Exploring Evidence Based Practice Implementation by Occupational Therapists: Implications for Fieldwork

Abstract

A fieldwork education model is used in occupational therapy to develop competency of professional skills, including evidence-based practice (EBP) and clinical reasoning. This quantitative study explored factors influencing implementation rates of EBP in New Zealand registered occupational therapists to better understand students’ experience of evidence-based practice while on fieldwork. An online survey exploring beliefs and practices related to clinical competence, professional reasoning and EBP was conducted. The survey included questions about related beliefs, the measure of Evidence Informed Professional Thinking (EIPT; Benfield & Johnston, 2020), and the Implementation Climate Scale (ICS; Ehrhart et al., 2014). The mean scores on the scales were entered into a linear regression model and backward stepwise regression was used to build a predictive model ascertaining primary influences for EBP implementation. On the measure of EIPT respondents reported infrequent engagement in clinical reasoning and EBP activities. Scores on the ICS results indicate some support of EBP practices in respondents’ workplaces. Habits of critical reflection have the strongest relationship to habits of implementing EBP in daily practice The only other factors significant in the predictive model were focus on EBP, and respondents’ level of education. Habits of critical reflection on practice and clinical reasoning activities have the strongest relationship with EBP engagement. Fieldwork students are likely to observe fieldwork educators who are infrequently engaging in critical activities of reflection and EBP. Development of strategies to enhance and habitualize critical reflection and clinical reasoning will increase EBP implementation rates. Pragmatic strategies between fieldwork educators, educational institutions, and students will likely enhance students’ learning and ultimately enhance overall EBPs in the profession.