EVIDENCE-BASED PRACTICE PROGRAM

RESEARCH PROGRAM

 

Evidence-Based Practice: Research Program

The overarching aim of biomedical and behavioral science is to positively impact the health of society.  This requires that new knowledge be integrated into medical and dental education programs, into clinicians offices and into public educational programs.  There is clear evidence that new knowledge is not being efficiently transferred and implemented in these three areas.  The San Antonio Evidence-Based Practice CATs Initiative includes an active research component addressing this problem of science transfer or Diffusion of Innovation, as it is now referred to.  These research activities fall broadly into the following three domains.

1.  Program Development, Implementation and Evaluation.

The aim of our NIH R25 Education Research Grant is to develop, implement and evaluate the effectiveness of an EBP teaching program in a dental school setting.  This required the development of new courses for students, faculty development programs and instruments to measure the impact of the program on both faculty and students.

During the initial stages of the project, we developed and tested the (KACE), an instrument to measure Evidence- Based Practice.  The KACE (see Hendricson et.al. 2011) measures four EBP dimensions: (1) knowledge of EBP concepts, (2) attitudes about EBP, (3) evidence accessing skills and (4) confidence in critical appraisal.  Our studies documented the reliability, validity and sensitivity of the KACE; and it now is available for use in other dental schools. We are currently testing two other instruments designed to assess mastery and use of evidence-based practice principles in the actual clinic setting.  These instruments are called the Assessment of Capacity in Evidence Search (ACES) and the FRESNO. 

The third method used in program evaluation is focus groups led by an educational researcher experienced in qualitative research.  Focus groups are scheduled throughout the academic cycle, and a detailed report is available.

Research Reports and Presentations Related to Program Development and Evaluation:

W.D. Hendricson, J.D. Rugh, J.P. Hatch, D.L. Stark, T. Deahl, and E.R. Wallmann.  Validation of an Instrument to Assess Evidence-Based Practice (EBP) Knowledge, Attitudes, Access and Confidence.  Journal of Dental Education, Vol. 75(2):131-144, 2011.

J.D. Rugh, W.D. Hendricson, B.J. Glass, J.P. Hatch, S. T. Deahl II, G. Guest, R. Ongkiko, K. Gureckis, A.A. Jones, W.F. Rose, P. Gakunga, D. Stark, and B. Steffensen.  Teaching Evidence-Based Practice at the University of Texas Health Science Center at San Antonio Dental School.  Texas Dental Journal, Vol. 128(2):187-190, 2011.

E.R. Wallmann, J.D. Rugh, J.P. Hatch, and W.D. Hendricson.  An Alternative Method to Evaluate Knowledge Change Using KACE Questionnaire.  J Dent Res 90(Special Iss A):S2126, 2011. IADR 89th General Session, San Diego, CA www.dentalresearch.org

S. McLin, E.R. Wallmann, J.D. Rugh, W.D. Hendricson, and J.P. Hatch.  Relationships of EBP Knowledge, Attitudes, and Confidence in Dental Students.  J Dent Res 89(Special Iss B):2010.  IADR/AADR 88th General Session, Barcelona, Spain www.dentalresearch.org

E.R. Wallmann, S. McLin, J.D. Rugh, W.D. Hendricson, and J.P. Hatch.  EBP Course Increases Knowledge, Attitudes, and Confidence in Dental Students.  J Dent Res Issue 89(Special Iss B):2010.  IADR/AADR 88th General Session, Barcelona, Spain (www.dentalresearch.org)

J.D. Rugh, W.D. Hendricson, J.P. Hatch, and B.J. Glass.  Keeping Up-to-Date:  The San Antonio CATs Initiative.  Journal of the American College of Dentists, Vol. 77(2):16-21, 2010.

A.A. Jones and J.D. Rugh.  Classroom Exercise for Evaluating Evidence-Based Practice Skills.  Sixth Annual Innovations in Health Science Education Conference, Austin, TX, February 18-19, 2010.

