Teaching evidence-based practice in physical therapy: A national survey of Philippine schools General Instructions: A. In responding to the following questions, kindly answer on behalf of either the faculty or faculty members (if there are more than one) who teach EBP in your institution. B.
In case you experience difficulty answering any question, consultation with other members of the faculty is highly encouraged. 1. Do you currently teach evidence-based practice (EBP) in your institution? Yes No If your answer is “No”, please proceed to Question 2 If your answer is “Yes”, please proceed to Question 3
For the following items, mark the box that correspond to your response 2. What factor(s) prevent(s) you from teaching EBP? You may mark one or more boxes. Not enough space and/or time in the curriculum to integrate EBP Lack of institutional mandate to incorporate EBP in the curriculum Lack of teachers who are qualified to teach EBP in the institution Lack of support from colleagues Lack of resources (journals, internet access) Lack of formal training in the EBP framework Inadequate knowledge of EBP concepts Inadequate knowledge of research methodology Lack of understanding of statistical procedures Others, (please specify) _________________________ After answering this item, please proceed to Question 11 3. How is EBP taught in your curriculum? EBP is incorporated in different course(s). (Proceed to Question 4) EBP is taught as a separate course. (Proceed to Question 5) EBP is taught as a separate course AND is incorporated in different course(s) (Proceed to Question 4) 4. In what subject(s) / course(s) are EBP content incorporated? You may mark one or more boxes. PT 1: Introduction to PT and Patient Care PT2: Light, Thermal Agents, and Hydrotherapy PT3: PT Examination and Evaluation PT4: Electrotherapy Thera Ex1: Basic Therapeutic Exercises, Physiology of exercises Thera Ex2: Therapeutic Exercise for Medical Conditions Thera Ex3: Therapeutic Exercise for Surgical, Neurologic, and Developmental Pediatric Conditions Seminar 1: Clinical correlations for Medical Conditions
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Seminar 2: Clinical correlations for Surgical, Neurologic, and Developmental Pediatric Conditions Orthotics and Prosthetics Organization and Administration in PT Ethics in Physical Therapy Research 1: Introduction to Research and Research proposal writing Research 2: Research Implementation and Presentation Others, (please specify)__________________________ 5. Do your students have an opportunity to apply the EBP framework in clinical decision-making for their individual clients during their clinical internship/practicum? Yes No Do not know If your answer is “No”, what are the possible barriers that your students encounter in implementing the EBP framework during their clinical internship? You may mark one or more boxes. Insufficient time Lack of interest among clinical supervisors to EBP Lack of information resources in the clinic Lack of support from the clinic to practice EBP Lack of training programs focusing on EBP Others, (please specify)_____________________
The following items inquire about the extent to which EBP content are integrated in the curriculum. 6. Which of the following EBP content listed below do you teach to your students? If you do NOT currently teach an EBP content, indicate at what level should the following EBP content/s be taught. Mark the box that corresponds to your answer. If your answer is YES to an EBP content, there’s no need to classify it into “UG” or “PG”. Legend: “UG” = undergraduate level
YES, I’m teaching this content
NO, I’m NOT teaching this content.
Mark these boxes only if your answer is NO UG
PG
“PG” = post-graduate (masters, doctorate, etc.) level
EBP Content: Asking the clinical question and searching for evidence
Formulating clinically relevant questions using the PICO format
Different types of clinical questions to guide the literature search
Constructing a focused search strategy
Locating clinical evidence using electronic databases
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(PICO stands for ‘Patient, Intervention, Comparison, Outcome’)
(Clinical questions can be categorized into questions on intervention, diagnosis, or prognosis)
(A focused search strategy involves the use of appropriate keywords and boolean terms ‘AND’, ‘OR, ‘NOT’ to effectively search for articles in bibliographic databases)
(Cochrane, Cumulative Index to Nursing and Allied Health Literature (CINAHL),MEDLINE, Physiotherapy Evidence Database (PEDro)
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YES, I’m teaching this content
NO, I’m NOT teaching this content.
