Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study.
Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study.
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DOI：
10.1186/1472-6920-5-40
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发表时间：
2005-12-19
影响因子：
3.6
通讯作者：
Lovarini, Meryl
中科院分区：
文献类型：
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作者：
McCluskey, Annie;Lovarini, Meryl
背景：许多卫生专业人员缺乏寻找和评估已发表研究的技能。这种技能和相关知识的缺乏需要解决，实践习惯需要改变，才能发生循证实践。研究前后的目的是评估多方面干预对专职医护人员的知识、技能、态度和行为的影响。方法：招募114名自选的职业治疗师。干预措施包括为期两天的讲习班和八个月的外展支助。支持包括电子邮件和电话联系以及工作场所访问。在基线、研讨会后和八个月后收集测量结果。主要结果是知识，使用改编的弗雷斯诺循证实践测试(总分从0到156)来衡量。次要结果是对循证实践的态度(报告技能和信心提高的百分比；报告障碍的百分比)，以及使用活动日记衡量的行为(参与/不参与搜索和评估活动的百分比)，以及作业完成。结果：研讨会结束后，知识有了显著的增长，并在后续工作中保持不变。改良弗雷斯诺测验总分的平均差值为20.6分(95%可信区间为15.6~25.5)。从工作后到随访的变化很小，没有显著差异(平均差异1.2分，95%可信区间，-6.0~8.5)。较少的参与者报告缺乏搜索和评估技能是循证实践的障碍(搜索=61%、53%、24%；评估为60%、65%、41%)。这些差异有统计学意义(p分别为0.0001和0.010)。行为几乎没有改变。研讨会前，参加批判性评估的比例为6%，研讨会后和后续评估的比例分别为18%和18%。近三分之二(60%)的人在随访时没有阅读任何研究文献。23名参与者(20.2%)完成了任务。结论：在有针对性的教育干预和外展支持下，循证实践技能和知识显著提高。然而，根据搜索和评估活动的频率，行为的变化很小。联合健康教育工作者应该更多地关注研讨会后的技能发展，特别是评估，并帮助学习者围绕循证实践建立新的惯例和优先事项。学习者还需要知道，这种性质的行为改变可能需要几个月甚至几年的时间。
BACKGROUND: Many health professionals lack the skills to find and appraise published research. This lack of skills and associated knowledge needs to be addressed, and practice habits need to change, for evidence-based practice to occur. The aim of this before and after study was to evaluate the effect of a multifaceted intervention on the knowledge, skills, attitudes and behaviour of allied health professionals.METHODS: 114 self-selected occupational therapists were recruited. The intervention included a 2-day workshop combined with outreach support for eight months. Support involved email and telephone contact and a workplace visit. Measures were collected at baseline, post-workshop, and eight months later. The primary outcome was knowledge, measured using the Adapted Fresno Test of Evidence-Based Practice (total score 0 to 156). Secondary outcomes were attitude to evidence-based practice (% reporting improved skills and confidence; % reporting barriers), and behaviour measured using an activity diary (% engaging/not engaging in search and appraisal activities), and assignment completion.RESULTS: Post-workshop, there were significant gains in knowledge which were maintained at follow-up. The mean difference in the Adapted Fresno Test total score was 20.6 points (95% CI, 15.6 to 25.5). The change from post-workshop to follow-up was small and non-significant (mean difference 1.2 points, 95% CI, -6.0 to 8.5). Fewer participants reported lack of searching and appraisal skills as barriers to evidence-based practice over time (searching = 61%, 53%, 24%; appraisal 60%, 65%, 41%). These differences were statistically significant (p = 0.0001 and 0.010 respectively). Behaviour changed little. Pre-workshop, 6% engaged in critical appraisal increasing to 18% post-workshop and 18% at follow-up. Nearly two thirds (60%) were not reading any research literature at follow-up. Twenty-three participants (20.2%) completed their assignment.CONCLUSION: Evidence-based practice skills and knowledge improved markedly with a targetted education intervention and outreach support. However, changes in behaviour were small, based on the frequency of searching and appraisal activities. Allied health educators should focus more on post-workshop skill development, particularly appraisal, and help learners to establish new routines and priorities around evidence-based practice. Learners also need to know that behaviour change of this nature may take months, even years.