Knowledge, skills and barriers to evidence-based practice and the impact of a flipped classroom training program for physical therapists: an observational study

Objective: To evaluate the knowledge, skills and barriers to evidence-based practice and the impact of evidence-based practice training for physical therapy clinicians.

Methods: Physical therapists from a health district in Sydney, Australia were invited to participate. The primary outcome was the Assessing Competency in Evidence-based Medicine scale (range 0–15; 15 is high knowledge and skill) to quantify knowledge and skills. The secondary outcomes were the four subscales of the BARRIERS scale (range 1–4; 4 is high barrier) to quantify barriers. Outcomes were collected at baseline and post an evidence-based practice training program (flipped classroom approach that addressed the core competencies for teaching evidence-based practice) of 3 months duration. Registration: Australian and New Zealand Clinical Trial Register (ACTRN12619000038190).

Results: 104 participants completed baseline data and 94 completed post-training data. The mean score for the Assessing Competency in Evidence-based Medicine scale for knowledge and skills at baseline was 9.5 (standard deviation 1.6). The mean BARRIERS subscale scores at baseline were: Healthcare Provider 1.9 (0.5); Research 2.2 (0.5); Setting 2.6 (0.5); and Presentation 2.6 (0.5). On average, training increased the Assessing Competency in Evidence-based Medicine scale score by 0.1 points (95% confidence interval −0.2 to 0.5) and reduced barriers by −0.1 (−0.2 to 0.0; Setting subscale) to −0.2 (−0.3 to −0.1; Healthcare Provider subscale).

Conclusions: Physical therapists have knowledge and skill in evidence-based practice that is comparable to other allied health professionals, medical students and medical doctors, and encountered barriers to using high-quality clinical research to guide practice. Training did not change knowledge and skills but did reduce barriers.