Confidence In Evidence-based Practice Research Articles

Utilising a ‘Community of Practice’ to support pharmacists to work in residential aged care: protocol for a longitudinal evaluation

IntroductionA Community of Practice is briefly defined as a group of people with a shared interest in a given area of practice who work collaboratively to grow collective knowledge. Communities...

Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study

BackgroundEvidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.MethodsOne hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman’s test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis.ResultsThere were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0).ConclusionsEBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

The effect of multicomponent approach in enhancing the level of confidence with evidence-based practice activities and promoting evidence-based practice culture among nurses in a clinical setting in the United Arab Emirates.

The aim of this work is to examine the effect of multicomponent interventions on enhancing the level of confidence of staff nurses with evidence-based practice in an acute care hospital in the United Arab Emirates. Evidence-based practice is one of the strategic pillars of nursing practice and a key to organizational success. To effectively implement and sustain evidence-based practice programmes in clinical sites, well-designed implementations can promote staff attitude, knowledge, skills, and confidence in translating research evidence into optimal patient care. Experienced and bachelor prepared nurse managers in collaboration with the clinical resource nurse undertook condensed staff training and interventions for the evidence-based practice programme, where 70 registered nurses participated. The intervention was conducted over a period of time extending from December 2019 until December 2020. The study design is quasi-experimental using the pre- and post-Self Efficacy Assessment tool to gauge the nurses' confidence in evidence-based practice. Also, SPSS software was used to explore the effect of the programme. Higher significant score on the evidence-based nursing practice self-efficacy scale postprogramme was noted (t= -7.667 and p value <.001). Participating in a well-structured evidence-based practice programme would positively enhance the nurse's confidence in the programme implementation and promote an evidence-based practice culture in clinical settings. Nurse managers must recognize their critical role in promoting evidence-based practice among nurses. A focused and well-designed intervention may assist in establishing a culture of evidence-based practice to ensure the best patient outcome.

Self-efficacy of Filipino Physicians Towards Research and Research Utilization: A Single-Center Quantitative Descriptive Survey

Research Question: What is the current status of self-efficacy beliefs towards research and research utilization (RU) of University of Santo Tomas Faculty of Medicine and Surgery (UST-FMS) graduates who had Clinical Epidemiology in their basic medical education curriculum? Significance of the Study: There is an increase in research and RU trends globally as adherence to practice based on evidence results in improved patient outcomes. Limited studies are available in describing research and RU of Filipino physicians and there is no study available specific for UST-FMS graduates. Objectives: The study aims to describe self-efficacy beliefs towards research and RU of UST-FMS graduates’ batches 2012-2016 who had Clinical Epidemiology in their basic medical education. Study Design: A single-center, quantitative descriptive survey design was used. Methodology: Participants were graduates of UST-FMS batches 2012-2016, currently working at the University of Santo Tomas Hospital. Evidence-based Practice Confidence Scale (EPIC scale) and Edmonton Research Orientation Survey (EROS) were used to assess the research and RU of the participants gathered through snowball sampling. Statistical Analysis: Descriptive statistics such as means and standard deviations were used to analyze the EPIC and EROS scores. Results: The UST-FMS graduates value research and are generally confident in their ability to participate in evidence-based medicine. However, they rarely conduct research and have a low understanding of statistics. Conclusion: The self-efficacy beliefs of UST-FMS graduates towards research and RU may be attributed to several factors. Clinical epidemiology as a subject may be improved by adding more lectures on statistics while hospitals should create avenues to support the conduct of research. Keywords: self-efficacy belief, research and research utilization, Clinical Epidemiology, medical education curriculum

Development and Testing of the RN Confidence in Evidence-Based Practice (RNcEBP) Survey: Assessing Evidence-Based Practice Culture.

Continual assessment of evidence-based culture is essential to inform growth in evidence-based practice (EBP). The RN Confidence in Evidence-Based Practice (RNcEBP) Survey was developed and tested over a 4-year period within a Magnet-designated organization. The primary aim of this institutional review board-approved study was to test reliability and validity of the workplace-focused RNcEBP Survey. The second aim of the electronic survey was to provide practical and concise assessment data to inform nursing professional development and support for EBP.

