CLINICAL AUDITS As part of the evidence-based cycle, clinicians should evaluate their own performance (35). Clinical audit is one of the main vehicles for implementing protocols into everyday practice (36), monitoring the results of effects to changes in practice (9) and to ‘benchmark’ standards in practice (7). Clinicians employed within the NHS are generally routinely monitored, audited, and critically appraised. However, clinicians working in private practice are often left to their own devices, thus, can potentially become more vulnerable to stagnation and loss in clinical performance.

CONCLUSION Evidence-based practice is here to stay; therefore clinicians need to understand the concept of EBP. Thereafter, they can begin to appreciate the clinical and economical benefits on offer, also, while realising the potential consequences associated with failure to apply it. Consideration must be given to the ever-expanding scholarly databases of research information and the continual changes in technology and protocols, not to mention the emphasis on more stringent legislation, civil cases of malpractice, and patients’ increasing demands and expectations. For the more vulnerable clinicians in private practice, a concerted and ongoing effort is needed to avoid becoming insular within a confined private clinic environment stagnated by lack of change. Finally, all clinicians must be proactive towards EBP, particularly CPD. In the future, simply complying with minimum standards may not be sufficient.

References: 1. Bannigan K. To serve better: Addressing poor performance in occupational therapy. British Journal of Occupational Therapy 2000;63(11):523-528 2. Alsop A. Evidence-based practice and continuing professional development. British Journal of Occupational Therapy 1997;60(11):503-550 3. Rosenberg W, Donald A. Evidence based medicine: an approach to clinical problem-solving. British Medical Journal 1995;310:1122-1126 4. Turner PA, Whitfield ATW. Physiotherapists’ reasons for selection of treatment techniques: A cross-national survey. Physiotherapy Theory and Practice 1999;15(4):235-246 5. Eakin P. The casson memorial lecture 1997: shifting the balance - evidence-based practice. British Journal of Occupational Therapy 1997;60(7):290-294 6. Sackett DL. Evidence-based medicine. Spine 1998;23(10):1085-1086 7. Turner PA, Harby-Owen H, Shackleford F, So A, Fosse T, Whitfield TW. Audits of physiotherapy practice. Physiotherapy Theory and Practice 1999;15:261-274 8. Druss B. Evidence based medicine: does it make a difference? Use it wisely. British Medical Journal 2005; 330: 92-94 9. Cape, J. (2000). Clinical effectiveness in the UK: Definitions, history and policy trends. Journal of Mental Health 2000;9(3):237-246 10. Bury T, Mead J. Evidence-based healthcare: a practical guide for therapists. Butterworth Heinemann 1998. ISBN 0750637838 11. Roberts S. Continuing professional development: what the future might hold. sportEX Medicine 2004;19:14-16 12. Coopey, M, Nix, MP, Clancy, CM. Translating research into evidence-based nursing practice and evaluating effectiveness. Journal Nurse Care Quality 2006;21(3):195-202 13. Turner PA. Evidence-based practice and physiotherapy in the 1990s. Physiotherapy Theory and Practice 2001;17:107-121 14. The Society of Sports Therapists’ Codes of Professional Conduct. Competences and scope of practice for sports therapy 2005 15. Rothstein JM. Outcomes and survival. Physical Therapy 1996;76(2):126-127 16. Humphris D, Littlejohns P, Victor C, O’Halloran P, Peacock J.

10

Implementing evidence-based practice: factors that influence the use of research evidence by occupational therapists. British Journal of Occupational Therapy 2000;63(11):516-522 17. Evrin NE. Clinical coaching: a strategy for enhancing evidence-based nursing practice. Clinical Nurse Specialist 2005;19(6):296-302 18. Bleakley C, MacAuley D. The quality of research in sports journals. British Journal of Sports Medicine 2002;36:124-125 19. Bleakley C, MacAuley D, McDonough S. Are sports medicine journals relevant and applicable to practitioners and athletes? British Journal of Sports Medicine 2004;38:541-548 20. Hoskins W, Pollard H. Hamstring injury management – part 2: Treatment. Manual Therapy 2005;10:180-190 21. Naylor CD. Grey zones of clinical practice: some limits to evidence-based medicine. Lancet 1995;345;840-842 22. Clark, N. (2004). Principles of injury rehabilitation. sportEX medicine 2004:19;6-10 23. The Chartered Society of Physiotherapists (CSP). Core Standards of Practice 2005 24. Steves R, Hootman JM. Evidence-based medicine: what is it and how does it apply to athletic training? Journal of Athletic Training 2004;39(1):83-87 25. Barnett M. Caring for a patient with COPD; a reflective account. Journal of Nursing Standard 2005;19(36):41-46 26. Grant A, Dornant TL. What is a learning portfolio? Journal of Diabetic Medicine 2001;18:1-4 27. Donaghy ME, Morss K. Guided reflection: A framework to facilitate and assess reflective practice within the discipline of physiotherapy. Physiotherapy Theory and Practice 1999;16:3-14 28. Wyatt JC, Sullivan F. Keeping up: learning in the workplace. British Medical Journal 2005; 331:1129-1132 29. Cayne JV. Portfolios: a developmental influence? Journal of Advanced Nursing 1995;21:395-405 30. Herbert R, Jamtvedt G, Mead J, Hagen KB. Outcome measures measure outcomes, not effects of intervention. Australian Journal of Physiotherapy 2005;51:3-4 31. Finch E, Brooks D, Stratford PW, Mayo NE. Physical rehabilitation outcome measures: A guide to enhanced clinical decision making, (2nd Edition). Lippincott, Williams & Wilkins 2002. ISBN 0-7817-4241-2 32. Liebenson C, Yeomans S. Outcome assessment in musculoskeletal medicine. Manual Therapy 1997;2(2):67-74 33. Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: Which are reliable and valid? Archive Physical Medicine and Rehabilitation 2004;85:815-822 34. Binkley JM, Stratford PW, Lott SA, Riddle DL. The lower extremity functional scale (LEFS): Scale development, measurement properties, and clinical application. Physical Therapy 1999;79(4):371-383 35. Straus SE, Sackett DL. Using research findings in clinical practice. British Medical Journal 1998;317:339-342 36. Buttery Y. Implementing evidence through clinical audit. In: T Bury, J Mead (eds). Evidence-based healthcare: a practical guide for therapists. Butterworth Heinemann 1998. ISBN 0750637838

THE AUTHOR

Nick originally trained as a sports masseur and later qualified as an osteopath before completing a BSc (Hons) in sports therapy, gaining a first class degree. Over the years Nick has

worked as team masseur to the GB and England cycling teams, covering both domestic and overseas events. Nick has been a keen athlete, competing in running and cycling events at all levels, culminating in winning the national cyclo-cross series. Nick is a part-time tutor at the Northern Institute of Massage (NIM). Specialist workshops include: i) Electrotherapy, ii) Lower limb biomechanics and orthotic prescription. Nick is a visiting lecturer at Teesside University and has carried out consultancy work for the University of Central Lancashire.

sportEX dynamics 2008;17(Jul):8-10