Questions about certainty and uncertainty in clinical practice.

Purpose: This article offers a critical response to Kamhi's (2011) essay regarding the need to balance certainty and uncertainty in evidence-based practice (EBP). Method: Points of concordance and discordance (counterpoints) between Kamhi's essay and the author's frames of reference were considered....

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Publicado en:Language, Speech & Hearing Services in Schools Vol. 42; no. 1; pp. 81 - 88
Autor principal: Nelson NW
Formato: commentary tables/charts Journal Article
Publicado: American Speech-Language-Hearing Association Jan2011
Acceso en línea:Ver este registro en EBSCOhost
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      pub: American Speech-Language-Hearing Association
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        10.1044/0161-1461(2010/09-0046)
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        atl: Questions about certainty and uncertainty in clinical practice.
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        au: Nelson NW
        affil: Western Michigan University, Kalamazoo.
      sug:
        subj:
          Uncertainty
          Decision Making, Clinical
          Speech-Language Pathologists
          Professional Practice, Evidence-Based
          Systems Theory
          Self-Efficacy
          Research Question
          Critical Thinking
          Validity
          Diffusion of Innovation
          Models, Theoretical Utilization
          Student Performance Appraisal
      ab: Purpose: This article offers a critical response to Kamhi's (2011) essay regarding the need to balance certainty and uncertainty in evidence-based practice (EBP). Method: Points of concordance and discordance (counterpoints) between Kamhi's essay and the author's frames of reference were considered. Results: In agreement with Kamhi, a major role is outlined for clinicians to use questions strategically (i.e., acting on uncertainty) to prioritize intervention targets and select approaches that best fit the context and stakeholders' values for purposes of planning, accomplishing, and evaluating change. The first counterpoint emphasizes a need for larger roles for theoretical frameworks involving systems theory and collaborative, contextualized approaches to assessment and intervention. The second notes opportunities for self-correction by using outcome data from relevant contexts outside of treatment sessions. Conclusion: Clinicians should capitalize on Kamhi's ideas by working with other key stakeholders to make points of certainty and uncertainty explicit. By generating insightful questions that can guide the process of EBP and gathering evidence from broader outcomes, clinicians can gain external validation for the approach taken or for the need to consider alternatives.
      pubtype: Academic Journal
      doctype:
        commentary
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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