Factors affecting paramedicine students’ learning about evidence‐based practice: a phenomenographic study

Abstract

Background Evidence-based practice is an important component of pre-service professional learning in medicine and allied health degrees, including new programmes in paramedicine. Despite substantial interest in this area, there is still a lack of clear understanding of how the skills and understandings needed to develop the capacity to apply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of five steps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine students’ learning about the first three steps in a final year unit which explicitly aims to develop their skills in relation to these. Methods We conducted a qualitative study of learning journals recorded by 101 of 121 students in a final year unit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research or did not complete their journal entries). We used phenomenographic approaches to the data analysis in order to identify both variation in students’ learning and the factors affecting this variation. Results We observed variation in students’ understanding of the purpose of literature analysis, the nature of medical research and its relationship to practice. In all three, we identify two main factors contributing to the variation in student learning outcomes: epistemological stance, and opportunities for metacognitive learning generated through peer interactions and self-reflection. We also found that as students begin to grapple with the complexity of medical research, this sometimes produced negative attitudes towards its value; such unintended outcomes need to be recognised and addressed. Conclusions We suggest key factors that should be considered in developing coursework intended to enhance students’ understandings about the processes and application of evidence-based practice. Providing collaborative learning opportunities that address the architecture of variation we observed may be useful in overcoming epistemological and metacognitive barriers experienced by students.

Beliefs, Attitudes, and Behaviors of Saudi Physiotherapists Toward Evidence-Based Practice

“…[ 1 ] These factors have led EBP to gain significant importance in clinical practice, including physiotherapy. [ 2 ] However, the literature suggests that significant barriers have hindered the adoption of EBP by physiotherapists. [ 3 ] A systematic review found that while physiotherapists from Western countries mostly have a positive attitude toward EBP in daily patient care and decision making, yet a sizeable proportion rely on personal experience, educational courses, and in-service training for patient care decision making.…”

The adoption of evidence-based policing: the pivotal role of first-line police leaders across England and Wales

“…(2019), who report that officers within frontline policing often know about EBP; however, the regular use in daily practice is limited, valuing instead the local tacit knowledge and experience of the “craft” of policing. In a similar way, Wilson et al . (2021), found that trainee paramedics gained the underpinning research skills during their studies, but the application to practice still required changes in both workplace attitudes and behaviours.…”

“…These research findings must be tempered though with those of Palmer et al (2019), who report that officers within frontline policing often know about EBP; however, the regular use in daily practice is limited, valuing instead the local tacit knowledge and experience of the "craft" of policing. In a similar way, Wilson et al (2021), found that trainee paramedics gained the underpinning research skills during their studies, but the application to practice still required changes in both workplace attitudes and behaviours. den Heyer (2023) suggests that one of the main barriers to the widespread adoption of EBP may be their immediate supervisors, who often act as gatekeepers to the sharing of research.…”

“…In a complementary way to the long history of the healthcare professions making the best use of evidence on which to base their professional practice, the formalised use of evidence on which to base policing practice has a relatively recent history and is continuing to evolve. Often referred to in the healthcare professions as evidence-based practice, its importance for trainee paramedics is identified (Wilson et al ., 2021), whilst in nursing, an evidence-based approach is viewed as means to provide high-quality care (Kumah et al ., 2022). The interpretation and use of “evidence-based policing (EBP)” has continued to evolve, with the concept often being initially attributed to Sherman (1998).…”

Ambulance Clinicians with ‘Research Skills’: Alien Concept or Artificial Intelligence? Attitudes, perceptions and experiences of evidence-based practice learning and implementation by student paramedics.

“…The subjects teaching and learning principles have thus become deeply-rooted in higher education curricular [European University Association, 2022]; but only in recent years has EBP begun to permeate the world of paramedic practice [Simpson et al, 2012]. Despite this paradigm, the impact of EBP may be limited in real-world practice because students (and quali ed staff) can struggle to implement these skills [Emms & Armitage, 2010;Warren, et al 2016] and whilst the concept may be considered favourable amongst graduates [Wilson et al 2021] a variety of barriers impact translation and application […”