Reviewing and Assessing Practice

An Effective Practitioner is expected to provide care and services that are evidence based. This activity is designed to help you explore the concept of evidence based practice in your clinical setting.

Identify an aspect of your professional practice that you regularly undertake in your current role and think about the following:

• What tacit knowledge or professional know-how do you and team members have in this area?  
• Can you offer a sound evidence base for this aspect of your practice?
• If there is a local guideline/protocol in place for this area of practice:
  • Find out who developed the guideline/protocol and who is responsible for updating it. 
  • Is the local guideline/protocol being followed in practice by you and your team members?
  • If not, why not? Have a discussion with your team members on why the local guideline/protocol is not being followed.
  • If the local guideline/protocol is not up-to-date, agree how you will get it updated.
• If there isn’t a local guideline/protocol in place for this aspect of your practice, what is the evidence base for this area of practice and is it being applied? If the evidence is not being applied, have a discussion with your team members on why the evidence is not informing your practice and agree a plan of how you might improve your practice based on the sound evidence base. 

Record your learning in your professional portfolio.

KSF Core Dimensions: Service Improvement, Quality

It is useful to be aware of what is happening locally, nationally and internationally in your area of interest; for example are there any audits, evaluations, research or service improvements in progress? This will ensure that if you are thinking of doing a project yourself you are not going to repeat activities that are currently being undertaken. It will also contextualise your own research interests and provide you with information to support your overall practice. It is also useful to get a picture of the importance that your organisation places on research related activities and how these influence evidence-based practice.

• Consult with your colleagues to find out if there are any studies/audits/evaluations/research related activities ongoing in your clinical area or your clinical field.
• Find out how you can contribute to these studies.
• Find out how you go about getting permission to undertake research-related activities.
• Consider the different types of research and research methods that you might use in an activity.
  • Qualitative methods tend to provide experiential information and if you want rich, in depth material such as descriptions of patient experiences, you should choose qualitative methods for example, unstructured, semi-structured interviews, or observations.
  • Quantitative methods are based on objective measurements and experiments and generate more factual information. If your research interest is more about quantity then you should choose quantitative methods such as questionnaires and surveys. For example, if you are undertaking a clinical audit you could use a questionnaire or survey to evaluate how a local protocol has been implemented in practice.
  • Action research follows a cyclical pattern and may use a qualitative or quantitative approach or a combination of both approaches.
• Download our Research-Related Activities Sheet and complete on your own or with your colleagues.
• Consider what type of support is available to practitioners within each of these areas identified and add any additional areas and support that you find in your local organisation.

Record your learning in your professional portfolio.

KSF Core Dimensions: Personal and People Development, Service Improvement

It’s important that you feel competent and confident in using IT in order to find and document evidence to inform your practice. These skills include core information literacy skills and presentation skills to disseminate your findings. This activity invites you to self-assess your IT skills and explore strategies for further development.

• Rate your IT skills in the following areas as either ‘no skills’, ‘basic’ or ‘competent’.
  • Using Email
  • Using the Internet
  • Searching online databases e.g. Knowledge Network
  • Using different computing devices e.g. personal computers, smart phones or tablets
  • Creating spread sheets/graphics presentation e.g. Microsoft Excel
  • Creating Presentations e.g. using Microsoft Powerpoint
  • Report writing e.g. using Microsoft Word
  • Poster design and creation
• Based on your IT skills review, develop a plan to develop relevant skills to the point where you feel competent in the areas identified.
• Seek out the resources that will help you improve your IT skills and discuss the plan and resources with your line manager.
  
  There is a wealth of online materials to help you develop your IT and information literacy skills e.g. IRISS’s online tutorial in information literacy.
  
  You could also contact your local learning and development department, librarian/knowledge broker to find out what resources are available to build your IT skills,  

Record your learning in your professional portfolio.

KSF Core Dimensions: Personal and People Development

Ethics should underpin everything you do as an Effective Practitioner. If your project involves service users, carers or family then you must be aware of national and your local research governance guidelines. 

• Visit the Research Governance guidelines website and familiarise yourself with the national policy in relation to research governance.  
• Meet with a colleague who has undertaken a project recently. Find out how the 7 principles of ethics influenced how the project was designed and conducted. 
• Can you think of a recent example of unethical research which was published e.g. MMR study?
  • Based on the 7 principles of ethics, what was it about the study that was unethical? 
  • What impact did it have on the public and you as a healthcare professional?  
  • What ethical issues do you envisage might arise doing your project? For example,
    • Beneficence: how will your study contribute in a positive way to service improvement?
    • Non-maleficence: how will you ensure that no harm will come to any participants during the project? 
    • Fidelity: how will you ensure that the way in which you represent findings is accurate and true to the participant meaning?
    • Justice: how will you ensure that you represent data and feedback accurately and without bias?
    • Veracity: how will you ensure that your project represents your participant’s point of view truthfully (linking back to ongoing informed consent).
    • Confidentiality: how will you maintain confidentiality and anonymity during your project?
    • Autonomy: how will you provide autonomy for your participants to ensure that they know their rights to withdraw?
• Refer to your professional code of practice in relation to ethics. Does the code of practice cover other ethical areas that you need to consider?
• Find out about your local protocols for informed consent and research governance arrangements as these will identify from whom you need to get permission to undertake your project and get any ethical approval required. 

Record your learning in your professional portfolio.

KSF Core Dimensions: Personal and People Development, Quality

If you are considering undertaking a project e.g  an audit, evaluation, service improvement or research, it is useful to document a plan as it helps to articulate the topic area, scope out the methods you wish to use to gather evidence and identify the resources you’ll need to carry out the project effectively. 

The plan is also a useful way to help others to understand the focus for your project and to potentially gain funding or other support that you may need.   

• Identify any areas of practice that you feel would benefit from more robust evidence and discuss this with your line manager. 
• Engage with other members of your multidisciplinary team to find out if they agree.
• Based on feedback from colleagues, pick one area of practice – this will be the basis for your project.
• Discuss your ideas for the project with your line manager, including any resources that you might need. 
• The next step is to document your plan and identify the resources you need to help you to write and implement your plan. Seek out the support you need from e.g. R&D department, clinical effectiveness department or knowledge broker.
  
  Use the following information as a guide for the layout of your plan.
  
  
  1. Why you have chosen your particular topic.
  2. The aims and objectives of your project.
  3. The methods you propose to use in your project. Document if you are going to take a qualitative or quantitative approach or a combination of the two.  
  4. Your target population – identify from whom you need to gather evidence. Are you focusing on the whole population or only part? If you are only focusing on a part of the population then how are you going to select your sample? 
  5. The ethical issues you envisage might arise doing this project and how you are going to address these issues.
  6. The arrangements you will put in place for the protection of the data you might collect. 
  7. How you comply with the necessary research governance arrangements.
  8. The resources you need to carry out your project effectively.
  9. A time table for completion of your project identifying the core activities and milestones. This can be represented as a project plan and through a Gantt chart.
• Identify colleagues who can give you constructive feedback on your plan. Update your plan based on their feedback.
• Contact your local clinical effectiveness/R&D team to inform them of your project and identify if you need to get more formal approval.

Record your learning in your professional portfolio.

KSF Core Dimensions: Service Improvement, Quality.