BMC Medical Education | |
Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools | |
Almira T Manuel2  Mark David S Basco3  Edward James R Gorgon1  | |
[1] Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, Pedro Gil Street, Malate 1004, Manila, Philippines;Department of Physical Therapy, Emilio Aguinaldo College, San Marcelino Street, Malate 1000, Manila, Philippines;Physical Therapy Department, Muenster Memorial Hospital, 605 North Maple Street, Muenster, TX, USA | |
关键词: Under-developed countries; Teaching methods; Medical education; Evidence based health care; Allied health; | |
Others : 1138515 DOI : 10.1186/1472-6920-13-154 |
|
received in 2013-02-22, accepted in 2013-11-21, 发布年份 2013 | |
【 摘 要 】
Background
Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP.
Methods
A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively.
Results
The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students’ inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively).
Conclusions
Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective ‘educating the educators’ strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.
【 授权许可】
2013 Gorgon et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150320044507527.pdf | 220KB | download |
【 参考文献 】
- [1]Ross EC, Anderson EZ: The evolution of a physical therapy research curriculum: Integrating evidence-based practice and clinical decision-making. J Phys Ther Educ 2004, 18:52-57.
- [2]Schreiber J, Stern P: A review of the literature on evidence-based practice in physical therapy. Internet J Allied Health Sci Pract 2005, 3:1-10.
- [3]World Confederation for Physical Therapy policy statement on description of physical therapy http://wcpt.org/policy/ps-descriptionPT
- [4]Herbert R, Jamtvedt G, Mead J, Hagen KB: Practical evidence-based physiotherapy. London: Elsevier Butterworth Heinemann; 2005.
- [5]Dean E: Physical therapy in the 21st century (Part I): toward practice informed by epidemiology and the crisis of lifestyle conditions. Physiother Theory Pract 2009, 25:330-353.
- [6]Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB: Evidence-based medicine: how to practice and teach EBM. Edinburgh: Churchill Livingstone; 2000.
- [7]Gorgon EJR, Barrozo HGT, Mariano LG, Rivera EF: Research evidence uptake in a developing country: a survey of attitudes, education and self-efficacy, engagement, and barriers among physical therapists in the Philippines. J Eval Clin Pract 2013, 19:782-790.
- [8]Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, Hill JC, Ogilvie L, Volk D: Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther 2003, 83:786-805.
- [9]Kamwendo K: What do Swedish physiotherapists feel about research? A survey of perceptions, attitudes, intentions and engagement. Physiother Res Int 2002, 7:23-34.
- [10]Metcalfe C, Lewin R, Wisher S, Perry S, Bannigan K, Moffett JK: Barriers to implementing the evidence base in four NHS therapies: dietitians, occupational therapists, physiotherapists, speech and language therapists. Physiother 2001, 87:433-441.
- [11]Pollock AS, Legg L, Langhorne P, Sellars C: Barriers to achieving evidence-based stroke rehabilitation. Clin Rehabil 2000, 14:611-617.
- [12]Salbach NM, Jaglal SB, Korner-Bitensky N, Rappolt S, Davis D: Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke. Phys Ther 2007, 87:1284-1303.
- [13]Rappolt S, Tassone M: How rehabilitation therapists gather, evaluate, and implement new knowledge. J Continuing Educ Health Professions 2002, 22:170-180.
- [14]Iles R, Davidson M: Evidence based practice: a survey of physiotherapists’ current practice. Physiother Res Int 2006, 11:93-103.
- [15]Coomarasamy A, Khan KS: What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. BMJ 2004, 329:1-5.
- [16]Stevenson K, Lewis M, Hay E: Do physiotherapists attitudes towards evidence-based practice change as a result of an evidence-based educational program? J Eval Clin Pract 2004, 10:207-217.
- [17]Rotor ER, Gorgon EJR: Teaching evidence-based practice: preliminary outcomes of students’ EBP-related attitudes and skills. Phil J Occ Ther 2011, 4:15-24.
