Use Of Evidence In Practice Research Articles

Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study

Few studies exist regarding the attitudes and behaviours of Egyptian physiotherapists in relation to the use of evidence in practice (EBP). The purpose of this study was to describe the beliefs, attitudes, knowledge, and behaviours of Egyptian physical therapists as they relate to evidence-based practice. It also explores their perception of possible barriers to implement EBP. Four hundred and seventy Egyptian therapists responded to our questionnaire with results revealing participants’ awareness towards EBP was quite diverse. Only terms of systematic review and randomized controlled trial were well understood while remaining terms showed various level of comprehension which were rather low. Results also revealed significant correlations between attitudes towards EBP and overall awareness as well as attitudes and knowledge (r = 0.270 and 0.107) respectively. In addition, a significant relationship was also found between EBP awareness and knowledge with (r = 0.219). With regards to the barriers, insufficient teaching in previous education was identified as the primary barrier (34.4 %), followed by lack of funding and resources (31.1 %), while lack of time (10.2 %) was reported as the least. These barriers highlight the need to enhance implementation of EBP within Egyptian Physiotherapists. Findings of this study can be used as a foundation for the implementation of EBP in various clinical settings by understanding the limitations and barriers reported. Our study concluded that despite Egyptian physiotherapists declare their awareness of EBP, nevertheless, knowledge is restricted to a small number of terms. More focus is required to enhance the knowledge and practice of EBP. Focusing on adjustable factors, including increasing the awareness of value of research would help reduce time and resource demands for physiotherapists when implementing EBP.

The SAFE (Social Accountability as the Framework for Engagement) for Health Institutions project: Rapid evidence narratives.

Family physicians stand to benefit from assistance with the implementation of social accountability strategies. To develop rapid evidence narratives for key social accountability topics that summarize and mobilize evidence for practical use in social accountability strategies linking front-line, "bottom-up" actions with complementary "top-down" standards from the SAFE (Social Accountability as the Framework for Engagement) for Health Institutions evaluation tool. The SAFE for Health Institutions project aims to accelerate transformation toward greater social accountability in family medicine practices and in other settings where family physicians work. A social accountability evaluation tool was developed to help with this transformation and includes a framework of 253 comprehensive top-down standards. Key social accountability topics linked to these standards were identified for rapid reviews of the literature, conducted between June and November 2021, with evidence reported as narratives. These rapid evidence narratives provide practical, evidence-based context including suggestions on how to address each topic across the micro, meso, and macro levels of care, connecting bottom-up actions with corresponding considerations for top-down policies, processes, and structures. Summaries of the rapid evidence narratives are being developed as a series of articles for Canadian Family Physician, focusing on what family physicians can do in clinical practices, with interdisciplinary teams, and in other work settings to accelerate change toward adopting or advancing socially accountable strategies. Rapid evidence narratives that summarize and mobilize evidence on key social accountability topics further the understanding of social accountability in family medicine and in other settings where family physicians work. Mapping actions across the micro, meso, and macro levels of care is a practical way to link front-line, bottom-up actions with a top-down social accountability strategy.

GP preferences for, access to, and use of evidence in clinical practice: a mixed-methods study.

GPs aim to provide patient-centred care combining clinical evidence, clinical judgement, and patient priorities. Despite a recognition of the need to translate evidence to support patient care, barriers exist to the use of evidence in practice. To ascertain the needs and preferences of GPs regarding evidence-based guidance to support patient care. The study also aimed to prioritise content and optimise structure and dissemination of future evidence-based guidance. This was a convergent parallel mixed-methods study in collaboration with the national GP professional body in the Republic of Ireland (Irish College of General Practitioners [ICGP]). Quantitative and qualitative findings were integrated at the interpretive level. A national GP survey was administered via the ICGP (December 2020) and seven GP focus groups were undertaken (April-May 2021). Of 3496 GPs, a total of 509 responders (14.6%) completed the survey and 40 GP participants took part in focus groups. Prescribing updates, interpretation of test results, chronic disease management, and older person care were the preferred topics for future evidence-based guidance. GPs reported that they required rapid access to up-to-date and relevant evidence summaries online for use in clinical practice. Access to more comprehensive reviews for the purposes of continuing education and teaching was also a priority. Multimodal forms of dissemination were preferred to increase uptake of evidence in practice. GPs indicated that rapid access to up-to-date, summarised evidence-based resources, available from their professional organisation, is preferred. Evidence should reflect the disease burden of the population and involve multifaceted dissemination approaches.

