The Effects of Modeling Evidence-Based Practice During the Clinical Internship

Sabus, Carla

doi:10.1097/00001416-200810000-00009

Cited by 22 publications

(19 citation statements)

References 26 publications

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“…Thus, lack of support at the clinical placement could explain why students did not apply research evidence to clinical practice. This is in agreement with several previous studies that have identified lack of support from clinical instructors as a barrier towards EBP (Bradley et al ., ; Stube and Jedlicka, ; Sabus, ; Ilic and Forbes, ; Stronge and Cahill, ; Jonsen et al ., ; Olsen et al ., ).…”

Section: Discussionmentioning

confidence: 99%

Evidence-based Practice Exposure and Physiotherapy Students' Behaviour during Clinical Placements: A Survey

Olsen

Lygren

Nortvedt

et al. 2014

Physiother. Res. Int.

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Background and purpose. Physiotherapists are expected to practice in an evidence-based way. Evidence-based practice (EBP) should be an integral part of the curriculum to ensure use of the five EBP steps: asking clinical questions, searching for and appraising research evidence, integrating the evidence into clinical practice and evaluating this process. The aim of this study was to compare self-reported EBP behaviour, abilities and barriers during clinical placements reported by five cohorts of final year physiotherapy students' with different EBP exposure across the 3-year bachelor programme. Methods. A cross-sectional study was conducted among five cohorts (2006-2010) with third year physiotherapy students at a University College in Norway. In total, 246 students were eligible for this study. To collect data, we used a questionnaire with 42 items related to EBP behaviour, ability and barriers. Associations were investigated using the Spearman's rho (r). Results. In total, 180 out of 246 third year physiotherapy students, who had recently completed a clinical placement, filled out the questionnaire (73 %). The association between the level of EBP exposure and students' self-reported EBP behaviour, abilities and barriers was low for most items in the questionnaire. Statistically significant correlations were found for eight items, related to information need, question formulation, use of checklists, searching and perceived ability to search for and critically appraise research evidence. The strongest correlation was found between the level of EBP exposure and ability to critically appraise research evidence (r = 0.41, p < 0.001). Conclusions. An association between the level of EBP exposure and physiotherapy students' EBP behaviour was found for elements such as asking and searching, ability to search for and critically appraise research evidence, and experience of critical appraisal as a barrier. Further research need to explore strategies for EBP exposure throughout the curriculum, regarding content, timing, amount and type of training.

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Section: Discussionmentioning

confidence: 99%

Evidence-based Practice Exposure and Physiotherapy Students' Behaviour during Clinical Placements: A Survey

Olsen

Lygren

Nortvedt

et al. 2014

Physiother. Res. Int.

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“…Our findings support this as all participants described how students used CIs as their main information source. CIs naturally have a unique position serving as instructors and role models to physiotherapy students [64,65], and are most likely potential role models also when it comes to promoting EBP among students [65]. Role modeling EBP can involve asking questions aloud, finding and appraising relevant evidence, discussing aloud how the evidence will be used to plan a treatment strategy ([40], p.200).…”

Section: Discussionmentioning

confidence: 99%

Evidence based practice in clinical physiotherapy education: a qualitative interpretive description

et al. 2013

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BackgroundHealth care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students’ use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers.MethodsIn total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process.ResultsFour integrative themes emerged from the analysis: “attempt to apply evidence-based practice”, “novices in clinical practice”, “prioritize practice experience over evidence-based practice” and “lack role models in evidence-based practice”. Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice.ConclusionsClinical instructors are in a position to influence students during clinical education, and thus, important potential role models in evidence-based practice. Actions from academic and clinical settings are needed to improve competence in evidence-based practice among clinical instructors, and future research is needed to investigate the effect of such efforts on students’ behaviour.

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“…Without regular communication between academic faculty and clinical instructors, students must negotiate the differences between the settings. 58 …”

Section: Barriers To Ebp Incorporationmentioning

confidence: 99%

Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

Hankemeier

Lunen

2013

Journal of Athletic Training

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Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood.Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers.Design: Qualitative study. Setting: Telephone interviews.Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer ¼ 10 6 4.7 years, experience as an ACI ¼ 6.81 6 3.9 years) were interviewed.Data Collection and Analysis: We interviewed each participant by telephone. Interview data were analyzed and coded for common themes and subthemes regarding barriers and educational emphases. Themes were triangulated through multipleanalyst triangulation and interpretive verification.Results: Barriers to EBP incorporation and educational emphasis placed on EBP were the main themes reported. Resources, personnel, and student characteristics were subthemes identified as barriers. Resource barriers included time, equipment, access to current literature, and knowledge. Coworkers, clinicians, and coaches who were unwilling to accept evidence regarding advancements in treatment were identified as personnel barriers. Programmatic improvement and communication improvement were subthemes of the educational emphasis placed on EBP theme. The ACIs reported the need for better integration between the clinical setting and the classroom and expressed the need for EBP to be integrated throughout the athletic training education program.Conclusions: Integration of the classroom and clinical experience is important in advancing ACIs' use of EBP with their students. Collaborative efforts within the clinical and academic program could help address the barriers ACIs face when implementing EBP. This collaboration could positively affect the ability of ACIs to implement EBP within their clinical practices.Key Words: education, curricular integration, collaboration Key PointsResources, opportunities, and integration should be provided to Approved Clinical Instructors (ACIs) to help create an educational program that focuses on valuing the best evidence, patient values, and clinical expertise. A culture of evidence-based practice (EBP) needs to be promoted in clinical practice. Understanding the barriers that ACIs face while implementing EBP within their clinical practices and with students can help athletic training education programs better prepare ACIs to incorporate EBP. Collaboration between the clinical and academic programs could help ACIs address barriers and improve their abilities to implement EBP in their clinical practices.

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The Effects of Modeling Evidence-Based Practice During the Clinical Internship

Cited by 22 publications

References 26 publications

Evidence-based Practice Exposure and Physiotherapy Students' Behaviour during Clinical Placements: A Survey

Evidence-based Practice Exposure and Physiotherapy Students' Behaviour during Clinical Placements: A Survey

Evidence based practice in clinical physiotherapy education: a qualitative interpretive description

Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

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