1. Dr. Elizabeth Skinner Allied Health Clinical Research Unit Grade 3 ICU Physiotherapist

2.  Keep it simple, so I’ve heard…  Easier said than done  Sharon Strauss  Teaching EBM  If you turn up to work, you either know (things could be done better) or you don’t know (what you could be doing)

3.  Identify and develop your topic  Find background information  Kate Huggins April 28 th  Evaluate what you find  Design your project

4.  Select the study design  Data collection process  Measurement technique  Select the sample  Select the analysis  Evaluate the ethics/HREC application  Estimate time/financial/training requirements  Prepare the proposal

5.  Complete the project  Data analysis  Manuscript preparation  Publication!

7.  We all know how to PICO(T)  Patient  Intervention  Control  Outcome (Time)  Why is it so hard to come up with an EBM question?

8.  When have you:  Supervised a student?  Supervised a Grade 1?  Wondered why another (more or less experienced) clinician chose a different treatment?

9.  Supervised a student  Supervised a Grade 1  Been asked a question?  By anyone?  Heard someone make an assumption?  Same or other disciplines  Tried to explain something to someone and realised you didn’t have all the answers?

10.  When should we refer patients to you after they aspirate oral intake? [SP]  What’s the difference in the role of physio between ICU and GEM? [Medical]  How quickly should we progress cuff deflation in a tracheostomized patient? [Team]

11.  Why don’t you do passive movements on patients in ICU?  Physio student  Physiotherapist  Nursing staff  Medical staff  To discharge an unsafe patient home  How do you know they’ll be worse off?

12.  What have you experienced that happened to you in the last week or month?  Or ever – do you have a soapbox?

13.  Clinical pressure in organ donors  Nurses ▪ Don’t treat  Organ donor co-ordinators ▪ Treat  Physios ▪ Some treat and some don’t…

14.  Have you been put under pressure to provide a treatment that doesn’t work?  Or does it?  Is there evidence it doesn’t work, or just no evidence at all?  Do you want to provide treatment that no- one else supports?  How do you advocate for this with no evidence?

15.  Should someone be studying it?  Should you be studying it? YOUR PROFESSION NEEDS YOU!

16.  A form of lack of acknowledgement from the treating team as to suggestions…  Sitting patients in ICU out of bed  Progressing weaning from ventilation  Progressing cuff down  What have you experienced?

17.  From the audience…  Soapbox/experiences  Pressure ▪ To treat or not to treat  Barriers

19.  What’s my question?  Stages of the body of evidence  Types of appropriate study design  Keep it simple  What needs to be done before you can do the glory study?

20.  Patients  Intervention  Comparator  Outcome  (T)ime  Audience

21.  Find background information and evaluate  Literature review  Systematic review  Quality of the existing information  Identify the gap – your gap

24.  Systematic review  Feasibility study (can we do this?)  Safety study (is it safe to do this?)  Reliability study  Validity study  Pre and post (cohort) study  Case-control study

27.  Designate a project leader  Data that is already available  Data that you can collect as part of your role  Data that your team members can collect as part of their role  Lay out the glory study and see what the barriers are  Multi-disciplinary/multi-site involvement

28.  What might be some of the barriers to keeping it simple?  Use the Allied Health Clinical Research Unit Staff

29.  Kast your mind back to the times where you weren’t sure, made an assumption, were asked a question or tried to answer one, advocate for treatment or limit treatment  get Interested as to how you could find the answers (because you can)  Seek support  Start small (Rome wasn’t built in a day)

30.  Patients unable to sit out of bed because of Vascaths in situ  The effect of mobilisation compared to bed rest on haemofilter life and adverse events in patients undergoing haemofiltration in ICU  Literature review  Safety and feasibility study

31. http://www.southernhealth.org.au/page/Research/Research_Groups/Allied _Health_Clinical_Research_Unit/Help_How_do_I_do_research/