Evidence-based practice (EBP) is an example of a life-long learning process; an approach to creating and sustaining a competent environment in the health care workplace. It can be viewed as a rigorous educational journey within which occupational therapists' and occupational therapy assistants' pursuit of the best practice occurs through the integration of clinical research and clinical reasoning. It is a mandate for improving clinical decisions in health care (Holm, 2000). This research integration can be described as orderly and stimulating; however, at times it also can be confusing and demanding. Practitioners using evidence to pursue best practice must integrate the research evidence found in the literature with institutional and personal expertise as well as with the client's preferences and values (Haynes, Sackett, Gray, Cook, & Guyatt, 1996). This article contains practical and simplified information to support and guide occupational therapists and occupational therapy assistants in the use of EBP. A self-assessment exam at the end of the article evaluates one's ability in EBP, helping to raise awareness and performance in skills using EBP.

Occupational therapy in the public schools must be responsive to the mission, culture, and philosophies of public education as expressed in thousands of school districts across the nation. Practice in the schools must be in compliance with the mandates of the Individuals with Disabilities Education Act of 1997 (Pub. L. 105-17) and other federal and state laws, and must reflect the use of evidence-based interventions to support students in their educational role. An understanding of educational theory as operationalized in the classroom and throughout the entire school must be used when designing and implementing intervention to meet student needs. An area of high interest to educators and occupational therapists, issues of sensory modulation and its effects on the student role are used to illustrate these concepts and to provide examples of applying these concepts in educational environment.

A shift to an evidence-based practice (EBP) model and the development and use of best-practice guidelines have been identified as the means to accomplish quality health care outcomes while maintaining fiscal responsibility. In this article, we propose a generic framework for adopting and implementing EBP and outcome management in various occupational therapy settings. Two general types of outcomes are identified as key to outcomes management: clinical and system outcomes. Strategies on how to evaluate these outcomes are discussed.

Evidence-based practice resources through AOTA or federally sponsored programs offer information that can strengthen your practice and can be confidently shared with your consumers and colleagues.

Applying evidence-based practice takes time but may be easier to achieve than you realize.

Summary: To ensure the future of the profession, practitioners need to foster relationships among education, practice, and research. The author describes ways to facilitate the growth of evidence-based practice to enhance intervention, payment, and client satisfaction.

Occupational therapists have used brushing as an intervention technique for many years. More recently, the Wilbarger Protocol has been used by pediatric occupational therapists who use a sensory integrative framework within occupational therapy. Specifically, this protocol has been recommended for use with children who have sensory modulation dysfunction (SMD) with manifestations of over responsiveness to sensory stimuli, also called sensory defensiveness. This article reviews relevant literature, provides an overview of some of the issues surrounding the application of this intervention technique, and provides strategies for applying this material to clinical practice. Implications for future research are discussed.

Adults with serious mental illness (SMI) face many barriers to employment, yet many of these individuals want to work. Recent years have brought about notable advances in the development and dissemination of vocational rehabilitation services for adults with SMI. Supported employment is now considered an "evidence-based" practice for people with SMI. Unfortunately, many adults with SMI do not have access to state-of-the-art employment services. Occupational therapists and occupational therapy assistants work with adults with SMI in both hospital and community-based mental health settings; many of our clients identify employment as an important life goal. Occupational therapy practitioners need to be knowledgeable of the core principles of evidence-based employment services, and of the intervention models that exist, in order to best support clients in achieving their employment goals.

Holm, MB. (2001 Jul 2). The 2000 Eleanor Clarke Slagle Lecture: Our mandate for the new millennium: Evidence-based practice. OT Practice, 6, CE-1 - CE-16.

The health care environment of the past quarter century went through numerous evolutionary processes that affected how occupational therapy services were provided. The last iterations of these processes included requests for the evidence that supported what we were doing. The 2000 Eleanor Clarke Slagle Lecture (a) examines the strength of the evidence associated with occupational therapy interventions -- what we do and how we do it, (b) raises dilemmas we face with our ethical principles when some of our practices are based on limited evidence, and (c) proposes a framework of continued competency to advance the evidence base of occupational therapy practice in the new millennium.

How does one actually use evidence-based practice in day-to-day interventions? The answer may be easier than you think.

Law, M. (2000 Aug 28). Evidence-Based Practice: What Can It Mean for Me? OT Practice, 5, 16-18.

The term evidence-based practice is widely used, but often misunderstood. Mary Law offers a practical definition and demonstrates how to build evidence into your daily practice.

Peterson, EW. (2003 Feb 10). Evidence-based practice: Case example: a matter of balance. OT Practice, 8, 12-14.

Clinicians engage in evidence-based practice when they make informed decisions based upon the information available. UIC students' success in implementing A Matter of Balance at the Ogden Senior Center attests to benefits of applying research in day-to-day practice.

Schindler, V, Laguardia, R, Melchiorre, S, & Bailey, H. (2004 Nov 29). Role development: an evidence-based intervention to develop roles and skills in clients with mental illness. OT Practice, 9, 16-20.

Summary: Role development is a set of guidelines for practice that can improve outcomes by helping clients develop successful social roles.

Strzelecki, MV. (2006 Jun 26). Evidence-based practice: facts and flexibility. OT Practice, 11, 16-19.

Ways to use evidence to enhance your practice.