Evidence-based practice training for health professionals in the Philippines.

Review Objectives: The objective of this review is to find, a ssess and synthesize the evidence on EBP programs in enhancing the EBP knowledge, skills and attitudes of allied health practitioners. Review questions: What is the effectiveness of using EBP programs for allied health practitioners in improving the EBP knowledge, skills and attitudes Inclusion criteria: Types of participants: This review will include as participants allied health practitioners (physiotherapists, occupational therapists etc) who participated in any EBP educational program or part of an EBP program (formulating clinical questions, searching the literature, critical appraisal skills program etc). Types of interventions: The intervention of interest in this review is any EBP training program defined as any formal program facilitating the search and use of evidence in practice. The contents (lectures only or lectures with actual demonstrations and practice), length (hours, days, weeks) and manner of delivery (face to face, face to face with supplementary materials etc) of the program may vary in each of the studies to be included as there is no standard EBP training program. Types of Outcome: The main outcomes measured are the EBP domains of knowledge, skills, attitudes and behaviour as a result of participating in the EBP program or a component of it. Specific measures may include but not limited to the use of the adapted Fresno questionnaire (22) to assess knowledge, skills and attitudes to EBP. The adapted Fresno question has good psychometric properties and is especially fitting novice rehabilitation professionals undergoing EBP training.

Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha=0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.

BackgroundAlthough allied health is considered to be one 'unit' of healthcare providers, it comprises a range of disciplines which have different training and ways of thinking, and different tasks and methods of patient care. Very few empirical studies on evidence-based practice (EBP) have directly compared allied health professionals. The objective of this study was to examine the impact of a structured model of journal club (JC), known as iCAHE (International Centre for Allied Health Evidence) JC, on the EBP knowledge, skills and behaviour of the different allied health disciplines.MethodsA pilot, pre-post study design using maximum variation sampling was undertaken. Recruitment was conducted in groups and practitioners such as physiotherapists, occupational therapists, speech pathologists, social workers, psychologists, nutritionists/dieticians and podiatrists were invited to participate. All participating groups received the iCAHE JC for six months. Quantitative data using the Adapted Fresno Test (McCluskey & Bishop) and Evidence-based Practice Questionnaire (Upton & Upton) were collected prior to the implementation of the JC, with follow-up measurements six months later. Mean percentage change and confidence intervals were calculated to compare baseline and post JC scores for all outcome measures.ResultsThe results of this study demonstrate variability in EBP outcomes across disciplines after receiving the iCAHE JC. Only physiotherapists showed statistically significant improvements in all outcomes; speech pathologists and occupational therapists demonstrated a statistically significant increase in knowledge but not for attitude and evidence uptake; social workers and dieticians/nutritionists showed statistically significant positive changes in their knowledge, and evidence uptake but not for attitude.ConclusionsThere is evidence to suggest that a JC such as the iCAHE model is an effective method for improving the EBP knowledge and skills of allied health practitioners. It may be used as a single intervention to facilitate evidence uptake in some allied health disciplines but may need to be integrated with other strategies to influence practice behaviour in other practitioners. An in-depth analysis of other factors (e.g. individual, contextual, organisational), or the relative contribution of these variables is required to better understand the determinants of evidence uptake in allied health.

Introduction: Evidence-based practice (EBP) is crucial for delivering optimal client care. Although healthcare sciences students, including occupational therapy students at the University of Pretoria, receive the same evidence-based practice training, their attitudes, knowledge, skills and practices in EBP remain mostly unknown. Determining these aspects in final-year students is important as it may impact their future practice. Methods: A non-experimental cross-sectional study was conducted using the Student Evidence-Based Practice Questionnaire. The survey was electronically distributed and completed by 50 final-year healthcare sciences students. Data analysis was performed using measures of central tendency. Results and Discussion: Participants have positive attitudes related to the implementation of evidence-based practice. However, gaps in practice remain. Students rate their evidence-based practice knowledge as “average”, which may impact their practice after graduation. Students report that they are more skilled in certain steps of EBP than others. Conclusion: The survey results can be used to strengthen evidence-based practice training for healthcare sciences students, potentially improving their ability to implement evidence-based practice after graduation. Several identified barriers to the implementation of evidence-based practice may be overcome through more purposeful training. Implications for practice Positive attitudes towards EBP do not necessarily translate into increased practice and skills in EBP. Educators should be aware of the challenges students experience with the different steps of EBP. Training of healthcare science students should be developed to include all five steps of EBP. Educating students on how to effectively use resources provided by their institutions can improve the evidence they find and apply.

