Knowledge, Attitude and Implementation of Evidence-Based Practice among Physiotherapists Working in the Kingdom of Saudi Arabia: A Cross-Sectional Survey

Developing multisectoral strategies to promote evidence-based practice in rehabilitation: findings from an end-of-grant knowledge translation symposium

PURPOSE

Following a longitudinal study to understand how evidence-based practice evolves during the initial years of occupational therapy (OT) and physiotherapy (PT) practice, we held an end-of-grant symposium with representatives from education, practice, research, and policy. The objectives were to: (1) elicit feedback on the implications of the study results; and (2) co-develop a list of actionable recommendations for each sector.

METHODS

Qualitative participatory approach. The symposium was held over two half days and consisted of a presentation of study findings, a discussion on the implications of the research for each sector and future recommendations. Discussions were audio recorded, transcribed verbatim and analyzed using qualitative thematic analysis.

RESULTS

The themes related to implications of the longitudinal study included: (1) A need to rethink what evidence-based practice (EBP) really is; (2) How to practice EBP; and (3) The continuing challenge of measuring EBP. The co-development of actionable recommendations resulted in nine strategies.

CONCLUSIONS

This study highlighted how we may collectively promote EBP competencies in future OTs and PTs. We generated sector-specific avenues that may be pursued to promote EBP and argued for the importance of pooling efforts from the four sectors so that we may achieve the intended ethos of EBP.IMPLICATIONS FOR REHABILITATIONThere is a need to revisit the definition of evidence-based practice (EBP) and the traditional 3-circle model in rehabilitation to include a broader conceptualization of what constitutes evidence.We recommend using EBP measures as tools for self-reflection and professional development that can support practitioners to be reflective and accountable evidence-based practitioners.Optimal promotion of EBP competencies in occupational therapists and physiotherapists should rest upon collaborative efforts from the education, practice, research, and policy sectors.

Exposure to Meta-Analysis During Graduate and Postgraduate Trainings Predicts the Good Knowledge and Use of Randomized Controlled Trials, Systematic Reviews, and Meta-Analyses Among Nigerian Physiotherapists

Background Evidence-based practice (EBP) is essential for physiotherapy as an integral part of the multidisciplinary rehabilitation team. Randomized controlled trials (RCTs), systematic reviews, and meta-analyses are the gold standard in the hierarchy of evidence. However, the extent of knowledge, attitudes, and professional use of RCTs and meta-analyses among physiotherapists in Nigeria remains unclear. Therefore, this study aimed to describe and explore the predictors of Nigerian physiotherapists' knowledge, attitudes, and professional behaviors toward RCTs, systematic reviews, and meta-analyses. Methods In this observational study, an electronic version of an adapted questionnaire assessing the knowledge, attitudes, and professional use of RCTs and meta-analyses was shared across electronic platforms of Nigerian physiotherapy professional organizations. Results We found good overall knowledge (76 {80.8%}) and attitude (83 {88.3%}) toward the use of RCTs, systematic reviews, and meta-analyses for evaluating health interventions. Exposure to meta-analysis during graduate and postgraduate training (odds ratio {OR}, 7.102; 95% CI, 1.680-30.021; p = 0.008) and the presence of a medical library at the workplace (OR, 0.264; 95% CI, 0.070-0.997; p = 0.049) were significant predictors of good knowledge of RCTs, systematic reviews, and meta-analyses. Self-rated (OR, 56.476; 95% CI, 1.356-2357.430; p = 0.034) and overall levels of knowledge (OR, 0.013; 95% CI, 0.000-0.371; p = 0.011) predicted the good use of RCTs, systematic reviews, and meta-analyses among respondents. Discussion To equip physiotherapy practitioners with the requisite skill in using RCTs, systematic reviews, and meta-analyses, graduate and postgraduate trainings should prioritize education on the use of RCTs, systematic reviews, and meta-analyses to inform clinical decisions and practice, while capable workplaces may set up medical libraries to ease access and enhance the use of RCTs, systematic reviews, and meta-analyses.

Assessment of Evidence-Based Practice (EBP) among physiotherapists in Cameroon: a cross-sectional survey

BACKGROUND

Evidence-Based Practice (EBP) is reported to ease effective and adequate decision making for all works of life including health professionals. Investigating the level of implementation of EBP among physiotherapists helps to identify barriers and propose solutions for its extensive implementation. Despite available data on EBP elsewhere, it remains limited or non-existent in Cameroon. This study was designed to establish the current state of EBP among physiotherapists in Cameroon, by assessing knowledge, practice, and barriers to its implementation.