J.D Rugh.  Other Voices:  Integration of Research and Scholarships within the Dental Curriculum Revisited.  ADEA Annual Session Symposium, Washington, DC, March 3, 2010.

W.D. Hendricson, J.D. Rugh, J.P. Hatch, and D.L. Stark.  Evaluation of EBP Knowledge, Attitudes, Access and Confidence.  J Dent Res 89(Special Iss A):891, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

J.D. Rugh, J.P. Hatch, and W.D. Hendricson.  Assessing Outcomes of Research Methods Courses.  J Dent Res 89(Special Iss A):673, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

E.R. Wallmann, J.D. Rugh, J.P. Hatch, S.R. Matteson, and S.T. Deahl, II.  Commonly Reported Statistics in Three Dental Journals. J Dent Res 89(Special Iss A):881, 2010. AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

J.D. Rugh.  Critically Appraised Topics:  an NIH-Funded Project.  Academic Center for Evidence-Based Practice, 2010 Summer Institute on Evidence-Based Practice, San Antonio, TX, July 7, 2010.

J.P. Hatch and J.D. Rugh.  The Science Transfer Series:  Keeping Up-To-Date.  Revista Odonto Ciência, 25, 5-7, 2010.

J.D Rugh.  Teaching Evidence Based-Practice and Life-Long Learning Skills:  The CATs Initiative.  University of Connecticut, School of Dental Medicine, Farmington, CT, April 5-8, 2010.

J. Rugh, W. Hendricson, J. Hatch, G. Guest, B. Glass, and L. Levy.  Bridging Oral Health Science, Education & Practice:  A CATs Initiative.  Innovations in Health Science Education, 5th Annual Conference, Austin, TX, February 5-6, 2009.

J.D Rugh.  Strategies to Deal with the Information Explosion in Dental Education & Practice, Dental School Faculty Ground Rounds, UTHSCSA, San Antonio, TX, February 27, 2009.

J.D Rugh.  Dental Research Methodology & Evidence Based Practice, (Faculty & Resident Workshop) College of Dental Medicine, University of Southern Nevada, Henderson, NV, March 10, 2009.

J.D Rugh.  Strategies for Assessing Students’ Capacity for Critical Appraisal in the Context of Teaching EBP Skills.  ADEA/Commission on Change & Innovation Meeting, Phoenix, AZ, March 2009.

J.D Rugh.  Teaching & Assessing Search and Critical Appraisal Skills.  (Symposium titled “Using Probiotics to Teach Evidence-Based Dentistry, Sponsored by Biochemistry, Nutrition & Microbiology Group) 86th ADEA Annual Session, Phoenix, AZ, March 2009.

J.D Rugh.  Strategies for Assessing Students’ Capacity for Critical Appraisal in the Context of Teaching EBP Skills.  ADEA/Commission on Change & Innovation Meeting, Phoenix, AZ, March 2009.

E.R. Wallmann, W.D. Hendricson, D. Stark, J.P. Hatch, and J.D. Rugh.  Relationships of EBP Knowledge, Attitudes, Access, and Confidence in Skills.  J Dent Res 88(Special Iss A):668, 2009.  IADR/AADR/CADR 87th General Session, Miami, FL www.dentalresearch.org

E.R. Wallmann, W.D. Hendricson, D.L. Stark, J.P. Hatch, and J.D. Rugh.  Relationships of EBP Knowledge, Attitudes, Access, and Confidence in Skills.  UTHSCSA 2009 Dental Science Symposium, April 15, 2009.

J.D Rugh.  EBP/CATs Initiative:  Progress Report & Vision for the Future.  UTHSCSA Faculty Advance/Faculty Development Program, San Antonio, TX, May 29, 2009.

J.D. Rugh.  Establishing Competencies for Critical Thinking & Evidence Based Practice Skills in Pre-doctoral & Residency Education.  UTHSCSA Faculty Advance, San Antonio, TX, May 29, 2009.

J.D. Rugh.  Critically Appraised Topics (CATs) in the Dental Curriculum.  Oregon Health Sciences University School of Dentistry, Portland, OR, August 12, 2009.

