1. Graduated Critical Appraisal in AT Education John T. Parsons, MS, ATC, AT/L Tamara Valovich McLeod, PhD, ATC, AT/L A.T. Still University

3. ASSIGNMENT CONTEXT

9. Patient-Oriented Evidence That Matters (POEM)

10. (Hurwtiz et al, JBJS , 2000) Common Problem Uncommon Problem Patient-Oriented Evidence Best Best source of POEMs Relevance: I Only if Time May not be relevant to everyday practice Relevance: II Disease-Oriented Evidence Danger Can be misleading Relevance: III Worst Read only if extremely interested Relevance: IV

13. ASSIGNMENT STRUCTURE

16. Grading Form

17. AT 5070

18. Later Assignments

19. Annotation Clinical Relevance Clinical Question LOE Analysis “ Bottom Line” Patient Education Critical Appraisal AT 5070 AT 5120 AT 5220

21. Clinical Question Citation Problem & purpose Methods & results LOE, applicability, & patient education

22. Annotation Clinical Relevance Clinical Question LOE Analysis “ Bottom Line” Patient Education Critical Appraisal AT 5070 AT 5120 AT 5220

23. CRAFTING A CLINICAL QUESTION

25. If Well-Formulated. . .

26. P I C O ATIENT NTERVENTION OMPARISON UTCOME

32. (Melnyk & Fineout-Overholt, 2005)

33. LEVELS OF EVIDENCE

36. SORT Ebell et al, Am Fam Phys , 2004

37. SORT

38. AAOS

39. Anecdotal Animal / Bench research Unpublished clinical observations Case series Poorly designed cohort / case-control Case-control Cohort Well-designed RCTs / prospective studies Level 5 Level 4 Level 3 3a: SR of case-control studies 3b: Individual case-control Level 2 2a: SR of cohort studies 2b: Individual cohort studies 2c: Outcomes research Level 1 1a: SR of RCTs 1b: Individual RCTs 1c: All or none studies

40. Annotation Clinical Relevance Clinical Question LOE Analysis “ Bottom Line” Patient Education Critical Appraisal AT 5070 AT 5120 AT 5220

41. CRITICAL APPRAISAL

42. Why Appraise? Current Literature Quantity concerns Quality concerns

48. STUDENT BEHAVIORAL MARKERS

49. Student Evaluations: From Class 2005-2006

50. Student Evaluations From Class 2006-2007

55. http://clinques.nlm.nih.gov/JitSearch. html The ClinicalQuestions Collection is a growing repository of questions that have been collected from healthcare providers in clinical settings across the country. The questions have been submitted by investigators who wish to share their data with other researchers. http ://www.cebm.utoronto.ca / Main CEBM site http ://www.pedro.fhs.usyd.edu.au/scale_item. html PEDro http ://ebmlibrarian.wetpaint.com / EBM Librarian - has info on appraisals and CATS http://www.cche.net/usersguides/ebm.aspHas info on the Users' Guides http ://pubs.ama-assn.org/misc/usersguides. dtl Users' Guides http ://www.ebmny.org/cats. html CATS http ://www.otcats.com / OT CATS