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

Abstract

BackgroundEvidence is needed to develop effective educational programs for promoting evidence based practice (EBP) and knowledge translation (KT) in physical therapy. This study reports long-term outcomes from a feasibility assessment of an educational program designed to promote the integration of research evidence into physical therapist practice.MethodsEighteen physical therapists participated in the 6-month Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program. The participant-driven active learning program consisted of four consecutive, interdependent components: 1) acquiring managerial leadership support and electronic resources in three clinical practices, 2) a 2-day learner-centered EBP training workshop, 3) 5 months of guided small group work synthesizing research evidence into a locally relevant list of, actionable, evidence-based clinical behaviors for therapists treating persons with musculoskeletal lumbar conditions--the Best Practices List, and 4) review and revision of the Best Practices List, culminating in participant agreement to implement the behaviors in practice. Therapists’ EBP learning was assessed with standardized measures of EBP-related attitudes, self-efficacy, knowledge and skills, and self-reported behavior at baseline, immediately-post, and 6 months following conclusion of the program (long-term follow-up). Therapist adherence to the Best Practice List before and after the PEAK program was assessed through chart review.ResultsSixteen therapists completed the long-term follow-up assessment. EBP self-efficacy and self-reported behaviors increased from baseline to long-term follow-up (p < 0.001 and p = 0.002, respectively). EBP-related knowledge and skills showed a trend for improvement from baseline to long-term follow-up (p = 0.05) and a significant increase from immediate-post to long-term follow-up (p = 0.02). Positive attitudes at baseline were sustained throughout (p = 0.208). Eighty-nine charts were analyzed for therapist adherence to the Best Practices List. Six clinical behaviors had sufficient pre- and post-PEAK charts to justify analysis. Of those, one behavior showed a statistically significant increase in adherence, one had high pre- and post-PEAK adherence, and four were change resistant, starting with low adherence and showing no meaningful improvement.ConclusionsThis study supports the feasibility of the PEAK program to produce long-term improvements in physical therapists’ EBP-related self-efficacy and self-reported behavior. EBP knowledge and skills showed improvement from post-intervention to long-term follow-up and a trend toward long-term improvements. However, chart review of therapists’ adherence to the participant generated Best Practices List in day-to-day patient care indicates a need for additional support to facilitate behavior change. Future versions of the PEAK program and comparable multi-faceted EBP and KT educational programs should provide ongoing monitoring, feedback, and problem-solving to successfully promote behavio...

Reported use of evidence in clinical practice: a survey of rehabilitation practices in Norway

“…Programs that include multi-component interventions that combine strategies and target barriers to use of a new practice have demonstrated effectiveness [ 34 ]. An example of this type of program is the Physical therapist-drive Education for Action Knowledge translation (PEAK), which included acquiring leadership support and electronic resources, a 2-day EBP training workshop, small group work to adapt research to the local context and create a best practice list (5 months), review the best practice list, and agreement to implement it [ 35 ]. While the baseline mean total EBPIS score was 25.5 (slightly lower than the samples studied in our project), a statistically significant improvement in score was demonstrated immediately after the project conclusion with no changes at a 6 month follow-up [ 35 ].…”

“…An example of this type of program is the Physical therapist-drive Education for Action Knowledge translation (PEAK), which included acquiring leadership support and electronic resources, a 2-day EBP training workshop, small group work to adapt research to the local context and create a best practice list (5 months), review the best practice list, and agreement to implement it [ 35 ]. While the baseline mean total EBPIS score was 25.5 (slightly lower than the samples studied in our project), a statistically significant improvement in score was demonstrated immediately after the project conclusion with no changes at a 6 month follow-up [ 35 ]. The EBPIS scores statistically improved after the program, however, a chart audit indicated only one best practice behavior demonstrated a statistically significant change.…”

Discrepancies Between the Motivational and the Skill Factor in Choosing the Physical Therapist Profession

“…De altfel, într-o lume dinamică a ocupaţiilor, deprinderile transferabile căpătate deopotrivă prin muncă şi învăţătură sunt înalt valorizate şi reprezintă garanţia înnoirii din interior a respectivelor sectoare de activitate. (Kurunsaari et al, 2015;Tilson, et al, 2016). …”

“…These are joined by the ability to make clinical decisions, or character traits, such as: politeness, amiableness, gentleness, * E-mail: gabigmares@yahoo.com correctness, seriousness, etc. (Cassady et al, 2012;Sander et al, 2016;Kurunsaari et al, 2015;Tilson et al, 2016).…”

“…Besides, in a dynamic world of occupations, the transferable skills that are acquired through both work and education are highly valued and they represent the guarantee for renewal of those particular activities. (Kurunsaari et al, 2015;Tilson et al, 2016). …”