Teaching Evidence-Based Practice in a Distance Education Occupational Therapy Doctoral Program: Strategies for Professional Growth and Advancing the Profession

ABSTRACT

The Centennial Vision of the American Occupational Therapy Association (AOTA) projects that by 2017 all occupational therapy (OT) practice areas will be supported by evidence. Achieving this goal requires preparing clinicians with the skills to assimilate, analyze, and apply research to their areas of practice and communicate the value of OT services to consumers and payers. These skills are at the heart of evidence-based practice (EBP). Educators must be prepared to teach EBP skills in both entry-level and postprofessional programs. This article outlines how EBP can be taught to postprofessional occupational therapy clinical doctoral students using a distance education format. Key features of a successful EBP course include having access to full-text electronic articles, opportunities for students to explore the literature in their own areas of interest, consistent and timely feedback on written work and discussion topics, and opportunities to collaborate with peers.     

The effect of education with workplace supports on practitioners' evidence-based practice knowledge and implementation behaviours

Background/aim: Individual and workplace barriers affect uptake of evidence‐based practice (EBP). This study evaluated the effects of a 1‐day workshop with workplace supports on allied health professionals’ EBP knowledge and behaviour. Methods: A prospective longitudinal pre‐post design was used. A total of 88 allied health professionals participated. Knowledge was measured using the Adapted Fresno Test (AFT), behaviour was measured using frequency counts of presentations using EBP methodologies and critically appraised topics (CATs) were produced. Mean differences were analysed using paired t ‐tests. Results: EBP knowledge significantly improved immediately after education on the AFT (from 36.67 to 46.84/156) a mean change of 10.17 points (95% confidence interval (CI): 7.19–13.50) ( P < 0.001). Behaviour also changed over 18 months. EBP content in presentations increased from 3 to 100% ( t = 24.39, P < 0.001, 95%CI: 0.86–1.03). CATs produced significantly increased by 0.26 per head ( t = 5.55, P < 0.001, 95% CI: 0.17–0.35). Conclusions: Education with workplace supports (supervision, incentives, resource allocation and working groups) may lead to improvements in EBP knowledge and implementation.     

Faculty training in evidence-based medicine: improving evidence acquisition and critical appraisal

INTRODUCTION: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are therefore unable to demonstrate this process for students and residents. METHODS: We conducted a yearlong case-based EBM workshop for 28 clinician educators, with precourse and postcourse evaluations of EBM resource use and literature appraisal skills. RESULTS: Of the original 28 participants, 26 completed the course. Self-assessed EBM resource use improved significantly. Self-reported EBM knowledge correlated with measured skill (r = 0.45), and both improved with the intervention (both p < .001). Higher EBM skills scores correlated with time logged on the course's EBM Web sites (r = 0.56; p < .05), workshop attendance rates (r = 0.55; p = .003), and fewer years since medical school graduation (r = -0.56; p < .005). DISCUSSION: An interactive, longitudinal, EBM course derived from a needs assessment can improve 2 skills important for evidence-based practice: online literature retrieval and critical appraisal skills.     

Changing social and HIV/AIDS risk behaviours: Effects of life skills education among urban street youths

Abstract

The objective of this study was to examine the effect of a life skills education intervention among male and female youth in Ibadan, Nigeria, on knowledge about prevention and safe sexual practices, sexual roles and responsibilities, HIV/AIDS, money management, assertiveness and communication through follow-up interviews four weeks and eight weeks following the intervention. The participants were 98 males and females, and part of an initial survey of social and health problems of street youths in Ibadan, Nigeria. They were locality-separated, with consecutive assignments to two groups of experimental (n?=?54, exposure to a manual driven life skills education) and control (n?=?44, non-exposure to life skills education, but attention given) participants, and evaluated subsequently at four weeks and then at eight-week follow-ups. At the four-week post-intervention assessment, the experimental group showed significantly increased scores in the knowledge of antisocial behaviour prevention (p < 0.01), about HIV/AIDS (p < 0.001), about safe sexual practices (p < 0.001), about social roles and responsibilities and about assertiveness and communication (p < 0.01). At eight-week follow-up assessment, substantial significant reductions in reported antisocial and unsafe sexual behaviours were observed across the experimental group compared with the control group. The results suggest that street youths can be empowered through life skills education but with limitation to safe sexual practices over a sustained period of time in Nigeria.     

