Promoting physical therapists’ of research evidence to inform clinical practice: part 1 - theoretical foundation, evidence, and description of the PEAK program

Abstract

BackgroundThere is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura’s social cognitive theory and Malcolm Knowles’s adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels.DiscussionThe 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a “Best Practices List” - a list of locally generated, evidence-based, actionable behaviors relevant to the groups’ clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice.SummaryThis, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program – an educational program designed to promote the use of research evidence to inform physical therapist practice. The four components of the program are described in detail. The companion paper reports the results of a mixed methods feasibility analysis of this complex educational intervention.

How Do Physical Therapists Treat People with Knee Osteoarthritis, and What Drives Their Clinical Decisions? A Population-Based Cross-Sectional Survey

“…Some preliminary work has found that small-group work, along with interactive and personal education, tends to be most effective. [25][26][27] Future studies, ideally using a randomized controlled design, should be conducted to identify which training methods are likely to result in improved clinical decisions based on the best available evidence by physical therapists of different ages and at different professional stages and eventually to determine the influence of these training methods on patients' outcomes. Our results also stress that current research on PT treatment of knee osteoarthritis does not reflect clinical practice.…”

Barriers against incorporating evidence-based practice in physical therapy in Colombia: current state and factors associated

“…The most frequently reported barrier concerns limited time, thereby constraining the identification and interpretation of research evidence; being able to apply research findings to clinical practice has also been reported [ 9 , 18 ]. Tilson et al [ 19 ], have recently identified other common barriers, including an inability to determine the legitimacy of research findings, insufficient research literature on specific patients’ problems, deficient information regarding retrieval skills and an inability to incorporate patient preferences into decision-making, such results coinciding with those reported by Jette et al [ 10 ].…”

Promoting physical therapists’ use of research evidence to inform clinical practice: part 3 – long term feasibility assessment of the PEAK program

“…The Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program is an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making [ 7 ]. A mixed methods analysis reported feasibility of the 6-month program based on therapist-participant focus groups and short term EBP learning outcomes [ 8 ].…”

“…A study to assess feasibility for implementing the PEAK program was conducted from 2010-2011 among physical therapists at the University of Southern California clinical practices. Previous reports describe the program and its theoretical underpinnings [ 7 ] and a mixed-method analysis of immediate post-PEAK outcomes [ 8 ]. The purposes of this manuscript are to report 1) long-term outcomes regarding therapists’ EBP-related attitudes, self-efficacy, knowledge and skills, and self-reported behaviors, and 2) therapists’ adherence to participant-generated, evidence-based behaviors in patient care.…”