title: Perspectives on research evidence and clinical practice: a survey of Australian physiotherapists. The propensity to adopt evidence-based practice among physical therapists Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts Do physiotherapists' attitudes towards evidence-based practice change as a result of an evidence-based educational programme? Survey of the perceived professional, educational and personal needs of physiotherapists in primary care and community settings. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Allied health professionals' use of online evidence: a survey of 790 staff working in the Australian public hospital system Knowledge and use of evidence-based practice by allied health and health science professionals in the United Kingdom. Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? Descriptors of American Physical Therapy Association physical therapist members' reading of professional publications
abstract: BACKGROUND AND PURPOSE Physiotherapists ' use of research evidence with clinical decision-making has interested research ers world-wide since 1980 ; however , little is known about such practice s in Australia . The present survey sought information on Australian physiotherapists ' perceptions of the importance of research , and barriers to uptake of evidence in clinical practice , when compared with an international cohort from 2001 . METHOD An Australian-relevant version of an English ( UK ) National Health Service ( NHS ) survey instrument was used to canvass 453 physiotherapists , r and omly selected from the South Australian Physiotherapy Registration Board 2004 - 2005 records . The first survey was mailed in August 2005 , a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005 . RESULTS There was a 51 % response rate . Of the non-responders , 12 % were not contactable at their listed address , highlighting the mobility of Australian physiotherapists . Most respondents had undertaken research as students ( 59.5 % ) or as students and clinicians ( 11.5 % ) . Of these , 37.1 % were encouraged to embark on more research , and 20.5 % were discouraged . The significant predictors of positive perceived importance of research were : previous research experience ; being positive about undertaking further research ; working in hospitals and holding a postgraduate degree . Clinicians working privately were significantly less likely than managers to be positive about research importance . The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research . CONCLUSIONS The study identified constraints on uptake of evidence into practice that were related to accessing , reading and interpreting published research , and implementing findings . Found consistently across employment categories were barriers relating to lack of time , uncertainty about what the research reported , scepticism about the value of research and being isolated from peer support and literature sources . The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey , suggesting an influence of increased exposure to information on evidence -based practice . A greater focus on research whilst training , the application of educational strategies for empowerment , better knowledge transfer and upskilling within the workplace , and ensuring dedicated time and organizational support for research activities are indicated Background Many authors , as well as the American Physical Therapy Association , advocate that physical therapists adopt practice patterns based on research evidence , known as evidence -based practice ( EBP ) . At the same time , physical therapists should be capable of integrating EBP within the day-to-day practice of physical therapy . The purpose of this study was to determine the extent to which personal characteristics and the characteristics of the social system in the workplace influence the propensity of physical therapists to adopt EBP . Methods The study used a 69 item mailed self-completion question naire . The question naire had four major sections . The first three sections were each drawn from a different theoretical framework and from different authors ' work . The instrument was developed to capture the propensity of physical therapists to adopt EBP , characteristics of the social system in the workplace of physical therapists , personal characteristics of physical therapists , and selected demographic variables of physical therapists . The eligible population consisted of 3,897 physical therapists licensed by the state of Georgia in the United States of America . A r and om sample of 1320 potential participants was drawn . Results 939 question naires were returned for a response rate of 73 % . 831 of the participants ' question naires were useable and became the basis for the study . There was a moderate association between desire for learning ( r = .36 , r2 = .13 ) , highest degree held ( r = .29 , r2 = .08 ) , practicality ( r = .27 , r2 = .07 ) and nonconformity ( r = .24 , r2 = .06 ) and the propensity to adopt EBP .  A negative correlation was found between age , years licensed and percentage of time in direct patient care . The findings demonstrated that the best three variables for predicting the propensity to adopt EBP  in physical therapy were : desire for learning , highest degree held , and practicality . Conclusion The study confirms there is no single factor to facilitate research evidence into day-to-day practice . Multiple practice change strategies will be needed to facilitate change in practice Background Training in the five steps of evidence -based practice ( EBP ) has been recommended for inclusion in entry-level health professional training . The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students . Few studies have investigated longitudinal changes in EBP attitudes and behaviours . This study aim ed to assess the changes in EBP knowledge , attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce . Methods A prospect i ve , observational , longitudinal design was used , with two cohorts . From 2008 , 29 participants were tested in their final year in a physiotherapy program , and after the first and second workforce years . From 2009 , 76 participants were tested in their final entry-level and first workforce years . Participants completed an Evidence -Based Practice Profile question naire ( EBP2 ) , which includes self-report EBP domains [ Relevance , Terminology ( knowledge of EBP concepts ) , Confidence , Practice ( EBP implementation ) , Sympathy ( disposition towards EBP ) ] . Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data . Effect sizes ( ES ) ( 95 % CI ) were calculated for all changes . Results Effect sizes of the changes in EBP domains were small ( ES range 0.02 to 0.42 ) . While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year ( ES -0.42 to -0.29 ) followed by an improvement in the second year ( ES + 0.27 ) . Scores in Terminology improved ( ES + 0.19 to + 0.26 ) in each of the first two workforce years , while Practice scores declined ( ES -0.23 to -0.19 ) in the first year and improved minimally in the second year ( ES + 0.04 ) . Confidence scores improved during the second workforce year ( ES + 0.27 ) . Scores for Sympathy showed little change . Conclusions During the first two years in the workforce , there was a transitory decline in the self-reported practice and sense of relevance of EBP , despite increases in confidence and knowledge . The pattern of progression of EBP skills beyond these early professional working years is unknown RATIONALE The concept of evidence -based practice ( EBP ) encourages health care professionals to provide the most effective health care , and to be accountable for the interventions they provide . Little work has been undertaken to examine how practically allied health professionals ' encompass EBP and how they perceptive and underst and the concept of EBP . The use of opinion leaders to disseminate new evidence into practice , and thereby encourage the behaviour of health care professionals has been proposed . AIMS The aims of this study were to investigate physiotherapists ' attitudes towards EBP and to examine change in their attitudes following an education package , which utilized local opinion leaders . METHOD Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster r and omized by location of work to two groups . The intervention group received an evidence -based programme on aspects of EBP including literature search ing and critical appraisal . The attention control group received a st and ard in-service training package on the management of common knee pathologies . The physiotherapists ' attitudes towards EBP were measured at baseline ( before r and omization ) and at 3 and 6 months follow-up . RESULTS Physiotherapists reported that they primarily relied on ' courses ' and ' in-service training ' for informing their clinical practice . Most agreed that clinical practice should be based on the best available evidence and that they would change their clinical practice if evidence suggested they should do so . However , many of the physiotherapists reported difficulty in reading journals and could not identify opinion leaders in key areas . In terms of clinical practice , literature , journals and research were ascribed low priority throughout . Differences in attitudes between the intervention and control groups were observed in relation to management support for EBP at 3 and 6 months follow-up . CONCLUSIONS In this study , physiotherapists appeared to be in favour of the idea of EBP , yet they remained reluctant to change their practice . Opinion leaders were not easily identifiable by physiotherapists , suggesting that this method alone may not be an effective method of changing attitudes in clinical practice . The process of changing attitudes in the clinical environment is a complex issue worthy of further research The emphasis of UK Government policy on primary -care-based services has led to more physiotherapists working in the community . The aims of the present study were to identify the perceived professional , educational and personal needs of community physiotherapists , and to determine good practice in meeting these needs . A survey of physiotherapists working in 15 National Health Service community trusts in the West Midl and s was carried out in September 2000 . The survey question naire was developed through focus groups and mailed to a r and om sample of 200 community physiotherapists . The response rate was 67 % , and the median age group of the respondents was 21 - 30 years . The participants worked mainly in ' urban but not inner city ' areas , most commonly in domiciliary ( 31 % , n = 38 ) and general practitioner surgery/health centre ( 26 % , n = 32 ) locations . Fifty-one per cent ( n = 66 ) of respondents had no specific learning objectives for continuing professional development ( CPD ) ; those with such objectives were more positive as to their helpfulness than those without them ( Mann-Whitney U-test z = 2.519 , P = 0.012 ) . Fifty-three per cent ( n = 68 ) also often/very often found it problematic getting cover for their caseloads so that they could take part in CPD activities . Access to library re sources and use of computers were problems , as were confidence in appraising literature and opportunities to discuss research evidence with colleagues . Fifty-nine per cent ( n = 77 ) of respondents indicated that they often/very often felt stressed by the size of their caseloads . Colleague support included mentorship , peer review , journal clubs , clinical interest groups and multidisciplinary