Dataset Information

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts.

ABSTRACT:

Background

Training in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce.

Methods

A prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2), which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts), Confidence, Practice (EBP implementation), Sympathy (disposition towards EBP)]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES) (95% CI) were calculated for all changes.

Results

Effect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42). While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29) followed by an improvement in the second year (ES +0.27). Scores in Terminology improved (ES +0.19 to +0.26) in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19) in the first year and improved minimally in the second year (ES +0.04). Confidence scores improved during the second workforce year (ES +0.27). Scores for Sympathy showed little change.

Conclusions

During the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown.

SUBMITTER: McEvoy MP

PROVIDER: S-EPMC3248363 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Publications

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts.

McEvoy Maureen P MP Williams Marie T MT Olds Timothy S TS Lewis Lucy K LK Petkov John J

BMC medical education 20111129

<h4>Background</h4>Training in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entr ...[more]

PMID: 22126299

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Project description:BackgroundFew studies have explored evidence-based practice (EBP) knowledge, attitudes and behaviours of health professional graduates transitioning into the workforce. This study evaluated changes in these EBP domains in physiotherapists after one year of working.MethodA mixed methods design was used. Participants completed two psychometrically-tested EBP questionnaires at two timepoints. The Evidence-Based Practice Profile questionnaire collected self-report EBP data (Terminology, Relevance, Confidence, Practice, Sympathy) and the Knowledge of Research Evidence Competencies collected objective data (Actual Knowledge). Changes were calculated using descriptive statistics (paired t-tests, 95% CI, effect sizes). Qualitative interview data collected at one timepoint were analysed using a descriptive approach and thematic analysis, to examine the lived experience of participants in the context of their first employment. The aim of the mixed methods approach was a broader and deeper understanding of participants' first year of employment and using EBP.ResultsData were analysed from 50 participants who completed both questionnaires at the two timepoints. After one year in the workforce, there was a significant decrease in participants' perceptions of Relevance (p<0.001) and Confidence with EBP (p<0.001) and non-significant decreases in the other domains. Effect sizes showed medium decreases for Relevance (0.69) and Confidence (0.57), small decreases in Terminology (0.28) and Practice (0.23), and very small decreases in Sympathy (0.08) and Actual Knowledge (0.11). Seven themes described participants experience of using EBP in their first working year.ConclusionsAfter a year in the workplace, confidence and perceptions of relevance of EBP were significantly reduced. A subtle interplay of features related to workplace culture, competing demands to develop clinical skills, internal and external motivators to use EBP and patient expectations, together with availability of resources and time, may impact early graduates' perceptions of EBP. Workplace role models who immersed themselves in evidence discussion and experience were inspiring to early graduates.

Project description:BackgroundDespite the recognition of integrating evidence-based practice (EBP) in educational programs, there is limited research about bachelor students' EBP profiles (EBP knowledge, attitudes and behaviour) in the health disciplines nursing, occupational therapy, physiotherapy and radiography. The aim of this study was to assess EBP profiles among bachelor students in health disciplines, and explore differences between health disciplines, educational institutions, students' assessment of EBP teaching and expectations of EBP performance.MethodsA survey using the 'Evidence-Based Practice Profile - Norwegian version' (EBP2-N) was conducted among final year bachelor students in health disciplines from four educational institutions. The questionnaire consisted of five domains (Relevance, Terminology, Confidence, Practice and Sympathy) and assessed the five steps of EBP. We performed regression analyses to analyse mean differences in domain scores between health disciplines, Cohen's d to illustrate the magnitude of the largest difference in each domain, Omega squared to describe portion of variance in domain scores, and Spearman's rho (rs) to assess the monotonic relationship between EBP2-N domains and assessment of EBP teaching and expectations of EBP performance, respectively.ResultsStudents reported highest overall mean score for Relevance, with an estimated standardized mean of 81.2 (CI 95%?=?80.4-82.0). The other EBP2-N domains had estimated standardized means of 54 and less. Statistically significant differences (p?<?0.03) between health disciplines were observed for all domains. The largest mean difference was found for Relevance with highest score for occupational therapy and lowest for radiography, with an estimated Cohen's d of 1.11. Moderate positive associations were observed between Relevance scores and students' assessment of EBP teaching (rs?=?0.31), and expectations of EBP performance from teachers (rs?=?0.36). We also observed a moderate positive correlation between Confidence and students' assessment of EBP teaching (rs?=?0.46).ConclusionBachelor students in health disciplines found EBP relevant, but revealed low understanding of EBP terminology, low confidence with EBP skills, and low use of EBP in clinical situations. We observed differences in EBP profiles between health disciplines and between educational institutions. The differences in scores raise questions about the understanding of EBP within disciplines, and the complexity of EBP in educational settings.

