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Clinical Skills

A New Publication World?

First, a confession. I spent much of my career as a journal editor, and spend time now as a journal editor (Chiropractic Journal of Australia). I mention this because I want to discuss issues around journal publication. In the evidence-based world, journal articles are still seen as the primary means of obtaining important information...
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Narrative Medicine

We have all heard that evidence-based clinical practice includes three essential components: best available research evidence; clinical experience; and patient values. Most programs in EBCP, including this blog, focus on the interpretation and application of research evidence. Lip service is given to clinician experience and patient values. I believe the reason for this is...
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A clinical resource to help manage chronic pain

Chronic pain, one of the most common and costly global health problems, can represent a substantial challenge for both patients and clinicians. Goal setting with patients, considered a “Best Practice” activity is a clinical practice inherent to chiropractic care and other health professions. However, there are relatively few resources to assist clinicians with helping...
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A Simple Guide to Critical Appraisal

When I review a clinical trial, I ask myself a set of questions to help me understand how well I think the paper makes its case. This is something I have come up with on my own, after many years as a joural editor, educator and teacher of evidence-based practice. Of course, there exist...
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The Post-Factual World: Reconciling It With Evidence-Based Practice

One of the great challenges we face in attempting to live in an evidence-based world and practice in an evidence-based manner is that we now effectively live in a post-fact world. Currently, we see this illuminated in politics, where presidential candidates seem to feel free to simply make up information; fact checking comes too...
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What position selectively places the most tension on the radial nerve?

In an effort to improve examination maneuvers that discriminate between causes of upper extremity neuropathy, researchers recently conducted a study to determine the upper extremity position that produces high radial nerve tension while simultaneously generating low tension (comparatively) in median and ulnar nerves.1 Selective tensioning of peripheral nerves has the potential to refine differential...
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Reporting Guidelines

A great deal of effort has been expended in developing reporting guidelines for different kinds of scientific papers. The idea is to provide a researcher and/or reader with a checklist of items that will help ensure the rigor of the paper they are writing or reading. Below is a list of some of these...
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The TIDieR Checklist (Template for Intervention Description and Replication)

I think we can all be justifiably proud of the clinical trial research we have seen conducted by our own research scientists and from those in related fields. That information has been critical in our growth as a profession and has contributed in some measure to our cultural credibility. But I think if I...
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Observation as one key to success

Very early in my career, I realized I needed to develop my ability to relate to patients. Specifically, I needed to learn much more about how individual patients value care. For example, pain reduction isn’t the only, or even the main, factor in how some patients measure success. But discovering how each patient measures...
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Skillful observation: a key to successful communication

During the past decade, several areas of research have illuminated our understanding of the importance of effectively building rapport, demonstrating empathy and successfully delivering cognitive reassurance (explaining a condition in understandable terms) in doctor-patient interactions.(1) Research has also shown that assuming the role of coach rather than primarily as provider can sometimes be a...
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