Quality and credibility of clinical practice guidelines recommendations for the management of neonatal hypoglycemia. A protocol for a systematic review and recommendations' synthesis.

Hypoglycemia is one of the most frequent metabolic conditions in neonates. Clinical practice guidelines (CPGs) influence clinical practice as high-quality CPGs facilitate the use of evidence in practice. This proposed study aims to systematically identify and appraise CPGs and CPG recommendations (CPGRs) for treating neonatal hypoglycemia (NH). We will conduct searches in MEDLINE, EMBASE, CINAHL, Cochrane Library, LILACS (Latin American & Caribbean Health Sciences Literature), and Epistemonikos. Authors will search CPGs-specific databases and grey literature. Two reviewers will independently perform the titles and abstract screening, full-text review, and data extraction. Two appraisers will assess the quality of the CPGs and their recommendations using AGREE II (Appraisal of Guidelines Research and Evaluation) and AGREE-REX (Appraisal of Guidelines Research and Evaluation-Recommendations Excellence) instruments. Scores of ≥ 60% in the rigour of development domain will be considered for defining high-quality with AGREE II tool. CPGRs with scores >60% in the three domains will be used to determine high quality with the AGREE REX tool. We will perform a synthesis of the CPGRs to identify the consistency among the CPGRs and the methodological quality of primary studies that support them. The results will help us to identify the methodological and quality gaps in the existing CPGs for the treatment of NH. Our findings will be submitted to peer-review journals and presented at academic conferences. Based on the study design, approval from the institutional ethics board is not required for this project. Systematic Review Registration Number (PROSPERO): CRD 42021239921.

The Experiences and Perceptions of Nurses Interacting With Research Literature: A Qualitative Systematic Review to Guide Evidence-Based Practice.

There is an evidence that some nurses struggle with reading and using research. This struggle becomes a barrier to engaging in evidence-based practice (EBP). Personal beliefs, attitudes about research, and difficulties with research language and statistics have been reported as important variables in quantitative studies. The aim of this review was to explore nurses' experiences and perceptions of interacting with research literature for work or educational purposes. Studies eligible for inclusion were qualitative, published in English from years 2009-2020, and included registered nurses engaged in interaction with research literature for any work or educational purpose. The Joanna Briggs Institute's qualitative systematic review methods were used. We included 11 qualitative studies with 186 participants. Most studies used focus groups or semi-structured interviews to collect data. Overall, study quality was moderate. We extracted 29 findings, which were synthesized into five categories, and meta-aggregated into one synthesis. Research is a complex field of engagement for nurses, who simultaneously value its contribution to their profession and feel the burden of unsupported expectations. Nurses perceive a double standard in their workplaces where expectations of using evidence in practice are often discussed, but EBP education and access to literature can be hard to access. Educators conducting research education should consider the complex emotional reactions this activity may engender in participants who may feel unprepared by their previous experience or education. Clinicians and workplace leaders trying to encourage the use of evidence in practice should consider the source of any reluctance to engage. An observed lack of engagement in their staff may be related to issues with understanding the materials.

Evidence-based Practice (EBP): beliefs, knowledge and behavior of physiotherapists. A survey research.

