Background and Purpose.
Educators recognize the need to develop effective strategies for teaching evidence-based practice (EBP) skills, with the ultimate goal of fostering this approach in clinical care. The purpose of this paper is to explore the connection between EBP and clinical decision making and to describe several curricular strategies for incorporating EBP in professional education. Understanding that physical therapists make patient care decisions under conditions of uncertainty and complexity, the search for research evidence provides one source of information that can be used in the decisionmaking process, but must be integrated with clinical judgment and specific patient needs. Educating students in EBP requires that we frame learning activities to support a balance between evidence and clinical judgment.
Model Description and Evaluation.
The traditional research course has typically addressed statistics and design, with a focus on critical interpretation of literature. To generate a valuing of EBP, however, the process must become a standard part of clinical decision making across the professional curriculum, potentially allowing for introduction of EBP concepts in a research-based course. Learning activities should reinforce EBP skills in asking clinical questions, accessing relevant literature, and interpreting the literature to support patient care decisions. Curriculum strategies may include seminars that require students to find literature to support decisions related to patient cases, online threaded discussions that allow students to share their decisionmaking processes, case conferences in a clinical setting to apply EBP skills to real patients, incorporation of EBP requirements for practical examinations, and writing critically appraised topics (CATs) that require critical analysis of literature. To be effective, activities should reflect the spectrum of EBP, including diagnosis, prognosis, and intervention, should be integrated through research and clinical courses, and should be modeled in the clinical setting to demonstrate the application of evidence in the real world of practice.
Discussion and Conclusion.
Many barriers to practicing and teaching EBP have been identified. Faculty must face the challenge of teaching EBP by fostering a spirit of inquiry and role modeling the process. We must continue to share ideas for teaching EBP and evaluate these methods for their immediate and long-term effectiveness in changing students' clinical behaviors.