*This post may contain affiliate links, which means I’ll receive a commission if you purchase through my links, at no extra cost to you.*
I think we’d all agree evidence based practice (EBP) is important in the physical therapy profession. This last November the APTA John Maley lecturer, Stacy Dusing, even called for the need for more clinical researchers in the PT field .
However, I think we’d also agree there is a giant chasm between research and its translation into practice. If it’s so important why isn’t it easier? This week’s post is about understanding barriers to EBP and offering some solutions.
Evidence Based Practice, Not as Simple as it Seems
Evidence-based practice is defined as the application of quality clinical research to help make decisions about how we treat patients. Sounds easy enough right? But the process of using EBP is much harder than it sounds.
First, you have to find an article. There are an overwhelming amount of studies out there. However, it can be difficult to find what you’re looking for OR find a quality study. Also, good luck finding one that has the entire article available to you. Sometimes just finding the research is half the battle.
Next you need to read the study and when I say read I mean READ. I’m talking notes in the margins, underlining, highlighting, googling unknown terms, etc. You’re also not going to read it once AND you might have multiple articles you want to read. Get cozy on the couch and hunker down because you’re going to be there awhile!
Assuming you get past the first two steps then you actually have to translate what you read into practice. But do you have the necessary equipment? The time? Did the article explain the intervention clearly enough for you to replicate it? Depending on the answers, what should be the best part of EBP might be the most frustrating
Evidence Based Practice Barriers
So, evidence based practice isn’t as simple as we’d like it to be. Ironically, there are studies on why it’s so hard to implement research study findings into the field. Most show the same recurring issues.
The biggest barrier would probably be lack of time. I mean, there’s for sure not time in the workday to be finding or reading research articles. Pursuing research doesn’t translate into billable units so we’re definitely not about to get time for it.
This means everything is done outside of our 9-5. As I mentioned before, even just searching for articles can take awhile. Add on the time to read and reread and you are an hour plus in the hole.
The problem is most of us don’t have time for that. We have other obligations and hobbies outside of the 9-5 already. Nor is it particularly healthy for us to “PT” all day and then go home and “PT” some more. But the process of using EBP is inherently time consuming.
Another problem is the restricted access to research. Yes, there are many free articles out there. But is it just me or has anyone noticed the studies you always really want to read aren’t available? I feel like most of the new or most applicable research is usually locked under a payment. Which in this day and age is enough for anyone to say “forget it”.
Many of the best databases for PT research require paid subscriptions for full access to some or all of their studies. My personal favorite is the PTJ through APTA, but as I wrote in a previous post, most PTs are not members of the APTA which means they don’t have access.
The last major barrier has to do with low clinician confidence in reading, interpreting, and understanding research. Let’s be honest. Research reading is not light reading. We’re not talking about leisure reading New York Times best selling fiction novel here. The content and wording is very dense, making it mentally taxing. After a full day of patients, that’s probably not most PT’s ideas of “winding down.”
For most of us we’re also not super familiar with research jargon and statistics. We all had research courses in school. However, let’s not kid ourselves. We were too busy worrying about courses like anatomy or neuro that our research course content didn’t probably make the cut into our long term memory.
Getting through an article can be frustrating when you’re not quite sure what every other word or number means. Even if you do get through it, you might not fully understand what the article was telling you. As mentioned before, it’s a lot of work to go through for little to no knowledge to be gained in the end.
I have seen a nice trend lately where researchers will provide an abstract of sorts in layman’s terms. There’s no jargon and it’s less wordy. It reads almost more like an everyday blog post or newspaper article. So it seems researchers are trying to think of ways to close the research-to-practice gap as well.
Tools to Make EBP Easier on You
So how do we make EBP more accessible, digestible, and less time consuming? I did some research on what’s out there for PT evidence based practice resources. Thankfully, I’ve found a few tools that might help simplify things for us all.
- AI Search Engines
AI has gotten a bit of a bad rap in the medical sphere. However, I think we focus primarily on the risks of AI versus how it could benefit us. As we said earlier, half the battle of research is finding what we’re looking for. AI search engines such as Chat GPT are able to perform the leg work of finding research for us.