METHODS

A cross-sectional survey was conducted online among French- and English-speaking physiotherapists in Cameroon over a period of six months from April to July 2023, using the EBP2 questionnaire. This enabled us to collect socio-demographic data from participants and information on their knowledge, understanding and practice of EBP and possible barriers to EBP according to 5 domains (Confidence, Relevance, Terminology, Practice, Compatibility) scored out of 100. Data were analysed using IBM SPSS 25.0 software and Pearson correlations (95% CI) and significance (p < 0.05).

RESULTS

A total of 110 physiotherapists practising in the 10 regions of Cameroon participated in the study. The majority were male (54.5%), the median age was 34 years (age range 20 to 50), the median year of graduation was 2019 (range 2004 to max 2022) with 72.7% never having knowledge or training in EBP. Participants scored below 50/100 for 3 domains (confidence, relevance, and compatibility) showing poor general knowledge and understanding of EBP, although they generally had a positive attitude towards EBP. The use of EBP in practice was low (26.3/100 SD. 6.5), despite that they appeared to have a good understanding of research terminology (55.4 SD. 17.2). Level of study of participants did not appear to significantly influence domain scores (P > 0.05). The main barriers to practice were lack of time (75.1%), workload (66%), cost of access to information resources like databases for seek informations about recent support protocols (60%), ease of access to computers (49%), and lack of resources or skills (49%).

CONCLUSION

Physiotherapists in Cameroon have a poor knowledge of EBP and a low level of practice of EBP, despite an overall positive attitude towards it. These results could inform stakeholders of higher education on the need to improve training of physiotherapy students in the domain of EBP in Physiotherapy. Also, it will help in raising the level of scientific research and promoting the implementation of EBP in Cameroon.

Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study

Few studies exist regarding the attitudes and behaviours of Egyptian physiotherapists in relation to the use of evidence in practice (EBP). The purpose of this study was to describe the beliefs, attitudes, knowledge, and behaviours of Egyptian physical therapists as they relate to evidence-based practice. It also explores their perception of possible barriers to implement EBP. Four hundred and seventy Egyptian therapists responded to our questionnaire with results revealing participants' awareness towards EBP was quite diverse. Only terms of systematic review and randomized controlled trial were well understood while remaining terms showed various level of comprehension which were rather low. Results also revealed significant correlations between attitudes towards EBP and overall awareness as well as attitudes and knowledge (r = 0.270 and 0.107) respectively. In addition, a significant relationship was also found between EBP awareness and knowledge with (r = 0.219). With regards to the barriers, insufficient teaching in previous education was identified as the primary barrier (34.4 %), followed by lack of funding and resources (31.1 %), while lack of time (10.2 %) was reported as the least. These barriers highlight the need to enhance implementation of EBP within Egyptian Physiotherapists. Findings of this study can be used as a foundation for the implementation of EBP in various clinical settings by understanding the limitations and barriers reported. Our study concluded that despite Egyptian physiotherapists declare their awareness of EBP, nevertheless, knowledge is restricted to a small number of terms. More focus is required to enhance the knowledge and practice of EBP. Focusing on adjustable factors, including increasing the awareness of value of research would help reduce time and resource demands for physiotherapists when implementing EBP.

Evidence-Based Physiotherapy Practice in Paediatric Subdiscipline: A Cross-Sectional Study in Saudi Arabia

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.

Knowledge, Attitude, and Practice towards Evidence-Based Medicine among Northern Saudi Primary Care Physicians: A Cross-Sectional Study

The evidence-based practice of primary care physicians is essential because they are the first line of contact with the local community, and they cater to most of their communities’ health needs. In the current study, in which we used a cross-sectional survey in northern Saudi Arabia, we assessed primary care physicians’ knowledge, attitude, practice, and barriers regarding evidence-based medicine (EBM). Of the 300 physicians who participated, less than half had high knowledge (43.7%) and attitude (47.7%) toward EBM. The chi-square test revealed that the knowledge categories were significantly associated with the age group (p = 0.002) and EBM training received in the past five years (p < 0.001), and the attitude categories were significantly associated with nationality (p = 0.008). Of the respondents, 155 (51.7%) used EBM in their daily clinical practice. Through logistic regression analysis, we found that the identified predictors of including EBM in clinical practice were the 31−45-year-old age group (adjusted odds ratio (AOR) = 2.11, 95% confidence interval (CI) = 1.65−2.73) and EBM training received during last 5 years (AOR = 2.12, 95% CI = 1.35−2.94). We recommend enhancing primary care physicians’ knowledge of EBM and its importance in clinical practice through appropriate training programs. A multi-centric mixed-method survey is warranted in other provinces of the KSA to recognize region-specific training demand.