Project description:BACKGROUND:Falls in older adults are an increasingly important public-health concern. Despite abundant research, fall rates have not been reduced, because implementation of evidence-based fall-prevention measures has been slow and limited. This study aims to explore physiotherapists' perceptions on external factors, such as public policy, organisation and leadership, regarding the relation between knowledge translation and the three elements of evidence-based practice (EBP) to effectively address barriers and facilitate the uptake of EBP in fall prevention. METHODS:We conducted semi-structured interviews with 18 physiotherapists (men?=?7; women?=?11) working with fall prevention in the primary healthcare system. The physiotherapists ranged in age from 27 to 60?years (median 36?years) and had worked as a physiotherapist from 1 to 36?years (median 7?years). Data are analysed using thematic analysis. RESULTS:The analysis revealed one main theme and four sub-themes. The main theme was 'Environmental empowerment enhances physiotherapists' capabilities for using EBP'. A resourceful work environment facilitates EBP, having access to information about research-based knowledge, supportive leadership, enough human resources and opportunities to learn and grow at work. The four sub-themes were as follows: 1) 'Tension between attributes of research-based knowledge and organisational routines and practices'; 2) 'Evidence must be informed by policymakers-What works?'; 3) 'Empowering culture and work environment-A steppingstone to EBP' and 4) 'Organisation readiness for EBP, managerial and clinical relations'. Success in environmental empowerment depends on the leader's role in creating preconditions at the workplace that may lead to important positive personal and organisational outcomes for EBP. Two-way communication and transfer-of-information are also key factors in the development of positive work engagement when using EBP. CONCLUSION:The findings of this study outline tension between policy, leadership, organisational facilitators and EBP. Leadership is influenced by policy with ripple effects for the organisation and clinicians. Organisational facilitators form structural empowerment, which is the foundation for creating an EBP environment. TRIAL REGISTRATION:2018/2227/REC south-east C. Registered 19 December 2018, Norwegian Ethics Committee for Medical and Health Research Ethics.

Project description:BackgroundThe Modified Fresno Test has been used to evaluate the use of the Evidence-Based Physiotherapy (EBP). So far, none of the versions of the Fresno Test were subjected to analysis of the factorial structure. The objective of the study was to describe the exploratory and confirmatory factor structure of the Modified Fresno Test adapted to the Portuguese-Brazilian and analyze the statistical feasibility for the elaboration of a short version.MethodsThe questionnaire was applied with a convenience sample of 57 physiotherapists, being 36 professionals (13 of these also professors) and 21 students from the last semester of the physiotherapy course. Exploratory Factor Analysis (EFA) was performed by the method of principal components. Confirmatory Factor Analysis (CFA) was performed by the method of maximum likelihood. The total score of the answers in the test and retest was evaluated, totalling 228 observations. Reliability was assessed by means of internal consistency, using Cronbach's alpha coefficient.ResultsReliability was satisfactory (α 0.81) for all questions of the instrument. The coefficient α calculated for the corrected item-total showed values higher than 0.20 except for item 9. Preliminary tests for Exploratory Factor Analysis showed acceptable values with Kaiser-Meyer-Olkin (KMO = 0.80) and Bartlett's test of sphericity [chi-square (78) = 1149.615, p < 0.001], indicating that the correlations were sufficient for analysis. The analysis revealed the presence of 3 factors (eigenvalues> 1), which explains 60.9% of the instrument's total variance. In Confirmatory Factor Analysis, none of the indices came close to an acceptable level (≥ 0.90), however, the second model which tested a three-factor structure provided a better fit to the data. From the results of this study the Modified Fresno Test short version was drawn.ConclusionThe analysis showed good factor validity and adequate internal consistency for the use of the instrument consisting of 13 questions and 3 factors. This model proved to be better than the original model. The short version consisting of 9 questions may be an appropriate alternative for use in the population of interest.

