Undergraduate physiotherapy students' competencies, attitudes and perceptions after integrated educational pathways in evidence-based practice: a mixed methods study

Abstract

This mixed methods study aimed to explore perceptions/attitudes, to evaluate knowledge/ skills, to investigate clinical behaviours of undergraduate physiotherapy students exposed to a composite education curriculum on evidence-based practice (EBP). Students' knowledge and skills were assessed before and after integrated learning activities, using the Adapted Fresno test, whereas their behaviour in EBP was evaluated by examining their internship documentation. Students' perceptions and attitudes were explored through four focus groups. Sixty-two students agreed to participate in the study. The within group mean differences (A-Fresno test) were 34.2 (95% CI 24.4 to 43.9) in the first year and 35.1 (95% CI 23.2 to 47.1) in the second year; no statistically significant change was observed in the third year. Seventy-six percent of the second year and 88% of the third year students reached the pass score. Internship documentation gave evidence of PICOs and database searches (95-100%), critical appraisal of internal validity (25-75%) but not of external validity (5-15%). The correct application of these items ranged from 30 to 100%. Qualitative analysis of the focus groups indicated students valued EBP, but perceived many barriers, with clinicians being both an obstacle and a model. Key elements for changing students' behaviours seem to be internship environment and possibility of continuous practice and feedback.

Evidence-based Practice Intentions and Long-term Behaviours of Physiotherapy Graduates Following an Intensive Education Programme

“…Half the respondents had completed this programme 4 or more years previously. Our findings add to the scant body of knowledge regarding post‐graduate EBP practices, as previous research has almost exclusively involved undergraduate students, or EBP programmes that are not embedded in a post‐graduate clinical programme (McEvoy et al, ; Wong et al, ; Bozzolan et al, ). The findings of this study will inform the development of future post‐graduate EBP programmes, and targeted experimental research, to determine whether EBP programmes for experienced graduate physiotherapists can indeed influence long‐term evidence‐seeking behaviour change.…”

Undergraduate Health Students’ Intention to Use Evidence‐Based Practice After Graduation: A Systematic Review of Predictive Modeling Studies

“…Depending on the student's experiences and level of learning, relating to such concepts can be challenging (Aglen, ). Context is also an important consideration for EBP teaching and learning as without providing a clinical setting, undergraduates are unable to identify applicability and relevance of EBP to their future clinical care (Bozzolan et al., ; Melnyk, ).…”

“The more you did, the more it made sense”: Problem‐based learning to improve early evidence‐based practice in an undergraduate physiotherapy professional programme

“…It stands to reason that in early EBP skill development, the methods of supporting social negotiation and collaboration must come from the instructional design rather than the content of the topic. Methods currently identified in the literature employed in entry‐level physiotherapy education in EBP to promote social negotiation and collaborative decision making (Hitch & Nicola‐Richmond, ) include group assignments (Gaspard & Prentice, ) and journal clubs, often strengthened by the invitation of students from other disciplines or practicing clinicians (Bozzolan et al, ). When PBL was used as the approach to EBP instruction in this study, the feedback from students highlighted the collaborative nature of the teaching environment, the inquiry and the assessment processes.…”

“…Although a large proportion of physiotherapists hold positive attitudes towards the principles of EBP, it has been noted that this does not necessarily translate to consistent and high-quality EBP in the clinical setting (Scurlock-Evans, Upton, & Upton, 2014). Furthermore, there is a general perception that allied health students perceive EBP as difficult, time-consuming, and irrelevant to their clinical practice (Bozzolan et al, 2014;Olsen, Bradley, Lomborg, & Nortvedt, 2013). These attitudes may prove a barrier to their engagement in learning about EBP.…”

“…In a recent systematic review to promote relevant and authentic learning in EBP (Hitch & Nicola-Richmond, 2017), the range of strategies identified in entry-level physiotherapy education did not explicitly use PBL. Teaching and learning strategies cited included poster presentations by students, simulated research projects (Gaspard & Prentice, 2014), and the application of pre-appraised evidence to practice (Bozzolan et al, 2014). Assignments embedded in or utilizing case studies were also used (Reicherter & Waller, 2014), and this form of learning was noted to make students aware of the type and quality (or lack thereof) of evidence available when working with a real life situation (Burger & Louw, 2014).…”