Embracing Evidence-based Physiotherapy: Exploring Physiotherapists' Experiences

Abstract

S Barnard, R Wiles University of Southampton The need for evidence-based practice (EBP) by all clinicians has become high priority for those commissioning and delivering healthcare within the NHS (Bury, 1998). A study investigating the understanding and impact of EBP on 56 physiotherapists within a single Region found differences in definitions, views and experiences between grades and between workplace cultures (Wiles and Barnard, 1998). Focus groups, group and individual interviews were conducted with junior physiotherapists, senior physiotherapists and physiotherapy superintendents and managers from three types of workplace setting. These were hospitals with strong university and academic links, district general hospitals, and community and domiciliary units. Participants were selected using stratified randomisation methods from participating trusts across the Region. Although the Local Research Ethics Committee advised that ethical approval was not necessary, permission to access physiotherapists was obtained from the senior physiotherapy managers group in the Region, who all agreed to participate. The research found that junior physiotherapists had a better understanding of what comprised EBP and were more likely to have the skills, but not the experience, to assess and implement it. Seniors had a greater concern for the impact of EBP on patient choice and professional autonomy, while superintendents/managers were more likely to consider the wider impact on delivery of physiotherapy services. Departments which had academic links with universities were found to facilitate evidence-based physiotherapy practice through a departmental culture of training and the expectation that interventions would be based on more than clinical experience. The role of key committed physiotherapists was seen to be a driving force towards EBP, particularly by seniors in clinical roles and superintendents/managers in managerial roles. The consensus conference discussing this research saw the allocation of responsibility for EBP development within departments to key physiotherapists as a means of facilitating EBP within the profession.