Challenges and Solutions for Educating Clinicians in Contemporary Evidence-Based Practice

Student thesis: Doctoral Thesis

Abstract

Evidence-based practice (EBP) provides a framework for integrating the best research evidence with clinical expertise and patient’s unique values and preferences in the delivery of health care. EBP is necessary for improving the quality of health care as well as patient outcomes. EBP is commonly integrated into the curricula of undergraduate, postgraduate,and continuing professional development health programs. Despite the established interest in EBP as a core competency for clinicians, clinicians frequently do not use research evidence to inform clinical decisions in practice.

The overall aim of this thesis is to facilitate improved translation of EBP
educational interventions into clinical and educational practice. To fulfil this objective, two main research issues were explored: (i) the quality of the current published EBP educational interventions; and (ii) efforts to improve the quality and the uptake of EBP education in practice.

The findings of these studies highlight that inadequate reporting of EBP educational interventions, along with the inconsistent coverage of the EBP topics and infrequent use of high-quality instruments to measure the effect of EBP education in existing studies, presents a considerable challenge for translating evidence into practice. The consensusbased, contemporary set of EBP core competencies, that was developed as part of this thesis, will contribute to harmonising the variations in the content of EBP education with possible subsequent future effect on the outcomes that are measured. The results of the
before-after pilot study suggest that a contemporary approach to EBP teaching, with a focus on teaching SDM skills and the interpretation of pre-appraised research evidence was feasible, acceptable to clinicians, and showed a small increase in clinicians’ skills in SDM and communicating evidence. The findings of this thesis also led to some recommendations for area needing improvement: (i) better reporting of intervention details in EBP educational studies in published studies; (ii) establishment of a repository of freely-available EBP learning resources; (iii) development of a set of core outcome measures for EBP educational studies; and (iv) integration of the set of EBP core competencies into EBP curricula for clinicians and student clinicians.
Date of Award12 Oct 2019
Original languageEnglish
SupervisorPaul Glasziou (Supervisor) & Tammy Hoffmann (Supervisor)

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