Date Presented 03/27/20
This poster presentation will review the methodology and results of a six-week online educational program focused on evidence-based practice in stroke rehabilitation to improve clinical competence and confidence in OT practitioners.
Primary Author and Speaker: Michelle Buccinna
PURPOSE: The purpose of this study was to see if an online asynchronous multicomponent education on evidence-based practice (EBP) and stroke rehabilitation would improve the confidence and competence of occupational therapy practitioners in using evidence-based assessments and interventions in clinical practice. According to Law and MacDermid (2014), evidence-based practice uses a “combination of many facets of current literature, client choice, expertise, and clinical judgment” (p. 5). Myers (2019) reported research use is low among American occupational therapists, and many rarely engage in evidence research utilization to apply knowledge from findings into practice. Many clinicians identify time restraints, limited opportunities for training, and education as barriers to implementing evidence-based practice (Munce et al. 2017). Current evidence supports occupational therapists overcoming EBP barriers to improve their confidence, competence, and knowledge in implementing evidence-based practice by continuing their evidence-based education (Brangan, Quinn, & Spirtos, 2015). According to Brangan et al. (2015), a series of education courses that focused on creating clinical questions, learning how to evaluate and appraise literature, and the challenges to becoming an evidence-based practitioner demonstrated a positive change in perceived levels of confidence in using evidence. A stroke-specific evidence-based assessment and intervention program allows occupational therapists to learn evidence-based practice implementation and utilize current evidence to support best practice.
DESIGN: A quasi-experimental pretest-posttest pilot study evaluated the effectiveness of a six-week, multi-faceted, online educational intervention on EBP and stroke rehabilitation assessment and intervention. Nine occupational therapists, with at least three months of stroke rehabilitation experience, were recruited from a hospital system. Participants completed six asynchronous online modules focused on learning EBP, stroke assessments and interventions, and implementing evidence into practice. Participants also participated in three live conference calls and collaborated through online discussion boards. Pretest/posttest surveys evaluated changes in occupational therapists’ EBP knowledge, competence, and confidence to use evidence-based stroke assessments and interventions.
METHODS: Non-standardized pretest and posttest surveys designed by the primary investigator which assessed participants’ knowledge of EBP, competence, and competence. Surveys included 14- Likert scale questions, demographics, and open-ended questions. Descriptive statistics were used to analyze the mean scores for competence, confidence, and knowledge.
RESULTS: Outcomes revealed positive changes in participants’ confidence (+16%), competence (+11%), and knowledge (+10) between pre- and post-education in evidence-based practice knowledge, stroke assessment, and intervention. The mean scores of perceived competence and confidence were analyzed against the participants’ level of education and years of experience. It was determined that occupational therapists with less clinical experience had the largest changes in confidence (17%) from pre- to post-education.
CONCLUSION: These findings demonstrate the use of an online continuing education platform on stroke-related evidence-based practice is an effective way to improve occupational therapists’ clinical competency and confidence in stroke rehabilitation practice. This study is relevant to occupational therapy as it supports educating occupational therapists on evidence-based practice skills to improve their confidence and competence in using evidence-based assessments and interventions to support their clinical reasoning.
References
Brangan, J. Quinn, S., & Spirtos, M. (2015). Impact of an evidence-based practice course on occupational therapist’s confidence level and goals. Occupational Therapy in Health Care, 29(1), 27-38. https://doi.org/10.3109/07380577.2014.968943
Law, M. & MacDermid, J. (2014). Introduction to evidence-based practice. In M. Law & J. MacDermid (Eds.), Evidence-based rehabilitation: A guide to practice, 3rd edition (1-14) Thorofare, NJ: SLACK.
Munce, E. P., Graham, I. D., Salbach, N. M., Jaglal, S. B., Richards, C. L., Eng, J. J., … Bayley, M. T. (2017). Perspectives of healthcare professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial. BMC Health Services Research, 17(440), 1-13. https://doi.org/10.1186/s12913-017-2389-7
Myers, C. T. (2019). Occupational therapists’ perception of online competence assessment and evidence-based resources. American Journal of Occupational Therapy, 73(2), 7302205090p1-73022050p8. https://doi.org/10.5014/ajot.2019.029322
