title: Using critical realistic evaluation to support translation of research into clinical practice.
abstract: A challenge that speech-language pathologists (SLPs) face is the translation of research into clinical practice. While randomised controlled trials (RCTs) are often touted as the "gold standard" of efficacy research, much valuable information is lost through the process; RCTs by nature are designed to wash out individual client factors and contexts that might influence the outcome in order to present the "true" impact of the intervention. However, in the area of behavioural interventions, the interaction of client factors and contexts with the treatment agent can substantially influence the outcome. This paper provides an overview of the theoretical background and methods involved in critical realistic evaluation (CRE) and discusses its current and potential application to speech-language pathology. CRE is based on the premise that a behavioural intervention cannot be evaluated without considering the context in which it was provided. While the ways in which contextual aspects and treatment mechanisms interact may seem endless, CRE methodology attempts to operationalise them into hypotheses to be empirically tested. Research based on these principles has the potential to support clinical translation of research outcomes and reduce the costs of unsuccessful treatment attempts for SLPs, clients and the service provider.
authors.affiliation: a School of Health Sciences , Flinders University , Adelaide , SA , Australia.|b Department of Communication Sciences and Disorders , University of Alberta , Edmonton , AB , Canada , and.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Swift
authors.affiliation: b Department of Communication Sciences and Disorders , University of Alberta , Edmonton , AB , Canada , and.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Langevin
authors.affiliation: c Faculty of Nursing , 5-166 Edmonton Clinic Health Academy, University of Alberta , Edmonton , AB , Canada.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Clark
mesh_terms: D001521:Behavior Therapy; D055317:Evidence-Based Practice / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D013066:Speech-Language Pathology / Q000379:methods*; D057170:Translational Research, Biomedical / Q000379:methods*; D016896:Treatment Outcome
keywords: critical realism; evidence-based practice; realistic evaluation; speech-language pathology; stuttering; translational research