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Background and Purpose. Physical therapists often struggle with integrating scientific research evidence into clinical practice and prefer attending continuing education conferences rather than reading research articles to inform clinical decision making. Strategies explicitly focused on knowledge translation may enhance the likelihood that information from continuing education will lead to practice change behaviors. The purpose of this case report is to describe the implementation of a continuing education program that emphasized knowledge translation for physical therapists.Case Description. The unique aspects of the course included 3 separate sessions, utilizing a workshop format with handson practice opportunities, explicit instruction on facilitating practice behavior change, online follow-up discussion board and resources, and group discussions on case-based application of course content.Outcomes. Eight physical therapists participated in the course, and 5 completed a follow-up survey. Data suggested that most participants demonstrated some improvement in knowledge and practice-related behaviors.Discussion. Evidence suggests that physical therapists rely heavily on continuing education to keep up to date in professional practice. Consideration of factors that are likely to enhance the application of knowledge from continuing education into clinical practice should improve the effectiveness of these activities and ideally lead to improved patient outcomes.Keywords: Continuing education, Knowledge translation.BACKGROUND AND PURPOSEThe creation of research evidence occurs as a result of structured processes for investigating facts and theories and should support optimal clinical decision making.1 The current definition of evidence-based practice (EBP) states that practitioners should integrate the evidence with clinical experience, patient values, and clinical circumstances into an optimal clinical decision for an individual patient.2,3 Evidence-based practice implies that physical therapists continually seek out and find the best research evidence to guide clinical decisions and analyze the strength and quality of that evidence. This may lead to a change in behavior by the clinician, such as implementing a new measure or intervention on a consistent basis. Recent evidence suggests that physical therapists have a positive attitude about the concept of EBP and the importance of research evidence for the profession.4,5Despite the positive attitude, multiple barriers limit the use of evidence by physical therapists that results in practice change.4'10 Berwick et al6 categorized these barriers into practitioner, organization, and research categories. At the practitioner level, many clinicians report difficulty accessing and interpreting the evidence that does exist.11,12 Clinicians may lack essential skills relative to using technology to complete literature, database searches, and statistical analysis and research processes.8,11"19 Physical therapists who have been in practice longer than 15 years have been reported to be less familiar with online databases and less likely to have received formal training in critical appraisal of research than physical therapists who have been in practice for less than 15 years.12 Time constraints are almost universally identified as a primary limiting factor, both for reading research and for implementing new ideas on the job.11'13,17,20'23 Clinicians also cite pressures of today's health care environment and administrators' emphasis on productivity as inhibiting their ability to gather, read, interpret, and apply scientific information into daily practice.8,11'13,18,20Additional barriers are related to the organization or setting, and to perceptions about the research evidence. For example, practitioners in settings not affiliated with teaching or research institutions report barriers to accessing relevant scientific evidence.11 Clinicians also often face difficulties in implementing changes in practice, perhaps due to resistance from other health care providers or lack of institutional support. … |
