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York EBSC NSCA July 2009


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Presentation to NSCA conference in Las Vegas July 2009 on a practical, evidence-based approach to strength and conditioning.

Presentation to NSCA conference in Las Vegas July 2009 on a practical, evidence-based approach to strength and conditioning.

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  • 1. A Practical, Evidence-Based Approach to Strength and Conditioning NSCA 32nd National Conference July, 2009 Ann M. York, PhD
  • 2. NSCA Mission Statement • “As the worldwide authority on strength and conditioning, we support and disseminate research- based knowledge and its practical application to improve athletic performance and fitness.” • “Bridging the gap between science and application.”
  • 3. Objectives • Define the process of evidence-based practice (EBP). • Discuss the challenges to EBP or EBSC • Identify some reasonable approaches to EBSC. • Leave with specific strategies and tactics to implementing EBSC.
  • 4. JASPA* Quiz
  • 5. JASPA = Journal Associated Score of Personal Angst • 0 = outlier • 1-3 = normal range • >3 = at risk for polythenia gravis and related conditions • Polythenia gravis: increasing sense of guilt and inadequacy associated with an inability to keep up with the journals. • Related condition: increased fall risk associated with tripping over piles of unread journals.
  • 6. Evidence-Based Approach “Evidence does not make decisions, you do!”
  • 7. Leaks in the Evidence-Based Knowledge Pipeline Aware Accept Target Doable Recall Agree Done Valid Research Strauss, Richardson, Glasziou &Haynes (2005)
  • 8. From EBP to EBSC…. • Consistent evidence of failure to translate research findings into clinical practice ▫ 30-40% patients do not get treatments of proven effectiveness ▫ 20–25% patients get care that is not needed or potentially harmful • What’s happening in the strength and conditioning realm? Schuster, McGlynn, Brook (1998). Milbank Memorial Quarterly Grol R (2001). Med Care
  • 9. Pressures Slowing Growth of EBP
  • 10. What is evidence worth? Usefulness = Validity X Relevance Work Strauss, Richardson, Glasziou & Haynes (2005)
  • 11. Why Bother with EBSC? Motivation: Who are you? • Client expectation • Doer (researcher/teacher • Competitive advantage • User (coach/trainer) • Lifelong learning • Replicator (gurus are • Satisfaction, pride good enough for you). • Ethical thing to do • Contribution to the profession • Professional development
  • 12. Cycle of EBSC
  • 13. Step 1: Asking a question • Background questions ▫ general: who, what, where, why, how • Foreground or PICO questions ▫ specific: questions on managing clients Foreground Questions Background Questions Less Experience More
  • 14. PICO Questions • P: person/problem • I: intervention • C: comparison • O: outcome
  • 15. What questions to ask? • Most common scenarios • Unique situations • Desire to become an expert • Curiosity • The more specific the question, the better.
  • 16. Step 2: Acquiring the Evidence • How much time do you want to spend? • What databases to you have access to? ▫ Online versus paper ▫ PubMed ▫ Ebsco ▫ Professional membership • What is your skill level at searching? • Think QUALITY of evidence!
  • 17. Evidence Pyramid Synopses Meta-Analysis Systematic Review Randomized Controlled Trial Cohort studies Case studies Basic/Bench Research Editorials/Gurus/Colleagues
  • 18. Narrative v. Systematic Reviews Narrative Systematic • No systematic • Rigorous methodology methodology • Focused research question • Tend to be broad • Search strategy developed • Potential for author’s bias • Inclusion/exclusion criteria • References gathered ad for references hoc • Quality assessment • Qualitative approach • Quantitative approach Qualitative Quantitative
  • 19. Evidence Information Management Push Technology • RSS Feeds* • PubMed saved searches* • Email alerts* Pull Technology • Specific searches for questions • Databases/publications/other resources Storage Technology • RefWorks, Endnote • Zotero,* Delicious,* Evernote* *Free!
  • 20. RSS Feeds + iGoogle = Efficiency How to use RSS feeds tutorial:
  • 21. Step 3: Appraise • Most traditional EBP training occurs at this step • Yet it is time consuming/intimidating • Many do not have skill or time to appraise well… • Solution?
  • 22. Let others do the first appraisal HIGH QUALITY Pre-appraised evidence ▫ Systematic Reviews (Cochrane, PubMed) ▫ Evidence summaries ▫ Professional organization guidelines BUT first you must ASK a good question and ACQUIRE the summaries!
  • 23. Then do your OWN appraisal: • Is the evidence source high quality? • Does it apply to my client? • Is it useful? • Does this fit with client goals/preferences?
  • 24. Step 4: Apply the Evidence “Evidence does not make decisions, you do!”
  • 25. Step 5: Assess • What worked? • How did this benefit your client? • What more do you want to know? • Do you have information to share?
  • 26. Summary • What role can EBSC play in your career? • What is your strategic plan of EBSC? • What tactics can you use to achieve this plan? List 3
  • 27. If you only have…. • 1 minute: Write a PICO question • 5 minutes: Set up an RSS feed, run a quick search. • 1 Hour: Read a study in depth, discuss a study with a colleague, watch a free online tutorial, explore a new database.
  • 28. Objectives Reveiw • Define the process of evidence-based practice or EBSC. • Discuss the challenges to EBSC. • Identify some reasonable approaches to EBSC. • Leave with specific strategies and tactics to implementing EBSC.
  • 29. Resources No doubt I will add to these slides. Updates, additional references, and EBP resources can be found at: NSCA EBSC Pageflake:
  • 30. Selected References • Davis, J. (2007). Evaluating education in evidence-based practice. JAMA: The Journal of the American Medical Association, 297(1), 39. • Guyatt, G., & Rennie, D. (Eds.). (2002). Users' guides to the medical literature. Chicago, Ill.: AMA Press. • Ho, P.M., Peterson, P.N., & Masoudi, F.A. (2008). Evaluating the evidence: Is there a rigid hierarchy? Circulation, 118, 1675-1684. • Shaneyfelt, T., Baum, K. D., Bell, D., Feldstein, D., Houston, T. K., Kaatz, S., et al. (2006). Instruments for evaluating education in evidence-based practice: A systematic review. JAMA: The Journal of the American Medical Association, 296(9), 1116-1127. • Slawson, D. & Shaughnessy, A.F. (2005). Teaching EBM: Should we be teaching information management instead? Academic Medicine, 80 (7), 685-689. • Strauss, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). Evidence-based medicine, how to practice and teach EBM. (3rd ed.). Edinburgh: Elsevier.
  • 31. Contact Information Ann M. York, PhD Associate Professor Master of Health Care Administration Program College of Health Sciences Des Moines University 3200 Grand Ave Des Moines IA 50325 515-271-1641
  • 32. Questions?