File
Igo S1
1Coventry University, School of Nursing, Midwifery and Health, Coventry, United Kingdom
Background: Evidence-based practice (EBP) is an educational paradigm that espouses that clinical decision making should be made through the judicious and conscientious use of best evidence. EBP is predicated on a fundamental principle that therapeutic knowledge is appraised and applied into practice with the ethical imperative to use such knowledge for the good of patient care. Despite the ubiquitous nature of EBP little is known about how physiotherapists use this clinical decision making process and it is not clear as to which theoretical frameworks of practice and knowledge paradigms underpin physiotherapists application of EBP.
Purpose: This study aimed to gain an in depth understanding of how physiotherapists apply EBP in the complex world of clinical practice. A key objective was to describe how knowledge, skills and behaviours, that relate to EBP, were translated into clinical practice.
Methods: Descriptive phenomenology was used explore physiotherapists experiences of EBP and to understand the essence of its practice. Criterion sampling was used to recruit twelve participants based on their ability to describe their experiences within a clinical context. The study was approved by an institutional ethical board and all participants gave informed consent.
In-depth interviews were used to explore these experiences. To ensure a fluid and flexible structure an interview guide was constructed which promoted discursive and reflective responses; the in-depth interviewing technique enabled the exploration of consciousness towards the phenomenon of EBP.
Colaizzi's method of data analysis was used to describe the experience and to explore the meanings behind the description. Seven stages of this process included: extracting significant statements, formulating meanings and describing the data to reveal fundamental structure of EBP.
Bracketing, free imaginative variation, participant validation and the use of a reflective diary were some of the methods used to ensure rigour and to maintain phenomenological congruence.
Results: The study´s findings revealed a complex picture comprising of three separate but interrelated themes. Physiotherapists had developed a personal framework of EBP that guided their behaviour; this framework comprised of an ontological perspective, (theme 1), an epistemological approach (theme 2) and methodological structure (theme 3).
This theoretical and practice framework was uniquely individual and required a complex set of cognitive processes that included knowledge identification, transformation, translation and implementation in specific client situations and practice contexts. To add to this complexity this framework took place within intra-personal, social and cultural milieus which influenced behaviour.
Conclusion(s): This study conceptualises physiotherapists' experiences of EBP and uncovers new understandings about how evidence is incorporated into clinical practice. But his study goes further by framing the findings and experiences into models that could be used to assist educationalists, practitioners and researchers to promote evidence based practice in a pragmatic way.
Implications: The two conceptual models developed from this study could be used as pragmatic tools for educators, practitioners and researchers to explore the context and application of EBP. These models could be used to act as primers to explore the theoretical and practical application of EBP and importantly to offer a structure to help facilitate its use in clincal practice.
Keywords: Evidence-based practice, Phenomenology, Clinical decision making
Funding acknowledgements: None
Purpose: This study aimed to gain an in depth understanding of how physiotherapists apply EBP in the complex world of clinical practice. A key objective was to describe how knowledge, skills and behaviours, that relate to EBP, were translated into clinical practice.
Methods: Descriptive phenomenology was used explore physiotherapists experiences of EBP and to understand the essence of its practice. Criterion sampling was used to recruit twelve participants based on their ability to describe their experiences within a clinical context. The study was approved by an institutional ethical board and all participants gave informed consent.
In-depth interviews were used to explore these experiences. To ensure a fluid and flexible structure an interview guide was constructed which promoted discursive and reflective responses; the in-depth interviewing technique enabled the exploration of consciousness towards the phenomenon of EBP.
Colaizzi's method of data analysis was used to describe the experience and to explore the meanings behind the description. Seven stages of this process included: extracting significant statements, formulating meanings and describing the data to reveal fundamental structure of EBP.
Bracketing, free imaginative variation, participant validation and the use of a reflective diary were some of the methods used to ensure rigour and to maintain phenomenological congruence.
Results: The study´s findings revealed a complex picture comprising of three separate but interrelated themes. Physiotherapists had developed a personal framework of EBP that guided their behaviour; this framework comprised of an ontological perspective, (theme 1), an epistemological approach (theme 2) and methodological structure (theme 3).
This theoretical and practice framework was uniquely individual and required a complex set of cognitive processes that included knowledge identification, transformation, translation and implementation in specific client situations and practice contexts. To add to this complexity this framework took place within intra-personal, social and cultural milieus which influenced behaviour.
Conclusion(s): This study conceptualises physiotherapists' experiences of EBP and uncovers new understandings about how evidence is incorporated into clinical practice. But his study goes further by framing the findings and experiences into models that could be used to assist educationalists, practitioners and researchers to promote evidence based practice in a pragmatic way.
Implications: The two conceptual models developed from this study could be used as pragmatic tools for educators, practitioners and researchers to explore the context and application of EBP. These models could be used to act as primers to explore the theoretical and practical application of EBP and importantly to offer a structure to help facilitate its use in clincal practice.
Keywords: Evidence-based practice, Phenomenology, Clinical decision making
Funding acknowledgements: None
Topic: Research methodology & knowledge translation; Education
Ethics approval required: Yes
Institution: Coventry University
Ethics committee: Coventry University Ethics Committee
Ethics number: JA109
All authors, affiliations and abstracts have been published as submitted.
