Challenges and future directions in the measurement of evidence-based practice: Qualitative analysis of umbrella review findings.

Abstract

We conducted a secondary analysis of qualitative data obtained in the context of a previously published umbrella review that aimed to compare SRson EBP measures. Two reviewers independently extracted excerpts from the results and discussion/conclusion sections of the 10 included SRs that aligned with the three research aims. An iterative six-phase reflexive thematic analysis according to Braun and Clarke was conducted. Our thematic analysis produced five themes describing the main challenges associated with measuring EBP, four themes outlining main recommendations for practice, and four themes representing areas of future research. Challenges include limited psychometric testing and validity evidence for existing EBP measures; limitations with the self-report format; lack of construct clarity of EBP measures; inability to capture the complexity of the EBP process and outcomes; and the context-specific nature of EBP measures. Reported recommendations for practice include acknowledging the multidimensionality of EBP; adapting EBP measures to the context and re-examining the validity argument; and considering the feasibility and acceptability of measures. Areas of future research included the development of comprehensive, multidimensional EBP measures and the need for expert consensus on the operationalization of EBP. This study suggests that existing measures may be insufficient in capturing the multidimensional, contextualand dynamic nature of EBP. There is a need for a clear operationalization of EBP andan improved understanding and application of validity theory.