Now a note about your Chat GPT prompt. Do not say “Find me research …”, instead use “suggest”. I had the most consistent luck if my prompt followed this format:
“Suggest recent PT research articles on . . .”
If you feel like your results aren’t recent enough I you can also modify it to something like this:
“Suggest PT research articles from 2021-2023 on . . .”
Depending on what I typed in my results weren’t always within the year range, but they weren’t far off. This biggest struggle with ChatGPT was that I couldn’t always find access to the whole article.
There is another form of AI I’d recommend. Everbility is an AI documentation assistant made specifically for allied health professionals! Not only does it give several options such as recording, voice transcription, and AI assisted note writing it also has a built-in function they call “assistant”.
The assistant function works very much like ChatGPT where you can provide a prompt and it will find research on specific topics. Everbility’s assistant can synthesize findings and give treatment ideas and recs. The company is constantly fine-tuning this feature. Since the program is geared specifically toward rehab professionals, I imagine this will continue to only get better and more user friendly in the way we as PT professionals need it to be, whereas ChatGPT will continue to be much more generalized.
You can try Everbility for 7 days free or book a demo on their website. If you like it, you’re in luck! Use this link to receive $10 AUD off 3 months or $30 AUD off an annual subscription. Note pricing is based on AUS dollars. There is a month-to-month plan at $50 AUS/mo (about $32 US) or yearly plan at $32/mo AUS ($23 US).
The AI engine route isn’t 100% but it can at least help guide our search vs looking for a needle in a haystack situation. Now even if we find the article we still have to do the work and time of actually reading it. That’s where the next resource comes in.
- PT Inquest Podcast
Podcasting has become a MAJOR media outlet over the last few years. The PT industry has been no exception. The PT Inquest podcast is basically a journal club but solely for PT research!
The hosts choose an article or a topic and few articles about that topic. They discuss the studies and current literature in terms of study quality, integration into practice, and comparisons to previous beliefs on the topic. With over 300+ episodes you’ll likely find something useful. The episodes last about an hour. I’d say that’s a pretty reasonable amount of time. Especially considering by the time we find an article, read it, and interpret the info we’re probably in an hour plus!
We said before it’s also mentally hard to read and ingest the info when reading a research article. Something like the PT Inquest Podcast can make things a little more digestible. Not to mention the flexibility a podcast gives you since you can listen on your way to work, while cooking dinner, or during a workout!
- PT Page Research Week
Surprise! New PT Page announcement! As I was researching for this post I started to wonder what The PT Page could do to help make EBP more accessible. I decided from time to time I’ll be doing a “research week” highlight post.
During research week I’ll be choosing a recently published article (shooting for the last 1-2 years) and posting a summary or discussion of sorts. The articles chosen will focus primarily on treatment interventions. I’ll do a quick run-down of the study – what the authors looked at and how. I’ll also go into any necessary background info that might need some unpacking to better understand the article.
The majority of the post will focus on findings, implications for PT practice, and how we might integrate results into our treatment. My first hope for research highlights is that a blog post will be another more digestible, less time-consuming way for PTs to access research. My 2nd hope is since discussions will focus on using the results it will help start to bridge the gap between current research and its integration into practice.
Got an article you want to see discussed on The PT Page? Requests are now open through the contact page or DM on Instagram @the_pt_page!
You won’t have to wait long for the first research highlight though! It will be out in a couple weeks as the next blog post. Check back to see what article it is!
Evidence based practice will be key in advancing our profession, but it needs to be accessible, digestible, and less time consuming if we want to get it integrated into practice. What other ideas or resources do you have for making EBP easier? Let’s discuss in the comments section. If you missed the last post here it is! And if you want to know the second that PT Page research week highlight is available make sure to hit the “subscribe” button below!
*This post may contain affiliate links, which means I’ll receive a commission if you purchase through my links, at no extra cost to you.*
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