An analytical observational study was conduct using a web-based questionnaire. Evidence-based practice is one of the most relevant concern of all health professions. This research has been done taking account of demographic information, attitudes and skills in reference to Evidence Based Practice (EBP) for application in the daily clinical practice. To describe beliefs and behaviors of physiotherapists from two Italian regions about EBP and its implementation in clinical practice, their knowledge in this field and the perception of its benefits and barrier in application in clinical practice. The participants completed a designed questionnaire, whose purpose was to determine beliefs, attitudes, knowledge, and behaviors regarding EBP, as well as demographic information about themselves and their practice settings. This survey was activated through the TSRM-PSTRP registers of Marche and Umbria regions that sent the questionnaire to all the registered physiotherapists. There was a response rate of 7.64% for Marche region, equal to a sample of 132 physiotherapists, and a response rate of 12.99% for Umbria region, equal to a sample of 110 physiotherapists, for a total sample of 242 physiotherapists. The questionnaire was filled out through an online Google platform called “Forms”. The responses were summarized for each item and the logistic regression analyses and the chi-square test were used to examine relationships among variables. The respondents agreed that the use of evidence in practice was necessary, that the literature was helpful in their practices and that the quality of patient care was better when evidence were used. For physiotherapists from Umbria, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “the application of EBP is necessary in the practice of physical therapy, EBP helps me making decisions about patient care and I actively seek practice guidelines pertaining to areas of my practice and EBP improves the quality of patient care”. For physiotherapists from Marche, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “EBP helps me making decisions about patient care, I actively seek practice guidelines pertaining to areas of my practice and I am confident in my ability to find relevant research to answer my clinical questions”. Training, familiarity with and confidence in search strategies, use of databases, and critical appraisal tended to be associated to younger therapists with fewer years of qualification. Physical therapists stated they have a positive attitude about EBP and they are interested in learning or improving the necessary skills to implement EBP. They noticed that they needed to increase the use of evidence in their daily practice.

Evidence-based Practice (EBP): beliefs, knowledge and behavior of physiotherapists. A survey research.

An analytical observational study was conduct using a web-based questionnaire. Evidence-based practice is one of the most relevant concern of all health professions. This research has been done taking account of demographic information, attitudes and skills in reference to Evidence Based Practice (EBP) for application in the daily clinical practice. To describe beliefs and behaviors of physiotherapists from two Italian regions about EBP and its implementation in clinical practice, their knowledge in this field and the perception of its benefits and barrier in application in clinical practice. The participants completed a designed questionnaire, whose purpose was to determine beliefs, attitudes, knowledge, and behaviors regarding EBP, as well as demographic information about themselves and their practice settings. This survey was activated through the TSRM-PSTRP registers of Marche and Umbria regions that sent the questionnaire to all the registered physiotherapists. There was a response rate of 7.64% for Marche region, equal to a sample of 132 physiotherapists, and a response rate of 12.99% for Umbria region, equal to a sample of 110 physiotherapists, for a total sample of 242 physiotherapists. The questionnaire was filled out through an online Google platform called “Forms”. The responses were summarized for each item and the logistic regression analyses and the chi-square test were used to examine relationships among variables. The respondents agreed that the use of evidence in practice was necessary, that the literature was helpful in their practices and that the quality of patient care was better when evidence were used. For physiotherapists from Umbria, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “the application of EBP is necessary in the practice of physical therapy, EBP helps me making decisions about patient care and I actively seek practice guidelines pertaining to areas of my practice and EBP improves the quality of patient care”. For physiotherapists from Marche, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “EBP helps me making decisions about patient care, I actively seek practice guidelines pertaining to areas of my practice and I am confident in my ability to find relevant research to answer my clinical questions”. Training, familiarity with and confidence in search strategies, use of databases, and critical appraisal tended to be associated to younger therapists with fewer years of qualification. Physical therapists stated they have a positive attitude about EBP and they are interested in learning or improving the necessary skills to implement EBP. They noticed that they needed to increase the use of evidence in their daily practice.

Identification of common features within massage therapists' professional identity.

