Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke

Phys Ther. 2007 Oct;87(10):1284-303. doi: 10.2522/ptj.20070040. Epub 2007 Aug 7.

Abstract

Background and purpose: The purpose of this study was to identify practitioner barriers (education, attitudes and beliefs, interest and perceived role, and self-efficacy) and organizational barriers (perceived support and resources) to physical therapists' implementation of evidence-based practice (EBP) for people with stroke.

Subjects: The participants were 270 physical therapists providing services to people with stroke in Ontario, Canada.

Methods: A cross-sectional mail survey was conducted.

Results: Only half of respondents had learned the foundations of EBP in their academic preparation or received training in searching or appraising research literature. Although 78% agreed that research findings are useful, 55% agreed that a divide exists between research and practice. Almost all respondents were interested in learning EBP skills; however, 50% indicated that physical therapists should not be responsible for conducting literature reviews. Average self-efficacy ratings were between 50% and 80% for searching and appraising the literature and below 50% for critically appraising psychometric properties and understanding statistical analyses. Despite Internet access at work for 80% of respondents, only 8% were given protected work time to search and appraise the literature.

Discussion and conclusion: Lack of education, negative perceptions about research and physical therapists' role in EBP, and low self-efficacy to perform EBP activities represent barriers to implementing EBP for people with stroke that can be addressed through continuing education. Organizational provision of access to Web-based resources is likely insufficient to enhance research use by clinicians.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel
  • Clinical Competence
  • Cross-Sectional Studies
  • Evidence-Based Medicine*
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Middle Aged
  • Ontario
  • Physical Therapy Specialty*
  • Physician's Role
  • Self Efficacy
  • Stroke Rehabilitation*
  • Surveys and Questionnaires