Beliefs, Attitudes, and Behaviors of Saudi Physiotherapists Toward Evidence-Based Practice: A Multicenter, Cross-Sectional Study

Background

Evidence-based practice (EBP) has gained significant importance in clinical practice worldwide, including physiotherapy, but there are limited studies that have assessed the knowledge, attitude, and behaviors of Saudi physiotherapists toward EBP.

Objective:

To determine the beliefs, attitudes, knowledge, and experience of Saudi physiotherapists in public hospitals of the Eastern Province of Saudi Arabia toward EBP as well as identify barriers that limit the integration of EBP in clinical practice.

Materials and Methods:

This cross-sectional design included all Saudi physiotherapists working in four major tertiary hospitals in the Eastern Province of Saudi Arabia. The Evidence-Based Practice Questionnaire was used to elicit responses. The association between attitudes, awareness, and knowledge scores and the demographic data such as age group, years of experience, and level of education was assessed.

Results:

The questionnaire was distributed to a total of 171 physiotherapists, of which 118 (69%) responded. About 90% of the participants agreed or strongly agreed that EBP is necessary for clinical practice. However, about 25%, 19%, and 18% of the participants reported that EBP does not consider clinical limitations, support physiotherapy intervention, or consider patients' physiotherapy preferences, respectively. The most common barrier in the implementation of EBP in daily clinical practice was insufficient time (>50%), followed by self-efficacy in retrieving evidence from the literature and translating research findings into clinical practice. Years of experience, age, and gender were significant factors associated with physiotherapists' beliefs and attitudes toward implementing EBP.

Conclusions:

Although EBP was favored, several barriers exist that hinder its adoption by physiotherapists. Institutional support and research skill development may help accelerate EBP adoption levels and should be considered by policymakers.

Evidence based physiotherapy practice in cardiopulmonary subdiscipline: A survey in United Arab Emirates

Background

Evidence based practice (EBP) is widely used by cardiopulmonary physical therapists worldwide. Therefore, it is important to identify whether the therapists have the required knowledge, skills and resources in order to deliver the best evidence-based practice.

Objectives

The main objective of this cross-sectional study is to analyse the self-reported characteristics of behaviour, knowledge, skills and resources, opinion and barriers related to evidence-based practice among cardiopulmonary physical therapists of United Arab Emirates (UAE).

Methods

An electronic questionnaire was circulated among 60 licensed cardiopulmonary physical therapists, of either gender, practicing in UAE with a minimum experience of 1 year via e-mail. The response was further subjected to descriptive analysis.

Results

The rate of response was 55% (33/60). The physical therapists of cardiopulmonary disciple reported that they understand the term Evidence Based Practice and frequently update themselves through scientific papers obtained via accessing various databases. Respondents also believe that the exposure in undergraduate or postgraduate course was not sufficient. However, they were also satisfied with amount of discussions taking place regarding EBP at their work place. The barriers commonly reported were difficulty in obtaining full-text papers, lack of time and lack of evidence-based training.

Conclusion

Thus, concluding that physical therapists from UAE who practiced in cardiopulmonary subdiscipline believe that they have knowledge and skills to use evidence-based practice. Although, they have favourable opinions regarding its application and they still encounter difficulties in implementing it successfully.

A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia

AIM

This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA.

BACKGROUND

Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme.

METHODS

A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation.

FINDINGS

Findings demonstrated that the educational intervention did improve participants' EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation.

CONCLUSION

This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.

University health sciences students rating for a blended learning course framework

OBJECTIVES

Online teaching methods are used to identify the effectiveness of blended learning. The present study aimed to evaluate the attitudes and satisfaction of health sciences students in Saudi Arabia towards blended learning.

METHODS

The study used mixed research approach by recruiting students from academic year 2017-2019. Phenomenography technique were used to examine the qualitative data for research.

RESULTS

The instrument was a valid measurement outcome for blended learning courses. Students generally preferred team-based learning rather than face-to-face lectures, which serves as a collaborative learning pedagogy. A high positive attitude and motivation was revealed among the students with respect to the blended model in teaching the research course.

CONCLUSION

The attitude and satisfaction of students seemed to play a vital role in teaching and learning outcomes. Moreover, it was found that the e-learning tools provided flexible learning environment to the students, regardless of location and time zone.