Assessing Cultural Intelligence and Study Abroad Experiences of Dietetics Students and Professionals

ObjectiveTo assess the relationship between study abroad participation and levels of cultural intelligence (CQ) of dietetics students and professionals.MethodsParticipants were recruited via e-mail to complete an online survey, which included the Cultural Intelligence Scale and an additional 21 items developed and partially validated by the researchers. A mixed-method analysis was used to examine relationships between CQ levels, study abroad program participation, and international travel experiences.ResultsParticipation in study abroad programs and international travel experiences were related to higher levels of CQ in metacognitive (P = 0.003; P < 0.001), cognitive (P = 0.001; P = 0.001), motivational (P < 0.001; P < 0.001), and behavioral (P = 0.02; P < 0.001) dimensions.Conclusions and ImplicationsResults suggest that participation in study abroad programs and international travel experiences may result in high CQ levels and may equip students and practicing dietitians with skills, knowledge, and resources for practicing in culturally diverse communities. Future experimental research implementing study abroad programs and international travel opportunities for this population may help determine how these experiences impact dietetics practice in the long term.     

Occupational noise exposure and hearing loss: A study of knowledge,attitude and practice among Tanzanian iron and steel workers

Abstract

We assessed Knowledge Attitude and Practice (KAP) regarding occupational noise exposure, Noise-induced hearing loss, audiometry and use of hearing protection devices among iron and steel factory workers exposed to high noise level. A modified, validated, structured questionnaire was used to collect information from 253 male workers randomly selected from the four factories. The sum scores for each domain of KAP were computed. Scores above 75% were defined as good knowledge and positive attitude. For practice, scores of >50% were defined as good. Independent samples t-test and Chi-squared test were used to analyze association between KAP and continuous/categorical variables respectively. Majority of workers displayed poor knowledge and poor practice (94%), but 76% displayed a positive attitude. Most of the workers (86%) had never been provided with hearing protection devices. The mean scores for attitude and practice differed significantly between the four factories (one-way ANOVA, p?<?0.001). Implementation of hearing conservation program with provision of hearing protection devices are suggested.     

Alcohol and adolescents: Knowledge,attitudes, and behavior

Students (n = 3017) from the 6th, 8th, 10th, and 12th grades in six school districts throughout Georgia and South Carolina completed a questionnaire to determine their knowledge, attitudes, and behavior regarding alcohol use. Results suggest that knowledge, attitudes, and behavior are significantly correlated. Two distinct attitudes were discovered: acceptable use of alcohol and unacceptable uses of alochol, and these interacted with knowledge and behavior in different ways. Students who reported school as their major source of information about alcohol were more knowledgeable and had the most conservative attitudes toward unacceptable use of alcohol (p < 0.001). White students scored higher on the knowledge test and had more liberal attitudes than minority students (p < 0.001). Females were more conservative than males (p < 0.001), and older students had more liberal attitudes (p < 0.001). Our results suggest that efforts to educate youth about alcohol should incorporate acceptable uses as well as the negative aspects of drinking.     

Integrating the Centennial Vision Into an Evidence-Based Fieldwork-Learning Experience

ABSTRACT

Occupational Therapy's Centennial Vision includes the concept of evidence-based practice (EBP) as a core mechanism to move the profession forward. The literature reveals that although EBP has become an expected norm by occupational therapy consumers and payers, it is difficult to implement secondary to a variety of issues. The implementation and use of an EBP fieldwork experience within the physical disabilities context require problem-based and collaborative learning approaches. Fieldwork students complete 15 practitioner-facilitated EBP modules regarding performance approaches specific to the fieldwork site. The response of the participants suggests that EBP can have a positive impact on new knowledge acquisition and its application to new clinical skills. Future program goals include the development of more in-depth outcome measures to ascertain the effectiveness of a fieldwork clinical-learning module program.     

