Undergraduate physiotherapy students’ competencies, attitudes and perceptions after integrated educational pathways in evidence-based practice

This mixed methods study was conducted with the goals of exploring perceptions/attitudes, to evaluate knowledge/ skills, investigating clinical behaviours of undergraduate physiotherapy students exposed to a composite education curriculum on evidence-based practice (EBP). Students’ knowledge and skills were assessed prior to and following integrated learning activities, using the Adapted Fresno test, whereas their behaviour in EBP was evaluated by examining their internship documentation. Students’ perceptions and attitudes were explored through four focus groups. Sixty-two students agreed to take part in the study. The within group mean differences (A-Fresno test) were 34.2 (95% CI 24.4 to 43.9) in the first year and 35.1 (95% CI 23.2 to 47.1) in the second year; no statistically significant change was seen in the third year. Seventy-six percent of the second year and 88% of the third year students reached the pass score. Internship documentation gave evidence of PICOs and database searches (95-100%), critical appraisal of internal validity (25-75%) but not of external validity (5-15%). The correct application of these items ranged from 30 to 100%. Qualitative analysis of the focus groups indicated students valued EBP, but perceived many barriers, with clinicians being both an obstacle and a model. Key elements for changing students’ behaviours seem to be internship environment and the potential of ongoing practice and feedback.