What's the Task Value? Understanding Doctor of Physical Therapy Students' Perceptions of the Value and Relevance of Evidence-Based Practice

Abstract

Background and Purpose. The profession of physical therapy requires clinicians to value and use evidence-based practice (EBP) in their decision-making process with patients. Although EBP has been incorporated into doctor of physical therapy (DPT) curricula for 2 decades, a gap between knowledge and practice persists. As a first step to addressing this gap, academic programs can focus on fostering students' valuing of EBP and research methods. The current method/model set out to achieve this with task value (TV) as the theoretical basis. Task value is a theory of motivation based on four constructs: intrinsic value (IV), cost, attainment, and utility. Based on the TV theory, the purposes of this method/model were to (1) clarify students' definition of EBP in clinical practice; (2) explicitly link “EBP/Research Methods” and their future role as a clinical practitioner; and (3) further students' understanding of EBP and research methods by providing an opportunity for them to practice these skills. Method/Model Description and Evaluation. Eighty-one, third-year DPT students enrolled in a 6-year, entry-level DPT program participated in the “EBP/Research Methods” course. The educational intervention incorporated a course advanced organizer to illustrate assignment linkages, a graphic that provided an overview that illustrated the EBP process in the clinic, EBP assignments, an interactive student response system to uncover students' knowledge and understanding in real time, and article critiques, which underscored the value and importance of EBP. Evaluation consisted of a 10-question online survey, with 7 questions designed to measure the four constructs of TV. Two reflective papers were used to identify students' definition of EBP; perceived costs to use in a clinical setting; and course activities that impacted students' understanding of EBP. The survey and reflective papers were administered before and after course intervention. Outcomes. Paired t tests were conducted on the seven questions related to the TV scale. Overall, mean values of IV of EBP reported on the presurvey were high and did not change significantly postsurvey. However, the cost measure decreased significantly from pre- to postsurvey P < .00, as did the measures of attainment (P = .001) and utility (P = .002). Qualitative data revealed that the contributors to perceived costs of learning about EBP included the following: lack of clinical experience, fear of challenging authority, lack of access to medical literature, and lack of time. Discussion and Conclusion. Although students generally reported a high level of IV for EBP that did not change significantly after the course, their perception of cost, attainment value, and utility value decreased significantly. These changes may have been due to students' increased understanding of EBP/Research Methods, which resulted in their perceiving greater cost. Educators may expect this response as students discover that EBP is complex and has an ongoing learning process. More positive perceptions may occur once students gain clinical experience. Pedagogical models must systematically and longitudinally target improvement of student value and motivation for using EBP. Recognition that EBP is a continuous process is critical to its development in students and practicing clinicians.

Lessons Learned After Integrating the Five Steps of Evidence-Based Practice Into a Doctor of Physical Therapy Curriculum

“…This project reinforced the idea of EBP as a trainable skill that requires practice and experiential learning. 8 Some lessons learned confirmed the importance of a multifaceted educational approach, including lectures, case-based assignments, and reflections. Early introduction to core EBP skills was found to facilitate the process of learning, with the greatest benefits through constant reinforcement and application.…”

“…Faculty buy-in was critical to reinforce EBP skills across all curricular elements including clinical courses, as was using standardized rubrics and assignments to assess and reinforce EBP skills. 8 The PT Toolkit also helped centralize necessary resources to conduct a comprehensive and efficient literature search. Roadblocks still exist including applicability in all clinical based courses, workload associated with assignments for both faculty and students, and full accessibility to evidence using the PT Toolkit once students graduate from the program.…”

“…6,8 As such, it is a priority to review, revise, and adapt courses that teach the foundational concepts and skills for EBP. 8 e results of this case study indicated that when implementing the guidelines for teaching EBP, students can meet the terminal objectives for entry-level DPT practitioners. However, there were limitations in fully assessing the fourth step because proportions of improvement were not compared between groups.…”

Utility value intervention fails to boost student motivation and performance in psychology courses.

“…When combined with past SoTL findings, these results suggest UV interventions more effectively increase the perceived value of individual course components than an entire course. In previous studies, perceived UV increased when the UV intervention focused on specific course elements (e.g., group discussions; Clinton & Kelly, 2017, but not when the intervention focused on the course as a whole (Hayward & English, 2018;McGinley & Jones, 2014). One limitation in studies focusing on entire courses was their delivery of multiple interventions simultaneously, making it difficult to discern the unique impact of the UV intervention.…”

“…These UV interventions, however, were limited in scope, focusing only on one-course component rather than the perceived value of the course as a whole. Other studies have focused on entire courses, including doctoral-level research methods in physical therapy and undergraduate introductory and upper-division psychology, but delivered multiple motivational interventions (i.e., empowerment, usefulness [UV], success, interest, and caring) at once (Hayward & English, 2018; McGinley & Jones, 2014). This approach limits the extent to which any perceived differences could be attributed to the UV component of the intervention.…”