Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

Download Full-text

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

Prosthetics and Orthotics International ◽

10.1177/0309364611431479 ◽

2011 ◽

Vol 36 (1) ◽

pp. 87-94 ◽

Cited By ~ 6

Author(s):

James Christensen ◽

Jan Andrysek

Keyword(s):

Online Survey ◽

Scientific Literature ◽

Evidence Based Practice ◽

Journal Article ◽

Healthcare Services ◽

Evidence Based ◽

Sources Of Information ◽

Clinical Practices ◽

Cross Sectional Survey ◽

Cross Sectional

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. Clinical relevance This study provides information about the underlying facilitators and inhibitors of evidence-based practice in prosthetics and orthotics. The findings aim to inform those involved in improving existing clinical practices, including educators, professional organizations and governing bodies.

Download Full-text

Epistemic beliefs as a determinant in evidence-based practice in physiotherapy – a Multi-Country (Europe) Cross-Sectional Online Survey Study

European Journal of Physiotherapy ◽

10.1080/21679169.2017.1374454 ◽

2017 ◽

Vol 20 (2) ◽

pp. 85-91 ◽

Cited By ~ 1

Author(s):

Paul Christiaan Beenen ◽

Dario Filiputti ◽

Erna Rosenlund Meyer ◽

Lidia Carballo-Costa ◽

Patricia Maria Duarte de Almeida ◽

...

Keyword(s):

Online Survey ◽

Evidence Based Practice ◽

Epistemic Beliefs ◽

Survey Study ◽

Evidence Based ◽

Cross Sectional

Download Full-text

Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence

Journal of Athletic Training ◽

10.4085/1062-6050-48.2.16 ◽

2013 ◽

Vol 48 (3) ◽

pp. 394-404 ◽

Cited By ~ 19

Author(s):

Dorice A. Hankemeier ◽

Jessica M. Walter ◽

Cailee W. McCarty ◽

Eric J. Newton ◽

Stacy E. Walker ◽

...

Keyword(s):

Athletic Training ◽

Online Survey ◽

Evidence Based Practice ◽

Athletic Trainers ◽

Cross Sectional Study ◽

Evidence Based ◽

Cross Sectional ◽

Master's Degrees ◽

Athletic Training Educators ◽

Perceived Importance

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Results: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.

Download Full-text

Assessment of impact of the COVID-19 pandemic from the perspective of patients with rheumatic and musculoskeletal diseases in Europe: results from the REUMAVID study (phase 1)

RMD Open ◽

10.1136/rmdopen-2020-001546 ◽

2021 ◽

Vol 7 (1) ◽

pp. e001546

Author(s):

Marco Garrido-Cumbrera ◽

Helena Marzo-Ortega ◽

Laura Christen ◽

Pedro Plazuelo-Ramos ◽

Dale Webb ◽

...

Keyword(s):

Disease Activity ◽

Online Survey ◽

Musculoskeletal Diseases ◽

Phase 1 ◽

Depression Scale ◽

Well Being ◽

Healthcare Services ◽

Study Phase ◽

Cross Sectional ◽

The Impact

AimTo assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases (RMDs).MethodsREUMAVID is a cross-sectional study using an online survey developed by an international multidisciplinary patient-led collaboration across seven European countries targeting unselected patients with RMDs. Healthcare access, daily activities, disease activity and function, well-being (WHO Five Well-Being Index (WHO-5)), health status, anxiety/depression (Hospital Anxiety and Depression Scale (HADS)) and access to information were evaluated. Data were collected in April–July 2020 (first phase).ResultsData from the first phase included 1800 patients with 15 different RMDs (37.2% axial spondyloarthritis, 29.2% rheumatoid arthritis, 17.2% osteoarthritis and others). Mean age was 53, 80% female and 49% had undertaken university studies. During the beginning of the pandemic, 58.4% had their rheumatology appointment cancelled and 45.6% reported not having received any information relating to the possible impact of SARS-CoV-2 infection in their RMDs, with the main source being patient organisations (27.6%).Regarding habits, 24.6% increased smoking, 18.2% raised their alcohol consumption, and 45.6% were unable to continue exercising. Self-reported disease activity was high (5.3±2.7) and 75.6% reported elevated pain. Half the patients (49.0%) reported poor well-being (WHO-5) and 46.6% that their health had changed for the worse during lockdown. According to HADS, 57.3% were at risk of anxiety and 45.9% of depression.ConclusionThroughout the first wave of the COVID-19 pandemic, patients with RMDs have experienced disruption in access to healthcare services, poor lifestyle habits and negative effects on their overall health, well-being and mental health. Furthermore, information on COVID-19 has not reached patients appropriately.