- [18]Turner P, Whitfield TWA: Physiotherapists’ use of evidence based practice: a cross-national study. Physiother Res Int 1997, 2:17-29.
- [19]Agarwal R, Kalita J, Misra UK: Barriers to evidence-based medicine practice in South Asia and possible solutions. Neurol Asia 2008, 13:87-94.
- [20]Scherer S, Smith MB: Teaching evidence-based practice in academic and clinical settings. Cardiopulmonary Phys Ther J 2002, 13:23-27.
- [21]Republic Act No. 5680: an Act Creating the Board of Examiners for Physical Therapists and Occupational Therapists http://www.prc.gov.ph/prb/default.aspx?id=37&content=217 webcite
- [22]Commission on Higher Education Memorandum Order No. 24 Series 2006: policies, standards and guidelines for physical therapy and occupational therapy education http://www.ched.gov.ph/index.php/archive/cmo-archives/2006-ched-memorandum-orders-2/ webcite
- [23]Chipchase LS, Williams MT, Robertson VJ: Factors affecting curriculum content and the integration of evidence-based practice in entry-level physiotherapy programs. J Allied Health 2007, 33:17-23.
- [24]Yousefi-Nooraie R, Rashidian A, Keating JL, Schonstein E: Teaching evidence-based practice: the teachers consider the content. J Eval Clin Pract 2007, 13:569-575.
- [25]Maher CG, Sherrington C, Elkins M, Herbert RD, Moseley A: Challenges for evidence-based physical therapy: accessing and interpreting high-quality evidence on therapy. Phys Ther 2004, 84:644-654.
- [26]Slavin MD: Teaching evidence-based practice in physical therapy: critical competencies and necessary conditions. J Phys Ther Educ 2004, 18:4-11.
- [27]O’Sullivan SB, Schmitz TJ: Physical rehabilitation. 5th edition. Philadelphia: F. A. Davis Company; 2007.
- [28]Kisner C, Colby LA: Therapeutic exercise: foundations and techniques. 5th edition. Philadelphia: F. A. Davis Company; 2007.
- [29]Akl EA, Maroun M, Neagoe G, Guyatt G, Schunemann HJ: EBM user and practitioner models for graduate medical education: what do residents prefer? Med Teach 2006, 28:192-194.
- [30]Guyatt GH, Meade MO, Jaeschke RZ, Cook DJ, Haynes RB: Practitioners of evidence based care: not all clinicians need to appraise evidence from scratch but all need some skills. BM J 2000, 320:954-955.
- [31]Fell DW, Burnham JF: Access is key: teaching students and physical therapists to access evidence, expert opinion, and patient values for evidence-based practice. J Phys Ther Educ 2004, 18:12-23.
- [32]Caldwell K, Coleman K, Copp G, Bell L, Ghazi F: Preparing for professional practice: how well does professional training equip health and social care practitioners to engage in evidence-based practice. Nurse Educ Today 2007, 27:518-528.
- [33]Taylor R, Reeves B, Ewings P, Binns S, Keast J, Mears R: A systematic review of the effectiveness of critical appraisal skills training for clinicians. Med Educ 2000, 34:120-125.
- [34]Portney LG: Evidence-based practice and clinical decision-making: it’s not just a research course anymore. J Phys Ther Educ 2004, 18:46-51.
- [35]Sabus C: The effects of modeling evidence-based practice during the clinical internship. J Phys Ther Educ 2008, 22:74-84.
- [36]Scholten-Peeters GG, Beekman-Evers MS, van Boxel AC, van Hemert S, Paulis WD, van der Wouden JC, Verhagen AP: Attitude, knowledge and behaviour towards evidence-based medicine of physical therapists, students, teachers and supervisors in the Netherlands: a survey. J Eval Clin Pract 2011, 19:598-606.