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      Students’ attitudes and perceptions of teaching and assessment of evidence-based practice in an occupational therapy professional Master’s curriculum: a mixed methods study

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          Abstract

          Background

          Most health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students’ attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students’ perceptions towards the teaching and assessment of evidence-based practice within a professional master’s curriculum and their self-efficacy for evidence-based practice.

          Methods

          The study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings.

          Results

          All student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous education had less favourable perceptions. Students’ self-efficacy for evidence-based practice was significantly higher across cohorts. Four main themes emerged from the focus group data: (a) Having mixed feelings about the value of evidence-based practice (b) Barriers to the application of evidence-based practice; (c) Opposing worlds and (d) Vital and imperfect role of the curriculum.

          Conclusion

          This study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12909-017-0895-2) contains supplementary material, which is available to authorized users.

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          Most cited references 42

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          Multiple imputation for nonresponse in surveys

           D. RUBIN,  DB Rubin,  R. Rubin (1987)
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            What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews

            Background An evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC). Methods/Findings We searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem-based approaches, compared to no intervention, increased knowledge but not appraisal skills. Conclusions EBHC teaching and learning strategies should focus on implementing multifaceted, clinically integrated approaches with assessment. Future rigorous research should evaluate minimum components for multifaceted interventions, assessment of medium to long-term outcomes, and implementation of these interventions.
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              Occupational therapists report a low level of knowledge, skill and involvement in evidence-based practice

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                Author and article information

                Contributors
                (514) 398-4496 , aliki.thomas@mcgill.ca
                lu.han2@mail.mcgill.ca
                brittony.osler@gmail.com
                emily.turnbull@mail.mcgill.ca
                erinashleydouglas@gmail.com
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                27 March 2017
                27 March 2017
                2017
                : 17
                Affiliations
                [1 ]ISNI 0000 0004 1936 8649, GRID grid.14709.3b, , School of Physical and Occupational Therapy, ; 3654 Sir William Osler, Montréal, Québec H3G 1Y5 Canada
                [2 ]ISNI 0000 0004 1936 8649, GRID grid.14709.3b, , Research Scientist, Center for Medical Education, Faculty of Medicine, McGill University, ; 1110 Pine Avenue West, Montréal, Québec H3G 1A3 Canada
                [3 ]ISNI 0000 0000 9810 9995, GRID grid.420709.8, , Centre for Interdisciplinary Research in Rehabilitation, ; Montréal, Québec Canada
                Article
                895
                10.1186/s12909-017-0895-2
                5368912
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: there is no funding for this research
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

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