Do physiotherapists' attitudes towards evidence-based practice change as a result of an evidence-based educational programme? Implementation of evidence-based practice across medical, nursing, pharmacological and allied healthcare professionals: a questionnaire survey in nationwide hospital settings Implementation of a protocol facilitates evidence-based physiotherapy practice in intensive care units. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial Effectiveness of the tailored EBP training program for Filipino physiotherapists: A randomised controlled trial Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? Perspectives on research evidence and clinical practice: a survey of Australian physiotherapists. Effectiveness of the tailored Evidence Based Practice training program for Filipino physical therapists: a randomized controlled trial Knowledge and use of evidence-based practice by allied health and health science professionals in the United Kingdom. Evaluation of the theory-based Quality Improvement in Physical Therapy (QUIP) programme: a one-group, pre-test post-test pilot study The propensity to adopt evidence-based practice among physical therapists A theory-based cross-sectional survey demonstrated the important role of awareness in guideline implementation. Evaluating two implementation strategies for whiplash guidelines in physiotherapy: a cluster randomised trial. Effectiveness of an interactive postgraduate educational intervention with patient participation on the adherence to a physiotherapy guideline for hip and knee osteoarthritis: a randomised controlled trial
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 Background Implementation of evidence -based practice ( EBP ) is regarded as core competence to improve healthcare quality . In the current study , we investigated the EBP of six groups of professionals : physicians , nurses , pharmacists , physical therapists , technicians , and other allied healthcare personnel . Methods A structured question naire survey of regional hospitals throughout Taiwan was conducted by post in 2011 . Question naires were mailed to all healthcare workers of 11 r and omly selected hospitals .  Linear and logistic regression models were used to examine predictors for implementing EBP . Results In total , 6,160 returned question naires , including 645 from physicians , 4,206 from nurses , 430 from pharmacists , 179 from physical therapists , 537 from technicians , and 163 from other allied healthcare professionals , were valid for the analysis . Physicians and pharmacists were more aware of EBP than were the other professional groups ( p < 0.001 ) . Positive attitudes toward and beliefs in EBP were significantly lower among nurses than in the other groups ( p < 0.001 ) . Physicians had more sufficient knowledge and skills of EBP than did the other professionals ( p < 0.001 ) ; in addition , they implemented EBP for clinical decision-making more often and perceived fewer personal barriers to EBP ( p < 0.001 ) . Multivariate logistic regression analyses showed that EBP implementation was associated with the following characteristics of participants : EBP training , having a faculty position , academic degree , one 's profession , and perceptions ( beliefs , attitudes , knowledge , skills and barriers ) . Conclusions This study depicts various levels of EBP implementation among medical , nursing , pharmacological , and allied healthcare personnel . There were significant differences in their implementation of EBP . We observed that certain factors were associated with EBP implementation , including personal background s and perceptions toward EBP . The data suggest that strategies for enhancing EBP implementation should differ for various groups of professionals OBJECTIVES To compare the physiotherapy service provided when therapists ' decisions are guided by an evidence -based protocol with usual care ( i.e. patient management based on therapists ' clinical decisions ) . DESIGN Exploratory , controlled , pragmatic sequential time block clinical trial . SETTING Level 3 surgical unit in a tertiary hospital in South Africa . PARTICIPANTS All patients admitted consecutively to the surgical unit over a 3-month period were allocated to usual or protocol care based on date of admission . INTERVENTIONS Usual care was provided by clinicians from the hospital department , and non-specialised physiotherapists were appointed as locum tenens to provide evidence -based protocol care . MAIN OUTCOME MEASURES Patient waiting time , frequency of treatment sessions , tasks performed and adverse events . RESULTS During protocol -care periods , treatment sessions were provided more frequently ( P<0.001 ) and with a shorter waiting period ( P<0.001 ) . It was more likely for a rehabilitation management option to be included in a treatment session during protocol -care periods ( odds ratio 2.34 , 95 % confidence interval 1.66 to 3.43 ; P<0.001 ) . No difference in the risk of an adverse event was found between protocol -care and usual-care periods ( P=0.34 ) . CONCLUSIONS Physiotherapy services provided in intensive care units ( ICUs ) when the decisions of non-specialised therapists are guided by an evidence -based protocol are safe , differ from usual care , and reflect international consensus on current best evidence for physiotherapy in ICUs . Non-specialised therapists can use this protocol to provide evidence -based physiotherapy services to their patients . Future trials are needed to establish whether or not this will improve patient outcome 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 Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence -based practice ( EBP ) . There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy . The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden . Methods An implementation strategy based on theory and current evidence was developed . A tailored , multi-component implementation intervention , addressing earlier identified determinants , was carried out in three areas comprising 28 physical therapy practice s including 277 physical therapists ( PTs ) ( intervention group ) . In two adjacent areas , 171 PTs at 32 practice s received no intervention ( control group ) . The core component of the intervention was an implementation seminar with group discussion s. Among other components were a website and email reminders . Data were collected at baseline and follow-up with a web-based question naire . Primary outcomes were the self-reported awareness of , knowledge of , access to , and use of guidelines . Secondary outcomes were self-reported attitudes toward EBP and guidelines . Analyses were performed using Pearson ’s χ2 test and approximative z-test . Results 168 PTs ( 60.6 % ) in the intervention group and 88 PTs ( 51.5 % ) in the control group responded to the follow-up question naire . 186/277 PTs ( 67.1 % ) participated in the implementation seminars , of which 97 ( 52.2 % ) responded . The proportions of PTs reporting awareness of ( absolute difference in change 20.6 % , p = 0.023 ) , knowledge where to find ( 20.4 % , p = 0.007 ) , access to ( 21.7 % , p < 0.001 ) , and frequent use of ( 9.5 % , NS ) guidelines increased more in the intervention group than in the control group . The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2 % ( p = 0.043 ) higher than the proportion in the control group . A higher proportion considered EBP helpful in decision making ( p = 0.018 ) . There were no other significant differences in secondary outcomes . Conclusions A tailored , theory- and evidence -informed , multi-component intervention for the implementation of clinical practice guidelines had a modest , positive effect on awareness of , knowledge of , access to , and use of guidelines , among PTs in primary care in western Sweden . In general , attitudes to EBP and guidelines were not affected Astract Background Evidence implementation continues to challenge health professionals most especially those from developing countries . Filipino physiotherapists represent a group of health professionals in a developing country who by tradition and historical practice , take direction from a doctor , on treatment options . Lack of autonomy in decision-making challenges their capacity to deliver evidence -based care . However , this scenario should not limit them from updating and up-skilling themselves on evidence - based practice ( EBP ) . EBP training tailored to their needs and practice was developed to address this gap . This study will be conducted to assess the effectiveness of a tailored EBP-training program for Filipino physiotherapists , in improving knowledge , skills , attitudes and behaviour to EBP . Participation in this program aims to improve capacity to EBP and engage with referring doctors to determine the most effective treatments for their patients . Methods / Design A double blind r and omised controlled trial , assessing the effectiveness of the EBP training intervention , compared with a waitlist control , will be conducted . An adequately powered sample of 54 physiotherapists from the Philippines will be recruited and r and omly allocated to EBP intervention or waitlist control . Intervention : The EBP program for Filipino physiotherapists is a one-day program on EBP principles and techniques , delivered using effective adult education strategies . It consists of lectures and practical workshops . A novel component in this program is the specially-developed recommendation form , which participants can use after completing their training , to assist them to negotiate with referring doctors regarding evidence -based treatment choices for their patients .Pre and post measures of EBP knowledge , skills and attitudes will be assessed in both groups using the Adapted Fresno Test and the Questions to EBP attitudes . Behaviour to EBP will be measured using activity diaries for a period of three months . Discussion Should the EBP-training program be found to be effective in improving EBP-uptake in Filipino physiotherapists , it will form the basis of a much needed national intervention which is context ually appropriate to Filipino physiotherapists . It will therefore form the genesis for a model for building EBP capacity of other health professionals in the Philippines as well as physiotherapists in developing countries . Trial Registration Current Controlled Trials : IS RCT 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 BACKGROUND The paradigm shift to evidence -based nursing practice in the United States has been slow . Although multiple barriers to evidence -based practice ( EBP ) have been identified through prior studies , there is a gap in the literature specifically identifying key variables ( e.g. , belief that EBP produces quality outcomes ) that are correlated with the extent to which nurses engage in EBP . AIM The primary aims of this study were to ( 1 ) describe nurses ' knowledge , beliefs , skills , and needs regarding EBP ; ( 2 ) determine whether relationships exist among these variables ; and ( 3 ) describe major barriers and facilitators to EBP . METHODS A descriptive survey was conducted with a convenience sample of 160 nurses who were attending EBP conferences