A qualitative study exploring contributors to the success of a community of practice in rehabilitation

BackgroundCommunities of Practice (CoPs) focus on learning, knowledge sharing, and creation, and research indicates they can improve healthcare performance. This article describes the development of a CoP that focused on synthesizing and adapting evidence in Physical Medicine and Rehabilitation (PM&R). This study aimed to investigate the CoP members’ experiences and perceived barriers and enablers of CoP success in the early phase of a CoP.MethodsPhysical therapists and a physician (n = 10) volunteered for a CoP that synthesized literature of PM&R evidence. CoP members participated in education and training on critical appraisal and knowledge synthesis, practiced critical appraisal skills, and summarized literature. Three months after CoP initiation, semi-structured interviews were conducted to understand the CoP members’ experiences and reflections. Members also completed an online survey that included the Evidence-Based Practice Confidence scale (EPIC), questions related to CoP activities, and demographics before CoP initiation. We utilized the Capability, Opportunity, and Motivation Model of Behaviour (COM-B) to explore how these experiences related to the behavioral adaptation and participation.ResultsTen themes related to the potential contributors to CoP success and failure were identified. These included project management, technological solutions, efficacy, organizational support, interaction, the bigger picture, self-development, time, and motivation.ConclusionsContributors to CoP success may include clearly articulated project goals and participant expectations, education and training, reliable technology solutions, organizational support, face-to-face communication, and good project management. Importantly, CoP members need time to participate in activities.

Knowledge, Attitude, Access and Confidence in Evidence-based practice amongst French dental undergraduates: A transcultural adaptation and psychometrics analysis of French version of the KACE questionnaire.

The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated. Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively. 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score. This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.

EPIC-Skala – Übersetzung und interkulturelle Adaptation für die Schweiz, Österreich und Deutschland

BackgroundThe Evidence-based Practice Confidence (EPIC) scale is a self-report questionnaire for health professionals. The EPIC scale was developed in Canada and is based on Bandura's self-efficacy theory. It comprises 11 statements on the organization and implementation of evidence-based practice (EBP) steps. The aim of the study was to translate the EPIC scale into German, to test its comprehensibility in German-speaking countries and to interculturally adapt the scale. MethodsThe translation process followed international guidelines. After two independent translations into German and two independent back translations had been conducted, an expert committee discussed discrepancies in view of intercultural comprehensibility and agreed on a preliminary German version. The comprehensibility of this version was evaluated with physical therapists from Switzerland, Austria and Germany. They were recruited using purposeful sampling and interviewed via telephone using a semi-structured questionnaire (cognitive interviewing). The interviews were recorded and analyzed independently by two authors using a structured evaluation scheme. Based on these results, the final version was created. All changes were discussed with the author of the EPIC scale. ResultsSixteen physical therapists of the three German-speaking countries were interviewed. Demographic data showed a balanced distribution of country of origin, age group, qualification and years of work experience. In general, participants reported a good overall comprehensibility. However, they reported that (too) many scientific terms caused comprehension problems and that some of these terms were unknown to participants. During the intercultural adaptation attention was paid to simplify and shorten sentences and to paraphrase terms that were difficult to understand. Moreover, the instructions were expanded to address partial lack of knowledge of scientific terms. ConclusionThe EPIC scale was successfully translated and interculturally adapted to the German language. The scale evaluates self-efficacy in EBP activities and could potentially be used to assess courses or be integrated into surveys. In the next step, the validity and reliability of the German scale should be established involving other health care professionals in this process.

Evidence-based practice ‘on-the-go’: using ViaTherapy as a tool to enhance clinical decision making in upper limb rehabilitation after stroke, a quality improvement initiative

Recovery of upper limb function after stroke is currently sub-optimal, despite good quality evidence showing that interventions enabling repetitive practice of task-specific activity are effective in improving function. Therapists need...

The impact of a small-group educational intervention for allied health professionals to enhance evidence-based practice: mixed methods evaluation

BackgroundHealthcare professionals are recommended to use evidence-based practice (EBP) principles to update and improve clinical practice. Well-designed educational initiatives, together with practice and feedback opportunities can improve individuals’ EBP knowledge, skills and attitudes.MethodsA concurrent mixed methods assessment was designed to evaluate the effectiveness and feasibility of four monthly workshops on allied health professionals’ knowledge, skills, self-efficacy and behaviour. In between workshops, professionals were encouraged to practice and integrate EBP learnings with colleagues in their workplace.Participants completed three pre and post intervention assessments: Evidence-based Practice Confidence Scale; adapted Fresno test; and an adapted EBP Implementation Scale. A purpose designed satisfaction questionnaire was completed immediately after the educational intervention and follow up focus groups were conducted after 3 months.Mean change in assessment data was quantitatively assessed and comments from the clinician satisfaction questionnaire and focus groups were thematically analysed and interpreted together with quantitative data using the Classification Rubric for EBP Assessment tools in Education (CREATE).ResultsSixteen allied health professionals participated in the EBP workshops and completed all baseline and post intervention assessments. Seven clinicians participated in follow up focus groups. All clinicians reported a positive reaction to the learning experience, preferring short monthly workshops to a full day session. They self-reported improvements in self-efficacy (mean change 15 p < 0.001) and implementing EBP behaviours (mean change 7, p < 0.001) from pre- to post-intervention. Although the positive change in EBP knowledge measured by the adapted Fresno test was not statistically significant (mean change 10, p = 0.21), clinicians described examples of improved knowledge and skills across all five key steps of EBP during the focus groups. A further, post hoc analysis of individual questions in the two self-reported scales indicated consistent improvement across key EBP knowledge and skills.ConclusionsA tailored small group EBP education intervention can enhance AHPs’ self-efficacy to develop answerable questions, search the literature, critically appraise, apply and evaluate research evidence. Through practicing these behaviours and sharing new learning with their peers, allied health professionals can enhance their capability and motivation to use research evidence to potentially improve clinical practice.