In Ontario, Canada, MTs are regulated and have a common scope of practice. However, diverse practice settings and approaches to care create a need for MTs to articulate their professional identity. This study sought to answer, "what common features are foundational to the professional identity of MTs in Ontario?" This quantitative research study was a part of a larger exploratory sequential mixed methods study. An online questionnaire-based cross-sectional study was conducted based on previous qualitative findings. MTs in Ontario, who held an active certificate, were invited to participate. Data were analyzed using descriptive statistics. The analysis revealed 17 common features that were endorsed by most respondents. Participants also reported thinking of themselves as healthcare professionals, rather than service providers, a feeling that was held across practice settings. Interesting and unexpected differences were noted in statements regarding the perception of MTs, areas of profession-specific knowledge, and the establishment of the therapeutic relationship. This study furthers an understanding of MTs' identity. Specifically, MTs consider themselves to be HCPs who are confident in their knowledge and abilities, especially their communication skills. They believe in providing individualized care and empowering their patients to take charge of their own health. Despite areas of overwhelming agreement, disagreement in endorsement was seen in areas such as MTs perception of their external image, use of evidence in practice, and the establishment of professional boundaries. These areas provide an opportunity for future research to continue to develop a body of knowledge regarding MTs professionalism and identity.

Advancing the management of upper extremity musculoskeletal conditions: Insights from the field of implementation science

IntroductionThe development of effective interventions in hand and upper extremity rehabilitation is critically important; yet even the most promising interventions may not successfully be implemented in practice. Occupational and physical therapists who provide specialized hand and upper extremity rehabilitation services (“hand therapists”) can face extensive, multi-level barriers when attempting to use research findings in real-world settings, widening the long-standing research-to-practice gap. Concepts from the field of implementation science can be leveraged to address this gap and expedite the application of research discoveries that can maximize treatment outcomes of the musculoskeletal upper extremity client. As the intersection of hand and upper extremity rehabilitation and implementation science draws growing attention, there is a great need for researchers and clinicians to infuse implementation science into the hand and upper extremity rehabilitation research and practice contexts. PurposeThe purpose of this article is to define implementation science and synthesize several studies from the hand and upper extremity rehabilitation field that have examined the effect of implementation strategies (eg, chart audit and feedback techniques; implementation teams) on implementation outcomes (eg, acceptability, fidelity). We also present recommendations for how (1) hand and upper extremity rehabilitation researchers can design studies to examine both patient outcomes and implementation outcomes relative to interventions for the musculoskeletal upper extremity and (2) hand and upper extremity rehabilitation specialists and administrators can develop implementation teams to facilitate the use of evidence in practice. ConclusionCollaboration between researchers and clinicians has great potential to advance the entirety of the hand and upper extremity rehabilitation profession, especially when such collaborations are guided by the implementation science field.

Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol

BackgroundClinical leadership is fundamental in facilitating service improvements in healthcare. Few studies have attempted to understand or model the different approaches to leadership which are used when promoting the uptake and implementation of evidence-based interventions. This research aims to uncover and explain how distributed clinical leadership can be developed and improved to enhance the use of evidence in practice. In doing so, this study examines implementation leadership in orthopaedic surgery to explain leadership as a collective endeavour which cannot be separated from the organisational context.MethodsA mixed-method study consisting of longitudinal and cross-sectional interviews and an embedded social network analysis will be performed in six NHS hospitals. A social network analysis will be undertaken in each hospital to uncover the organisational networks, the focal leadership actors and information flows in each organisation. This will be followed by a series of repeated semi-structured interviews, conducted over 4 years, with orthopaedic surgeons and their professional networks. These longitudinal interviews will be supplemented by cross-sectional interviews with the national established surgical leaders. All qualitative data will be analysed using a constructivist grounded theory approach and integrated with the quantitative data. The participant narratives will enrich the social network to uncover the leadership configurations which exist, and how different configurations of leadership are functioning in practice to influence implementation processes and outcomes.DiscussionThe study findings will facilitate understanding about how and why different configurations of leadership develop and under what organisational conditions and circumstances they are able to flourish. The study will guide the development of leadership interventions that are grounded in the data and aimed at advancing leadership for service improvement in orthopaedics. The strength of the study lies in the combination of multi-component, multi-site, multi-agent methods to examine leadership processes in surgery. The findings may be limited by the practical challenges of longitudinal qualitative data collection, such as ensuring participant retention, which need to be balanced against the theoretical and empirical insights generated through this comprehensive exploration of leadership across and within a range of healthcare organisations.