or workshops in four states located within the Eastern Region of the United States . RESULTS Although participant beliefs about the benefit of EBP were high , knowledge of EBP was relatively low . Significant relationships were found between the extent to which the nurses ' practice is evidence -based and ( 1 ) nurses ' knowledge of EBP , ( 2 ) nurses ' beliefs about the benefits of EBP , ( 3 ) having an EBP mentor , and ( 4 ) using the Cochrane Data base of Systematic Review s and the National Guideline Clearinghouse . CONCLUSION AND IMPLICATION S Health care systems need to implement interventions that not only increase nurses ' EBP knowledge and skills , but also strengthen their beliefs about the benefit of evidence -based care . EBP mentors may be key in accelerating a more rapid shift toward evidence -based nursing practice . Theoretically driven r and omized controlled trials are urgently needed to test the effectiveness of interventions on advancing evidence -based care 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 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 This study evaluated the effectiveness of the context ualized EBP training program for Filipino physical therapists in terms of knowledge , skills , attitudes and behavior . Methods A r and omized controlled trial was design ed to assess the effectiveness of the EBP training program .  Fifty four physical therapists were r and omly allocated to the EBP group ( intervention ) and waitlist ( control ) group . The EBP group had a one day face-to-face training with an online support , whilst the control was waitlisted . There were three measurement points which were pre , post , and three months post intervention for knowledge , skills and attitudes . Activity diaries were used to measure behavior . The diaries were collected after three months . Data analysis was by intention to treat in EBP domains of knowledge , skills and attitudes . Results Fifty-four physical therapists were included in the study . Fifty two ( 52 ) completed the post training assessment and 26 completed the 3 months post training assessment for EBP knowledge , skills and attitudes . There were significant improvements in these domains in the EBP group from pre to post training and over a period of three months ( p < 0.05 ) compared with the waitlist control group . Thirty seven ( 37 ) physical therapists completed their activity diaries over three months . Behavior significantly improved in the EBP group in terms of EBP behaviors ( formulating PICO , search ing , appraising and applying the evidence ) when faced with both new/unique and usual case scenarios ( p < 0.05 ) . More physical therapists in the waitlist control group significantly performed non-EBP behaviors ( asking doctors and reading textbooks ) when faced with new/unique cases compared with the EBP group ( p < 0.05 ) . No differences were noted between groups regarding non-EBP behaviors ( asking colleagues and doctors and reading textbooks ) particularly when faced with usual cases . Conclusion The context ually design ed EBP training program for Filipino physical therapists was effective in improving knowledge , skills and attitudes to EBP from pre to post training . Improvements were also observed at three months post training in knowledge , skills , attitudes and behavior to EBP . This model of training can be modified as needed based on the needs of the local context . Findings need to be interpreted with caution due to study limitations .Current controlled trialsIS RCT N74485061 ( Registration date : February 9 , 2011 ) 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 Background Guideline adherence in physical therapy is far from optimal , which has consequences for the effectiveness and efficiency of physical therapy care . Programmes to enhance guideline adherence have , so far , been relatively ineffective . We systematic ally developed a theory-based Quality Improvement in Physical Therapy ( QUIP ) programme aim ed at the individual performance level ( practicing physiotherapists ; PTs ) and the practice organization level ( practice quality manager ; PQM ) . The aim of the study was to pilot test the multilevel QUIP programme ’s effectiveness and the fidelity , acceptability and feasibility of its implementation . Methods A one-group , pre-test , post-test pilot study ( N = 8 practice s ; N = 32 PTs , 8 of whom were also PQMs ) done between September and December 2009 . Guideline adherence was measured using clinical vignettes that addressed 12 quality indicators reflecting the guidelines ’ main recommendations . Determinants of adherence were measured using quantitative methods ( question naires ) . Delivery of the programme and management changes were assessed using qualitative methods ( observations , group interviews , and document analyses ) . Changes in adherence and determinants were tested in the paired sample s T-tests and expressed in effect sizes ( Cohen ’s d ) . Results Overall adherence did not change ( 3.1 % ; p = .138 ) . Adherence to three quality indicators improved ( 8 % , 24 % , 43 % ; .000 ≤ p ≤ .023 ) . Adherence to one quality indicator decreased ( −15.7 % ; p = .004 ) . Scores on various determinants of individual performance improved and favourable changes at practice organizational level were observed . Improvements were associated with the programme ’s multilevel approach , collective goal setting , and the application of self-regulation ; unfavourable findings with programme deficits . The one-group pre-test post-test design limits the internal validity of the study , the self-selected