Session Information
04 SES 03 B, The Skilled Practitioner
Paper Session
Contribution
In 1997 Sackett argued that evidence-based practice involves “the integration of clinical expertise, patient values, and the best evidence into the decision-making process for patient care.” Whilst there is some agreement about what constitutes the “gold standard” with respect to evidence and a level of consensus in theory, if not in practice, that client (family) values should drive interventions in early intervention, what constitutes clinical expertise is less clear. Defining what this entails is critical if the expertise and wisdom of the experienced and highly skilled practitioner are to be fully utilised and valued. Furthermore, the processes through which clinical expertise comes to influence practice need also to be identified. It is this with which this paper is concerned.
The project is aiming to explore the understandings of practitioners and researchers working in Australia, Canada and the United States of practice-based evidence. Specifically, they have been asked to consider:
1. What characterises the expert practitioner?
2. What makes their practice worth emulating?
3. What is meant by practice-based evidence?
4. Through what processes does expert practice inform intervention?
5. What weightings are given to “best evidence”, practitioner expertise and client values in determining practice?
Method
Expected Outcomes
References
Barkham M. & Mellor-Clark J. (2000) Rigour and relevance: the role of practice-based evidence in the psychological therapies. In: Evidence Based Counselling and Psychological Therapies: Research and Applications (eds N. Rowland & S. Glass) London: Routledge. Dollaghan, C. (2007). The handbook of evidence-based practice in communication disorders. Baltimore, MD: Paul H. Brookes. Dreyfus HL, Dreyfus SE. Mind Over Machine: The Power of Human Intuition and Expertise in the Era or the Computer. New York: The Free Press; 1986. Dreyfus, H. L., & Dreyfus, S. E. (2005). Expertise in real world contexts. Organization Studies, 26, 779-792. Ericsson, K. A., Charness, N., Hoffman, R. R., & Feltovich, P. J. (2006). The Cambridge handbook on expertise and expert performance. Cambridge, UK: Cambridge University Press. Haynes, R. B., Devereaux, P. J., & Guyatt, G. H. (2002). Clinical expertise in the era of evidence-based medicine and patient choice. Evidence-Based Medicine, 7, 36–38. King, G., Bartlett, D. J., Currie, M., Gilpin, M., Baxter, D., Willoughby, C., et al. (2008). Measuring the expertise of pediatric rehabilitation therapists. International Journal of Disability, Development and Education, 55, 5–26. Norman, G., Young, M., & Brooks, L. (2007). Non-analytical models of clinical reasoning: The role of experience. Medical Education, 41, 1140–1145. Schmidt, H. G., & Rikers, R. M. J. P. (2007). How expertise develops in medicine: Knowledge encapsulation and illness script formation. Medical Education, 41, 1133–1139. Schon, D. A. (1983). The reflective practitioner. New York: Basic Books.
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