Title: Making decision-making visible- teaching the process of evaluating interventions

Abstract

Significant educational efforts to increase evidence-based practice have emphasized increasing knowledge, however these efforts have had minimal effect on sustained engagement of working healthcare professionals. Critically, many new interventions with limited evidence of effectiveness continue are readily adopted-indicating that openness to change is not the problem. The selection of an intervention is the outcome of an elaborate and complex process, which is shaped with how they represent the problem and their knowledge. This process is mostly invisible to others. An alternative strategy for increasing EBP use is to teach healthcare professionals to make visible to themselves, explicitly teaching how to develop an evidence-informed cognitive model, and explicitly teach the thinking process of deciding how to assess and provide a specific intervention with clients (See figure 1: the simple view of intervention selection). This complex thinking process has many places where errors in thinking can lead to adverse decisions. However, it also identifies where specific EBP activities are implemented to be able to make quality decisions and not just when confronted with a clinical dilemma. The objective of this presentation is to: a) explain why teaching how students develop richer cognitive model increases their implementation of EBP activities; b) explain how developing an evidence-informed cognitive model of client problems improves heuristic reasoning, and c) describe the criteria which can be used to understand and integrate new interventions with previous strategies. Making the process visible to clinicians/students increases the skills required to judiciously select one intervention over others.