evidence to support or refute clinically relevant information—such as theoretical concepts; normative data; population characteristics; accuracy of diagnostic tools; efficacy of a particular practice, strategy, device, or service delivery model; and/or the influence of culture and language;
• suggestions for collecting internal evidence on individual clients (e.g., baseline data, observations, progress monitoring);
• information about their clinical expertise, expert opinion, and experience in this topic area; and
• information related to considering and incorporating client perspectives (e.g., values, needs, priorities, cultural considerations).

What Is the Importance of Infusing Evidence Into Course Content?

Infusing evidence into your course content benefits the participant in several ways. These courses provide

• the “why” of the content and the “who may benefit” of the content’s impact—to make the implications for practice obvious;
• the degree of scientific evidence that is available to guide practice and highlight where further research is needed;
• references for all content and clinical recommendations; and
• evidence for clinical recommendations that are ethically supportable (DePalma, 2007).

Steps to Consider in CE Course Development

1. Work with an ASHA Approved CE Provider or course developer to confirm learner needs.
2. Develop learning outcomes for the presentation/course.
3. Search trustworthy sources for evidence to help develop content and practice recommendations related to the topic and learning outcomes.
4. Evaluate the validity, risk of bias, clinical relevance, study limitations, and applicability of the evidence.
5. Include the Evidence (external and internal), Clinical Expertise and Expert Opinion, and Client Perspectives when developing and presenting the course. In addition to identifying potential risks and adverse consequences, if any, here are some recommended approaches to discussing the evidence. Not all items will apply to every presentation, and presentation types may overlap.

Extrapolate From the Evidence (external and internal)

• • Present general steps of the approach or theoretical framework.
  • Present historical foundations for the approach.
  • Talk about peer-reviewed research that supports or contradicts the focus of the course content, and report on the state of the evidence as a whole.
  • State specific objectives/questions.
  • Identify the level of evidence.
  • Provide a description of study subjects (i.e., number, age, characteristics), and report on the population(s)/group(s) to which the findings apply. Note any gaps in the evidence for a particular population or client characteristic (e.g., included only men; lacked adults ages 50 years and older; failed to account for language differences, reading level, etc.).
  • Describe the data collection processes used.
  • Report on the method and data analysis used—including validity, reliability, and attempts to control for subject bias.
  • Summarize the results, outcomes, and practice applications—including clinical relevance and/or statistical
  • Describe strengths and limitations of the evidence.
  • Discuss study funding and financial considerations along with fidelity to the study design methodology and any reporting biases.
  • Discuss areas for future research.

Consider Your Clinical Expertise and the Expertise of Others

• • Provide general steps of the approach or theoretical framework.
  • Reference empirical research upon which the new approach or technique is based.
  • Report on policy papers that provide expert consensus.
  • Reference published literature—such as empirical research, theoretical work, or expert consensus—that may have influenced policy.
  • Report on data from institutions (e.g., schools, government or regulatory agencies) that influenced policy—such as Medicare claims.
  • Describe the influence of client advocacy on the development of policy.
  • Identify the historical and possible future directions for the policy.
  • Describe political influences on the policy.
  • Describe scope of practice, licensure, or other regulatory issues.

Incorporate Client Perspectives

• • Provide client characteristics—such as disorder, age, age of onset, language(s) used, baseline skills, and so forth—in a way that follows HIPAA, FERPA, and other privacy policies.
  • Describe validated questionnaires or health-related inventories/surveys.
  • Report on observations of study subjects and clients undergoing routine or experimental therapy / clinical care practices, and note any modifications or adjustments used to support the individual’s participation.
  • Include research studies directly investigating client perspectives and experiences with their condition and/or with a treatment or service.
  • Provide information from culturally responsive and trauma-informed interviews of the patient/student and family / care partner with their permission.
  • Describe how preferences and values are incorporated into total client/student care.
  • Address potential practice, ethical, or legal consequences and issues.
  • Consider the diversity reflected in the available evidence and whether it included a variety of perspectives and experiences. How do cultural and linguistic variations influence the acceptability of a treatment plan or its outcomes?
  • If possible, have patients/students and family / care partners as presenters of information during the course.

6. Provide references on slides or handouts and include a complete references list.

References cited in a presentation can be reviewed and considered at a future time to support or perhaps initiate change in clinical practice.

After finding and evaluating the evidence, the presenter should provide references to the audience to support what is being offered as it is being offered. That is, the presenter should provide a citation for each component that is included on the slides or handouts. A references list that is provided as a final slide—or that is provided to the audience but not integrated into the presentation as it proceeds—is not sufficient. Each piece of information on the slides should be directly hyperlinked its corresponding reference. This practice serves to educate the audience about EBP and allows them to return to the references, as needed, to expand their knowledge after the CE offering.

Guidance on How to Cite Your References

For style guidance and specific formatted examples of how to cite your references, see the links below.

• Reference examples from APA style
• APA Formatting and Style Guide (7th Edition) - Purdue OWL® - Purdue University