Project description:Aims and objectivesTo describe the nature and scope of nurse-midwifery practice in Texas and to determine legislative priorities and practice barriers.BackgroundAcross the globe, midwives are the largest group of maternity care providers despite little known about midwifery practice. With a looming shortage of midwives, there is a pressing need to understand midwives' work environment and scope of practice.DesignMixed methods research utilising prospective descriptive survey and interview.MethodsAn online survey was administered to nurse-midwives practicing in the state of Texas (N = 449) with a subset (n = 10) telephone interviewed. Descriptive and inferential statistics and content analysis was performed.ResultsThe survey was completed by 141 midwives with eight interviewed. Most were older, Caucasian and held a master's degree. A majority worked full-time, were in clinical practice in larger urban areas and were employed by a hospital or physician group. Care was most commonly provided for Hispanic and White women; approximately a quarter could care for greater numbers of patients. Most did not clinically teach midwifery students. Physician practice agreements were believed unnecessary and prescriptive authority requirements restrictive. Legislative issues were typically followed through the professional organisation or social media sites; most felt a lack of competence to influence health policy decisions. While most were satisfied with current clinical practice, a majority planned a change in the next 3 to 5 years.ConclusionsAn ageing midwifery workforce, not representative of the race/ethnicity of the populations served, is underutilised with practice requirements that limit provision of services. Health policy changes are needed to ensure unrestricted practice.Relevance to clinical practiceRobust midwifery workforce data are needed as well as a midwifery board which tracks availability and accessibility of midwives. Educators should consider training models promoting long-term service in underserved areas, and development of skills crucial for impacting health policy change.

Project description:BackgroundThe implementation of evidence-based practice (EBP) in daily health care practice is strongly encouraged; it is widely recognized as a means to improve the quality and safety of health care for patients and reduce avoidable costs. Primary care nurses and physiotherapists face numerous challenges in trying to ensure that they deliver effective daily care. Broadly promoted educational interventions aim to increase the integration and implementation of EBP in their daily practice.ObjectiveThis systematic review will retrieve and evaluate publications examining the effectiveness of educational interventions to increase the integration and implementation of EBP among nurses, nurse practitioners, and physiotherapists active in primary care.MethodsWe will conduct a systematic review of published articles in relevant professional, scientific journals (from their start dates) and in the following electronic databases, from inception until October 31, 2020: Medline Ovid SP (from 1946), PubMed (NOT Medline[sb]; from 1996), Embase.com (from 1947), CINAHL Ebesco (from 1937), the Cochrane Central Register of Controlled Trials Wiley (from 1992), PsycINFO Ovid SP (from 1806), Web of Science Core collection (from 1900), PEDro (from 1999), the JBI Database of Systematic Reviews and Implementation Reports (from 1998), and the Trip Database (from 1997). We will use the predefined search terms of "evidence-based practice," "nurses," or "physiotherapists" and combinations with other terms, such as "educational interventions." We will also conduct a hand search of the bibliographies of all the relevant articles and a search for unpublished studies using Google Scholar, the ProQuest Dissertations and Theses dissemination, Mednar, WorldCat, OpenGrey, and Grey Literature Report. We will consider publications in English, French, German, and Portuguese.ResultsThe electronic database searches were completed in October 2020. Retrieved articles are currently being screened, and the entire study is expected to be completed by March 2021.ConclusionsThis systematic review will provide specific knowledge about the effectiveness of educational interventions to increase the implementation and integration of EBP in the daily practice of nurses and physiotherapists providing primary care services. Its findings will inform us about the types and frequencies of the most successful educational interventions.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42017077309; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77309.International registered report identifier (irrid)DERR1-10.2196/17621.

Dataset Information

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts.

Background

Methods

Results

Conclusions

Publications

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts.

Similar Datasets

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