Evidence based practice: A survey of physiotherapists’ current practice

School of Physiotherapy, La Trobe University, Australia.
Physiotherapy Research International 06/2006; 11(2):93-103. DOI: 10.1002/pri.328
Source: PubMed

ABSTRACT [corrected] Evidence-based practice is the explicit use of current best evidence in making decisions about the care of individual patients and is a concept of growing importance for physiotherapy. The aim of the present study was to investigate Australian physiotherapists' self-reported practice, skills and knowledge of evidence-based practice and to examine differences between recent and experienced graduates, physiotherapists with low and high levels of training and physiotherapists working in private practice and hospital settings.
A survey was sent to 230 physiotherapists working in hospitals and in private practice. One hundred and twenty-four were completed and returned.
Although 69.4% of respondents said they frequently (at least monthly) read research literature, only 10.6%, 15.3% and 26.6% of respondents, respectively, searched PEDro, Cochrane and Medline or Cinahl databases frequently, and only 25.8% of respondents reported critically appraising research reports. Recent graduates rated their evidence-based practice skills more highly than more experienced graduates, but did not perform evidence-based practice tasks more often. Physiotherapists with higher levels of training rated their evidence-based practice skills more highly, were more likely to search databases and to understand a range of evidence-based practice terminology than those with lower levels of training. Private practice and hospital physiotherapists rated their evidence-based practice skills equally and performed most evidence-based practice activities with equal frequency.
Respondents had a positive attitude toward evidence-based practice and the main barriers to evidence-based practice were time required to keep up to date, access to easily understandable summaries of evidence, journal access and lack of personal skills in searching and evaluating research evidence. Efforts to advance evidence-based practice in physiotherapy should focus on reducing these barriers.

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    • "Lack of support from colleagues to implement research findings (9.8%), Lack of support from employer to implement research findings (6.7%) Conclusions of research are not justified (3.6%). Iles/Australia (2006) 80% of Respondents agreed that there are gaps in EBP knowledge, 59% Reported that they often formulate questions to improve knowledge. "
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    ABSTRACT: Evidence-Based Practice (EBP) has been widely implemented in different health-related areas. Several studies investigated important characteristics in EBP by physiotherapists and systematic review is needed. Therefore the aim of this study is to describe the current evidence on EBP knowledge, skills, behaviour, opinions and barriers by physiotherapists. Searches were conducted on MEDLINE, EMBASE, CINAHL, PSYCINFO, LILACS, and SciELO in September 2014. We retrieved quantitative cross-sectional studies that investigated EBP knowledge, skills, behaviour, opinions, and barriers in physiotherapy. Risk of bias was assessed using a scale to evaluate representativeness of the sample, response rate, the accuracy of the data, evidence of power calculation and the instrument used. The search yielded 12,392 potentially eligible studies. Of these, 12 studies were included in the review (pooled sample = 6411 participants). In 3 studies that analysed knowledge, approximately 21-82% of respondents claimed to have received prior information on EBP. In 2 studies that reported skills and behaviour, nearly half of the sample had used databases to support clinical decision-making. In 6 studies that investigated opinions, the majority of the samples considered EBP necessary or important. The barriers most frequently reported were: lack of time, inability to understand statistics, lack of support from employer, lack of resources, lack of interest and lack of generalisation of results. Although the majority of physiotherapists have a positive opinion about EBP, they consider that they need to improve their knowledge, skills and behaviour towards EBP. They also faced barriers that might hinder the implementation of EBP. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Manual Therapy 10/2014; 20(3). DOI:10.1016/j.math.2014.10.009 · 1.76 Impact Factor
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    • "The use of physical therapy guidelines has been shown to contribute to EBP, improve the quality of care, and decrease costs [2,8,11]. However, the availability and use of guidelines in different countries and settings also tend to vary [3,5,12-14]. In Sweden, few guidelines for physical therapy treatments are available and less than half of the PTs in a recent survey stated that they use guidelines on a regular basis [5]. "
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    ABSTRACT: Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's chi2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.
    BMC Health Services Research 03/2014; 14(1):105. DOI:10.1186/1472-6963-14-105 · 1.66 Impact Factor
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    • "Items on teaching and evaluation methods, barriers to teaching EBP in the clinical practice courses, and challenges and facilitating strategies to teaching EBP were derived from the Philippines-based qualitative research by Gorgon et al. Items on challenges and facilitating strategies were augmented by literature on barriers to integrating EBP in the PT curriculum [23] and to EBP uptake among PT practitioners [7,8,12,14]. "
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    ABSTRACT: Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students' inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective 'educating the educators' strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.
    BMC Medical Education 11/2013; 13(1):154. DOI:10.1186/1472-6920-13-154 · 1.41 Impact Factor
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