Date Presented 04/04/19
Practitioner understanding and use of evidence-based practice (EBP) is critical for quality, cost-effective OT services. This study used a modified Delphi method with two rounds of online questionnaires to develop a set of EBP competencies for OTs. The final list of competencies represented nine domains and encompassed a wide range of knowledge, skills, and behaviors related to OT practice.
Primary Author and Speaker: Christine Myers
Additional Authors and Speakers: Samantha DeMaria, Jamie Pomeranz
PURPOSE: Evidence-based practice (EBP) is considered a vital element for quality, cost-effective occupational therapy services. While valuable for clients and health care organizations, the profession lacks published occupational therapy competencies for EBP in the United States. Published competencies will allow occupational therapists to self-assess their perceived abilities to carry out EBP and will provide health care and community organizations a tool for quality improvement. The purpose of this study was to develop a set of evidence-based practice competencies for occupational therapists.
DESIGN: A modified Delphi method with two rounds of online questionnaires was used. In order to ensure a diverse and experienced sample, participants were recruited through either a random sample of 300 certified occupational therapists or a purposive sample. Occupational therapists from these samples were emailed an invitation to complete a screening questionnaire. Qualified participants were occupational therapy practitioners, educators, and researchers who met inclusion criteria, including advanced education or training in EBP.
METHOD: The study consisted of two stages. In the first stage, a comprehensive literature review of EBP and EBP competencies for health care professionals was conducted. The literature review informed the creation of a list EBP competency statements relevant to occupational therapy. In the second stage, approved by the authors’ institutional review board, participants were asked to indicate the relative importance of the competency statements using a 5-point Likert scale in two rounds of online questionnaires. Items were considered as meeting consensus if greater than 75% of respondents rated an item as very important or extremely important. A measure of dispersion (interquartile range) and median score were calculated for each item. In round two, participants reviewed and rated items that did not attain consensus in round one; interquartile ranges and medians from round one were provided. Following the two rounds, all items that reached consensus were retained.
RESULTS: Competency statements were extracted from the literature to develop a list of 78 competencies. Participants (n = 17) reached consensus on 29 competencies in round one and 27 competencies in round two. The final list of 56 competencies represented nine domains: understands evidence-based practice, demonstrates knowledge and skills, asks clinical questions, acquires knowledge, appraises evidence, applies evidence, integrates patient values, assesses practice outcomes, and implements evidence-based practices.
CONCLUSION: The final set of EBP competencies encompassed a wide range of knowledge, skills, and behaviors related to occupational therapy practice. The competencies have potential to guide occupational therapists in determining continuing competence needs related to EBP. In order to determine the validity and usefulness of these competencies, future research should investigate application by occupational therapists working in a variety of health care and community settings, with differing backgrounds and education.
IMPACT STATEMENT: A clearly delineated set of EBP competencies can be used across settings and practice areas to support individual and organizational efforts for maximizing quality of occupational therapy services.
References
American Occupational Therapy Association. (2017) . Vision 2025. American Journal of Occupational Therapy, 71, 7103420010. https://doi.org/10.5014/ajot.2017.713002
Jünger, S., Payne, S.A., Brine, J., Radbruch, L. & Brearley, S.G. (2017). Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliative Medicine, 31(8), 684 – 706. DOI:10.1177/0269216317690685
Marr, D. (2017). Centennial Topics— Fostering full implementation of evidence-based practice. American Journal of Occupational Therapy, 71, 7101100050.https://doi.org/10.5014/ajoot.2017.019661
Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The Establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. doi:10.1111/wvn.12021
