Recommendations for Infusing Evidence Into Continuing Education Course Content

It is the position of the American Speech-Language-Hearing Association (ASHA) that audiologists and speech-language pathologists incorporate the principles of evidence-based practice (EBP) in clinical decision making to provide high-quality clinical care. Evidence-based practice refers to an approach in which current high-quality external scientific evidence is integrated with practitioner clinical expertise/expert opinion and client/patient/caregiver preferences and values in clinical decision making.

Continuing education events are the primary source for professionals to obtain information about current theory, methods, and practice. Therefore, the ASHA Continuing Education Board encourages ASHA Approved CE Providers and other course presenters and planners to incorporate current, high-quality external scientific evidence, practitioner clinical expertise/expert opinion, and client/patient/caregiver preferences and values into continuing education course content. In this way, CE providers can further the growth, awareness, and inclusion of EBP in the field of speech-language pathology and audiology.

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 sources for evidence to help develop content and practice recommendations related to the topic and learning outcomes.

Scientific evidence (e.g., meta-analysis, systematic reviews, individual studies)
Practitioner clinical expertise/expert opinion (e.g., published clinical practice guidelines)
Client/patient/caregiver preferences and values (e.g., validated questionnaires or health-related inventories/surveys, observations of study subjects and clients undergoing routine or experimental therapy/clinical care practices)

4. Evaluate the validity, clinical relevance, and applicability of the evidence.

5. Include the following three evidence areas when developing and presenting the course.

Not all items will apply to every presentation, and there may be overlap of presentation types.

Scientific Evidence

When peer-reviewed empirical evidence exists (e.g., published books, journal articles, etc.), recommended activities include:

Present general steps of the approach or theoretical framework
Talk about peer-reviewed research that supports or contradicts the focus of the course content
Identify the level of evidence
Provide a description of study subjects (i.e., number, age, characteristics)
Describe the data collection processes
Summarize the results, outcomes, and practice applications
Describe strengths and limitations of the evidence
Discuss areas for future research

When original research findings or findings from published literature are available (e.g., reports of empirical investigations, systematic reviews, meta-analyses, consensus statements, clinical practice guidelines, quality improvement data) recommended activities include:

Present historical foundations for the approach
Identify the level of evidence
State specific objectives/questions
Report on the population(s)/group(s) to which the findings apply
Report on the method and data analysis used, including validity, reliability, and attempts to control for subject bias
Report on the outcomes from research, including clinical relevance and/or statistical significance
Describe strengths and limitations of the evidence

Practitioner Clinical Expertise/Expert Opinion

When peer-reviewed empirical evidence is limited or lacking, but the approach/treatment is supported by practitioner/expert opinion (e.g., published literature by a practitioner, historical, presentations or lectures by a practitioner and/or associated), recommended activities include:

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.
Describe the data collection processes used to determine the effectiveness of the approach.
Describe the population, include demographic information.
Identify potential risks or adverse consequences in addition to potential benefits.
Address potential practice, ethical, or legal consequences and issues
Remind people of the lack of peer-reviewed empirical evidence
Describe study subjects and clients undergoing routine or experimental therapy/clinical care practice.

When federal, state, professional, institutional, or regulatory policies are applicable (e.g., historical or current policies published by ASHA and other federal, state, and professional agencies), recommended ativities include:

Describe the legal foundations and precedents for the issue.
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 this policy.
Describe political influences on the policy.
Describe scope of practice, licensure, or other regulatory issues.

Preferences and Values of the Patient/Student and Family/Caregiver

When information on preferences and values of the patient/student and family/caregiver are available (e.g., outcomes from questionnaires, including patient/student/family/caregiver self-report, as evidenced by voice recordings or videotaped or live participation in course presentations), recommended activities include:

Describe validated questionnaires or health-related inventories/surveys.
Report on observations of study subjects and clients undergoing routine or experimental therapy/clinical care practices.
Provide information from interviews of the patient/student and family/caregiver.
Describe how preferences and values are incorporated in total patient/student care.
If possible, use patients/students and family/caregivers as presenters of information in the course.

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