Thomas Aliki, Han Lu, Osler Brittony P, Turnbull Emily A, Douglas Erin
School of Physical and Occupational Therapy, 3654 Sir William Osler, Montréal, Québec, H3G 1Y5, Canada.
Research Scientist, Center for Medical Education, Faculty of Medicine, McGill University, 1110 Pine Avenue West, Montréal, Québec, H3G 1A3, Canada.
BMC Med Educ. 2017 Mar 27;17(1):64. doi: 10.1186/s12909-017-0895-2.
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.
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.
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.
This study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.
包括职业治疗在内的大多数健康职业，都将循证实践的应用视为一项理想的能力和职业责任。尽管越来越强调循证实践以改善患者预后，但健康职业中仍存在众多研究与实践的差距。除了努力促使临床医生采用循证实践外，大学课程也有强烈的动力去设计能够支持培养与循证实践相关的知识、态度、技能和行为的课程。尽管北美地区的职业治疗课程越来越注重循证实践，但关于学生对循证实践的态度、他们对该内容在课程中的整合及影响的看法，以及课程对他们准备好进行循证实践的影响的研究却很少。本研究考察了职业治疗专业硕士课程学生对循证实践教学与评估的看法以及他们进行循证实践的自我效能感。
本研究采用混合方法解释性序列设计。定量阶段包括一项横断面问卷调查，该调查探讨了参与该项目的四个学生队列以及一个新毕业生队列对循证实践的态度、对循证实践教学与评估的看法以及循证实践自我效能感。问卷调查之后是一个由高年级学生组成的焦点小组，旨在进一步探讨定量研究结果。
所有学生队列对循证实践都持积极态度；各队列之间没有差异。在对课程中循证实践教学与评估的看法方面存在显著差异；低年级队列和有过先前教育经历的学生看法不太积极。各队列学生进行循证实践的自我效能感显著更高。焦点小组数据中出现了四个主要主题：(a) 对循证实践价值的复杂感受；(b) 循证实践应用的障碍；(c) 相互对立的世界；以及 (d) 课程至关重要但并不完美的作用。
本研究提供了重要数据，以支持专业康复项目中循证实践课程的设计与修订。