Download Full-text

Knowledge translation in action: Evaluation of a digital health initiative in illicit substance use. (Preprint)

10.2196/preprints.29026 ◽

2021 ◽

Author(s):

Steph Kershaw ◽

Louise Birrell ◽

Hannah Deen ◽

Nicola C Newton ◽

Lexine A Stapinski ◽

...

Keyword(s):

Health Professionals ◽

Online Survey ◽

Digital Health ◽

Evidence Based ◽

Digital Information ◽

Crystal Methamphetamine ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

System Usability Scale ◽

Baseline Knowledge

BACKGROUND The Cracks in the Ice Community Toolkit (cracksintheice.org.au) was developed to provide, evidence-based, up-to-date information and resources around crystal methamphetamine to Australians. Given the high rates of Internet use in the community and the potential for misinformation, Cracks in the Ice has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine. OBJECTIVE This study aimed to: 1) determine if Cracks in the Ice is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, family/friends, health professionals and the general community and 2) to examine the association between use of Cracks in the Ice and knowledge and attitudes about crystal methamphetamine. METHODS A cross-sectional online survey, open to Australian residents (aged 18+ years), was conducted from November 2018 to March 2019. People who had previously visited the website (website visitors) and those who had not (naïve) were recruited. At baseline, knowledge, attitudes and demographics were assessed. Cracks in the Ice website visitors then completed a series of site evaluation questions including system usability scale (SUS) and naïve participants were asked to undertake a guided site tour of a replicated version of the site prior to completing the evaluation questions and repeating knowledge and attitudes scales. RESULTS Of a total 2108 participants, 27% reported lifetime use of crystal methamphetamine, 21% were family/friends, 14% health professionals and 39% community members. Average SUS scores were 73.49 (SD 13.30) indicating good site usability. Health professionals reported significantly higher SUS scores than community member (P=.02) and people who use crystal methamphetamine (P<.01). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, average knowledge scores increased following exposure to the website (Mean = 15.2, SEM = 0.05) compared to baseline (Mean = 14.4, SEM = 0.05, P<.001). Largest shifts in knowledge were observed for items related to prevalence, legal issues and the effects of the drug. Stigmatising attitude scores among the naïve group were significantly lower following exposure to Cracks in the Ice (Mean = 41.97, SEM = 0.21) compared to baseline (Mean =44.3, SEM =0.21; P<.001). CONCLUSIONS This study provides an innovative evaluation of a national e-health resource. Cracks in the Ice is achieving its aim of disseminating evidence-based, non-stigmatising and useful information and resources about crystal methamphetamine to key end-user groups, and received good usability scores across its target groups. Interaction with Cracks in the Ice led to immediate improvements in knowledge about crystal methamphetamine, and a decrease in stigmatising attitudes. Cracks in the Ice demonstrates the important role of digital information and support platforms for translating evidence into practice as well as improving knowledge and reducing stigma.

Download Full-text

Core Competencies in Evidence-Based Practice for Health Professionals

JAMA Network Open ◽

10.1001/jamanetworkopen.2018.0281 ◽

2018 ◽

Vol 1 (2) ◽

pp. e180281 ◽

Cited By ~ 53

Author(s):

Loai Albarqouni ◽

Tammy Hoffmann ◽

Sharon Straus ◽

Nina Rydland Olsen ◽

Taryn Young ◽

...

Keyword(s):

Health Professionals ◽

Evidence Based Practice ◽

Core Competencies ◽

Evidence Based

Download Full-text

Physiotherapists and Evidence Based Practice: An Opportunity or Threat to the Profession?

Sociological Research Online ◽

10.5153/sro.575 ◽

2001 ◽

Vol 6 (1) ◽

pp. 62-74 ◽

Cited By ~ 4

Author(s):

Rose Wiles ◽

Sue Barnard

Keyword(s):

Health Professionals ◽

Evidence Based Practice ◽

Central Element ◽

Professional Autonomy ◽

Future Research ◽

Evidence Based ◽

The Status ◽

Using Data ◽

The Uk ◽

The Impact

The profession of physiotherapy in the UK is undergoing a period of change. Prominent among these aspects of change is the movement to evidence based practice (EBP). EBP is a central element of policy in the National Health Service (NHS). It is being implemented in physiotherapy as a means of securing contracts with purchasers but also as a means of contesting challenges from alternative practitioners and health professionals to the areas of work that physiotherapists view as their territory. Using data collected from a qualitative study of 56 physiotherapists of different grades working in different sectors of the NHS, this paper explores physiotherapists’ views of EBP and the impact that they expect it to have on professional boundaries and on the status and practice of physiotherapy. The study indicated that physiotherapists’ views may differ according to their position in the profession. Senior physiotherapists appeared to view the development of EBP as a threat to the profession which would decrease professional autonomy and the status of the profession. In contrast, junior and superintendent physiotherapists appeared to view EBP as an opportunity for strengthening the profession. The impact EBP will have on the profession of physiotherapy and its relationships with a range of health professionals is as yet unknown as are the responses that physiotherapists are likely to have to this development. This study identifies the areas in which conflicts are likely to be played out. A focus for future research analysing the impact of EBP is suggested.

Download Full-text

The Impact of Policy Changes, Dedicated Funding and Implementation Support on Early Intervention Programs for Psychosis

The Canadian Journal of Psychiatry ◽

10.1177/07067437211065726 ◽

2022 ◽

pp. 070674372110657

Author(s):

Bastian Bertulies-Esposito ◽

Srividya Iyer ◽

Amal Abdel-Baki

Keyword(s):

Quality Assurance ◽

Early Intervention ◽

Online Survey ◽

Interdisciplinary Teams ◽

Provincial Government ◽

Cross Sectional ◽

Implementation Support ◽

Wide Range ◽

Before And After ◽

The Impact

Introduction Early intervention services for psychosis (EIS) are associated with improved clinical and economic outcomes. In Quebec, clinicians led the development of EIS from the late 1980s until 2017 when the provincial government announced EIS-specific funding, implementation support and provincial standards. This provides an interesting context to understand the impacts of policy commitments on EIS. Our primary objective was to describe the implementation of EIS three years after this increased political involvement. Methods This cross-sectional descriptive study was conducted in 2020 through a 161-question online survey, modeled after our team's earlier surveys, on the following themes: program characteristics, accessibility, program operations, clinical services, training/supervision, and quality assurance. Descriptive statistics were performed. When relevant, we compared data on programs founded before and after 2017. Results Twenty-eight of 33 existing EIS completed the survey. Between 2016 and 2020, the proportion of Quebec's population having access to EIS rose from 46% to 88%; >1,300 yearly admissions were reported by surveyed EIS, surpassing governments’ epidemiological estimates. Most programs set accessibility targets; adopted inclusive intake criteria and an open referral policy; engaged in education of referral sources. A wide range of biopsychosocial interventions and assertive outreach were offered by interdisciplinary teams. Administrative/organisational components were less widely implemented, such as clinical/administrative data collection, respecting recommended patient-to-case manager ratios and quality assurance. Conclusion Increased governmental implementation support including dedicated funding led to widespread implementation of good-quality, accessible EIS. Though some differences were found between programs founded before and after 2017, there was no overall discernible impact of year of implementation. Persisting challenges to collecting data may impede monitoring, data-informed decision-making, and quality improvement. Maintaining fidelity and meeting provincial standards may prove challenging as programs mature and adapt to their catchment area's specificities and as caseloads increase. Governmental incidence estimates may need recalculation considering recent epidemiological data.

Download Full-text

Mapping allied health evidence-based practice: providing a basis for organisational realignment

Australian Health Review ◽

10.1071/ah14161 ◽

2015 ◽

Vol 39 (3) ◽

pp. 295 ◽

Cited By ~ 4

Author(s):

Jenny Ziviani ◽

Shelley A. Wilkinson ◽

Fiona Hinchliffe ◽

Rachel Feeney

Keyword(s):

Self Efficacy ◽

Online Survey ◽

Allied Health ◽

Evidence Based Practice ◽

Outcome Expectancy ◽

Evidence Based ◽

Organisational Structure ◽

Cross Sectional ◽

Efficacy Outcome ◽

Ebp Attitudes

Objective Ahead of the convergence of two major paediatric services, we examined evidence-based practice (EBP) self-efficacy, outcome expectancy, knowledge and use among allied health (AH) staff in two major Queensland (Qld) paediatric services. This was to determine whether any differences existed based on organisational affiliation, profession and any previous training to inform a strategy to enhance AH EBP within the new organisational setting. Methods All AH staff from the two Brisbane (Qld) tertiary paediatric hospitals were invited to participate in the survey. Using a cross-sectional design, EBP self-efficacy, outcome expectancy, knowledge and use, as well as previous EBP training, were assessed with an online survey. Background demographic information obtained included professional discipline and hospital. Results One hundred and thirty-eight health practitioners completed the survey (37% response rate). Most practitioners had accessed EBP training. Mean scores for EBP attitudes (self-efficacy and outcome expectancy) and knowledge were higher than for EBP use scores. Greater variation was observed across professional disciplines than organisations. Training impacted positively on EBP measures but explained a small proportion of total variance in regression models. Conclusions The results underscore the need to provide organisational supports to AH staff for EBP implementation. Strategies other than training are required to maximally enhance EBP attitudes. The new organisational structure provides an opportunity for this cultural shift to occur. What is known about the topic? Factors affecting the EBP capabilities of AH professionals are complex and are associated with institutional culture and barriers, personal self-belief and individual experience and ability, and can exist at clinician, team and organisational levels. What does this paper add? The data from the present study confirm the emerging literature examining various AH professional groups’ EBP behaviours and ratings with a large and diverse cohort from a variety of backgrounds and across organisations. Respondents possessed a positive attitude towards EBP and moderate EBP knowledge, with these scores exceeding EBP use scores. Organisational affiliation had little impact on EBP measures. What are the implications for practitioners? Although the results of the present study highlight the importance of training in literature searching, EBP and research design and/or analysis, the findings also indicated that strategies other than training are required to maximally enhance EBP attitudes and use by AH staff. To harness the positive approach AH staff have to EBP, strategies such as incorporation of EBP principles and plans in departmental meetings and strategic reviews, as well as strengthening organisational governance in relation to EBP and research, must be developed within the new organisational structure and context; a powerful, but often overlooked, enabler of EBP.

Download Full-text

Nurses’ views of fundamental relational skills used in clinical practice: a cross-sectional pilot study

Frontiers of Nursing ◽

10.2478/fon-2021-0023 ◽

2021 ◽

Vol 8 (3) ◽

pp. 223-232

Author(s):

Fiona Timmins ◽

Jan M. A. de Vries ◽

Yvonne Muldowney ◽

Catherine Mc Cabe ◽

Jacqueline Whelan ◽

...

Keyword(s):

Communication Skills ◽

Communication Systems ◽

Online Survey ◽

Core Competencies ◽

Communication Technologies ◽

Cross Sectional ◽

Nursing Curricula ◽

Information And Communication ◽

The Impact ◽

Relational Skills

Abstract Objective Effective communication skills are one of the core competencies of nursing curricula internationally. Nurses are generally regarded as proficient. Despite our complete trust in the profession, deficiencies and gaps exist. However, it is not clear to which extent nurses use key communication skills in practice, and whether or not confident in using these skills compounds environmental issues that occur. This study explored nurse's confidence and application of relational skills competencies in nursing practice. Methods A 13-item online survey was used to collect data. Results Being self-aware on key areas where there was more uncertainty. Nurses also lacked confidence in exploring the impact of their personal feelings and values on their interactions. Nurses were also less confident on responding appropriately to instances of unsafe or unprofessional practice and using information and communication systems and technology. Conclusions Given the potential impact of poor relational skills on quality client care, an increased emphasis on caring and compassion, and the ever-expanding use of communication technologies, there is a need to explore the need for reflective practice to enhance continuous professional development for nurses to enhance their relational skills.

Download Full-text