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Phys Ther. 2007 Oct;87(10):1284-303. Epub 2007 Aug 7.

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

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  • 1Department of Physical Therapy, Faculty of Medicine, University of Toronto, 160-500 University Ave, Toronto, Ontario, Canada M5G 1V7. nancy.salbach@utoronto.ca

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.

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