Abstract
BackgroundTraining in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce.MethodsA prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2), which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts), Confidence, Practice (EBP implementation), Sympathy (disposition towards EBP)]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES) (95% CI) were calculated for all changes.ResultsEffect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42). While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29) followed by an improvement in the second year (ES +0.27). Scores in Terminology improved (ES +0.19 to +0.26) in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19) in the first year and improved minimally in the second year (ES +0.04). Confidence scores improved during the second workforce year (ES +0.27). Scores for Sympathy showed little change.ConclusionsDuring the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown.
Highlights
Training in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training
Relevance declined with transition into the workforce, increased during the second year; Terminology continued to improve and Confidence increased during the second year
The findings suggested that participants, all of whom had been exposed to entry-level EBP training, graduated with a strong perception of the importance of EBP, were confident and had a good understanding of EBP terminology but engaged in little practice of EBP
Summary
Training in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce. Since the publication of the Sicily statement [4], there has been greater attention paid to EBP training in entrylevel education (Bachelor degrees or equivalent) This consensus document recommended that every individual practitioner be trained in the five-step model of EBP with skills to ask a research question, access, appraise and apply the evidence, and assess the process. Glasziou [5] advocated that EBP training should be introduced early, and embedded and applied throughout entry-level training [5] In theory, this training should ‘future-proof’ graduates with the life-long learning skills required for making evidence-based health care decisions [4]
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