1. College of Occupational Therapy Annual Conference An exploration of the attitudes, knowledge and ability of Occupational Therapists in applying evidence to practice
Samantha Turner
Lecturer in Occupational Therapy
University of Plymouth
@mampy #COT2017

2. Plan for session Provide a brief overview of the article
Identify the main findings
Engage in a critical discussion related to the article
Discuss the recommendations
Identify key learning points to take home
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

3. Overview
Aim- to synthesise the findings from research related to the attitudes, utilisation, knowledge and understanding of evidence-based practice (EBP)
Systematic review using a narrative analysis approach
Published research between within peer reviewed journals
32 papers were selected - 23 quantitative, 8 qualitative and 1 mixed methods design
McMaster critical appraisal tool (Law et al., 1998)
PRISMA flow chart
Greenhalgh (2015) identifies the importance of guiding decision making in practice by having a balance between the use of epidemiological evidence, clinical judgement and the patients’ perspective.
There were a total of 32 papers selected for review. Each of the papers main findings were produced in a clear table. The findings were split into a few main headings- attitudes and values toward EBP, research based practice and traditional methods and education, knowledge surrounding EBP, implementation of EBP, perceived limits and barriers to EBP implementation
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

4. Findings Disparity- attitudes and behaviour Enhances credibility
Attitudes/Values
Research
Education
Implementation
Disparity- attitudes and behaviour
Enhances credibility
Too much effort
Difficult transition
Ensuring up to date knowledge
Time constraints
Inapplicable to practice
Positive in demonstrating effectiveness
Informing knowledge gaps
Client centeredness & EBP
Limited searching & appraisal skills
Higher educational attainment = positive attitude
PG study
Academic hospital
Recent graduates
Consistent results in lack of utilisation
Relying on colleagues
? Difference between OT & other AHP’s
Organisational factors
Years of practice
As you can imagine some of these the findings were the same across the themes.

5. Perceived limits and barriers
Workload/time Pressures
Insufficient staff/resources/finances
Lack of training/knowledge
Lack of organisational support/culture
Relevance/applicability/availability and quality of evidence
Conflict with client centred practice

6. Critical analysis
Is this really a review of EBP in its entirety? (Strauss et al., 2011)
Narrative literature reviews are at risk of confirmation bias
Potential publication bias due to only using peer reviewed articles
Most of the reviewed research used convenience sampling ? Limited representativeness and generalisability
1. The term EBP was used however there was a lack of clarity as to whether the articles reviewed were discussing EBP in relation to the 5 step process or just parts of it
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

7. Recommendations Dedicated staff members Journal clubs Mentoring
Training and education initiatives
Development of future generation
Research collaboration
Potential use of dedicated staff members in organisations who can search for relevant evidence and distribute between staff group
It identifies the use of journal clubs to review evidence
It highlights the importance of using mentoring as a way to support peers in developing these skills
Need for educational and training initiatives to build confidence and skill
Importance of HE institutions developing research confident practitioners
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

8. Discussion
Has this article supported your thinking related to the use of EBP or has it challenged it?
Have you got any further comments in relation to the critique of this review?
How has this article encouraged your thinking about EBP?
Do any of the findings relate to your area of practice?
What ideas could you take from this article to improve EBP in your clinical setting?
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

9. Concluding thoughts…
There is a disparity within our profession related to EBP
While there are a range of barriers there are also a range of opportunities – consider these in your own practice
Could a few minor changes lead to more effective implementation of EBP to benefit the client and our profession?
Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research (Upton et al., 2014)

10. Contact details
Address: Plymouth University School of Health Professions Faculty of Health and Human Sciences Peninsula Allied Health Centre Room SF24 Derriford Road Plymouth PL68BH Tel:

11. Reference list
Critical Appraisal Skills Programme (CASP) (2013) Systematic Review Checklist. Oxford: CASP. Available at:
Greenhalgh, T. (2015) Real vs Rubbish EBM. Available at:
Law, M., Stewart, D., Pollock, N., Letts, L., Bosch, J. & Westmorland, M. (1998) Guidelines for Critical Review Form: Quantitative Studies. Available at: mcmaster.ca/Portals/20/pdf/ebp/quanguidelines.pdf
Strauss, S.E., Richardson, W.S., Glaszious, P. & Haynes, R.B. (2011) Evidence-based medicine: how to practice and teach EBM (4th ed). Edinburgh, Scotland: Churchill Livingstone.
Upton, D., Stephens, D., Williams, B. and Scurlock-Evans, L. (2014) ‘Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research’, British Journal of Occupational Therapy, 77(1), pp. 24–38. Doi: / X