April 1970 Audio: "Houston, we've had a problem here."
TACOMA, Wash. – Whether you are commanding the 1970 lunar mission of Apollo 13 or designing a treatment plan for a person who suffered a stroke, the “flight plan” has to be flexible and open to unexpected challenges. This is the sincere—and poetic—argument made by George Tomlin, distinguished professor of occupational therapy at University of Puget Sound.
Tomlin is concerned that the push by society and health insurers for “evidence-based practice” —in which therapies must meet strict, scientific guidelines—may push health practitioners down a narrow and inflexible track that could inhibit, rather than enhance, the recovery of patients suffering from stroke, injury, autism, or another trauma or disability. He believes there is a better way, if only the health care system will embrace it.
Tomlin will present his thoughts in a free lecture titled “Evidence, Knowledge, and Decision-Making in Occupational Therapy: It’s Not Rocket Science… Or is it?” on Thursday, Nov. 15, at 7:30 p.m., in Kilworth Memorial Chapel on campus. Tickets are not required for the talk, which is sponsored by the John D. Regester Faculty Lectureship.
In his talk Tomlin will address the issue of “evidence-based practice,” that is, the acceptance of treatments only if they are demonstrated through randomized, controlled trials written up in scientific literature. Tomlin says the current push for this approach is so strong that some health insurers are denying payment to practitioners who cannot show published evidence that their treatments are effective.
Yet this evidence, Tomlin argues, has serious shortcomings. It fails to take into account the effect some treatments may have on the quality of patients’ daily lives, and it fails to acknowledge that not everyone responds well to the “best practices” that arise out of clinical trials.
Just as the Apollo 13 astronauts—Jim Lovell, Jack Swigert, and Fred Haise—found when their lunar mission went badly wrong, threatening their safe return to Earth, the practitioner dealing with unique individuals has to apply “theoretical understanding, and oftentimes, creativity and a willingness to solve problems by trial and error,” Tomlin says.
“Altered or atypical life trajectories—whether the lunar mission of Apollo 13, a child having autism, or an adult experiencing a stroke—entail adaptations to the original, anticipated ‘flight plan,’” Tomlin argues. It is this flexibility, he says, that helps turn setbacks into “lives of restored participation and meaning.”
Tomlin will describe an alternative, “breakthrough” model of evidence, created by Professor Bernhard Borgetto of Germany, called the “research pyramid.” This model, Tomlin believes, will better reveal the most effective treatments for occupational therapy clients.
In addition to Tomlin’s Nov. 15 Regester lecture, the public is invited to a series of free talks on health and science in the new Weyerhaeuser Hall. The inaugural Weyerhaeuser Colloquium Series presents public talks by professors and students in occupational therapy, exercise science, psychology, neuroscience, and physical therapy. The sessions, from 4 to 5:30 p.m. on Tuesdays, will also offer conversation, snacks, and beverages. A full schedule is available at: www.pugetsound.edu/wcs
George Tomlin has taught at University of Puget Sound for 28 years. He has lectured widely, including at Pacific University in Oregon, The University of British Columbia in Canada, University of Applied Sciences and Arts in Germany, Bethlehem University in the West Bank, and Gunma University in Japan. As an occupational therapist he has worked in children’s mental health, physical and industrial rehabilitation, and ergonomics. During his doctoral studies Tomlin investigated medical decision-making, and in a book chapter, he questioned the division of professional reasoning into “scientific approaches” applied to treatment techniques and “nonscientific approaches” applied to interacting with people, arguing instead that scientific thinking offers many modes of reasoning beneficial to patients.
To view the “research pyramid,” visit: http://www.pugetsound.edu/faculty-pages/tomlin
For details on the Weyerhaeuser Colloquium Series, visit: www.pugetsound.edu/wcs
Press photos of George Tomlin may be downloaded from: www.pugetsound.edu/pressphotos
Photos on page: Top right: George Tomlin; Above: Apollo 13 liftoff, April 11, 1970 and Apollo 13 command module successful splashdown - Mission Control celebrates, April 17, 1970 (NASA photos).
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