Individual and organizational factors associated with evidence‐based practice among physical and occupational therapy recent graduates: A cross‐sectional national study

Abstract

Background Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate‐level entry education to address graduates' readiness for evidence‐based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence‐based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence‐based activities among graduates of professional OT and PT master's programs. Methods A cross‐sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence‐based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis. Results 257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence‐based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence‐based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12). Conclusions Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence‐based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence‐based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence‐based professionals.

Exploring if and how evidence-based practice of occupational and physical therapists evolves over time: A longitudinal mixed methods national study

“…This is somewhat concerning when studies show that early career practitioners generally hold positive attitudes towards EBP [14,16,17], but that only half use EBP [13]. Findings from our nationwide study showed that two-thirds of the participating OT and PT graduates reported using EBP upon entry to practice [5]. In studies including different health professions, PTs showed more positive attitudes towards EBP but lesser use of EBP than other professions such as physicians, nurses, podiatry and radiology [18,19].…”

“…Enactment of EBP in the clinical and/or practice context can be operationalized through the self-reported use of EBP and indirectly through the number and type of evidence-based (EB) activities done in daily practice [5]. In our previous work, use of EBP was defined as "the actual application of EBP concepts, tools, and procedures into specific actions" [5] (p.3) .…”

“…Enactment of EBP in the clinical and/or practice context can be operationalized through the self-reported use of EBP and indirectly through the number and type of evidence-based (EB) activities done in daily practice [5]. In our previous work, use of EBP was defined as "the actual application of EBP concepts, tools, and procedures into specific actions" [5] (p.3) . Identifying a gap in knowledge related to a patient situation, effectively conducting an online literature search to address the research question, and critically appraising the strengths and weaknesses of study methods are some examples of use of EBP.…”

“…Identifying a gap in knowledge related to a patient situation, effectively conducting an online literature search to address the research question, and critically appraising the strengths and weaknesses of study methods are some examples of use of EBP. Evidence-based (EB) activities refers to "the implementation of research evidence to the surrounding environment" [5] (p.3) . Informally sharing and discussing literature/research findings with colleagues or patients, integrating research evidence with expertise, and making time and reading research reports are examples of EB activities.…”

Promoting the use of a self-management strategy among novice chiropractors treating individuals with spine pain: A mixed methods pilot clustered-clinical trial

“…Academic programs play a vital role in helping shape future health providers' EBP competencies; they must first lay the foundations of EBP (the "what", "why", "how" and "when" of EBP) and, over the course of training, ensure that students move along a trajectory of progressive development of EBP competencies [40,42]. Importantly, educational institutions are expected to adequately prepare future graduates to appreciate and navigate the many organizational factors (e.g., patient overload, staff shortage) that can often impede the sustained use of EBPs [43]. In the context of becoming evidence-based practitioners, Singer and Bossarte (2006) suggest three reasons for why students may be interested in taking part in a research project during their formal training: 1) altruistic purposes" as people want to help others; 2) project-related purposes" (e.g., interesting topic); and 3) "self-serving purposes" (e.g., incentives) [44].…”