Mark these boxes only if your answer is NO UG
PG
EBP Content: Critically appraising the evidence
Commonly used study designs and their major strength and limitations
Assessing the relevance of study design to the question asked
Hierarchy or levels of evidence
Difference between narrative, systematic review, and meta-analysis
Difference between clinical and statistical significance
Interpreting the results of statistical procedures such as t tests, chi-square tests
Interpreting the results of statistical procedures such as p-value, confidence interval
Understanding sensitivity and specificity, number needed to treat, odds ratio
Understanding intention to treat analysis, power calculation
Use of appraisal tool(s) to assess validity
Ways in which study validity can be threatened
Difference between internal and external validity
Critical appraisal of systematic reviews
Interpreting forest plots in systematic reviews
Critical appraisal of studies about intervention (RCTs and clinical trials)
Critical appraisal of studies about diagnosis (cohort, case-control studies)
Critical appraisal of studies about prognosis (longitudinal studies)
YES, I’m teaching this content
NO, I’m NOT teaching this content.
Mark these boxes only if your answer is NO UG
PG
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(Randomized controlled trials (RCTs), cross-ssectional studies, longitudinal studies, cohort designs...)
(For example, questions on intervention are best answered by RCTs, meta-analysis, or systematic reviews while questions on prognosis are best answered by longitudinal studies)
(For example, systematic reviews and meta analysis are higher in the hierarchy of evidence compared to RCTs)
(Critical Appraisal Skills Program ‘CASP’ tool, PEDro scale)
(The presence of study bias significantly affects the validity of a study)
(Forest plots present the summary statistic for each trial in a meta-analysis)
EBP Content: Integrating the evidence and communicating the results
Communicating the results of the appraisal in a level appropriate to the individual patient
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YES, I’m teaching this content
NO, I’m NOT teaching this content.
Deciding on an appropriate clinical decision considering the patient’s needs and treatment preferences
Mark these boxes only if your answer is NO UG
PG
EBP Content: Others
Others, (please specify)___________________________________________________ ______________________________________________________________________
Others, (please specify)___________________________________________________ ______________________________________________________________________
The following items inquire about the different methods of teaching EBP content, and evaluating the performance of students at your institution. 7. What method(s) does your institution use to teach EBP contents to your students? You may mark one or more boxes. Lectures Journal reporting (making a summary out of the result of an assigned journal and presenting to class)
Small group discussions Guided literature search (guided library or internet search)
Critical appraisal of journal articles Mentoring during thesis discussions Research colloquium (undergraduate thesis presentation / defense)
Workshops/seminars/conference presentations on using appraisal tools (PEDro) Workshops/seminars/conference presentations on electronic searching Developing Critically Appraised Topics (CATs) Others,(please specify)______________________________________ 8. What method(s) does your institution use to evaluate the performance of your students in EBP? You may mark one or more boxes. Oral examination Written examinaton Recitation Written assignments Oral reporting (for journal reports) Poster presentations Undergraduate thesis Others, (please specify)______________________________________
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The following items inquire about the experiences of Filipino educators in teaching EBP. 9. What are the difficulties/challenges that your institution have encountered in teaching EBP? You mark one or more boxes. Students’ lack of interest in EBP Students’ inadequate knowledge of statistics Insufficient computer skills Lack of sufficient evidence to answer clinical question Lack of confidence among fellow educators in teaching EBP Negative attitude toward teaching EBP from other faculty members Limited ability to critically appraise the literature Difficulty teaching EBP concepts (learned from post-graduate education) to undergraduate students Inadequate EBP competency from undergraduate training Lack of time in the curriculum to incorporate EBP Lack of structure in teaching EBP Lack of structure in evaluating EBP competencies Inadequate learning activities to foster continuity of learning during clinical internship Lack of access to internet databases Inadequate skill in searching through internet databases (Cochrane, PubMed) Lack of internet access in the institution Lack of professional journals in the library (Physical Therapy, Australian Journal of Physiotherapy) My institution does not mandate the inclusion of EBP in the curriculum Others, (please specify) ______________________________________ 10. Of the above difficulties/challenges you identified/mentioned above, what strategy(ies) have your institution implemented to address these?
Modification of the course syllabus to incorporate EBP Provision of journal articles to students Mentoring program for junior faculty members Incorporating research evidence in lectures Reviewing students on basic principles of statistics Creation of online discussion groups (journal clubs) Encouraging students to incorporate evidence during oral examinations Providing faculty members with a “protected time” to engage in research Providing hypothetical clinical cases to students for discussion Others, (please specify) _________________________________________ The following items inquire about personal and institutional demographics/characteristics. 11. How many faculty members (e.g. lecturers, instructors, professors) does your department have? _____ members 12. Of the number specified above, how many are teaching research in your institution? (Please specify) ________ 13. How many are teaching EBP in your institution? (Please specify) ________ 14. What is the age range of the faculty member teaching EBP? If more than one, the response should represent the majority. 20 - 25 31 - 35 41 and above 26 – 30 36 - 40
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15. What is the gender of the faculty who teaches EBP? Female Male If more than one faculty member teaches EBP, choose among the choices below that represent the majority. Female = Male Female > Male Male > Female 16. Kindly indicate the time since graduation majority of your faculty members teaching EBP finished their undergraduate education Less than 1 year 6 – 10 years 16 years and above 1 – 5 years 11 – 15 years 17. What is the highest degree that majority of faculty members, who teach EBP, have attained? Bachelor’s degree Master’s degree in Physical Therapy Non-physical therapy master’s, please specify_______________________________ Doctorate in Physical Therapy Non-physical therapy doctorate, pease specify_______________________________ 18. Did any of the faculty members receive formal instruction/training on the EBP process as part of their academic preparation? Yes If yes → Undergraduate Master’s / Doctorate No 19. Did any of the faculty members attend formal courses/seminars/workshops on research topics? Yes No 20. Did any of the faculty members attend formal courses/seminars/workshops on EBP? Yes No 21. Did any of the faculty members, who teach EBP, handle research topics in the past? Yes No If “Yes”, how many years did he/she handle research topics in the past? Less than 1 year 6 – 10 years greater than 15 years 1 – 5 years 11 – 15 years 22. In your institution, how many years have the majority of all faculty members been teaching physical therapy? Less than 1 year 6 – 10 years greater than 15 years 1 – 5 years 11 – 15 years 23. Which of the following best describes the institution you are currently affiliated with? College → Public Private University → Public Private Others (please specify) _________________________________ 24. Which of the following best describes the location of the institution you are currently affiliated? Rural / Provincial Urban / City 25. What is your current position (e.g. lecturer, instructor, professor, dean, etc.) within the college/department? (Please specify) __________________________ 26. Does your institution provide faculty members with continuing education opportunities (e.g. provides funding for attending formal courses/seminars/workshops, organizes formal courses/seminars/workshops for the faculty)? Yes No
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If “Yes”, what is the average number of continuing education courses/seminars/workshops that majority of the faculty attends? 5 27. Do faculty members have access to physical therapy/academic journals (e.g. APTA’s Physical Therapy, Physiotherapy, etc.) in print at your institution? Yes No If “Yes”, do majority of the faculty read scientific articles published in academic/professional journal/s? Yes → how often do they read these journals? Once/week Twice/week Thrice/week More than thrice/week No 28. Does your institution subscribe to online physical therapy/academic journals? Yes No 29. Do majority of the faculty have access to the internet and relevant online databases (Ovid, CINAHL, Cochrane) at your institution? Yes No 30. Do majority of the faculty have access to the internet and relevant online databases (Ovid, CINAHL, Cochrane) at home or at locations other than your institution? Yes No 31. Does your department/institution have a resource person (e.g. clinical practice leader, research expert) available to assist you with EBP? Yes No 32. In your institution, how many years have the majority of all faculty members been practicing physical therapy in a clinical setting? Less than 1 year 6 – 10 years greater than 15 years 1 – 5 years 11 – 15 years 33. Do majority of faculty members belong to one or more professional practice-oriented organizations (e.g. Philippine Physical Therapy Association, Philippine Hypertension Society)? Yes No 34. Do majority of faculty members regularly treat patients? “Treat” refers to personally assessing and managing patients referred for therapy. Yes No If “Yes”, how many patients in average do they regularly treat in a week? less than 5 5-10 more than 10 35. Do majority of faculty members routinely apply evidence-based practice to their patients? “Routinely” refers to applying evidence-based treatment and/or assessment procedures every therapy session per patient. Yes No
Please check if you have answered all applicable items. You can either return this questionnaire via regular mail (kindly refer to the cover letter for details) Or through these e-mail addresses:
[email protected] [email protected] Thank you very much for your participation – we truly appreciate your help!
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