The effectiveness and feasibility of TREAT (Tailoring Research Evidence and Theory) journal clubs in allied health: a randomised controlled trial

Rachel J Wenke,Ian Hughes,Rae Thomas,Sharon Mickan

doi:10.1186/s12909-018-1198-y

Rachel J Wenke, Ian Hughes + Show 2 more

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https://doi.org/10.1186/s12909-018-1198-y

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Abstract

BackgroundJournal clubs (JC) may increase clinicians’ evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, however there is a lack of research into their effectiveness in allied health. We investigated the effectiveness of a structured JC that is Tailored According to Research Evidence And Theory (TREAT) in improving EBP skills and practice compared to a standard JC format for allied health professionals. Concurrently, we explored the feasibility of implementing TREAT JCs in a healthcare setting, by evaluating participating clinicians’ perceptions and satisfaction.MethodsWe conducted an explanatory mixed methods study involving a cluster randomised controlled trial with a nested focus group for the intervention participants. Nine JCs with 126 allied health participants were randomly allocated to receive either the TREAT or standard JC format for 1 h/month for 6 months. We conducted pre-post measures of EBP skills and attitudes using the EBP questionnaire and Assessing Competence in Evidence-Based Medicine tool and a tailored satisfaction and practice change questionnaire. Post-intervention, we also conducted a focus group with TREAT participants to explore their perceptions of the format.ResultsThere were no significant differences between JC formats in EBP skills, knowledge or attitudes or influence on clinical practice, with participants maintaining intermediate level skills across time points. Participants reported significantly greater satisfaction with the organisation of the TREAT format. Participants in both groups reported positive changes to clinical practice. Perceived outcomes to the TREAT format and facilitating mechanisms were identified including the use of an academic facilitator, group appraisal approach and consistent appraisal tools which assisted skill development and engagement.ConclusionsIt is feasible to implement an evidence-based JC for allied health clinicians. While clinicians were more satisfied with the TREAT format, it did not significantly improve their EBP skills, attitudes, knowledge and/or practice, when compared to the standard format. The use of an academic facilitator, group based critical appraisal, and the consistent use of appraisal tools were perceived as useful components of the JC format. A structured JC may maintain EBP skills in allied health clinicians and facilitate engagement, however additional training may be required to further enhance EBP skills.Trial registrationACTRN12616000811404 Retrospectively registered 21 June 2016.

Highlights

Journal clubs (JC) may increase clinicians’ evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, there is a lack of research into their effectiveness in allied health
There is a lack of research exploring the effectiveness of JCs by allied health clinicians working in healthcare services
We evaluated the effectiveness of the to Research Evidence And Theory (TREAT) JC format on improving clinicians’ EBP skills, knowledge, attitudes and practice compared with the standard JC format for allied health professionals

Summary

Introduction

Journal clubs (JC) may increase clinicians’ evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, there is a lack of research into their effectiveness in allied health. While heterogeneity among studies restricted meta analyses in these reviews, previous randomised controlled trials have demonstrated increased self-reported knowledge in medical interns [10], and objective critical appraisal skills in surgeons [11] who participated in a JC compared to control groups. The largest study evaluating the effectiveness of JCs in allied health, recruited 93 clinicians across five professional groups (physiotherapy, speech pathology, nutrition, occupational therapy and social work) to participate in a structured journal club model based on principles of adult learning and a collaborative approach between researchers and clinicians [7]. It is important that future research evaluates JCs that are grounded in existing research and theory, and the goals of any intervention are tailored to the specific organisational and/or professional context [7, 9, 15]

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