Tools to assess Evidence-Based Practice behaviour among healthcare professionals

Rengerink, Katrien Oude; Zwolsman, Sandra E.; Ubbink, Dirk T.; Mol, Ben Willem J.; Dijk, Nynke van; Vermeulen, Hester

doi:10.1136/eb-2012-100969

Cited by 50 publications

(57 citation statements)

References 94 publications

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“…It is considered very difficult to measure actual EBM behaviour. [54, 55] Existing tools mainly focus on the formulation of PICO and searching for studies, which do not do justice to the more integrative concept of EBM. Within this study, based on the theory of Fishbein, we therefore chose to describe the possible changes in behaviour by expressing intentions.…”

Section: Discussionmentioning

confidence: 99%

Learning results of GP trainers in a blended learning course on EBM: a cohort study

et al. 2015

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BackgroundGeneral practitioners (GPs) experience barriers to the use of evidence-based medicine (EBM) related to a negative attitude and to insufficient knowledge and skills. We therefore designed a blended learning intervention to develop the competence of GP trainers in EBM. This study investigated the effectiveness of this intervention in increasing the trainers’ EBM competencies (i.e. knowledge, skills, attitude and behaviour).MethodsIn total 129 GP trainers participated in the blended learning course on EBM consisting of four 3-h face-to-face meetings and an intensive preparatory e-course before each meeting over a 12-month period. The primary outcomes were changes in knowledge and skills (Fresno test), changes in attitude (McColl test) and intentions to change behaviour. Secondary outcomes were changes in self-rated knowledge, skills and attitude, and the relation between personal characteristics and changes in knowledge, skills and attitude. Data were collected before the start of the intervention (T0), at the end of the last day of the intervention (T1) and four months after the end of the intervention (T2).ResultsThe mean changes in scores on the Fresno test were ∆T1-T0 = 40.8 (SD ±36.7, p < .001) and ∆T2-T0 = 20.8 (±39.9, p < .001). The mean changes in scores on the McColl test were ∆T1-T0 = 2.2 (SD ±12.8, p = .16) and ∆T2-T0 = -.87 (±10.0, p = .49). Of the GP trainers, 16.7 % fulfilled their intentions to change in behaviour, 47.6 % partly fulfilled them and 35.7 % did not fulfil them at all. Female trainers scored significantly higher on the Fresno test after the intervention compared to male trainers. There was a weak positive correlation between self-rated knowledge and the scores on the Fresno test. A moderate correlation was found between the overall score on the McColl test and self-rated attitude.ConclusionAn intensive blended learning course on EBM for GP trainers induces an increase in knowledge and skills that, although decreased, remains after four months. Attitude and behaviour towards EBM show no differences before and after the intervention, although GPs’ intention to use EBM more often in their practice is present.

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Section: Discussionmentioning

confidence: 99%

Learning results of GP trainers in a blended learning course on EBM: a cohort study

et al. 2015

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“…When interviewing the GPs, we found that aspects that we did not observe during the consultations played a role in decision-making, but GPs do not share the source on which they base their decisions with their patients. This is in contrast with the content of formal education and the concept of shared decision-making [2, 3]. …”

Section: Discussionmentioning

confidence: 99%

“…Also, in a recent systematic review, we showed that no objective measures are available for assessing the actual practice of EBM by GPs [3]. Application of EBM is studied only by measuring the frequency of application of evidence.…”

Section: Introductionmentioning

confidence: 99%

Observations of evidence-based medicine in general practice

Zwolsman¹,

Dijk²,

Waard

2013

Perspect Med Educ

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No objective measures are available for assessing the practice of evidence-based medicine (EBM) in general practitioner (GP) trainees, as there is no description of the EBM behaviour that is expected from trainees. As a first step to do so, we aimed to identify which expressions of EBM (defined as the integration of evidence, clinical experience and patient situation) can be observed in daily GP practice. Secondly, we aimed to identify which considerations GPs had regarding EBM but did not share with the patient during consultations. We performed a qualitative study, in which GPs were observed during and interviewed after clinical consultations, with a focus on expressions and considerations related to EBM during clinical decision-making. We observed 147 consultations by 34 GPs (17 trainers and 17 trainees). EBM behaviour was rarely visible in GPs’ decision-making. When interviewing the GPs, we found that aspects of EBM that played a role in decision-making were not discussed with the patient. Explicit consideration of all aspects of EBM would make EBM measurable and GPs more aware of the foundations of their decisions. EBM behaviour is difficult to observe during GP consultations and therefore cannot be assessed through observations alone.

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“…However, systematic reviews over such tools have mostly identified instruments developed for healthcare professionals and medical students [9, 12–14]. In addition, a limited number of instruments have established measurement properties [12, 13, 15] and few measure all five steps of EBP [12, 14, 15]. …”

Section: Introductionmentioning

confidence: 99%

Translation, cross-cultural adaption and measurement properties of the evidence-based practice profile

et al. 2017

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BackgroundThe evidence-based practice profile (EBP2) questionnaire assesses students’ self-reported knowledge, behaviour and attitudes related to evidence-based practice. The aim of this study was to translate and cross-culturally adapt EBP2 into Norwegian and to evaluate the reliability, validity and responsiveness of the Norwegian version.MethodsEBP2 was translated and cross-culturally adapted using recommended methodology. Face validity and feasibility were evaluated in a pilot on bachelor students and health and social workers (n = 18). Content validity was evaluated by an expert panel. Nursing students (n = 96), social educator students (n = 27), and health and social workers (n = 26) evaluated the instrument’s measurement properties. Cronbach’s alpha was calculated to determine internal consistency. Test–retest reliability was evaluated using the intra-class correlation coefficient (ICC) and standard error of measurement (SEM). Discriminative validity was assessed by independent sample t test. A confirmatory factor analysis (CFA) was performed to assess the structural validity of a five-factor model (Relevance, Sympathy, Terminology, Practice and Confidence) using the comparative fit index (CFI) and the root mean square error of approximation (RMSEA). A priori hypotheses on effect sizes and P values were formulated to evaluate the instrument’s responsiveness.ResultsThe forward–backward translation was repeated three times before arriving at an acceptable version. Eleven of 58 items were re-worded. Face validity and content validity were confirmed. Cronbach’s alpha was 0.90 or higher for all domains except Sympathy (0.66). ICC ranged from 0.45 (Practice) to 0.79 (Terminology) and SEM from 0.29 (Relevance) to 0.44 (Practice). There was a significant mean difference between exposure and no exposure to EBP for the domains Relevance, Terminology and Confidence. The CFA did not indicate an acceptable five-factor model fit (CFI = 0.69, RMSEA = 0.09). Responsiveness was as expected or better for all domains except Sympathy.ConclusionsThe cross-culturally adapted EBP2-Norwegian version was valid and reliable for the domains Relevance, Terminology and Confidence, and responsive to change for all domains, except Sympathy. Further development of the instrument’s items are needed to enhance the instruments reliability for the domains Practice and Sympathy.

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Tools to assess Evidence-Based Practice behaviour among healthcare professionals

Abstract: Valid and reliable EBP behaviour assessment tools are available. However, only one questionnaire validly assessed all five EBP steps, covering the entire concept of EBP.

Cited by 50 publications

References 94 publications

Learning results of GP trainers in a blended learning course on EBM: a cohort study

Learning results of GP trainers in a blended learning course on EBM: a cohort study

Observations of evidence-based medicine in general practice

Translation, cross-cultural adaption and measurement properties of the evidence-based practice profile

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