Abstract
BackgroundDedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs. It is important to understand the effectiveness of this training. This study investigated EBP outcomes in entry-level physiotherapy students from baseline to completion of all EBP training (graduation).MethodsMixed methods with an explanatory sequential design. Physiotherapy students completed two psychometrically–tested health professional EBP instruments at baseline and graduation. The Evidence-Based Practice Profile questionnaire collected self-reported data (Terminology, Confidence, Practice, Relevance, Sympathy), and the Knowledge of Research Evidence Competencies instrument collected objective data (Actual Knowledge). Focus groups with students were conducted at graduation to gain a deeper understanding of the factors impacting changes in students’ EBP knowledge, attitudes, behaviour and competency. Descriptive statistics, paired t-tests, 95% CI and effect sizes (ES) were used to examine changes in outcome scores from baseline to graduation. Transcribed focus group data were analysed following a qualitative descriptive approach with thematic analysis. A second stage of merged data analysis for mixed methods studies was undertaken using side-by-side comparisons to explore quantitatively assessed EBP measures with participants’ personal perceptions.ResultsData were analysed from 56 participants who completed both instruments at baseline and graduation, and from 21 focus group participants. Large ES were reported across most outcomes: Relevance (ES 2.29, p ≤ 0.001), Practice (1.8, p ≤ 0.001), Confidence (1.67, p ≤ 0.001), Terminology (3.13, p ≤ 0.001) and Actual Knowledge (4.3, p ≤ 0.001). A medium ES was found for Sympathy (0.49, p = 0.008). Qualitative and quantitative findings mostly aligned but for statistical terminology, participants’ self-reported understanding was disparate with focus group reported experiences. Qualitative findings highlighted the importance of providing relevant context and positive role models for students during EBP training.ConclusionsFollowing EBP training across an entry-level physiotherapy program, there were qualitative and significant quantitative changes in participants’ knowledge and perceptions of EBP. The qualitative and quantitative findings were mainly well-aligned with the exception of the Terminology domain, where the qualitative findings did not support the strength of the effect reported quantitatively. The findings of this study have implications for the timing and content of EBP curricula in entry-level health professional programs.
Highlights
Dedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs
Participants There were 127 physiotherapy students enrolled in the first EBP course and 96 (77.2%) completed the initial questionnaire; there were 125 students enrolled in the third EBP or Honours course and 109 (87.2%) completed the final questionnaire
This study found that there were significant changes with mostly large effect sizes for the quantitatively assessed domains of Relevance, Terminology, Practice, Confidence, Sympathy and Actual Knowledge in physiotherapy students from first year to graduation
Summary
Dedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs. This study investigated EBP outcomes in entry-level physiotherapy students from baseline to completion of all EBP training (graduation). The principles of EBP dovetail well with the pedagogical principles applied by educational institutions in health professional education These include: creating an academic culture that values and understands the relevance of EBP, providing sound training in client and inter-professional communication skills, profession-specific technical skills, and skills in the five steps of EBP (ask, access, appraise, apply, assess) [1]. Most quantitative studies investigating the effectiveness of EBP training outside medicine have been pre-post in design with short term follow-up after one or two courses, and included students [6, 7] or clinicians [8]. Very few studies have investigated EBP outcomes across a wider time frame in the non-medical health professions; the exceptions were McEvoy et al [8] who investigated quantitative changes in EBP outcomes in physiotherapy students from graduation to one or 2 years in the workforce and Lewis et al [9] who evaluated changes in entry-level health professional students’ EBP knowledge, attitudes and behaviours after two sequential EBP courses spanning up to 2 years
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