What's the Task Value? Understanding Doctor of Physical Therapy Students' Perceptions of the Value and Relevance of Evidence-Based Practice

Abstract

Background and Purpose. The profession of physical therapy requires clinicians to value and use evidence-based practice (EBP) in their decision-making process with patients. Although EBP has been incorporated into doctor of physical therapy (DPT) curricula for 2 decades, a gap between knowledge and practice persists. As a first step to addressing this gap, academic programs can focus on fostering students' valuing of EBP and research methods. The current method/model set out to achieve this with task value (TV) as the theoretical basis. Task value is a theory of motivation based on four constructs: intrinsic value (IV), cost, attainment, and utility. Based on the TV theory, the purposes of this method/model were to (1) clarify students' definition of EBP in clinical practice; (2) explicitly link “EBP/Research Methods” and their future role as a clinical practitioner; and (3) further students' understanding of EBP and research methods by providing an opportunity for them to practice these skills. Method/Model Description and Evaluation. Eighty-one, third-year DPT students enrolled in a 6-year, entry-level DPT program participated in the “EBP/Research Methods” course. The educational intervention incorporated a course advanced organizer to illustrate assignment linkages, a graphic that provided an overview that illustrated the EBP process in the clinic, EBP assignments, an interactive student response system to uncover students' knowledge and understanding in real time, and article critiques, which underscored the value and importance of EBP. Evaluation consisted of a 10-question online survey, with 7 questions designed to measure the four constructs of TV. Two reflective papers were used to identify students' definition of EBP; perceived costs to use in a clinical setting; and course activities that impacted students' understanding of EBP. The survey and reflective papers were administered before and after course intervention. Outcomes. Paired t tests were conducted on the seven questions related to the TV scale. Overall, mean values of IV of EBP reported on the presurvey were high and did not change significantly postsurvey. However, the cost measure decreased significantly from pre- to postsurvey P < .00, as did the measures of attainment (P = .001) and utility (P = .002). Qualitative data revealed that the contributors to perceived costs of learning about EBP included the following: lack of clinical experience, fear of challenging authority, lack of access to medical literature, and lack of time. Discussion and Conclusion. Although students generally reported a high level of IV for EBP that did not change significantly after the course, their perception of cost, attainment value, and utility value decreased significantly. These changes may have been due to students' increased understanding of EBP/Research Methods, which resulted in their perceiving greater cost. Educators may expect this response as students discover that EBP is complex and has an ongoing learning process. More positive perceptions may occur once students gain clinical experience. Pedagogical models must systematically and longitudinally target improvement of student value and motivation for using EBP. Recognition that EBP is a continuous process is critical to its development in students and practicing clinicians.