Assessing the Effectiveness of an Evidence-based Practice Pharmacology Course Using the Fresno Test

Dental and medical practitioners’ awareness and attitude toward evidence based practice in Riyadh, Saudi Arabia. A comparative study

Evaluation of an Evidence-Based Medicine Curriculum in a PGY1 Pharmacy Residency Program Using the Fresno Test

This cross-sectional study explored the behaviour, knowledge, skills and resources, opinion, and perceived barriers of paediatric physiotherapists practising in Saudi Arabia regarding evidence-based practice (EBP). Sixty-eight paediatric physiotherapists from Saudi Arabia participated. Data were collected by electronic questionnaire and the Likert scale was used to score knowledge, skills and resources, opinion, and barriers to EBP implementation. Approximately 78% of the participants were motivated to use EBP in their daily practise and 82.3% have reported the use of best scientific evidence in their clinical practise. Participants with higher database usage over the last 6 months showed significant association with EBP knowledge scores (t = 2.46, p = 0.01), skills and resources scores (t = 3.81, p < 0.001), and opinion scores (t = 2.43, p = 0.01). Furthermore, a higher level of education in participants was significantly associated with EBP knowledge scores (t = 2.41, p = 0.01). Most paediatric physiotherapists believed that EBP is essential in their clinical practise as it improves patient care and quality of health services. Difficulty in obtaining full-text papers and lack of time were identified as major barriers to implementing EBP followed by the lack of management support, motivation in research, and EBP training.

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months’ employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students’ high EBP capability beliefs might inspire staff in this matter.

The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use of evidence-based practice is mostly found among practitioners in the private not-for-profit health sector. Better training in evidence-based practice, improved regulatory system and greater collaboration between the public, private for-profit and private not-for-profit sectors with regards to training in evidence-based practice - literature search and critical appraisal skills - were suggested as needed to improve the present situation.

This paper reports if estimates of final year nursing students' self-rated abilities in responding to evidence-based practice (EBP) issues is a psychometrically robust measure. EBP as it applies to nursing continues to be heralded as a method to improve clinical patient care. Health professionals such as nurses are well positioned to respond to this demand; however, evidence suggests they are not always able to embrace this important foundation of everyday nursing practice. Instrument development. The study was a survey set in a large teaching university in Adelaide, South Australia. The evidence-based practice survey was made available to a convenience sample of 471 final year nursing students, with a response rate of 79.6% (n = 375). Rasch analysis was used to critique and develop a scale for future learning based on the conjoint estimates of nursing students' self-efficacy estimates, when meeting the challenges of various EBP of differing complexities. Outcomes confirm that final year nursing students' EBP ability measures can be reliably estimated and a hierarchical scale of learning can be developed for use by beginning registered nurses' in their staff development. Although Australian health and nursing authorities acknowledge the desirability of the nursing workforce in adopting EBP for patient management, elements of this approach remains problematic for nurses. Measures to estimate EBP skills difficulty can be reliably generated to inform EBP education and skills development.

Existing studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses' characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ 2/df = 3.20, p < 0.001; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center's affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses.

Evidence-based practice (EBP) training is essential for undergraduate students in making sound clinical decisions during patient care. However, EBP training is not included in the curriculum of undergraduate dental students in India and there is a dearth of research that assessed the effectiveness of EBP training in India. Hence, this study aimed to assess the effectiveness of EBP training to dental undergraduate students. Final year undergraduate students and interns of a dental institution participated in this pre and postexperimental study. All the participants received a 2-day workshop (didactic lectures, hands-on and group activities) in a classroom setting. A validated 35 item instrument titled EBP Knowledge, Attitudes, Access and Confidence questionnaire was used for the outcome assessment of EBP training. Fifty undergraduate students (33 interns and 17 final year) participated in the study. Statistically significant improvement was observed in six out of 10 items related to EBP knowledge. All the items related to attitude showed a significant positive change in scores. Only four out of nine items related to accessing evidence showed a statistically significant change. Participants reported moderate confidence gain in critical appraisal skills. The current study demonstrated moderate improvement in the effectiveness of EBP training in improving EBP knowledge, accessing evidence and critical appraisal skills.

Objectives Practitioner ratings of their adherence to evidence-based psychotherapy or counseling practices in working with autistic youth could be an efficient method for tracking the success of efforts to implement effective practices in community behavioral health service settings. Tools of this sort that generalize across multiple evidence-based practices (EBPs) have not been developed to date. In this study, a practitioner self-report measure of adherence to EBPs for autistic youth was developed and evaluated. Methods A multiple baseline study of seven behavioral health practitioners was conducted to determine if internet-based self-directed training on Modular EBPs for Youth on the Autism Spectrum (MEYA; meya.ucla.edu), a free internet-based practitioner training app, would facilitate an increase in clinician adherence to EBP techniques such as cognitive behavioral therapy and behavioral intervention practices. Practitioners made self-ratings on the MEYA Integrity Scale-Practitioner Version (MEYA-IS-PV). Expert coders unaware of phase or study hypotheses also rated the therapists’ adherence to EBPs for each session. Caregivers rated youth outcomes at each session on the Youth Top Problems scale. Results Linear mixed models showed that MEYA-IS-PV scores corresponded to expert ratings of adherence, increased following the onset of training in EBPs, and predicted improvements in youth behavioral health. Visual analysis of the multiple baseline data confirmed that 5 of 7 practitioners increased their self-reported adherence in EBPs in varying magnitudes once training began. Conclusions Self-ratings of adherence are promising for examining adherence to EBPs in psychotherapy or counseling for autistic youth.

Fresno test to measure evidence-based practice knowledge and skills for Portuguese undergraduate nursing students: A translation and adaptation study