A structured process to develop scenarios for use in evaluation of an evidence-based approach in clinical decision making

Abstract

Background and purpose: Scenarios are used as the basis from which to evaluate the use of the components of evidence-based practice in decision making, yet there are few examples of a standardized process of scenario writing. The aim of this paper is to describe a step-by-step scenario writing method used in the context of the authors' curriculum research study.

Methods: Scenario writing teams included one physical therapy clinician and one academic staff member. There were four steps in the scenario development process: (1) identify prevalent condition and brainstorm interventions; (2) literature search; (3) develop scenario framework; and (4) write scenario.

Results: Scenarios focused only on interventions, not diagnostic or prognostic problems. The process led to two types of scenarios - ones that provided an intervention with strong research evidence and others where the intervention had weak evidence to support its use. The end product of the process was a scenario that incorporates aspects of evidence-based decision making and can be used as the basis for evaluation.

Conclusion: The use of scenarios has been very helpful to capture therapists' reasoning processes. The scenario development process was applied in an education context as part of a final evaluation of graduating clinical physical therapy students.

Keywords: clinical decision making; curriculum; evaluation; physical therapists.

Figure 1

Scenario development process.