Table 1 Theoretical basis and strategies to address modifiable barriers
Barrier: Lack of confidence/skill searching, appraising and synthesizing research evidence | ||
|---|---|---|
KT intervention | Underpinning theory or group of theories | Strategy/rationale |
Workshop | Problem based learning, learning styles | Workshops used problem based learning approach and a variety of approaches to ensure that different learning styles were catered to, maximizing the likelihood of increased confidence and skill levels |
EAS | Cognitive | Accurate, relevant research evidence on cerebral palsy assessment and treatment was provided via the EAS building skill by modeling synthesis and summary of treatment areas. The EAS bypassed the need for high-level appraisal skills. |
Mentoring | Educational | AHPs were included in the problem solving process during mentoring sessions and aimed to increase confidence and build skill base. |
BARRIER: LACK OF TIME | ||
KT intervention | Group of theories that the intervention relates to | Strategy/rationale |
EAS | Cognitive | The provision of accurate, relevant research evidence bypassed the need for extensive time spent searching and appraising research via databases and journals. |
Paid EBP time in policy | Reimbursement | Paid, protected time for AHPs to engage in EBP activities was provided |
Leadership | Changing policy suggested management ‘buy in’ and endorsement to support changes throughout the organization (leadership theory) | |
Documentation changes including a reminder system | Total quality management (TQM) | Patient documentation and work processes were reorganized to support clinical decision making and save time (reminder systems, checklists and directing participants to the EAS) |
BARRIER: EVIDENCE CONSIDERED AS NOT CLINICALLY RELEVANT | ||
KT intervention | Group of theories that the intervention relates to | Strategy/rationale |
Workshop teaching EAS | Educational | AHPs were involved in the problem solving process, so that they ‘owned’ and were a part of the process and could see the applicability of the EAS. Having the 8 week period in between workshops, allowed independent learning and time to apply the EAS information to a real client |
Motivational | Facilitators aimed to convince AHPs of the relevance of research in their area by exploring the EAS through clinical examples and role playing | |
EAS | Marketing | An appealing product (the EAS) was developed and this was disseminated in a variety of ways (workshop, mentoring, documentation changes) |
BARRIER: NO ACCESS TO FULL ARTICLES AND RESEARCH DATABASES | ||
KT intervention | Group of theories that the intervention relates to | Strategy/rationale |
EAS | Organizational learning | All staff members at every level of the organization had access to current cerebral palsy evidence and exchange of information via mentoring sessions and team meetings was promoted |
BARRIER: SOME STAFF WITH NEGATIVE ATTITUDES TOWARDS EBP | ||
KT intervention | Group of theories that the intervention relates to | Strategy/rationale |
Workshop | Social | Credible staff facilitated workshops, modeled positive attitudes and |
emphasized ‘buy in’ from decision-makers in the organization | ||
Mentoring | Social | Mentors were selected with positive attitudes towards EBP so that target behavior was modeled |