A training process: implication of contest of evidence-based practice application in clinical settings

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Abstract text
Background:
Evidence based practice (EBP) is an important milestone in clinical practice. EBP is regarded as a problem-solving approach to the delivery of care. However, barriers exist when promoting EBP in clinical settings and approaches of five steps in clinical practice were varied among different hospitals.

Objectives:
To examine strengths and limitations of EBP via the latest contest of evidence-based practice.

Methods:
A total of 16 groups participated in the latest EBP contest held in August 2011 in Taiwan. After submission of an EBP report and an oral presentation of EBP steps, comments to each group were obtained, which were from a total of five health care professionals, including physicians, nurses, pharmacologist, and epidemiologist. All comments were reviewed systematically and content analysis was used to examine overall strengths and limitations of EBP.

Results:
Mean scores of different EBP steps varied and ranging from 2.7 to 3.36. The highest mean score fell in the step of evidence search (mean=3.3, range: 1-5), while the lowest mean score fell in the steps of application and audit (means<3). Clinical questions were sometimes misclassified and resulted in misjudged the appropriate level of evidence. Clear definition of intervention in the EBP process is required for it is to be generalisable. Consideration of directness of research findings and clinical context was sometimes ignored. When applying research findings to different clinical contexts, the use of scientific evidence to evaluate cost effectiveness is warranted.

Conclusions:
The present study found that application of EBP in different clinical settings requires continuing in-job training to improve consistency and quality of the practice, in particular on the EBP steps of application and audit. The ways of knowledge translation may need to be viewed as a specific part of EBP education and training.
Authors
Tiao M1
1 Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung , Taiwan
Presenting author and contact person
Presenting author: 
Ling-Ling Lee
Contact person Affiliation Country
Ling-Ling Lee (Contact this person) Tzu Chi College of Technology, Department of Nursing Taiwan
Mao-Meng Tiao (Contact this person) Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung , Taiwan Taiwan