J.D. Rugh, R.K. Klepac, W.D. Hendricson, J.P. Hatch, G.F. Guest, D. Stark, and B.J. Glass.  CATs:  Enhancing the Integration of Science in a Professional Curriculum. Association of Psychologists in Academic Health Centers, 4th National Conference, St. Louis, MO, October 16, 2009.

J.D Rugh.  Integrating Science into Dental Education.  Distinguished Scientist Keynote Address, Annual Dental Research Symposium, SUNY Buffalo School of Dentistry, Buffalo, NY, March 8, 2008.

G.F. Guest, R.M. Weed, and J.D. Rugh.  The Integration of Evidence-based Dentistry and Critically Appraised Problems in the Patient Care Process.  Journal of Dental Education, 72(2):240, 2008.

J.D Rugh.  Evidence Based Dentistry:  CATs Initiative.  ADEA Annual Session, Dallas, TX, March 31, 2008.

J.D Rugh.  Dental Practice, Research and Education:  Building Bridges for Tomorrow.  (Distinguished Scientist Lecture, 2008), Dental Science Symposium, UTHSCSA Dental School, San Antonio, TX, April 16, 2008

J.D Rugh.  CATs in Dentistry:  Teaching EBP Using Critically Appraised Topics.  2008 Summer Institute on Evidence Based Practice:  Educators Workshop, San Antonio, TX, June 2, 2008.

E.R. Wallmann, W.D. Hendricson, J.P. Hatch, and J.D. Rugh.  Relationship Between Faculty Knowledge and Teaching of Evidence Based Practice.  J Dent Res 87(Special Iss B):1939, 2008.  IADR/CADR 86th General Session, Toronto, ON, Canada www.dentalresearch.org

J.D Rugh.  Assessment of Student Search and Critical Appraisal Skills (90-Minute Workshop).  American Dental Education Association, Commission on Change & Innovation Meeting, Chicago, IL,June 23-24, 2008.

J.D Rugh.  CATs in Dentistry:  Teaching EBP Using Critically Appraised Topics.  Invited Educators’ Workshop, ACE Summer Institute on Evidence Based Practice, UTHSCSA School of Nursing, San Antonio, TX, June 25, 2008.

J.D Rugh.  Strategies to Deal with the Information Explosion in Dental Education & Practice.  Oregon Health Sciences University, School of Dentistry (Faculty Workshop), Portland, OR, August 12-13, 2008.

J.D Rugh.  Assessment of Student Search and Critical Appraisal Skills.  Texas A & M Health Science Center, Baylor College of Dentistry, Dallas, TX, October 7, 2008.

J.D Rugh.  Strategies to Deal with the Information Explosion in Education & Practice:  A CATs Initiative.  University of the Incarnate Word, School of Nursing & Health Professions, San Antonio, TX, November 17, 2008.

J.D Rugh.  Strategies to Deal with the Information Explosion in Dental Education & Practice.  Marquette University School of Dentistry, Milwaukee, WI, December 18, 2008.

2.  Information Science:

Critical to the use of new biomedical science to positively impact the health of society is the knowledge of how to classify, store and retrieve new information.  In collaboration with the UTHSCSA Dolph Briscoe, Jr. Library staff, we have undertaken a series of studies focusing on strategies for locating, evaluating and using research evidence.  Studies have included the comparison of search strategies and search engines, tracking trends in scientific publication and identifying limitations in computerized literature retrieval systems.

Our research on information science fulfills both a research and an educational objective.  As much as possible, we involve dental students in these projects.  Student researchers reinforce their evidence-based practice skills by conducting information science research.

Research Reports and Presentations Related to Information Science:

Tibbitts, LR, Ruxmohan, SD, Nguyen, T, Lemke, KC, Rugh, JD.  Descriptive Usage Analysis of UT Health Science Center Online Critically Appraised Topics (CATs) Database 2011-2014.  UT Health Science Center 33rd Annual School of Dentistry Dental Science Symposium. San Antonio, TX, April 1, 2015.