Challenges and Opportunities of Evidence Use in Practice in Australian Children’s Development Programs

ABSTRACT This paper explores the role of evidence and its use in a cluster of Australian community-based child development programs. The paper draws on findings from a 2016–2017 study commissioned by a not-for-profit organization to review their programs’ alignment with government evidence-based program expectations. Cunningham and Duffee’s (2009) evidence-based practice style typology is utilized to examine how different purposes of use drive styles of and approaches to evidence sourcing, application, and reporting. Perspectives on what constitutes evidence and how such evidence is valued, used, and reported can vary considerably between individual programs, irrespective of enforced standards and expectations. It is argued that a single-dimensional approach to program evidence-based evaluation and reporting is not appropriate and potentially damaging in contexts where community-based programs have different purposes, structures, cultures, and intentions. Given a program’s particular evidence-use style, evidence-based criteria, processes, and reporting requirements should be matched accordingly.

KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS EVIDENCE-BASED PRACTICE AMONG OCCUPATIONAL THERAPISTS OF KARACHI

OBJECTIVE Evidence-based practice is considered as keystone in this advanced era of clinical practices. Little evidence regarding the use of evidence in practice among Occupational therapists is available both nationally and internationally. A number of specific organizational factor that affects the practice are evident in clinical setting. Therefore, this study aims to evaluate knowledge, attitude and practice among occupational therapists as a new paradigm. STUDY DESIGN A cross-sectional survey was conducted among Occupational therapists recruited through the non-probability sampling technique. STUDY SETTING AND PARTICIPANTS The data was collected through Questionnaire adapted from Knowledge, Attitude and Practice (KAP) American College of Sports Medicine (APTA). Only 26 OT were recruited from a sample of 30 with mean age of 23.9±2.27. RESULTS The findings of this study revealed that 46.2% have knowledge of EBP however, 53.8% participants do not take into account patient preferences while 34.65% use professional literature in clinical decision making. CONCLUSION It was concluded that majority of the occupational therapists have knowledge of Evidence-based practice but these are not implicated in to clinical practice and patient management. Therefore, further studies are required in the domain to evaluate the knowledge of therapist and its implication into patient care. KEYWORDS: Occupational Therapists, Evidence-based practice, Knowledge, Practice.

Electronic evidence as a new type of evidence in administrative judiciary

The article deals with the peculiarities of the evidence by means of evidence. There is a great deal of evidence available today and they are gaining in popularity and proliferation in the institution of which is an important component of administrative justice. Such popularity is driven by the judicial reform adopted in 2017. This topic has been and is currently being considered by scientists, but it still needs more analysis. In particular, we believe that the most important topic is disclosure: the use of evidence in practice, because there are many problems in proving the use of such evidence. The object of the study is the procedural legal relationship of the proving of the circumstances in specific administrative cases. In particular, using of new types of so-called in administrative proceedings. In the article is revealed the essence of the concept of electronic evidence, are characterized their features. Examples of such as, information from websites, correspondence, social networks, etc., sources of their receipt and where they are stored are also considered. The issue of supporting such evidence with an signature is highlighted, which is equally important. And part of the article is devoted to the peculiarities of presenting such evidence to court in administrative cases. During the course of the scientific research it became clear to us that the rules of the current legislation do not contain clear instructions on the procedure for the use of data in the process of proof, in particular in administrative proceedings. It is also worth emphasized the problems that arise in the process of proof while using evidence. The main issue that needs to be resolved is the clear regulation of the procedure for collecting, filing and presenting such evidence in court, as the study shows that the legislator has identified only general principles for their application in practice. Also, the recognition of the document as a copy or an original remains unaddressed because it does not have clear criteria for their delineation. We believe that this topic is quite relevant nowadays and has not been disclosed, and it should be the subject of research by many scientists.

How can we monitor the impact of national health information systems? Results from a scoping review.