Evaluation of the role of near-peer teaching in critical appraisal skills learning: a randomized crossover trial.

ObjectivesThe study sought to evaluate near-peer tutors’ teaching of critical appraisal skills to medical students as an aspect of Evidence-based Medicine. MethodsIn a randomized crossover trial, 241 students completing a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module in the Faculty of Medicine Universitas Indonesia (FMUI) were randomly assigned to intervention or control groups. During tutorial sessions, intervention group participants were assigned to near-peer tutors, who were newly graduated doctors, and those in the control groups were assigned to staff tutors. After two tutorial sessions, intervention and control groups exchanged tutors for the next two sessions. Outcomes were measured using written knowledge and skills multiple choice questions (MCQ) test, the Evidence-based Practice Confidence Scale (EPIC) and a student attitude questionnaire, along with student evaluation of tutors to evaluate the process. ResultsOn completion of the module, the written test scores of intervention group students were similar to those of the control group (t(239) = 1.553, p=0.122), as well as overall Evidence-based Practice Confidence Scale scores (F(2/170) = 0.179, p = 0.673) and attitude scores (t(219) =-0.676, p = 0.085). In the tutor evaluations, the students rated their near-peer tutored sessions as better than those tutored by staff in most respects. ConclusionsNear-peer tutors were as effective as and more readily accepted than staff tutors in teaching critical appraisal skills. These findings support the broader implementation of peer-teaching in other areas of medical education.

Evidence-based practice self-efficacy of undergraduate speech pathology students following training

Aim: The aims of this study were to determine the self-efficacy of speech pathology students in conducting evidence-based practice before and after a comprehensive evidence-based practice course, and the impact of timing of the course (Semester 1/2).Method: Students attended a 13-week course in their final year of study. The evidence-based practice confidence scale (EPIC) was used to measure the students’ self-efficacy pre- and post-training.Results: Ninety-two percent of students enrolled over six semesters participated. Students began the evidence-based practice course with high confidence in asking patients their preferences but low confidence in interpreting and analysing statistics. A significant improvement in confidence in all evidence-based practice areas was found, with greatest improvement occurring in the critical appraisal of research. Overall, the teaching had greatest effect on a group of skills for finding valid EBP information. There were significant differences between semester one and two students in only 18% of responses. Semester two students were more confident in half of these responses.Conclusions: An evidence-based practice course made a significant difference to student self-efficacy across all aspects, with few differences related to timing of the course. Implications are discussed.Implications for RehabilitationHealth professionals must be confident implementing evidence-based practice throughout the course of their careers, as best practice changes over time.A capstone unit of study/course for undergraduate speech pathology students significantly improved their self-efficacy in implementing evidence-based practice.This has positive implications for evidence-based practice across a wide range of clinical settings including rehabilitation and disability as the graduate entry level students enter the workforce.For on-going success, graduate entry level students must continue to implement evidence-based practice as clinicians if they are to maintain their confidence and further develop their skill set.

Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers.

To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk etal. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk etal.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk etal.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to evaluate the effectiveness of organisational strategies aimed at increasing professionals' confidence in Evidence-Based Practice, supporting its use and implementation.

Athletic Trainers' Current Knowledge and Envisioned Use of Foundational Evidence-Based Practice Concepts

