Engagement in Evidence-Based Practice Activities and Thinking by Rehabilitation Therapists: Predictive Factors

Objective To explore relationships between therapists’ recurrent, self-regulated evidence-related activities and antecedent factors that may influence these habits. Design Secondary analysis of survey data using multivariate regression/correlations analyses. Setting Representative sample of 30 inpatient rehabilitation clinics across the United States. Participants 163 rehabilitation therapists (N=163), specifically physical and occupational therapists and speech-language pathologists. Interventions Not applicable. Main Outcome Measures Evidence-informed professional thinking, which is comprised of measures of recurrent, self-regulated evidence-informed practice (EIP) and reflective critical clinical reasoning (CCR) activities by therapists. Results Scores indicate infrequent engagement in EIP activities (mean=4.22, SD=0.93), with somewhat greater engagement in CCR (mean=5.00, SD=0.920). Therapists generally had positive attitudes toward evidence-based practice (EBP) on the Evidence-Based Practice Attitude Scale-36. The EIP and CCR were highly related ( r =.651, P =.001). Even after linear controls for other possible predictors, beliefs that EBPs lead to greater Job Security predicted greater engagement in both EIP and CCR ( P <.001). Openness was also independently related to engagement in EIP ( P <.001) and to CCR ( P <.011), apparently mediated by Feedback, Professional Education, and awareness of Limitations (of EBP). Specialty certification was clearly related to EIP ( P <.016), but many common educational and experience background variables had weak or nonsignificant relationships with therapists’ EIP or CCR habits. Conclusions Self-regulated engagement in EIP and CCR are predicted by identifiable but somewhat complex antecedents. CCR was more strongly related to EIP than any other variable. Results suggest that implementation strategies that engage therapists’ reflective critical clinical reasoning will be more successful at increasing therapists’ engagement in self-regulated EBP habits than in strategies that do not.