Military and Civilian Speech-Language Pathologists' Attitudes towards Evidence-Based Practice: A Pilot Study

The renewal of military combat in Iraq and Afganistan (2001-) and the subsequent influx of soliders with traumatic brain injury (TBI) revealed shortcomings in the military’s healthcare relative to patients with TBI. To address these concerns, the military drastically reformed TBIrelated healthcare policy and services. Military healthcare policy reform claims to address the shortcomings of previous military heathcare policy, which include insufficient TBI training for healthcare providers , a problem that policy reform alone cannot remedey. Questions remain relative to the status of TBI-related military healthcare; specifically, were the shortcomings in TBI-related miltiary healthcare a function of inefficient systemic healthcare policy, or did the inoptimal TBI-related healthcare services also involve the attitudes of the healthcare proviers? This study investigated the attitudes of the healtchare providers serving veterans with TBIs relative to civilian healthcare providers. Specifically, attitudes of speech-language pathologists (SLP) treating veterans of Operation Enduring Freedom/Operation Iraqi Freedom with TBI at various military hospitals were compared to attitudes of SLPs treating patients with TBI at civilian hospitals. This study examined the use of evidence-based practice (EBP), a primary factor contributing to quality of care. A positive attitude towards EBP, which emphasizes incorporating cun*ent research findings into therapy, results in healthcare providers who do not lack training in their area of specialty, as some TBI Network of Care providers do (VAOIG). SLPs in each sector were surveyed using a modified version of the survey used by Toulkidis, Donnelly, and Ward (2005) to investigate attitudes towards EBP. Data from this research revealed a significant difference in the years of experience with TBI reported by the SLPs (zscore: -2.164; probability of error: .030); the civilian population had more TBI experience. A trend towards significance was revealed in the SLP populations’ confidence that they have sufficient communication skills with patients (z-score: -1.809; probability of error: .071); the civilian SLPs felt they had better communication skills with their patients. There was also a trend towards significance in the SLP populations’ feelings regarding the expense of evidence-based practice resources (z-score: -1.675; probability of error: .094); military SLPs generally felt that EBP resources were less of a concern. Due to the limited attitudinal differences between SLPs working in the military and civilan sectors, it was concluded that there is no appreciable difference between these two sectors relative to their attitudes toward EBP.