Reconfiguring evidence-based practice for occupational therapists

Aims: Evidence-based practice is an approach to clinical decision making which combines the best available evidence with individual patient care. Debate as to what makes good evidence and how this should be applied in practice as well as ambiguity about the meaning of evidence-based practice and concern regarding its confl ict with other models of occupational therapy, have created uncertainty for occupational therapists attempting to become ‘evidence-based’. The aim of this study was to explore the meanings attributed to evidence-based practice by occupational therapists and to propose a defi nition and framework of evidence-based practice that refl ects participants’ perceptions. Method: A mixed methodology qualitative design incorporating focus groups, in-depth interviews and observation was used to explore perceptions of evidence-based practice by occupational therapists at one setting in England. Findings: The fi ndings indicate that evidence-based practice is typically associated with use of research but that this is only partially relevant to occupational therapy and the treatment of individuals. A defi nition of and framework for evidence-based occupational therapy which refl ects these fi ndings is presented. Conclusion: Acknowledgement of a range of evidence, from research fi ndings to clients’ selfreports, corresponds with participants’ conception of clinical reasoning as a complex process that takes multiple factors into account. This, together with participants’ client-centred approach and emphasis on the human experience of health encounters, forms the basis of a reconfi guration of evidence-based occupational therapy.