Evidence-based physiotherapy and clinical guidelines: attitudes, knowledge and implementation among clinical educators
Palavras-chave:Education, Evidence-based practice, Knowledge translation, Practice guideline
Introduction – Evidence-based physiotherapy (EBP) is now well established in the teaching curricula, leading to expectations that students will have opportunities to implement EBP steps during internships. However, the position of clinical educators towards EBP can act against this educational process. Aims – Our aims were to describe for the first time EBP domains in clinical Portuguese educators and to quantify associations between individual exposures with EBP-related outcomes. Methods – A cross-sectional mail survey to clinical educators from the physiotherapy course of CESPU was conducted. Two mailings were sent to 289 contacts (separately and three weeks apart). Sociodemographic and postgraduate information was collected as exposure variables and a questionnaire on EBP domains was created. Results – There was a positive attitude towards EBP (all five questions ≥87%). Although 25% of the sample received no training in EBP, almost all of the participants reported knowing how to ‘ask’, ‘search’, and ‘critically appraise’. Only 60% of educators used clinical guidelines and less than half could integrate their recommendations into practice. Complementary training between 16h-30h/per year was positively associated with different aspects of EBP (all documented at p≤0.009), with decreasing trends in the strength of the associations after those intermediate values. Discussion – Although the picture of EBP domains among clinical educators seemed quite regular in comparison with other samples, only 60% of them declared using clinical guidelines in their practice (vs. 86%). Conclusions – Clinical educators in physiotherapy seem to have a positive attitude towards EBP with high levels of previous training in the area. However, the use of Clinical Guidelines and how to integrate their recommendation into practice both need to be promoted. The target range for complementary training seems to be between 16-30h/per year. Out of this scenario, there appears to exist an excessive focus on the component of ‘clinical expertise’ of EBP.
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