Question
How do you recommend that a therapist approach a situation when a client or family member catches them off-guard by asking a question regarding prognosis when that therapist does not have a keen knowledge of the research right off hand?
Answer
Most questions that are going to come to us about prognosis are going to hit us out of the blue. Obviously, we cannot be expected to have all of this knowlege in our heads or be able to access it immediately. If you work in a specialty practice, let's say your a pediatric therapist and see lots of kids with Cerebral Palsy, I think you can probably anticipate 3 or 4 high volume questions of prognosis that almost every parent has a right to ask their threrapist. So for those, I would suggest that instead of a journal club in your clinic, have a critical appraisal club. Identify 3 to 4 questions of prognosis that you know you are going to have to answer on a routine basis. Over the course of a year, maybe every other month, each therapist will take a turn and be responsisble for presenting the critical appraisal. You can even put together a 2 to 3 page document that goes through the whole critical appraisal for that question of prognosis. Put them in document protectors and put then into a 3 ring binder to have them in your clinic. Go ahead and do the EBP method in advance so that you can have this information at your fingertips.
In the senario you gave in the question (being caught off-guard by a question of prognosis) it would work to say, 'That is a really great question. I really don't know the answer, but I promise you that I will look. If there is any evidence to guide an appropriate answer, we'll talk about it next week.' Then, follow through.
