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BACKGROUND: The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources.
OBJECTIVE: The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics.
STUDY DESIGN: Cross sectional survey.
METHODS: An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada.
RESULTS: A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice.
CONCLUSIONS: Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice.
CLINICAL RELEVANCE: This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.
Unfortunately, double blind studies aren't conclusive for treatments that involve hands on, practitioner involvement.
Whereas in say a drug trial, where a medication is simply handed to the patient, the variables are measurable. Age, gender, diagnosis, etc.
In orthotics or surgery, the treatment is individualised. Each practitioner does it uniquely, and each patient is treated uniquely. The variables are endless, and not measurable.
What kind of orthotic? How casted, prescribed, adjusted, modified? By whom?
What surgery? What approach? p/op care? physio? By whom? What about intuition/gut feeling?
Primarily evidence based medicine is used to justify medical care spending. As such, it is supported by the biggies, and the educators who don't practice, but are now invited to conferences to give useless lectures about boring topics.
Examining the associations among clinician demographics, the factors involved in the implementation of evidence-based practice, and the access of clinicians to sources of information.
Christensen J, Andrysek J. Prosthet Orthot Int. 2012 Mar;36(1):87-94.
Quote:
BACKGROUND:
An important way of improving healthcare services is through the implementation of evidence-based practice; but this requires an understanding of the extent to which it is occurring and the factors that are driving its implementation.
OBJECTIVE:
To examine the associations among the demographics of clinicians, the factors involved in the implementation of evidence-based practice, and the access of clinicians to various sources of information.
STUDY DESIGN:
Cross-sectional survey.
METHODS:
An online survey that was distributed to 300 Canadian prosthetic and orthotic clinicians. Associations of selected survey items were determined.
RESULTS:
Four primary associations were found and a further 18 were considered to be indicative of potential trends. Two of the primary associations were related to authorship and the utilization of scientific literature. Specifically, those clinicians who had previously authored or co-authored a peer-reviewed journal article were more likely to utilize scientific literature to guide their clinical practice.
CONCLUSIONS:
This study has highlighted important demographics which can be targeted for greater implementation of evidence-based practice. Above all, facilitating engagement of clinicians in research and its dissemination may promote a higher consumption of research evidence leading to improved evidence-based practice.
Unfortunately, double blind studies aren't conclusive for treatments that involve hands on, practitioner involvement.
Whereas in say a drug trial, where a medication is simply handed to the patient, the variables are measurable. Age, gender, diagnosis, etc.
In orthotics or surgery, the treatment is individualised. Each practitioner does it uniquely, and each patient is treated uniquely. The variables are endless, and not measurable.
What kind of orthotic? How casted, prescribed, adjusted, modified? By whom?
What surgery? What approach? p/op care? physio? By whom? What about intuition/gut feeling?
Primarily evidence based medicine is used to justify medical care spending. As such, it is supported by the biggies, and the educators who don't practice, but are now invited to conferences to give useless lectures about boring topics.
Cheers
Frederick
Fred:
I just now read your posting.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Factors influencing evidence-based practice
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