in-service training ; respondents with experience of these re sources expressed more positive attitudes to them than those without ( Mann-Whitney U-test z = 2.871 , P < 0.0005 for each ) . Forty-two per cent ( n = 54 ) indicated that there were problems with safety issues . This study has identified needs that will have an impact on the ability of community physiotherapists to meet the dem and s of clinical governance . National Health Service management at all levels has a responsibility to facilitate the education , training and support of community physiotherapists BACKGROUND AND PURPOSE Little research has been done regarding the attitudes and behaviors of physical therapists relative to the use of evidence in practice . The purpose s of this study were to describe the beliefs , attitudes , knowledge , and behaviors of physical therapist members of the American Physical Therapy Association ( APTA ) as they relate to evidence -based practice ( EBP ) and to generate hypotheses about the relationship between these attributes and personal and practice characteristics of the respondents . METHODS A survey of a r and om sample of physical therapist members of APTA result ed in a 48.8 % return rate and a sample of 488 that was fairly representative of the national membership . Participants completed a question naire design ed to determine beliefs , attitudes , knowledge , and behaviors regarding EBP , as well as demographic information about themselves and their practice setting s. Responses were summarized for each item , and logistic regression analyses were used to examine relationships among variables . RESULTS Respondents agreed that the use of evidence in practice was necessary , that the literature was helpful in their practice s , and that quality of patient care was better when evidence was used . Training , familiarity with and confidence in search strategies , use of data bases , and critical appraisal tended to be associated with younger therapists with fewer years since they were licensed . Seventeen percent of the respondents stated they read fewer than 2 articles in a typical month , and one quarter of the respondents stated they used literature in their clinical decision making less than twice per month . The majority of the respondents had access to online information , although more had access at home than at work . According to the respondents , the primary barrier to implementing EBP was lack of time . DISCUSSION AND CONCLUSION Physical therapists stated they had a positive attitude about EBP and were interested in learning or improving the skills necessary to implement EBP . They noted that they needed to increase the use of evidence in their daily practice OBJECTIVE To measure the impact of a state health department policy to provide allied health professional staff with access to a point-of-care , 24h , online evidence system in terms of awareness , use and clinical impact of the system on clinical practice ; to identify perceived barriers to use , and differences in measures between seven professional groups ( physiotherapists , occupational therapists , speech pathologists , dieticians , clinical psychologists , pharmacists and social workers ) . METHOD A convenience sample of 790 allied health professionals from 65 r and omly selected hospitals in New South Wales , Australia . A self-administered question naire was distributed . Rates of use , frequency and types of re sources accessed were calculated . Comparisons between professional groups were undertaken using Chi-square analyses and t-tests . RESULTS The results showed that 82 % of allied health professionals had heard of the online evidence system  , and of those 76 % had used it . Pharmacists had the highest rates of use and social workers the lowest . Of users , 90 % agreed that use of the system had the potential to improve patient care and 45 % reported direct experience of this . Computer skills and easy access were significantly associated with use and frequency of use . Among non-users , lack of specific training in the use of the online evidence system and lack of time were the most frequently reported reasons for not using the system . However , among users there was no relationship between this training and the frequency or effectiveness of use , i.e. the ability to find the information required . CONCLUSIONS Allied health professionals will use an online evidence system when it is provided , however there are marked differences in use by professional groups . General training aim ed at improving computer skills appears more important in encouraging use of an online evidence system , than specific system-based training . Perceptions of organisational and professional support for allied health professionals to use online evidence as a legitimate part of their work play an important role in influencing system use Clinical  effectiveness ( CE ) and evidence -based practice ( EBP )  are the cornerstone of modern-day health care . Although many studies have explored attitudes and perceived knowledge of individual professions , few have compared these factors between professional groups , especially in the allied health professions ( AHP ) and health science services ( HSS ) . We report a study comparing the knowledge and practice of 14 different professional groups from the AHP and HSS in terms of EBP and CE . The aim was to highlight any differences between the 14 professional groups along with the needs of the groups . A postal question naire survey was completed by a r and om sample of 1,000 members of AHP and HSS across the United Kingdom . There were significant differences between professional groups with , in general , professionals from the HSS groups rating their knowledge and application of CE and EBP  as lower than members of the AHP . Differences were also noted between individual professional groups . For example , podiatrists , radiographers , and orthoptists reported having less knowledge of CE and EBP than physiotherapists , occupational therapists , dietitians , speech and language therapists , and psychologists . Barriers to implementing EBP were similar for all groups , with lack of both time and money cited as the main issues . A number of differences between professions were recorded that highlight the difference in educational and policy approach required for greater uptake of EBP RATIONALE The concept of evidence -based medicine is important in providing efficient health care . The process uses research findings as the basis for clinical decision making . Evidence -based practice helps optimize current health care and enables the practitioners to be suitably accountable for the interventions they provide . Little work has been undertaken to examine how allied health professionals change their clinical practice in light of the latest evidence . The use of opinion leaders to disseminate new evidence around the management of low back pain into practice has been proposed . AIMS The aim of this study was to investigate if physiotherapists ' clinical management of patients with low back pain would change following an evidence -based education package , which utilized local opinion leaders and delivered the best evidence . METHOD Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster r and omized by location of work , to two groups . The intervention group received an evidence -based programme on the management of low back pain , including advice regarding increasing activity levels and return to normal activity and challenging patients ' fears and beliefs about their pain . The control group received a st and ard in-service training package on the management of common knee pathologies . The physiotherapists ' clinical management of patients with low back pain was measured prior to training and 6 months post training . Outcome measures were based on physiotherapists completing ' discharge summary ' question naires , which included information relating to the use and importance of therapies for treating their low back pain patients . RESULTS There were few significant differences in treatment options between the intervention and control groups post training . Whilst there was some indication that physiotherapists were already utilizing aspects of psychosocial management for patients with low back pain , there was little change in what physiotherapists perceived to be important to patient recovery and actual clinical practice following the intervention . CONCLUSIONS Psychosocial factors have been identified as an important factor in the recovery of patients with low back pain . This project incorporated the latest evidence on the management of low back pain and utilized the theory of opinion leaders to disseminate this evidence into clinical practice . Whilst there were some limitations in the overall size of the study , the results help to give an insight into the challenges faced by the health care system and research ers alike to ensure quality evidence is actually utilized by practitioners for the benefits of patient care One of the components of evidence -based practice ( EBP ) is reading the literature . The purpose of this investigation was 1 ) to determine which publications are read most frequently by physical therapists ( PTs ) , 2 ) to identify employment and education characteristics related to reading patterns , and 3 ) to determine how PTs use information gained from reading professional publications . A survey was constructed , pretested , revised , and then mailed to a r and om sample of 1,000 physical therapists , 500 from the general American Physical Therapy Association ( APTA ) membership and 500 from the combined Geriatric and Orthopedic section memberships . The data were analyzed with descriptive statistics . After all mailings , 43.3 % of the sample responded . Of those responding , 66.3 % were employed as clinicians , 14.7 % as clinician-administrators , 6 % as educators , and 4.9 % as administrators . Overall , and for clinicians , the two most frequently read professional publications were non peer- review ed . For clinician groups “ patient management ” was among the top two most selected uses of information from reading professional publications . Educators and those with an advanced doctorate indicated “ class lectures ” as either their second most frequently selected use or tied for first with “ keeping current . ” Only educators and those with or pursuing an advanced doctorate reported using information from reading professional publications for “ research ideas ” or “ research methods ” among their top five uses . Slightly more than 10 % of the respondents cited a peer- review ed published article as having been most influential on their practice . Non peer- review ed professional publications appear to serve as a more frequent source of information for “ patient management ” than do peer- review ed publications . Efforts to increase the use of EBP need to be explored and evaluated for impact on physical therapists ’ practice
target: RESULTS Many physiotherapists hold positive attitudes towards EBP .
  However , this does not necessarily translate into consistent , high- quality EBP .
  Many barriers to EBP implementation are apparent , including : lack of time and skills , and misperceptions of EBP .
background: BACKGROUND Despite clear benefits of the Evidence -Based Practice ( EBP ) approach to ensuring quality and consistency of care , its uptake within physiotherapy has been inconsistent .
  OBJECTIVES Synthesis e the findings of research into EBP barriers , facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation .