Article

Multiple ways of knowing: Teaching research under EPAS 2015

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Abstract

Educational Policy and Accreditation Standards (EPAS) 2015 add new research requirements focusing on multiple ways of knowing and culturally informed approaches to knowledge building. These new requirements link to indigenous ways of knowing that orient the worldviews of many non-Western cultures. This article identifies key issues that distinguish culturally informed approaches to knowledge building from Western approaches. It provides an overview of a range of indigenous and culturally informed research principles. Two reflective examples of why and how these culturally informed methods are important to high-quality research are also presented. The examples show how different ways of knowing add to understanding and may enhance research usefulness.

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This chapter explores EBP from three different perspectives: first, its application in practice decision-making; second, its use in defining health-care policy, costs, and administrative practices; and third, its impact on privileging certain research methods and research funding. EBP was initially developed to bring research evidence into treatment planning before treatments were begun, yet it has become a means to reshape professional autonomy and instead prioritize administrative authority. Research funding has also, and usefully, been shifted to support the knowledge base of EBP. At the same time, other types of research—qualitative, indigenous, and even exploratory and descriptive studies—have received lesser funding and have been somewhat delegitimatized by EBPs’ emphasis on experimental research outcomes. The EBP model, intended to support client decision-making, has often become bureaucratically standardized at policy and administrative levels.
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This chapter explores opportunities and challenges in teaching evidence-based practice (EBP) and in supervising EBP in clinical practice. While support for teaching EBP is apparent, educators, administrators, and supervisors often work from different definitions of EBP and understand it in dissimilar ways. Educators and supervisors often conflate EBP with empirically supported treatments (ESTs), removing both client and clinician from their teaching emphasis. The complexity of practice is often standardized, omitting issues of human diversity, unique personal histories, and limitations of available resources. Suggestions for teaching and supervision are offered. Professional organizations endorse EBP but lack clear plans for promoting it in education and supervision.
Chapter
The EBP practice decision-making process is implemented in six steps. This chapter outlines each of these six steps and their purposes. Following a thorough assessment, Step 1 is to identify practice information needs based on the assessment, Step 2 is to efficiently locate relevant information, Step 3 is to evaluate its quality and relevance to the specific client, Step 4 is to actively and collaboratively discuss the best available research results with the client, Step 5 is to collaboratively finalize a treatment plan, and Step 6 is to implement the treatment. The PICOT model, another model to conceptualize the clinician’s role in EBP, is also explicated. The hierarchy of research evidenced, drawn from evidence-based medicine, is introduced. The different logic and methods of EBP and of practice evaluation are examined. Resources for locating practice research are introduced. A clinical case example of the EBP process is provided.
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