Implementation of Evidence-based Practice Among Clinical Instructors

Purpose/Hypothesis : Clinical Instructors (CIs) have an important role in the education of physical therapy students. The use of evidence-based practice (EBP) by CIs could significantly influence students continued use of these practices into the future. Therefore, the purpose was to assess the access to relevant literature, self-efficacy, and barriers to the use of EBP by CIs associated with the physical therapy program at A.T. Still University.Number of Subjects : 90Materials/Methods : This was a descriptive study based on two previously validated surveys. Items related to accessing research used a ÒYesÓ, ÒNoÓ, ÒDo Not KnowÓ response, while items assessing barriers, confidence, and time spent using EBP used a percentage scale ranging from 0-100%. All data was collected using Survey Monkey, an anonymous electronic survey tool. The survey was open for a total of 8 weeks with follow-up emails at 4 weeks following the initial e-mails to all CIs and closure 4 weeks later.Results : The majority of respondents were female, worked full-time with patient care as their primary role in an orthopedic setting. Most (47%) had an entry-level or transitional DPT with 22% reporting their highest degree as a baccalaureate. The majority of respondents indicated they had access to paper journals (77%) and online databases and journals (84%). Use of online databases less than 1 time per month was reported by 54%, and 50% reported reading 2-5 articles per month. A majority of respondents (66%) reported using research in clinical decision-making 5 or fewer times per month. Confidence in the ability to appraise the literature was generally high (51.4-78.6%) with respondents practicing more than 15 years reporting the lowest confidence. Sixty-two percent of the respondents reported feeling 50% or less confident with their ability to interpret the results of statistical procedures with those practicing less than 5 years more confident than other groups. Time was identified as one of the top 3 barriers to implementing EBP by 86 of the 90 respondents. Other barriers included lack of generalizability to their patient population (62.2%) and the ability to apply literature given the unique patient characteristics (60%). Additional barriers include an inability to understand statistical analysis (51%) and a lack of information resources (50%). Finally, 44% indicated a lack of interest as a barrier to the use of EBP.Conclusions : There is still limited use of resources for clinical decision-making, despite increased access to journals and online databases since 2003. Confidence to appraise the literature was high. Those with more experience reported lower confidence and the majority of respondents indicated they were not confident with interpreting statistics. Time is the most frequently listed barrier to implementation of EBP.Clinical Relevance : While the findings of this study support increased access to research and improved levels of efficacy with EBP, several barriers persist and implementation levels remain fairly low. Further research into potential mechanisms for increasing use of EBP within the clinical environment is needed.

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  • Control #: 1727636
  • Type: Poster
  • Event/Year: CSM2014
  • Authors: Lori Bordenave, Annlee Burch, Deanne Fay, Tawna Wilkinson, Lora Davis, Allison Grady, Robin Golden, Kylie Fulton
  • Keywords: Evidence Based Practice (EBP)|Clinical Instructors|implementation

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