sample its external validity . Conclusions The QUIP programme has the potential to change physical therapy practice but needs considerable revision to induce the ongoing quality improvement process that is required to optimize overall guideline adherence . To assess its value , the programme needs to be tested in a r and omized controlled trial 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 OBJECTIVE To assess physiotherapists ' adherence to the  Dutch guidelines  for nonspecific low back pain , the motivational determinants related to guideline adherence , and the role of physiotherapists ' awareness of their performance in this respect . STUDY DESIGN & SETTING This was a cross-sectional survey among a r and om sample of 1,500 private practice physiotherapists in the Netherl and s. The actual  guideline adherence  was measured by means of vali date d clinical vignettes and self-reported adherence by asking the physiotherapists to report their own level of adherence . The assessment of motivational determinants was based on a theoretical framework . RESULTS The  response rate was 31.5 % ( N=472 ) . The average guideline adherence rate was 50.4 % ( SD=16.8 ) . Only 38.5 % of the physiotherapists had realistic perceptions of their personal performance . Awareness levels seriously interfered with the relationship between motivational determinants and actual guideline adherence . Actual adherence was mainly related to the perceived relative advantages and awareness of adherence to the perceived social norm . CONCLUSION The moderating role of awareness in this study confirms the view that motivational determinants of a particular behavior can only be accurately assessed if people hold realistic perceptions of that behavior . Our approach illustrates the added value of a theory-based approach in guideline implementation studies QUESTION Are implementation strategies involving education any more effective than mere dissemination of clinical practice guidelines in changing physiotherapy practice and reducing patient disability after acute whiplash ? DESIGN Cluster-r and omised trial . PARTICIPANTS Twenty-seven physiotherapists from different private physiotherapy clinics and the 103 patients ( 4 dropouts ) who presented to them with acute whiplash . INTERVENTION The implementation group of physiotherapists underwent education by opinion leaders about whiplash guidelines and the dissemination group had the guidelines mailed to them . OUTCOME MEASURES The primary outcome was patient disability , measured using the Functional Rating Index , collected on admission to the trial and at 1.5 , 3 , 6 and 12 months . Physiotherapist knowledge about the guidelines was measured using a custom-made question naire . Physiotherapist practice and cost of care were measured by audit of patient notes . RESULTS There were no significant differences between groups for any of the patient outcomes at any time . The implementation patients had 0.6 points ( 95 % CI -7.8 to 6.6 ) less disability than the dissemination patients at 12 months ; 44 % more physiotherapists in the implementation group reported that they prescribed two out of the five guideline -recommended treatments ; and 32 % more physiotherapists actually prescribed them . The cost of care for patients in the implementation group was $ 255 ( 95 % CI -1505 to 996 ) less than for patients in the dissemination group . CONCLUSION Although the active implementation program increased guideline -consistent practice , patient outcomes and cost of care were not affected Abstract Purpose : To determine the effectiveness of an interactive educational intervention on a physiotherapy guideline for hip and knee osteoarthritis . Method : Physiotherapists were r and omly allocated to a 3-h interactive educational course with the collaboration of three patient partners or no intervention . Assessment s comprised question naires on adherence ( score range 0–24 ) , knowledge ( score range 0–76 ) , and barriers to use the guideline ( score range 0–80 ) . Assessment s were conducted 1 week before the interactive course ( T0 ) immediately after ( T1 ) , and 3 months thereafter ( T2 ) . Change scores were compared between the groups by means of Mann – Whitney U tests and linear mixed models . Results : 284 of 4328 eligible PTs ( 7 % ) were included . The intervention ( n = 133 ) was significantly more effective than no intervention ( n = 151 ) concerning self-reported adherence and knowledge with mean differences in change scores ( 95 % CI ) at T1 and T2 being 1.4 ( 0.7–2.0 ) and 0.9 ( 0.2–1.7 ) for adherence and 6.8 ( 4.5–9.1 ) and 3.9 ( 1.7–6.2 ) for knowledge , ( all p values < 0.005 ) . In both groups the barrier score increased at T1 and decreased at T2 , with a significantly larger increase at T1 and decrease at T2 in the intervention group ( mean differences 3.1 ( 1.8–4.4 ) and 3.3 ( 0.5–6.1 ) , respectively . Conclusions : A short interactive educational course with patient participation on a PT guideline on hip and knee osteoarthritis showed a small to moderate positive effect on self-reported guideline adherence and knowledge , whereas for perceived barriers an advantage was only seen on the longer term . Implication s for Rehabilitation Continuing professional development is important and effective , it works very well when patients are engaged in the process , and hence it is supportive overall of enhancing clinical practice . Interactive education can reduce barriers in guideline usage in daily practice
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 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 .