Access Is Key: Teaching Students and Physical Therapists to Access Evidence, Expert Opinion, and Patient Values for Evidence-Based Practice

Abstract

Background and Purpose. Access to literature that supports evidence-based practice (EBP), including identification and retrieval, is essential to implementation of EBP in physical therapy. This article will discuss importance of teaching access to EBP resources, discuss resources to identify and retrieve evidence-based literature, and outline strategies for teaching access of EBP literature in physical therapy education. With rapid growth in physical therapy articles, access to literature is essential, including a significant role for electronic access. Methods and Materials. A review of physical therapy and rehabilitation literature was completed with an informal listserv survey to characterize common methods and strategies used to teach access to EBP information in physical therapy education programs. Summary of Literature. The importance of teaching access to EBP information is discussed. A variety of sources that can be used to identify applicable articles are summarized. Options for retrieval of those articles including specific search strategies are discussed as well as barriers to access. Specific strategies and instructional activities for teaching access to EBP information and teaching resources are described. Discussion and Conclusion. Tremendous potential exists for improved patient care as students and physical therapists are instructed in EBP. Access to evidence-based literature is a foundational prerequisite for application of EBP and will result in optimal clinical outcomes. Key Words: Evidence-based practice, Education, Teaching, Literature, Access. INTRODUCTION To be able to consistently apply evidence basis to their daily physical therapy practice, each physical therapist (PT) must learn to effectively access and apply appropriate, scientifically sound information whenever available. Access to evidence-based information includes at least two components: 1) identifying and locating information and 2) retrieval of article or manuscript. Access truly is key, as expressed by Farmer and Richardson1 who stated Perhaps single most important thing policy makers could do to encourage evidence-based practice among health professionals would be to provide good access to information professionals and information resources. 1(p98) Information professionals, particularly medical librarians, are experts who can guide physical therapists to quality information and can educate them in effective search strategies. Evidence-based practice (EBP) is the conscientious, explicit, and judicious use of current best evidence in making decisions about care of individual patients2 and involves three elements, the integration of best research evidence with clinical expertise and patient values.3(p1) Therefore, students and therapists must he taught to identify, access, and apply information. Attention to information from these three elements-best research evidence, clinical expertise, and patient values-will enable one to make sound clinical decisions, ie, evidence-based decision making (EBDM). While best research evidence is found in recent, relevant, peer-reviewed research publications, as addressed in other articles in this issue, students should be taught to pay attention to type, quality, and rigor of each study as they access evidence. Students searching for best research evidence must be equipped to recognize relative strength of conclusions drawn from any particular stud4,5 and relative importance of all three elements of EBP. Clinical expertise includes use of clinical skills and past experience of health care provider,3(p1) but can often be found in form of published clinical practice guidelines6 or intervention guidelines, usually developed by agencies or professional groups for specific problems. Such guidelines, ideally based on recent research evidence,6 are often developed with no uniformity in methodology7 and are usually available in print or on government or organization Web sites, for example, www. …