Abstract
BackgroundEvidence based practice (EBP) is being increasingly utilized by health care professionals as a means of improving the quality of health care. The introduction of EBP principles into the chiropractic profession is a relatively recent phenomenon. There is currently a lack of information about the EBP literacy level of US chiropractors and the barriers/facilitators to the use of EBP in the chiropractic profession.MethodsA nationwide EBP survey of US chiropractors was administered online (Nov 2012-Mar 2013) utilizing a validated self-report instrument (EBASE) in which three sub-scores are reported: attitudes, skills and use. Means, medians, and frequency distributions for each of the sub-scores were generated. Descriptive statistics were used to analyze the demographic characteristics of the sample. Means and proportions were calculated for all of the responses to each of the questions in the survey.ResultsA total of 1,314 US chiropractors completed the EBASE survey; the sample appeared to be representative of the US chiropractic profession. Respondents were predominantly white (94.3%), male (75%), 47 (+/− 11.6) years of age, and in practice for more than 10 years (60%). EBASE sub-score means (possible ranges) were: attitudes, 31.4 (8–40); skills, 44.3 (13–65); and use, 10.3 (0–24). Survey participants generally held favorable attitudes toward EBP, but reported less use of EBP. A minority of participants indicated that EBP coursework (17%) and critical thinking (29%) were a major part of their chiropractic education. The most commonly reported barrier to the use of EBP was “lack of time”. Almost 90% of the sample indicated that they were interested in improving their EBP skills.ConclusionAmerican chiropractors appear similar to chiropractors in other countries, and other health professionals regarding their favorable attitudes towards EBP, while expressing barriers related to EBP skills such as research relevance and lack of time. This suggests that the design of future EBP educational interventions should capitalize on the growing body of EBP implementation research developing in other health disciplines. This will likely include broadening the approach beyond a sole focus on EBP education, and taking a multilevel approach that also targets professional, organizational and health policy domains.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-015-0060-0) contains supplementary material, which is available to authorized users.
Highlights
Evidence based practice (EBP) is being increasingly utilized by health care professionals as a means of improving the quality of health care
A small minority of the sample indicated that the following topics were major parts of their chiropractic education: coursework about EBP (17%), applying research evidence to clinical practice (13%), and critical thinking/analysis (29%) (Table 2)
Only 42% agreed or strongly agreed that ‘EBP takes into account a patient’s preference for treatment’. These findings suggest that the basic principles of EBP may be misunderstood by Doctors of Chiropractic (DCs) given the original definition of EBP clearly states that clinical expertise, patient values and best available research evidence are all integral components of evidence-based practice [1]
Summary
Evidence based practice (EBP) is being increasingly utilized by health care professionals as a means of improving the quality of health care. Despite the growing awareness of EBP, there still remains a large gap between this appreciation of EBP and the actual uptake and application of EBP in clinical settings This gap between knowledge and awareness of EBP - and actual clinical use of EBP - is found in almost all healthcare fields, including medicine, nursing, and physical therapy [5,6]. While the enthusiasm for EBP in chiropractic is encouraging, a key aspect of its success will be whether or not it translates to changes in clinical practice These changes would include the reduced use of unsupported clinical tests and procedures, as well as increased emphasis on those with an evidence base [17]
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