Abstract
BackgroundHealth care educators need valid and reliable tools to assess evidence based practice (EBP) knowledge and skills. Such instruments have yet to be developed for use among physical therapists. The Fresno Test (FT) has been validated only among general practitioners and occupational therapists and does not assess integration of research evidence with patient perspectives and clinical expertise. The purpose of this study was to develop and validate a modified FT to assess EBP knowledge and skills relevant to physical therapist (PT) practice.MethodsThe FT was modified to include PT-specific content and two new questions to assess integration of patient perspectives and clinical expertise with research evidence. An expert panel reviewed the test for content validity. A cross-sectional cohort representing three training levels (EBP-novice students, EBP-trained students, EBP-expert faculty) completed the test. Two blinded raters, not involved in test development, independently scored each test. Construct validity was assessed through analysis of variance for linear trends among known groups. Inter and intra-rater reliability, internal consistency, item discrimination index, item total correlation, and difficulty were analyzed.ResultsAmong 108 participants (31 EBP-novice students, 50 EBP-trained students, and 27 EBP-expert faculty), there was a statistically significant (p < 0.0001) difference in total score corresponding to training level. Total score reliability and psychometric properties of items modified for discipline-specific content were excellent [inter-rater (ICC (2,1)] = 0.91); intra-rater (ICC (2,1)] = 0.95, 0.96)]. Cronbach's α was 0.78. Of the two new items, only one had strong psychometric properties.ConclusionsThe 13-item modified FT presented here is a valid, reliable assessment of physical therapists' EBP knowledge and skills. One new item assesses integration of patient perspective as part of the EBP model. Educators and researchers may use the 13-item modified FT to evaluate PT EBP curricula and physical therapists' EBP knowledge and skills.
Highlights
Health care educators need valid and reliable tools to assess evidence based practice (EBP) knowledge and skills
Educators are encouraged to develop EBP curricula that address the 5-step model described in the Sicily Statement on Evidence Based Practice[2] as core principles of EBP (Table 1)
Modified Fresno Test Development Development of the modified FT consisted of three phases: 1) discipline-specific modification, 2) development of new items, and 3) establishment of content validity
Summary
Health care educators need valid and reliable tools to assess evidence based practice (EBP) knowledge and skills. Such instruments have yet to be developed for use among physical therapists. The Fresno Test (FT) has been validated only among general practitioners and occupational therapists and does not assess integration of research evidence with patient perspectives and clinical expertise. The introduction in 1992 of formal methods for teaching evidence based medicine[3] prompted health care educators to integrate EBP core principles into their curricula[4,5,6,7,8]. Educators are encouraged to develop EBP curricula that address the 5-step model described in the Sicily Statement on Evidence Based Practice[2] as core principles of EBP (Table 1). Over one hundred instruments for evaluating EBP curriculum effectiveness have been identified[9], only one - the Fresno Test (FT)[10] - has established validity and reliability and covers a broad range of EBP knowledge and skills
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