Context: The Board of Certification (BOC) requires 10 continuing education units (CEUs) in evidence-based practice (EBP) each reporting period. It is unknown whether participation in programming in the Foundations category for CEUs results in improved knowledge of and confidence in EBP. Objective: To examine a continuing professional education (CPE) program in relation to perceived knowledge of and confidence in EBP concepts among athletic trainers (ATs) and to determine ATs' perceptions regarding barriers to, use of, and resources for EBP. Design: Mixed-methods, within-subjects design; preintervention-postintervention evaluation of ATs' EBP knowledge and perceptions. Setting: A CPE workshop hosted at 2 Division I universities. Patients or Other Participants: Convenience sample of 123 AT workshop attendees. Intervention(s): Five-hour BOC-approved Foundations of EBP workshop. Main Outcome Measure(s): The Evidence-Based Concepts: Knowledge, Attitudes, and Use survey. The ATs' EBP knowledge was assessed via multiple-choice questions. Descriptive statistics, differences between scores, and correlations were ascertained. Open-ended questions were classified according to common themes and coded. Results: The 11-point knowledge score showed knowledge increased significantly (t = −12.42, P &amp;lt; .001, d = 1.31, 95% confidence interval = −2.41, −1.75) preworkshop (mean = 6.39 ± 1.63) to postworkshop (mean = 8.47 ± 1.55). Confidence in knowledge increased significantly (z = −9.51, P &amp;lt; .001) preworkshop (median = 26) to postworkshop (median = 38). The ATs identified barriers to EBP use as time, resources, environment, and experience in EBP; envisioned use of EBP included implementing patient-reported outcomes and internet resources. Conclusions: This workshop demonstrated improved immediate perceived knowledge and confidence in EBP concepts. Although a larger number of clinical EBP programs have been approved by the BOC, Foundations of EBP programming is valuable for CEU opportunities to narrow the gap regarding EBP knowledge. Future investigations may evaluate transference of EBP knowledge into professional practice.

Advancing Evidence-Based Practice in Physical Therapy Settings: Multinational Perspectives on Implementation Strategies and Interventions.

It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations.

Validation of the Evidence-Based Practice Confidence (EPIC) Scale With Occupational Therapists

This study evaluated the reliability, minimal detectable change (MDC), and construct validity of the Evidence-Based Practice Confidence (EPIC) scale among occupational therapists. In a cross-sectional mail survey, 126 occupational therapists completed the EPIC scale and a questionnaire to provide data for validity testing. Seventy-nine occupational therapists (63%) completed a second EPIC scale a median of 24 days later. Test-retest reliability was .92 (95% confidence interval [.88, .95]). The MDC values at the 90% and 95% confidence levels were 3.9 percentage points and 4.6 percentage points, respectively. The total EPIC score was significantly associated with holding a master's or doctoral degree; education in evidence-based practice (EBP); higher EBP knowledge and skill; and frequently searching, reading, and using research findings in clinical decision making (p < .05). The EPIC scale has excellent reliability and acceptable construct validity for use in evaluating EBP self-efficacy among occupational therapists.

Promoting Best Practices for Managing Acute Low Back Pain in an Occupational Environment.

Providers treating low back pain must be confident and knowledgeable in evidence-based practice (EBP) to provide the best outcomes. An online education course was created in an effort to increase knowledge and confidence in EBP and clinical practice guidelines specific to low back pain in an occupational setting. There were 80 participants who completed the pre-test and post-test. The results showed a statistically significant improvement in knowledge and confidence scores after completion of the course. An online education course was shown to be a cost-effective, accessible tool to increase knowledge and confidence of EBP for different health care providers.

Evidence based practice confidence upon entry to physical therapy school is related to previous research-related experience

Evidence based practice confidence upon entry to physical therapy school is related to previous research-related experience

Nurses' research capacity and use of evidence in acute care: baseline findings from a partnership study.

The aim of this study is to report baseline findings from a research-focused academic-service partnership. Despite widespread efforts, the research-practice gap remains considerable. A research-focused academic-service partnership may offer a strategy for decreasing this gap. With the use of a shared model and a descriptive correlational design, 75 acute care nurses were sampled from July to October 2013. Attitudes toward evidence-based practice (EBP) were favorable, but knowledge of common research language was low and EBP confidence was reported as moderate. Evidence-based practice confidence had the strongest relationship to EBP use and was greatest in those who held professional certification and were more educated. Findings continue to demonstrate the need for new approaches to reduce the research-practice gap.

The Correlation between Confidence and Knowledge of Evidence-Based Practice among Occupational Therapy Students

Evidence-based practice (EBP) is used throughout multiple health-care professions and includes the use of best research available, client preferences, and the practitioner’s experience. Occupational therapy educational programs are required to incorporate EBP into their curriculum. A convenience sample of occupational therapy students from a private university completed a survey designed to measure students’ knowledge and confidence in EBP. The survey consisted of the Knowledge of Research Evidence Competencies (K-REC) and the Evidence-Based Practice Confidence (EPIC) scale, as well as demographic questions. Of the respondents (n = 47), third-year students indicated higher confidence in the ability to utilize EBP and higher levels of knowledge related to EBP than second- or first-year students. The more didactic and clinical experience that the students had, the more knowledge related to EBP they had, which increased their confidence in the implementation of EBP. The knowledge and confidence that students gain of EBP within their educational training and clinical experiences can influence their future use and implementation of EBP as clinicians. Without this information, therapists will lack the confidence and ability to apply EBP principles in a changing and demanding health-care environment.