1. The impact of small-group EBP education programme: barriers and facilitators for EBP allied health champions to share learning with peers

2. The impact of monthly small-group EBP education programme: early insights

3. Introduction
All health professionals need to provide evidence-based, high quality clinical care
EBP champions volunteered to encourage use of EBP in clinical allied health teams
EBP champions requested further education within clinical routines
knowledge
confidence
practical strategies

4. Scenario: Learning to share new EBP knowledge and skills with clinical peers
IMPLEMENTATION:
Small group learning with volunteer allied health clinicians
Distributed time: 2 hours/month; 4 months
Action tasks to share EBP skills and knowledge
EVALUATION:
Self–report questionnaires & focus group interviews
Feasibility
Effectiveness
Impact
to inform…
EVIDENCE:
Intensive EBP workshops promote short term knowledge acquisition
Longer term small group work improves EBP self-efficacy & self reported EBP behaviours
SUSTAINABILITY:
PROBLEM: Clinicians do NOT have time for intensive EBP education
REALITY: Volunteer champions keen to help clinical peers learn

5. Small group EBP education: what we did
Expression of Interest to attend
2 hours/month over 4 months
Didactic learning + small group work + local application
Short action task with clinical teams each month
Clinicians choose topic learnt to share with peers

6. Mixed Methods Evaluation plan
Before and after:
EBP Confidence Scale (EPIC): 9 items, 1-10 rating scale
Salbach & Jaglal, 2011
Adapted Fresno Test: 7 item questionnaire of applied skills
McCluskey & Bishop, 2009
EBP Implementation Scale: 13 items, frequency of use
Melnyk, Fineout-Overholt & Mays, 2008
Immediately after:
Satisfaction survey: rating scale + 4 open-ended questions
3 months later:
Focus group (volunteer sample)

7. CREATE framework Tilson et al, 2011 Focus Group
EBP Implementation Scale
Adapted Fresno Test
EBP Confidence Scale
Satisfaction Survey
Focus Group
Tilson et al, 2011

8. Data analysis Quantitative data analyses: Qualitative data analyses:
EPIC scale, Adapted Fresno and EBP implementation scale: Within group changes between pre-post measured using non-parametric Wilcoxon Matched pairs
Descriptive summary for satisfaction survey
Qualitative data analyses:
Content analysis performed on open ended questions of the questionnaires.
Transcripts independently thematically coded by two researchers into categories and sub-categories to provide a descriptive summary of the data.

9. Participant Summary Participant details (n= 16) % (n=16) Male: Female
25% (4)
Research higher degree
43.8% (7)
Years Clinical Experience
<2 years
6.3% (1)
2 - <5 years
18.8% (3)
years
62.5% (10)
years
>15 years
Profession
Dietitian
12.5% (2)
Occupational Therapist
Speech Pathologist
Physiotherapist
18.8 (3)
Pharmacist
Medical Imaging
Social Worker
Music Therapist

10. Did the EBP workshops increase participants’ EBP skills, knowledge, self-efficacy?
Significant improvements in self-efficacy (EBP Confidence)
Non-significant change in knowledge & skills (Adapted Fresno)
Domain
Assessment
Mean pre (total %)
Mean post (total %)
Mean difference CI 95%
Difference between means (p= )
Self-Efficacy
EBP Confidence TOTAL
(maximum = 90)
64.50
(72%)
(87%)
-13.71
( to -9.90)
0.000**
Knowledge & Skills
Adapted Fresno TOTAL (maximum = 168)
(64%)
116.25
(69%)
-9.62
(-25.5 to 6.29)
0.215

11. Did the EBP workshops increase participants’ EBP skills, knowledge, self-efficacy?
EBP Confidence: [post –hoc analysis]
Significant pre-post differences in
formulating a question to guide literature search
conducting an online literature search
critically appraising the applicability of the research evidence to local context
discriminating between statistical and clinical significance
integrating research evidence, clinical judgement & clients’ preference
Adapted Fresno:
Significant difference in one item
estimating magnitude of clinical and statistical significance

12. Does a small group education experience change clinicians’ behaviour?
Significant improvement in total score of EBP implementation scale, indicating greater frequency of EBP use (p=0.02)

13. Does a small group education experience change clinicians’ behaviour?

14. Is a 4 month EBP programme feasible and acceptable for clinicians?

15. Is a 4 month EBP programme feasible and acceptable for clinicians?
Attendance at EBP training

16. What are the barriers and facilitators to sharing learning with peers?
*Preliminary findings from qualitative data
Barriers:
Other clinical and non-clinical demands
Time to prepare teaching to others
Facilitators:
Having a workbook to refer to with practical examples
Opportunities for incidental teaching
Examples of how participants shared learning:
prepared in-services for new graduates & new staff
prepared summaries and handouts to team of key learnings
provided support with critically appraising articles to others in journal club
showed others how to search for articles
giving incidental support as questions arise

17. Conclusion
Small group training delivered over 2 hours across four months may lead to improved self-efficacy and changed behaviours in EBP in allied health clinicians
Monthly EBP training format is a feasible and acceptable format for allied health clinicians
Good attendance
High satisfaction
Need to explore further opportunities to promote shared learning in EBP training

18. Any Questions?

19. Does a small group education experience change clinicians’ behaviour?
EBP Implementation Scale
Question
Mean pre
Mean post
Confidence interval 95%
Sig.
Used a clinical/EBP guideline or systematic review to change practice?
1.56
1.50
 0.06 (-3.18 to 3.30)
0.763
Evaluated the outcomes of a practice change?
1.31
1.44
 -0.13 (-0.53 to 0.27)
0.480
Shared research evidence with a multi-disciplinary team member?
1.68
2.69
 -1.01 (-1.55 to-0.47)
0.004*
Accessed the Cochrane database of systematic reviews?
2.06
 -0.5 (-1.07 to 0.07)
0.021*
Shared evidence from a study to more than 2 colleagues
1.37
2.31
 -0.94 (11.52 to -0.36)
0.002*
Generated a PICO question about my clinical practice?
1.25
2.15
 -0.90 (-1.46 to -0.34)
Accessed national guidelines?
1.81
2.19
 -0.38 (-1.15 to 0.39)
0.058
TOTAL score (maximum 65)
23.50
30.06
-6.56 (-9.95 to -3.17)
0.002