Effectiveness of Music in Enhancing Nutrition Education Outcomes Among Adolescents

ObjectiveTo determine the effectiveness of healthy eating songs (HES) in improving adolescents’ healthy eating knowledge, attitude, and practice.DesignPretest-posttest quasi-experimental nonequivalent group design. Students from 2 of the selected schools (n = 37 and n = 35) received nutrition education using conventional classroom instruction and HES, whereas the other 2 (n = 30 and n = 31) received theirs using conventional classroom instruction only.SettingIbadan, Nigeria.ParticipantsA total of 133 students selected from 4 junior secondary schools participated in the study.Main Outcome MeasuresChanges in healthy eating knowledge, attitude, and practice at the school level.AnalysisIndependent t tests were used for analyzing summary data, whereas the linear mixed model was used to analyze the fixed effects of predictor variables at P < 0.05.ResultsNutrition education had a significant effect on knowledge (F = 65.7, P < 0.001), attitude (F = 85.2, P < 0.001), and practice (F = 131.5, P < 0.001). Improvement in knowledge, attitude, and practice was observed in both groups. However, the intervention group performed better than the comparison group in knowledge (95% confidence interval [CI], ?0.1 to 2.8), attitude (95% CI, 1.7–9.7), and practice (95% CI, 2.8–5.8). Geographical location had a significant effect on knowledge (F = 7.1, P = 0.005). Interaction effect of treatment and geographical location was significant on knowledge and attitude of students.Conclusions and ImplicationsThe use of HES may be an effective way of improving adolescents’ healthy eating knowledge, attitude, and practice. However, testing culturally appropriate HES in more diverse audiences is warranted.     

Evaluating the Long-Term Impacts of an Applied Interdisciplinary Product Development Curriculum on Food Science,Nutrition, and Packaging Science Undergraduate Students

ABSTRACT

The research objective was to evaluate the long-term impacts of an Applied Interdisciplinary Product Development (AIPD) curriculum on students’ self-confidence in product development skills and knowledge in various disciplines other than their own. The results of the Subject Knowledge Assessment (SKA) showed that students who completed the AIPD course did not have significantly different scores from the comparison group (P 0.05). However, significant differences were found between the treatment and comparison groups for five of the nine statements pertaining to confidence in product development skills on the Exit Questionnaire (EQ; P < 0.05). Results from the focus groups conducted with students who participated in the AIPD course supported the results of the EQ and SKA. Therefore the conclusion can be made that students who completed the AIPD course have maintained their advanced skill level over their peers in such areas as product development skills and soft skills.     

A Trial of an All‐Terrain Vehicle Safety Education Video in a Community‐Based Hunter Education Program

Purpose: All‐terrain vehicle (ATV) injury is an increasingly serious problem, particularly among rural youth. There have been repeated calls for ATV safety education, but little study regarding optimal methods or content for such education. The purpose of this study was to determine if an ATV safety video was effective in increasing ATV safety knowledge when used in a community‐based statewide hunter education program. Methods: During the baseline phase, surveys focusing on ATV safety were distributed to students in the Arkansas hunter safety program in 2006. In the intervention phase a year later, an ATV safety video on DVD was provided for use in required hunter education courses across Arkansas. The same survey was administered to hunter education students before and after the course. Findings: In the baseline phase, 1,641 precourse and 1,374 postcourse surveys were returned and analyzed. In the intervention phase, 708 precourse and 694 postcourse surveys were completed. Student knowledge of ATV safety after watching the video was higher than in preintervention classes. Knowledge of appropriate helmet usage increased from 95% to 98.8% (P < .0001). Awareness of the importance of not carrying a passenger behind the driver increased from 59.5% to 91.1% (P < .0001). Awareness of importance of hands‐on ATV rider training increased from 82.1% to 92.4% (P < .0001). Conclusions: A brief ATV safety video used in a hunter education course increased ATV safety knowledge on most measures. A statewide hunter education program appears to be a useful venue for ATV safety education.     

Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España

ObjectiveTo describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors.DesignCross-sectional, national survey design, carried out between January and March 2020.SettingPC in Spain.ParticipantsSeven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience.Main measurements(1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out.ResultsThe mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150 h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization.ConclusionsThese findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results.     

