Does self-efficacy influence the application of evidence-based practice: A survey and structural equation model

Abstract

<p class="a"><strong>Background:</strong> Implementation of Evidence-Based Practice (EBP) is complex and consequently, even within organizations that have made efforts to promote EBP use, EBP is often underutilized by individual clinicians.</p> <p class="a"><strong>Purpose:</strong> The aim of our study was to better understand the relationship between self-efficacy and EBP implementation in clinical environments that have undergone efforts to increase EBP utilization. We suggest that EBP is a set of behaviors that result from individuals acquiring, applying, and sharing new knowledge with others in the organization. We hypothesize, based upon a social cognitive theoretical approach, that these behaviors are influenced by clinician perception of self-efficacy.</p> <p class="a"><strong>Methods:</strong> We analyzed data provided by a 2011 survey of clinicians working within a national sample of hospitals that were actively participating in the Clinical Practice Model Resource Center (CPMRC), a collaborative consortium of health care organizations working to guide the implementation of EBP into the work worlds of clinicians. Structural equation modeling was used to examine the relationships between the acquisition, application, and sharing of evidence, and self-efficacy.</p> <p class="a"><strong>Results:</strong> Self-efficacy increased the acquisition of evidence and application of evidence. Self-efficacy did not exert a significant influence on sharing evidence. Acquisition of evidence increased both application of evidence and sharing of evidence. Application of evidence then increased sharing of evidence among sampled clinicians.</p> <strong>Conclusions:</strong> Efforts to promote self-efficacy in clinicians are powerful in that they directly promote the acquisition and application of evidence, and indirectly encourage communication between clinicians in an effort to justify and reinforce new knowledge. Efforts to boost self-efficacy would benefit from a focus on helping clinicians become more comfortable with actions related to acquiring evidence and generating new knowledge

Does the therapist matter? Therapist characteristics and their relation to outcome in trauma-focused cognitive behavioral therapy for children and adolescents

“…This is the first study to evaluate the effect of therapist characteristics on patient outcome in traumatized children and adolescents receiving evidence-based trauma-focused treatment. We did not find any statistically significant effects of theoretical background and prior clinical experience of therapists on PTSS, which is only partially in line with prior research (Abrahamson et al, 2012 ; Berglar et al, 2016 ; Huppert et al, 2001 ). There are two possible explanations for this finding: The first explanation might be a power problem.…”

“…However, these studies have investigated very heterogeneous samples and the results regarding the impact of the therapist variables on outcome are highly contradictory. For example, some of the studies that have looked at the relevance of therapists’ professional clinical experience have not found a significant effect on outcome (Andersson, Carlbring, Furmark, & the SOFIE Research Group, 2012 ; Dinger, Strack, Leichsenring, Wilmers, & Schauenburg, 2008 ; Okiishi et al, 2006 ; Turner et al, 2011 ), whereas other studies with adults have found that training experience in the mental health field was associated with better treatment results (Abrahamson, Arling, & Gillette, 2012 ; Berglar et al, 2016 ; Huppert et al, 2001 ). This implies that therapist age may be related to better outcome.…”

Computerized Clinical Training Simulations with Virtual Clients Abusing Alcohol: Initial Feasibility, Acceptability, and Effectiveness

“…Students' self-reported self-efficacy improved from pre-test to post-test for the total score and for each domain score (i.e., exploration, insight, and action). Though self-reported self-efficacy does not directly measure changes in applied clinical skills, clinical self-efficacy is an essential predictor of real-world implementation of evidence-based practice (Abrahamson et al 2012;Bornheimer et al 2018). Additionally, we found some initial correlational evidence that simulation performance may be related to changes in selfefficacy.…”

Putting positive weight‐related conversations into practice: The pilot implementation of a Knowledge Translation Casebook

“…Similarly, previous research has shown that an increase in knowledge can increase self-efficacy (Crowe, Ewart, & Derman, 2018;Bandura, 1989). Importantly, research has also demonstrated that increasing self-efficacy in clinicians promotes the application of evidence-based practice (Abrahmson, Arling, & Gillette, 2013).…”