The Chaeli Campaign Journal Club: Strengthening evidence-based practice and contributing to practice-based evidence in under-resourced South African communities

Background

The Chaeli Campaign is a Cape Town based non-profit organisation offering programmes largely for children and youth with disabilities in diverse under-resourced communities in South Africa. Their therapy team established a Health Professions Council of South Africa accredited interdisciplinary journal club in January 2012, with the aim to improve the team's service to the community.

Objectives

Our first objective was to make our practice more evidence-based through reading systematically and critically in our field. Our second objective was to write up and share some of our practices to contribute to the generation of practice-based evidence.

Method

First-person action research was applied. The core group of participants over time comprised two occupational therapists, one physiotherapist, two speech therapists, two teachers and four community development workers. Nine iterative cycles of planning, action, review and revised planning have been implemented on an annual basis in this non-formal, long-term action research project.

Results

For over nine and a half years we have pre-read, discussed and completed evaluation questionnaires on 54 peer-reviewed journal articles, conducted 12 conference presentations and published three articles in accredited journals. Participants reported a broadened understanding of issues around disability, more reflective, contextually and culturally appropriate practice and improved interdisciplinary teamwork.

Conclusion

The Chaeli Campaign journal club has built the capacity of therapists, teachers and community development workers to find, read, evaluate and use research evidence to improve their practice. It has also given participants the opportunity to ethically research, present and write up their grass roots interventions, thus contributing to locally applicable practise-based evidence. It is hoped that the sharing of our experience will assist and encourage other teams to start interdisciplinary journal clubs as a step towards facilitating two-way knowledge translation from evidence to practice and from practice to evidence.

Expert opinions on knowledge-translation interventions for occupational therapists working with neonates in South Africa: A Delphi study

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Contribution

Evidence-based practice and clinical reasoning in occupational therapy: A cross-sectional survey in Chile

INTRODUCTION

Evidence-based practice (EBP) is a critical framework for supporting clinical decision-making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline-specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non-English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision-making.

METHODS

A cross-sectional online survey of Chilean occupational therapists included socio-demographic information, closed questions using a fivepoint Likert scale and open-ended questions. Numerical data were summarised using frequencies and percentages. Cross-tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis.

RESULTS

Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision-making.

CONCLUSION

Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP.