Understanding Behavior Change in Clinical Practice Guideline Implementation: A Qualitative Study.

Background And Purpose: Growing numbers of clinical practice guidelines (CPGs) are available to neurologic physical therapists to guide and inform evidence-based patient care. Adherence to CPG recommendations often necessitates behavior change for therapists and patients. The purpose of this qualitative study was to gain insight into the experiences, perspectives, and drivers of behavioral change for therapists working to improve adherence to a CPG.

Development of a Novel Evidence-Based Practice-Specific Competency for Doctor of Physical Therapy Students in Clinical Education: A Modified Delphi Approach.

Introduction: Evidence-based practice (EBP) results in high-quality care and decreases unwarranted variation in practice.

Review Of The Literature: Few performance criteria related to EBP are included in physical therapy clinical education (CE) performance measures, despite EBP requirements in Doctor of Physical Therapy education. The purpose of this study was to develop EBP-specific competencies that may be used for Doctor of Physical Therapy students for use throughout CE.

Use of the knowledge to action model improved physical therapist adherence to a common clinical practice guideline across multiple settings: a multisite case series.

Background: When a new guideline is published  there is a need to understand how its recommendations can best be implemented in real-world practice. Yet, guidelines are often published with little to no roadmap for organizations to follow to promote adherence to their recommendations. The purpose of this study was to evaluate the impact of using a common process model to implement a single clinical practice guideline across multiple physical therapy clinical settings.

Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke.

Background: People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined.

Objective: We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum.

The ecosystem of evidence cannot thrive without efficiency of knowledge generation, synthesis, and translation.

Evidence-based medicine (EBM) has experienced numerous advances since its inception over 2 decades ago. Yet a persistent gulf remains between how medicine is actually practiced and the goal of providing care based on best available research evidence integrated with patient perspective and clinical expertise. A primary source of challenge for EBM is induced by inefficiencies in the generation, synthesis, and translation of evidence.

Locomotor Training and Strength and Balance Exercises for Walking Recovery After Stroke: Response to Number of Training Sessions.

Background: Evidence-based guidelines are needed to inform rehabilitation practice, including the effect of number of exercise training sessions on recovery of walking ability after stroke.

Objective: The objective of this study was to determine the response to increasing number of training sessions of 2 interventions-locomotor training and strength and balance exercises-on poststroke walking recovery.

Design: This is a secondary analysis of the Locomotor Experience Applied Post-Stroke (LEAPS) randomized controlled trial.

Effectiveness of neuromuscular electrical stimulation for management of shoulder subluxation post-stroke: a systematic review with meta-analysis.

Objectives: To examine the effectiveness of neuromuscular electrical stimulation (NMES) for the management of shoulder subluxation after stroke including assessment of short (1 hour or less) and long (more than one hour) daily treatment duration.

Data Sources: MEDLINE, CENTRAL, CINAHL, WOS, KoreaMed, RISS and reference lists from inception to January 2017 Review methods: We considered randomized controlled trials that reported neuromuscular electrical stimulation for the treatment of shoulder subluxation post-stroke. Two reviewers independently selected trials for inclusion, assessed trial quality, and extracted data.

The Interface of Clinical Decision-Making With Study Protocols for Knowledge Translation From a Walking Recovery Trial.

Background And Purpose: Despite efforts to translate knowledge into clinical practice, barriers often arise in adapting the strict protocols of a randomized, controlled trial (RCT) to the individual patient. The Locomotor Experience Applied Post-Stroke (LEAPS) RCT demonstrated equal effectiveness of 2 intervention protocols for walking recovery poststroke; both protocols were more effective than usual care physical therapy. The purpose of this article was to provide knowledge-translation tools to facilitate implementation of the LEAPS RCT protocols into clinical practice.

Development and validation of the guideline for reporting evidence-based practice educational interventions and teaching (GREET).

Background: The majority of reporting guidelines assist researchers to report consistent information concerning study design, however, they contain limited information for describing study interventions. Using a three-stage development process, the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) checklist and accompanying explanatory paper were developed to provide guidance for the reporting of educational interventions for evidence-based practice (EBP). The aim of this study was to complete the final development for the GREET checklist, incorporating psychometric testing to determine inter-rater reliability and criterion validity.

Promoting physical therapists' use of research evidence to inform clinical practice: part 3--long term feasibility assessment of the PEAK program.

Background: Evidence is needed to develop effective educational programs for promoting evidence based practice (EBP) and knowledge translation (KT) in physical therapy. This study reports long-term outcomes from a feasibility assessment of an educational program designed to promote the integration of research evidence into physical therapist practice.

Methods: Eighteen physical therapists participated in the 6-month Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program.

A bibliometric analysis of statistical terms used in American Physical Therapy Association journals (2011-2012): evidence for educating physical therapists.

Background: A primary barrier to the implementation of evidence based practice (EBP) in physical therapy is therapists' limited ability to understand and interpret statistics. Physical therapists demonstrate limited skills and report low self-efficacy for interpreting results of statistical procedures. While standards for physical therapist education include statistics, little empirical evidence is available to inform what should constitute such curricula.

Use of Tablet Computers to Promote Physical Therapy Students' Engagement in Knowledge Translation During Clinical Experiences.

Background And Purpose: Physical therapists strive to integrate research into daily practice. The tablet computer is a potentially transformational tool for accessing information within the clinical practice environment. The purpose of this study was to measure and describe patterns of tablet computer use among physical therapy students during clinical rotation experiences.

A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine.

Background: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.

Concordance and discordance between measured and perceived balance and the effect on gait speed and falls following stroke.

Objective: To ascertain the existence of discordance between perceived and measured balance in persons with stroke and to examine the impact on walking speed and falls.

Design: A secondary analysis of a phase three, multicentered randomized controlled trial examining walking recovery following stroke.

Subjects: A total of 352 participants from the Locomotor Experience Applied Post-Stroke (LEAPS) trial.

A Delphi survey to determine how educational interventions for evidence-based practice should be reported: stage 2 of the development of a reporting guideline.

Background: Undertaking a Delphi exercise is recommended during the second stage in the development process for a reporting guideline. To continue the development for the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) a Delphi survey was undertaken to determine the consensus opinion of researchers, journal editors and educators in evidence-based practice (EBP) regarding the information items that should be reported when describing an educational intervention for EBP.

Methods: A four round online Delphi survey was conducted from October 2012 to March 2013.

A systematic review of how studies describe educational interventions for evidence-based practice: stage 1 of the development of a reporting guideline.

Background: The aim of this systematic review was to identify which information is included when reporting educational interventions used to facilitate foundational skills and knowledge of evidence-based practice (EBP) training for health professionals. This systematic review comprised the first stage in the three stage development process for a reporting guideline for educational interventions for EBP.

Methods: The review question was 'What information has been reported when describing educational interventions targeting foundational evidence-based practice knowledge and skills?'MEDLINE, Academic Search Premier, ERIC, CINAHL, Scopus, Embase, Informit health, Cochrane Library and Web of Science databases were searched from inception until October - December 2011.

Use of handheld computers in clinical practice: a systematic review.

Background: Many healthcare professionals use smartphones and tablets to inform patient care. Contemporary research suggests that handheld computers may support aspects of clinical diagnosis and management. This systematic review was designed to synthesise high quality evidence to answer the question; Does healthcare professionals' use of handheld computers improve their access to information and support clinical decision making at the point of care?

Methods: A detailed search was conducted using Cochrane, MEDLINE, EMBASE, PsycINFO, Science and Social Science Citation Indices since 2001.

Promoting physical therapists' use of research evidence to inform clinical practice: part 2--a mixed methods evaluation of the PEAK program.

Background: Clinicians need innovative educational programs to enhance their capacity for using research evidence to inform clinical decision-making. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. This, second of two, papers reports a mixed methods feasibility study of the PEAK program among physical therapists at three university-based clinical facilities.

Promoting physical therapists' of research evidence to inform clinical practice: part 1--theoretical foundation, evidence, and description of the PEAK program.

Background: There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory.

Development and validation of the ACE tool: assessing medical trainees' competency in evidence based medicine.

Background: While a variety of instruments have been developed to assess knowledge and skills in evidence based medicine (EBM), few assess all aspects of EBM - including knowledge, skills attitudes and behaviour - or have been psychometrically evaluated. The aim of this study was to develop and validate an instrument that evaluates medical trainees' competency in EBM across knowledge, skills and attitude.

Methods: The 'Assessing Competency in EBM' (ACE) tool was developed by the authors, with content and face validity assessed by expert opinion.

Implementation of a blended learning approach to teaching evidence based practice: a protocol for a mixed methods study.

Background: Evidence based practice (EBP) requires that health professionals are competent in integrating the best evidence in their decision making. Being 'evidence-based' requires skills and knowledge in epidemiology, biostatistics and information literacy. EBP is commonly taught in medical and health sciences degrees, yet there is little evidence to guide educators as to the best teaching modality to increase learner competency in EBP.

Evidence of effectiveness of health care professionals using handheld computers: a scoping review of systematic reviews.

Background: Handheld computers and mobile devices provide instant access to vast amounts and types of useful information for health care professionals. Their reduced size and increased processing speed has led to rapid adoption in health care. Thus, it is important to identify whether handheld computers are actually effective in clinical practice.