ASHA’s Strategic Pathway and You: Focus on Objective 3 Did you know ASHA has a roadmap for achieving the association’s vision and mission? The association’s “Strategic Pathway to Excellence” identifies eight strategic objectives to do just that through the year 2025, when ASHA will be 100 years old. The Envisioned Future document describes this centennial vision. Members are integral ... ASHA News
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ASHA News  |   March 01, 2016
ASHA’s Strategic Pathway and You: Focus on Objective 3
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ASHA News & Member Stories / ASHA News
ASHA News   |   March 01, 2016
ASHA’s Strategic Pathway and You: Focus on Objective 3
The ASHA Leader, March 2016, Vol. 21, 58-59. doi:10.1044/leader.AN1.21032016.58
The ASHA Leader, March 2016, Vol. 21, 58-59. doi:10.1044/leader.AN1.21032016.58
Did you know ASHA has a roadmap for achieving the association’s vision and mission? The association’s “Strategic Pathway to Excellence” identifies eight strategic objectives to do just that through the year 2025, when ASHA will be 100 years old. The Envisioned Future document describes this centennial vision.
Members are integral to working toward the strategic objectives and realizing the Envisioned Future: 2025 outcomes. Each month, the Leader examines an objective and how a member is addressing it.
Objective 3: Enhance the generation, publication, knowledge translation and implementation of clinical practice research.
Margaret Rogers, ASHA chief staff officer for science and research and staff “owner” of the objective, describes the challenges that are driving the initiatives under this objective:
Increasingly, payers and policy makers are demanding high-quality, peer-reviewed research that demonstrates the efficacy of an intervention to approve reimbursement for these services. Although we’ve all seen this trend coming for quite some time now, and although ASHA and many researchers in communication sciences and disorders (CSD) have been ramping up efforts to meet this mandate for more than a decade, we still must address many challenges if we are to be successful in shoring up a secure place for our professions in this “show-me-the-data” world.
Generation. The number of researchers focused on clinical practice research (see sidebar for ASHA’s definition) is not nearly sufficient. Further, many who are trying to generate clinical practice research need much guidance and mentoring to succeed in this highly competitive funding environment. ASHA, with grant support from the National Institute on Deafness and Other Communication Disorders (NIDCD), has developed a number of research mentoring and education programs to help scientists advance their research—and these programs appear to be helping early-career researchers garner grant support. ASHA, also with NIDCD grant support, created the Clinical Research Education (CREd) Library to advance knowledge of clinical practice research methods to accelerate the generation of high-quality applied research in CSD.
Publication. Rejection is all too common in attempts to publish clinical practice research, in part because of some inherent challenges associated with applied research—the practical difficulties that can interfere with experimentally controlling all the elements that might influence the outcome, for example, as well as the large inter-subject variability typical of study populations with disabilities. The ASHA journals are undergoing major changes in 2016, motivated in part by the need to fine-tune the publication culture to be as “clinical-practice-research-savvy” as possible. Multimedia enhancements, clinical abstracts and increased social media promotion of journal content are a few of the changes planned to stimulate greater use of research evidence in clinical practice.
Knowledge translation. We know from a variety of disciplines that even with an abundance of research on a topic, knowledge translation is not assured, and it can take a long time for research to influence clinical practice. So ASHA is working to help members find research evidence as easily as possible. The Practice Portal and new Evidence Maps are two of ASHA’s major knowledge- translation vehicles, and their usage statistics are steadily growing. The Topic Collections on ASHAwire and the journals’ social media initiatives are also helping to draw more attention to research published in ASHA journals.
Implementation science. The evolving field of implementation science, which encompasses the study of the methods that promote the integration of innovation, research and evidence-based guidelines into practice, is a fledgling area of research in CSD. ASHA and the American Speech-Language-Hearing Foundation, however, aim to support growth in this area so that, as a discipline, we will become better prepared to successfully bridge the research-to-practice gap.
Swathi Kiran at Boston University provides her own perspective on the challenges in clinical practice research and what has helped her to sustain her program of applied research in aphasia.
Swathi Kiran, PhD, CCC-SLP, speech, language and hearing sciences professor, Boston University
Early in the planning of any clinical practice research, I think it is essential to involve clinicians, and sometimes patients, because these stakeholders are probably the best people to help you zero in on what’s really important and feasible. To move our field forward so that we are meeting the mandates of evidence-based practice, it is critical to engage clinicians in the formulation of clinically important research questions, as well as pay close attention to what research is needed to sustain and advance the professions.
Also, as clinical practice researchers, we not only have to be really strategic and smart about asking important clinical research questions that everybody—from patients to clinicians to policy-makers—cares about, we must also systematically identify the most promising steps to bring that line of research along so that large-scale, impactful studies can be supported. This approach is also critical to getting research grants funded.
There’s nothing simple about developing and sustaining a program of clinical practice research, but early-career scientists in CSD are fortunate to have access to ASHA’s research mentoring programs and ASHFoundation funding. Indeed, when applying for federal research grants to investigate an intervention, one needs to be able to demonstrate both the feasibility and efficacy of an approach to successfully compete for funding that will support large-scale clinical trials. Early in my research career, I received excellent mentoring, both as a doctoral student and later through ASHA’s research mentoring programs, which I consider to have been key to my funding success. I was also very fortunate to have received ASHFoundation funding, which enabled me to conduct small-scale studies that were the stepping stones to larger, federally funded investigations. With ASHFoundation support, I was able to show the feasibility and promise of the approach that we were testing, thus laying a strong foundation for the NIH grants that followed.
Although conducting clinical research has its own set of challenges, another major challenge is translating that research into consumable, actionable knowledge. In disseminating study results, it can be difficult to distill the actionable pieces of information into a research article or a 20-minute conference presentation. However, if it isn’t there, clinicians will wonder: “This is great science, but how do I apply this in my everyday practice?” Without a clear take-home message, they might be less inclined to access the research literature in the future.
With implementation science, there are emerging opportunities to bridge the research-clinical practice divide and accelerate the adoption of evidence-based practices. There are very few examples of implementation science in the field of communication disorders, but it is important to try to understand how one’s research might later be integrated into clinical practice or perhaps even influence policy. By testing how well a given approach can be adapted in real-world settings, we can better determine how to structure the approach early on to maximize the likelihood of it being used successfully by many individuals across many settings.
Some of my recent research, for example, focuses on the integration of technology as an adjuvant to traditional language therapy. Understanding what facilitates and what interferes with the success of such approaches as implemented across a variety of settings and individuals will help us to improve the approach so that it can be adopted more easily and used as successfully as possible. As this is the ultimate aim of clinical practice research, it is important that we make headway on testing approaches in the targeted settings and with the targeted populations as early in the research and development process as is possible to help ensure seamless transitions across the generation, publication, knowledge translation and implementation phases of clinical practice research.
ASHA’s Definition of Clinical Practice Research

Clinical practice research encompasses several components of developmental and health research intended to produce knowledge essential for improving the human condition by investigating clinical methods aimed at preventing, identifying, assessing and treating disorders, and improving the health, educational outcomes and quality of life for people with disorders.

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March 2016
Volume 21, Issue 3