BackgroundNational health information (HI) systems provide data on population health, the determinants of health and health system performance within countries. The evaluation of these systems has traditionally focused on statistical practices and procedures, and not on data use or reuse for policy and practice. This limits the capacity to assess the impact of HI systems on healthcare provision, management and policy-making. On the other hand, the field of Knowledge Translation (KT) has developed frameworks to guide evidence into practice.MethodsA scoping review of the KT literature to identify the essential mechanisms and determinants of KT that could help monitor the impact of HI systems.ResultsWe examined 79 publications and we identified over 100 different KT frameworks but none of these were focused on HI systems per se. There were specific recommendations on disseminating evidence to stakeholders at the institutional and organizational level, and on sustaining the use of evidence in practice and the broader community setting.ConclusionsWe developed a new model, the HI-Impact framework, in which four domains are essential for mapping the impact of national HI systems: (i) HI Evidence Quality, (ii) HI System Responsiveness, (iii) Stakeholder Engagement and (iv) Knowledge Integration. A comprehensive impact assessment of HI systems requires addressing the use of HI in public health decision-making, health service delivery and in other sectors which might have not been considered previously. Monitoring Stakeholder Engagement and Knowledge Integration certifies that the use of HI in all policies is an explicit point of assessment.

Deimplementation in Clinical Practice: What Are We Waiting For?

Deimplementation in Clinical Practice: What Are We Waiting For?

Knowledge, Attitude and Barrier to Evidence-based Practice among Physiotherapists in Selected Districts of Nepal.

Evidence-based practice is considered as one of the most accepted practice all over the world. Physiotherapists in Nepal have started evidence-based practice, but there has been no study regarding evidence-based practice in physiotherapy in Nepal. A cross-sectional study was carried out among 164 physiotherapists working in different clinics and physiotherapy centers of selected districts of Nepal. A self-reported questionnaire was distributed and collected later. It was found that the physiotherapists had a positive attitude towards evidence-based practice with 95.2% agreeing or strongly agreeing that evidence-based practice is necessary forthe practice of physical therapy and an overall total mean score of 34.73(72.35%) out of 48 and an overall mean 2.8 out of 4. It was also found that physiotherapists had moderate knowledge towards evidence-based practice with an overall total mean score of 19.18(68.5%) out of 28 and an overall mean of 2.74 out of 4. It was found that those having a specialization degree had two times greater knowledge than without specialization. The major barriers to evidence-based practice were obtained insufficient time and traditional methods of treatment. Physical therapists of Nepal stated they had a positive attitude towards evidence-based practice with the majority of the physiotherapists interested in learning more about the topic. They believed that they needed to increase the use of evidence in practice. They thought major barrier as insufficient time hence continuous professional development training that incorporate evidence-based practice were of greater importance.

Evidence use in equity focused health impact assessment: a realist evaluation

BackgroundEquity-focused health impact assessment (EFHIA) can function as a framework and tool that supports users to collate data, information, and evidence related to health equity in order to identify and mitigate the impact of a current or proposed initiative on health inequities. Despite education efforts in both the clinical and public health settings, practitioners have found implementation and the use of evidence in completing equity focussed assessment tools to be challenging.MethodsWe conducted a realist evaluation of evidence use in EFHIA in three phases: 1) developing propositions informed by a literature scan, existing theoretical frameworks, and stakeholder engagement; 2) data collection at four case study sites using online surveys, semi-structured interviews, document analysis, and observation; and 3) a realist analysis and identification of context-mechanism-outcome patterns and demi-regularities.ResultsWe identified limited use of academic evidence in EFHIA with two explanatory demi-regularities: 1) participants were unable to “identify with” academic sources, acknowledging that evidence based practice and use of academic literature was valued in their organization, but seen as less likely to provide answers needed for practice and 2) use of academic evidence was not associated with a perceived “positive return on investment” of participant energy and time. However, we found that knowledge brokering at the local site can facilitate evidence familiarity and manageability, increase user confidence in using evidence, and increase the likelihood of evidence use in future work.ConclusionsThe findings of this study provide a realist perspective on evidence use in practice, specifically for EFHIA. These findings can inform ongoing development and refinement of various knowledge translation interventions, particularly for practitioners delivering front-line public health services.