Lowery, R, Rugh, JD, Hatch, JP, Adams, E, & Rockey, KA. Growth of Evidence-Based Publications in Orthodontic Journals. 91st General Session & Exhibition of the IADR, Seattle, WA, March 2 0-23, 2013.

Key, MD, Rugh, JD, & Hatch, JP. Accuracy of PubMed Classification of Orthodontic Randomized Controlled Trials. Consortium for Orthodontic Advances in Science and Technology: Neuro-Musculo-Skeletal Interactions in Health and Disease. Chapel Hill, NC, October 19-21, 2012.

S. Daruwalla, J.D. Rugh, J.P. Hatch, A.E. Myatt, and A.J. Fohn.  MEDLINE Indexing Time for Dental Specialty Articles.  J Dent Res 90 (Special Iss A):S2118, 2011.  IADR 89th General Session, San Diego, CA www.dentalresearch.org

A.J. Fohn, J.D. Rugh, S. Daruwalla, A.E. Myatt, and J.P. Hatch.  Trends in MEDLINE Indexing Lag Time for Four Dental Specialties. .  J Dent Res 90 (Special Iss A):S2122, 2011.  IADR 89th General Session, San Diego, CA www.dentalresearch.org

C.C. Kartaltepe, J.D. Rugh, J.P. Hatch, A.E. Myatt, and R. Badgett.  Biomedical Literature Searching:  PubMed vs. EviDents.  J Dent Res 90 (Special Iss A):S2119, 2011.  IADR 89th General Session, San Diego, CA www.dentalresearch.org

V. Raj, J.D. Rugh, M. Enriquez, and E. Kartaltepe.  PubMed Search Success Rates for High vs. Low Level Evidence.  J Dent Res 90 (Special Iss A):2120, 2011.  IADR 89th General Session, San Diego, CA www.dentalresearch.org

S. L. Shin, J.D. Rugh, J.P. Hatch, and A.E. Myatt.  Accuracy of National Library of Medicine’s Classification of Orthodontics Meta-Analyses.  J Dent Res 90(Special Iss A):S2926, 2011.  IADR 89th General Session, San Diego, CA www.dentalresearch.org

C.M. Riggs, J.D. Rugh, A. Myatt, and J.P. Hatch.  Accuracy of MEDLINE Indexing for Dental-Related Randomized Controlled Trials.  J Dent Res 89 (Special Iss A):1118, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

S.L. Shin, J.D. Rugh, A.E. Myatt, and J.P. Hatch.  Accuracy of Library of Medicine’s Classification for Meta-Analysis Related to Orthodontics.  Hinman Student Research Symposium, Memphis, TN, October 29-31, 2010.

3.  Diffusion of Innovation:

The aim of this research is to study theoretical models and practical strategies to speed the movement of new biomedical knowledge into clinical practice.  Through a summer program we call FAST CATs (Faculty, Alumni, Student Team CATs), we are testing the technique of “academic detailing” to stimulate the adoption of innovative products and evidence-based procedures and techniques.  Dental students who volunteer for this summer selective program receive advanced training in evidence-based practice skills and human relations.  They then visit community dentists to promote the new modalities and identify the real world obstacles to their adoption. Click (here) to learn more about FAST CATs.


Research Reports and Presentations Related to Diffusion of Innovation:

J.D. Rugh, N. Sever, B.J. Glass, and S.R. Matteson.  A University Sponsored Academic Detailing Program in Dentistry—the FAST CATs Pilot Program.  Journal of Dental Education Vol. 75(10):1316-1322, 2011.

J.D. Rugh, N. Sever, W.D. Hendricson, R.R. Parma, K. Gureckis, J.P. Hatch, and B.J. Glass.  Academic Detailing in Private Professional Practice:  A CATs Pilot Project.  Sixth Annual Innovations in Health Science Education Conference, Austin, TX, February 18-19, 2010.

