Evidence-based decision making in dental hygiene education, practice, and research.
OBJECTIVE
The purpose of this article is to highlight key aspects of the white paper prepared in 1999 for the American Dental Hygienists' Association (ADHA) Institute for Oral Health on Evidence-Based Decision Making and its Application to Dental Hygiene Education, Practice, and Research. These aspects include the need for evidence-based decision making, how it supports contemporary practice and education, basic evidence-based concepts, and strategies for integrating evidence-based decision making into dental hygiene.


METHODS
A review of the biomedical literature, evidence-based Internet sites and textbooks, and clinical guideline development was systematically conducted to identify models of evidence-based practice, skills needed to practice and teach evidence-based decision making (EBDM), and challenges faced by those implementing an EBDM approach. These resources were then analyzed and synthesized to develop a model for initiating the development of evidence-based dental hygiene practice.


RESULTS
The need for using an evidence-based decision making approach was well supported throughout the literature. Consistency was found in how EBDM methodology and levels of evidence were defined and in the skills required for evidence-based practice. Implied in the use of an evidence-based approach were corresponding requirements in three areas: 1) redesigning educational programs to better prepare students and current practitioners to integrate the most current knowledge into their clinical decision-making; 2) conducting research for areas in which evidence applicable to clinical practice is lacking or limited; and 3) designing more effective dissemination tools making relevant research findings more easily accessible and part of every day practice.


CONCLUSIONS
Variations in practice patterns, difficulties in keeping current with the scientific literature, and providing students with knowledge, skills, and competencies necessary for contemporary practice are challenges facing the health care professions today, including dental hygiene. To address these problems, an evidence-based approach has been recommended by national organizations. This paper reviews the issues and proposes a model and strategies for engaging dental hygiene clinicians, educators, and researchers in EBDM. Those involved in each area will need training in EBDM concepts and skills before this approach can be fully integrated into education and practice or used to guide research activities. National leadership will be needed to coordinate and prioritize research strategies, promote curricular changes, and improve access to clinically relevant information so that an EBDM approach can become the norm in practice.
Forrest
J L
JL
National Center for Dental Hygiene Research, University of Southern California School of Dentistry, Los Angeles, California, USA.
Miller
S A
SA
D002983:Clinical Competence; D003479:Curriculum; D003657:Decision Making; D003756:Dental Hygienists / Q000193:education*; D018865:Dental Research; D019317:Evidence-Based Medicine; D005178:Faculty; D006801:Humans; D007255:Information Services; D020407:Internet; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D013782:Textbooks as Topic