Prática baseada em evidências: competências entre enfermeiros novatos e preceptores em hospital de ensino

Objetivo: verificar competências para a Prática Baseada em Evidências entre enfermeiros novatos e seus preceptores. Métodos: estudo observacional, transversal, constituído por amostragem não probabilística a fim de se alcançar o número máximo de participantes. Foram realizadas entrevistas estruturadas utilizando-se Evidence-Based Practice Questionnaire para verificação das competências. Resultados: participaram 83,1% da população (n=104 enfermeiros), maioria de mulheres, jovens adultas. Em média, foram moderadas as competências para Prática Baseada em Evidências (novatos = 4,8; preceptores = 5,0). Ambos acreditam ser fundamental a utilização de evidências na prática. Entretanto, a avaliação crítica das evidências no cotidiano de atuação tem sido pouco recorrente entre eles. Definir tempo no trabalho para buscar evidências apresentou-se como dificuldade, sendo maior entre novatos (p=0,05). Preceptores apresentaram melhor habilidade em informática para busca de evidências (p=0,043). Conclusão: em geral, as competências para Prática Baseada em Evidências foram similares entre enfermeiros novatos e preceptores.

Transforming a Library Service within a Provincial Healthcare Organization: Forging a New Path

Introduction: Prior to 2011, libraries within Alberta Health Services (AHS) operated using a variety of self-determining service models across 19 locations. Evaluation of library services demonstrated significant gaps in service delivery and access to resources, cost inefficiencies and variation in library service standards across the province. National and international trends reflected ongoing library closures and challenges to demonstrate library contributions to organizational goals and improvements in health information literacy.
 Description: In January 2011, all AHS library services were aligned under the Knowledge Management Department to capitalize on the natural fit between libraries as conduits to evidence and knowledge management practices that support the use of evidence in practice. The mandate was to develop enterprise-wide library resources and services to support clinical decision-making and quality patient care under the umbrella of the Knowledge Resource Service (KRS). The Business Case for KRS Optimization guided this initiative. 
 Outcome: KRS is now a focal point for access to, and expertise in, healthcare information resources and services. Organization-wide evaluations conducted in 2011 and 2014 show increased user satisfaction, while utilization analytics reflect continued growth.
 Discussion: The KRS Optimization Initiative was a proactive, internally driven effort to extend library services and resources beyond the traditional library space, streamline ‘back-office’ functions and allow staff to contribute to organizational initiatives. The path has been winding yet lessons learnt include the value of dedicated staff, teamwork, and maintaining a focus on improving service for all AHS staff and clinicians.

A validation study of public health knowledge, skills, social responsibility and applied learning.

ObjectivesTo design and validate a questionnaire to measure medical students’ Public Health (PH) knowledge, skills, social responsibility and applied learning as indicated in the four domains recommended by the Association of Schools & Programmes of Public Health (ASPPH). MethodsA cross-sectional study was conducted to develop an evaluation tool for PH undergraduate education through item generation, reduction, refinement and validation. The 74 preliminary items derived from the existing literature were reduced to 55 items based on expert panel review which included those with expertise in PH, psychometrics and medical education, as well as medical students. Psychometric properties of the preliminary questionnaire were assessed as follows: frequency of endorsement for item variance; principal component analysis (PCA) with varimax rotation for item reduction and factor estimation; Cronbach’s Alpha, item-total correlation and test-retest validity for internal consistency and reliability. ResultsPCA yielded five factors: PH Learning Experience (6 items); PH Risk Assessment and Communication (5 items); Future Use of Evidence in Practice (6 items); Recognition of PH as a Scientific Discipline (4 items); and PH Skills Development (3 items), explaining 72.05% variance. Internal consistency and reliability tests were satisfactory (Cronbach’s Alpha ranged from 0.87 to 0.90; item-total correlation > 0.59). Lower paired test-retest correlations reflected instability in a social science environment. ConclusionsAn evaluation tool for community-centred PH education has been developed and validated. The tool measures PH knowledge, skills, social responsibilities and applied learning as recommended by the internationally recognised Association of Schools & Programmes of Public Health (ASPPH).