Rehabilitation Research Boot Camp: A Renewed Look at Evidence-Based Practice
Presented by Chad E. Cook
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Learning Outcomes
- Recognize how research innovations have transformed healthcare delivery and clinical decision-making over the past century
- Recall the historical evolution of evidence-based practice, highlighting key milestones and paradigm shifts
- Define the three foundational pillars of EBP—clinical expertise, patient values, and best available evidence—and their interdependence in practice
- Differentiate between levels of evidence using the pyramid and design hierarchy, with emphasis on study design and methodological rigor
- Evaluate ethical considerations in clinical research, including informed consent, bias, and the protection of vulnerable populations
- Analyze the implications of shifting research emphases, such as pragmatic trials, big data, and translational science, on clinical outcomes and relevance
- Compare current healthcare outcome trends in light of evolving research methodologies and systemic challenges
- Reflect on the course perspectives to synthesize key themes and consider future directions for EBP in clinical practice
Meet your instructor
Chad E. Cook
Dr. Cook is a professor at Duke University with a Category A appointment in the Duke Clinical Research Institute and an adjunct appointment in the Department of Population Health Sciences. He is a clinical researcher, physical therapist, and profession advocate with a long history of clinical care excellence and service and…
Chapters & learning objectives
1. How Research Has Changed Healthcare
This chapter examines the transformative power of medical discovery, highlighting how innovations like penicillin and genome mapping have saved billions of lives. It emphasizes the empirical nature of medicine, in which conclusions must be continually revised as the “half-life” of medical knowledge continues to shrink at a staggering pace.
2. Evidence-Based Practice: A Historical Tutorial
Learners will trace the origins of evidence-based practice from its philosophical groundwork in the 1970s to its formal definition in the mid-1990s. This history is essential for understanding the original intent of EBP—to standardize care and bridge the gap between research and practice—while identifying modern barriers, such as information overload.
3. The Three Pillars of Evidence-Based Practice
This section explores the vital interdependence between the best available evidence, clinical expertise, and patient values. It is important because an overemphasis on research alone can lead to inappropriate care, requiring clinicians to balance these pillars to achieve truly personalized, evidence-informed results.
4. Classification of Strength of Evidence
This chapter introduces the traditional evidence-based pyramid and the methodological rigor required for different study designs. Understanding this hierarchy, along with its limitations and potential for oversimplification, helps clinicians better synthesize complex data and select the most appropriate research for their specific clinical questions.
5. Ethical Considerations of Research
Participants will evaluate the historical atrocities that necessitated the development of the Nuremberg Code and Institutional Review Boards to protect human subjects. Reviewing past ethical breaches, such as the Tuskegee and Willowbrook studies, underscores the permanent necessity of informed consent, beneficence, and justice in clinical science.
6. Why Are Our Outcomes Worsening?
This chapter critiques the alarming trend of rising disability and worsening morbidity despite increased research funding and guidelines. It highlights the need to rethink healthcare delivery by addressing health behaviors and social factors that traditional biomedical models often fail to influence.
7. Course Summary
The final chapter synthesizes the course’s core themes to help clinicians reflect on future directions for evidence-based practice. By integrating historical lessons with modern challenges, learners will be better prepared to adapt their clinical decision-making to their patients’ evolving needs.
