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Occupational Therapy - Dallas

Occupational therapy research guide for TWU Dallas students, faculty and staff.

What is Evidence Based Practice?

There are a lot of different definitions regarding what EBP is, simply put it is a combination of:

  • scientific research
  • clinical expertise 
  • patient preferences.

Venn diagram of evidence based practice

Evidence based practice combines hard objective research with clinician expertise and patient preference creating a holistic method of treatment greater than the sum of its parts. As new scientific studies discover better treatments, this model represents an evolving and ever improving way to improve practice methods and approaches to patient care.

Sackett's 5 Steps to EBP

Sackett defines the 5 steps to the EBP process as follows. His full article on the subject may be viewed here:

5 steps to EBP

  1. Assess
    Assess the situation, can improvements be made to the current method of treatment for a patient?
  2. Ask
    Formulate a clear and detailed question using the PICO(t) format.
  3. Acquire
    Consult your librarian for the best possible evidence from high quality, peer-reviewed sources
  4. Appraise
    Evaluate the evidence for quality using critical appraisal tools 
  5. Apply
    Apply the information in combination with clinical experience and patient values

EBP pyramid

The EBP pyramid is a visualized representation that depicts the quality level of a particular type of evidence--the higher on the pyramid it features the better the quality. One word of warning to the wise though, people are fallible and even though a systematic review or meta-analysis may feature at the top of the pyramid--if it is poorly researched and written a well executed lower level of evidence can prove better.

Evidence based Practice pyramid of evidence



In order to get the best answers it is important to ask the right questions!!!

The universally accepted way to do this in healthcare is to use the PICO(t) acronym.

Picot diagram


PICOT can be used to answer a variety of different types of question:

PICOt question type grid