Editor's Note - April 2019

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By Andrea Spridgen

Cooking and enjoying meals together has always been important in my family. But we have two styles of cooks, some who are most comfortable strictly following a recipe, relying on tested instruction to ensure a successful outcome, and some who rarely consult one, relying instead on past experience and intuitive knowledge of what flavors will combine just right to make a delicious dish. Despite our different approaches, we all usually produce tasty meals. While I tend not to use a recipe, there are times when I find combining my personal knowledge with a recipe to guide me—confirming how much leavening muffins need, for example—is the best approach. O&P decision-making and evaluating expectations of interventions can be a little like the approaches to cooking; it's possible to rely heavily on evidence or theory without consideration of experience or anecdotal knowledge, and it's also possible to rely too heavily on clinical judgement without support from research. The articles in this issue suggest that perhaps using some of each strategy is the most effective.

"Capacity Equals Performance…Doesn't It?" introduces two recent studies that seem to challenge the acceptance of theory absent application of experience. In these cases, the availability of activity trackers allowed researchers to compare users' actual experience and performance in real-world settings with their capacity as demonstrated in the controlled conditions of the lab setting. The results of objective outcome measures in the lab showing increased ability would indicate an increase in performance, while the addition of data from experience paints a different picture. Thus, arriving at an optimal rehabilitation strategy for patients may require considering both types of information.

Similarly, "Is Experience Evidence? The Role of Expertise in Clinical Decision-making" examines the way in which application of evidence-based practice (EBP) may be informed by clinical experience. This article points out that in its early forms, EBP included clinical expertise as one form of evidence, though of lower quality than more objective measures. Particularly in a profession in which research sample sizes are often limited, including all forms of evidence in clinical decision-making seems to serve the best interests of the highly individualized needs of O&P patients.

This month, The O&P EDGE also features the first of a two-part series of interviews with women executive directors of five national O&P organizations who share their perspectives on the directions of their organizations, their leadership inspirations, and women in O&P, "Unity Through Diversity: Five Women Executive Directors Help Point the Way."

Happy Reading.