J.C. Francis, J.D. Rugh, and J.P. Hatch.  Are Trends in Clinical Orthodontics Practice Correlated with Research Findings?  J Dent Res 89(Special Iss A):412, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

C. Mueller, J.D. Rugh, and J.P. Hatch.  Trends in Sources of New Knowledge for Dental Practitioners.  J Dent Res 89(Special Iss A):300, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

R.R. Parma, J.D. Rugh, J.P. Hatch, C. Mueller, and K.M. Gureckis.  Comparison of Sources of New Knowledge of Adopters vs. Non-Adopters.  J Dent Res 89(Special Iss A):882, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

J.D. Rugh, T.Goggins, and J. P. Hatch.  Practitioners’ Perceptions of Knowledge Half-Life and Adoption of New Concepts.  J Dent Res 89(Special Iss A):302, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

J.D. Rugh, N. Sever, W.D. Hendricson, R. Parma, K.M. Gureckis, J.P. Hatch, and M.R. Hernandez.  Facilitating Student Encounters in an Academic Detailing Program.  J Dent Res 89(Special Iss A):304, 2010.  AADR 39th Annual Meeting, Washington, DC www.dentalresearch.org

J.D. Rugh.  Keeping Up-to-Date with the Explosion of New Knowledge.  U.S. Army Fort Hood Dental Services AEGD.  Fort Hood, TX, August 27, 2010.

J.D. Rugh, N. Sever, W.D. Hendricson, R.R. Parma, K. Gureckis, B.J. Glass, S.R. Matteson, and J.P. Hatch.  An Academic Detailing Program to Enhance the Diffusion of Innovation.  3rd Annual AADR Fall Focused Symposium:  Salivary Diagnostics: Scientific & Clinical Frontiers.  Arlington, VA, November 12-13, 2010.

R.R. Parma, J.D. Rugh, J.P. Hatch, J.B. Summitt, and K.M. Gureckis.  Impediment to Acceptance of Sealants for Suspected Fissure Caries Lesions. J Dent Res 88(Special Iss A):2516, 2009.  IADR/AADR/CADR 87th General Session, Miami, FL www.dentalresearch.org

J.D. Rugh, T. Goggins, and J.P. Hatch.  Practitioners’ Perceptions of the Half-Life of Dental School Knowledge. J Dent Res 88(Special Iss A):2016, 2009.  IADR/AADR/CADR 87th General Session, Miami, FL www.dentalresearch.org

J.D. Rugh, N. Sever, W.D. Hendricson, J.A. Johnson, R.R. Parma, K.M. Gureckis, J.B. Summitt, and J.P. Hatch.  Pilot Test of an Academic Detailing Program in Dentistry.  J Dent Res 88(Special Iss A):2022, 2009.  IADR/AADR/CADR 87th General Session, Miami, FL www.dentalresearch.org

J.D. Rugh, T. Goggins, and J.P. Hatch.  Practitioners’ Perceptions of the Half-Life of Dental School Knowledge.  UTHSCSA 2009 Dental Science Symposium, April 15, 2009.

J.D. Rugh, N. Sever, W.D. Hendricson, J.A. Johnson, R.R. Parma, K.M. Gureckis, J.B. Summitt, and J.P. Hatch.  Pilot Program of Academic Detailing in Dentistry.  UTHSCSA 2009 Dental Science Symposium, San Antonio, TX, April 15, 2009.

J.D. Rugh, N.M. Sever, W.D. Hendricson, R.R. Parma, K.M. Gureckis, J.B. Summitt, and J.P. Hatch.  Pilot Test of an Academic Detailing Program in Dentistry.  Summer Institute on Evidence-Based Practice. 8th Annual Meeting, San Antonio, TX, July 9-11, 2009.  (Abstract #59, p. 216)

J.D. Rugh, R.K. Klepac, N. Sever, W.D. Hendricson, R.R. Parma, K.M. Gureckis, and J.P. Hatch.  Encouraging the Integration of Current Scientific Findings in Private Professional Practice:  A Pilot Project.  Association of Psychologists in Academic Health Centers, 4th National Conference, St. Louis, MO, October 16, 2009.

Funding and Resources: The EBP teaching program is state supported; however, a 4-year $648,000 NIH R-25 Education Research Grant Supports the evaluation component of the program.