Integrating Evidence Based Medicine into Your Practice: Introduction
August 17, 2008 
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How do you find answers to your clinical questions? This is the first post in a series that I will be writing to help readers understand the easiest process I use to research a clinical question I may have. It’s not as difficult to find the information you need quickly if you know where and how to search for it! I am a big advocate of using the existing literature to assure that we are performing our examination and treatment techniques as best a possible.
I always challenge my students and colleagues to understand the reasoning behind everything we do, from selecting a special test during an exam to performing specific exercises. There is always a reason behind our treatment selections, some valid and some, well, not so valid. Some of my favorites:
“This is what I was taught in school.”
“This is how I learned it while on a clinical.”
“I saw this at a seminar once.”
or my favorite:
“This is how I’ve been doing it for 15 years.” (Personally I hope that I am doing things a little differently in 15 years as our knowledge continues to expand!)
These are not the reasons I am looking for when I make clinical decisions and I would be willing to bet that your patients would agree! I make it a point to always know why I choose every aspect of care for a patient. This also allows me to better educate my patients as I can describe my rationale as we progress to different parts of their rehabilitation program. So how do I use research to make sure I am treating my patients as best as possible? First, it starts with a question:
“What is the best exercise to strengthen the infraspinatus?”
“What settings should I use on the ultrasound to promote healing of a ligament?”
“What is the most specific and reliable test to assess the ACL?”
The key here is to be specific. I would recommend doing several specific searches rather than sifting through too much vague information.
Next post: Finding the answers to your questions!
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