Creating Evidence-Based Practitioners: Perspectives from the Clinic
Purpose: Educators striving to produce leaders in physical therapy (PT) must ensure their graduates commitment to best practice standards through use of evidence-based practice (EBP). Learning about the perspectives and experiences of those who successfully practice using an evidence-based approach provides insight into factors necessary for EBP adoption. The purpose of this study was to describe and interpret the experience of implementing EBP from the perspectives of physical therapists who use this approach.Methods/Description: A phenomenological design was utilized to explore the experience of implementing EBP. Twelve physical therapists who use EBP and were serving as clinical instructors were recruited through purposeful sampling. Data were collected through one-on-one semi-structured interviews and were coded using the constant comparison method to identify common categories and themes.Results/Outcomes: Participants reported engaging in a wide variety of EBP activities. Two main themes, Internal Drive and Culture of Support, and one overarching them, Better Patient Outcomes, emerged. Subthemes identified under Internal Drive included Pushing to Be Better, Outside the Box, Squeeze it In, and a Growing Process. Subthemes under Culture of Support included Like-minded Colleagues, Organizational/Administrative Support, Importance of Setting Type, Access to Articles, and Student Interns.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: To develop leaders in PT that will embrace the need for best practice standards, educators need to address factors that will lead to continued use of EBP after graduation. Themes identified in this study have significant relevance to professional PT programs attempting to accomplish this task. The Internal Drive subthemes of Pushing to be Better and Outside the Box suggest that educational programs consider ways to identify applicants who exhibit a drive to improve, tolerance of uncertainty, and the ability to be flexible in seeking solutions. Admitting students who possess these qualities and then providing opportunities to practice EBP in ambiguous situations will likely lead to increased EBP implementation. In the theme Squeeze it in, participants used a variety of ways to overcome the barrier of time, but all participants voiced the intentional development of strategies to ensure time for EBP. PT programs may look for students who fit critical tasks into busy schedules and then work to develop the students’ abilities to apply evidence in real-time situations requiring creative solutions to meet time demands. The Culture of Support in the work environment also applies to educational programming, as participants discussed wishing for more guidance from their educational institutions relative to seeking employers who would support development of EBP skills. Finally, professional PT programs must recognize that a high variety of activities and supports are used for successful EBP, and infuse curricular strategies to expose their students to all of these.References: 1. Bernhardsson S, Johansson K, Nilsen P, Öberg B, Larsson ME. Determinants of guideline use in primary care physical therapy: a cross-sectional survey of attitudes, knowledge, and behavior. Physical Therapy. 2014;94(3):343-354. 2. da Silva TM, Costa LdCM, Garcia AN, Costa LOP. What do physical therapists think about evidence-based practice? A systematic review. Manual Therapy. 2015;20(3):388-401. 3. Dannapfel P, Peolsson A, Nilsen P. What supports physiotherapists' use of research in clinical practice? 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