Evidence-based Practice Exposure and Physiotherapy Students' Behaviour during Clinical Placements: A Survey

Abstract

Background and purpose. Physiotherapists are expected to practice in an evidence-based way. Evidence-based practice (EBP) should be an integral part of the curriculum to ensure use of the five EBP steps: asking clinical questions, searching for and appraising research evidence, integrating the evidence into clinical practice and evaluating this process. The aim of this study was to compare self-reported EBP behaviour, abilities and barriers during clinical placements reported by five cohorts of final year physiotherapy students' with different EBP exposure across the 3-year bachelor programme. Methods. A cross-sectional study was conducted among five cohorts (2006-2010) with third year physiotherapy students at a University College in Norway. In total, 246 students were eligible for this study. To collect data, we used a questionnaire with 42 items related to EBP behaviour, ability and barriers. Associations were investigated using the Spearman's rho (r). Results. In total, 180 out of 246 third year physiotherapy students, who had recently completed a clinical placement, filled out the questionnaire (73 %). The association between the level of EBP exposure and students' self-reported EBP behaviour, abilities and barriers was low for most items in the questionnaire. Statistically significant correlations were found for eight items, related to information need, question formulation, use of checklists, searching and perceived ability to search for and critically appraise research evidence. The strongest correlation was found between the level of EBP exposure and ability to critically appraise research evidence (r = 0.41, p < 0.001). Conclusions. An association between the level of EBP exposure and physiotherapy students' EBP behaviour was found for elements such as asking and searching, ability to search for and critically appraise research evidence, and experience of critical appraisal as a barrier. Further research need to explore strategies for EBP exposure throughout the curriculum, regarding content, timing, amount and type of training.

Manipulating practices: A critical physiotherapy reader

“…They found that students who were exposed to more teaching in evidence-based practice more often conducted a critical review of research than those who were exposed to less teaching in evidence-based practice. However, in clinical situations involving patients, there was no difference in terms of how the students utilised research-based knowledge (Olsen et al, 2014). Although students tried to use an evidence-based approach, they felt uncertain, as novices in clinical practice, about how to actually go about doing it.…”

Evidence-based practice work file - A learning strategy for occupational therapy students during clinical placements: a descriptive cross-sectional study

“…This implies that EBP is asked for in student's work, including in the exams throughout the three years of education. The students attended approximately 10 hours of EBP teaching before their second-year clinical placement, which can be defined as low level exposure of EBP teaching according to Olsen et al (5). The students were not, before this study, required to apply EBP work to the clinical placement period.…”

“…Healthcare students report various barriers to EBP during clinical placements, which include lack of time, high workload, lack of support during clinical placements, students and clinical instructors prioritizing hands-on experience during clinical placements, lack of role models in clinical placements and insufficient autonomy to change practice (1,(4)(5)(6)(7). Stronge and Cahill (1) examined the knowledge, attitudes and behaviours of occupational therapy bachelor's students towards EBP.…”

“…There are different approaches to teaching and learning EBP, such as standalone or single teaching courses, including workshops, conferences, lectures, journal clubs and e-learning. In addition, EBP should be integrated across theoretical and clinical courses (5,11), and teaching in relation to clinical placement may improve EBP skills, believes and attitude (12). In occupational therapy curricula it is required to incorporate efficient teaching strategies for EBP in order to expect bachelor's students to apply an evidencebased practice (13).…”

“…In occupational therapy curricula it is required to incorporate efficient teaching strategies for EBP in order to expect bachelor's students to apply an evidencebased practice (13). Questions remain about optimal EBP teaching strategies throughout the occupational therapy curriculum (5,11). There is a need for educational strategies addressing all EBP steps to improve EBP teaching (14), including applying EBP teaching to real world environments (9).…”