Midwives’ knowledge,attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study

IntroductionDespite the enormous benefits of childhood and maternal immunisation to individual and population health, the uptake of maternal vaccines during pregnancy remains suboptimal. Midwives are a trusted information source for parents and play an important role in the provision of immunisation information. Understanding midwives’ attitudes and vaccine knowledge, along with their confidence to discuss maternal and childhood immunisation with parents, is key to reducing parental decisional conflict and achieving immunisation goals.MethodsAn online study was conducted to investigate midwives’ knowledge and attitudes towards maternal and childhood vaccination along with their confidence to answer parents' vaccine-related questions. Midwives were recruited by email via the midwifery peek body, the Australian College of Midwives.ResultsA total of 359 midwives completed the online survey. The majority of midwives supported maternal (influenza 83%, pertussis 90.5%) and childhood immunisation (85.8%); however, 69.4% of respondents wanted further training about immunisation. Midwives who felt their midwifery education adequately covered immunisation were more confident advising parents about maternal (p = 0.007) and childhood immunisation (p < 0.001). Similarly, Midwives were significantly more likely to confidently advise parents about maternal (p < 0.001) and childhood immunisations (p < 0.001) if they had completed a specific immunisation training course outside of their midwifery course.ConclusionMost midwives working in Australia support vaccination. However, access to contemporary, culturally appropriate education that enables midwives to engage confidently with parents about immunisation is lacking. Education based on a women-centred approach within the pre-registration curriculum along with continuing professional development programs could enable midwives to reduce the evidence to practice gap by increasing vaccine uptake.     

Urban–Rural Differentials in Overweight and Obese Individuals with Diarrhea in Bangladesh

Objective: The study aimed to determine urban and rural differences in overweight and obesity (OO) with diarrhea regarding subjects’ sociodemographic, clinical characteristics, etiology, and antimicrobial susceptibility.

Methods: Relevant information from 2000 to 2011 were extracted from the data archive of the Diarrheal Disease Surveillance System of urban Dhaka (1248, 4.5%) and rural Matlab (615, 3.4%) hospitals of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b).

Results: The proportion of OO significantly increased in both urban (3–7%; chi-square for trend p < 0.001) and rural (1–6%; p < 0.001) areas over the study period. In multivariate modeling, monthly income more than US$100 (odds ratio [OR] = 54.44, 95% confidence interval [CI], 25.37–116.82, p < 0.001), high wealth quintile (OR = 18.23, 95% CI, 8.63–38.49, p < 0.001), access to sanitary toilet (OR = 3.07. 95% CI. 1.76–5.26. p < 0.001), boiled drinking water (OR = 2.77, 95% CI, 1.09–7.05, p = 0.032), antimicrobial use before hospitalization (OR = 4.99, 95% CI, 2.85–8.74, p < 0.001), fever (OR = 0.14, 95% CI, 0.37, 0.50, p < 0.001), watery stools (OR = 5.59, 95% CI, 2.11–14.80, p < 0.001), dehydrating diarrhea (OR = 5.17, 95% CI, 2.54–10.52, p < 0.001), intravenous saline infusion after hospitalization (OR = 2.65, 95% CI, 1.28–5.49, p = 0.009), and Salmonella infection (OR = 0.20, 95% CI, 0.50–0.83, p = 0.027) remained significantly associated with urban OO individuals. At least 88% of Shigella isolates were susceptible to ciprofloxacin in both urban and rural areas; for mecillinum it was 90%. Ciprofloxacin had the least detected resistance for Vibrio cholerae (0%) and trimethoprim-sulfamethoxazole (TMP-SMX) showed the greatest resistance (Dhaka 86%; Matlab 98%). Susceptibility for Salmonella showed ampicillin (95%), chloramphenecol (100%), ciprofloxacin (95%), ceftraxone (93%), TMP-SMX (95%) at both sites.

Conclusion: Urban OO with diarrheal illnesses was significantly different from that in rural areas, including antimicrobial susceptibility.     

Impact of a short,culturally relevant training course on cancer knowledge and confidence in Western Australia's Aboriginal Health Professionals

Objective: To develop, deliver and evaluate a cancer education course for Indigenous Health Professionals. Method: The cancer education course combines expert presentations, interactive sessions and visits to local cancer treatment centres. Three four‐day courses have been run, in both metropolitan and regional Western Australia (WA). Cancer knowledge and confidence were measured at baseline, course completion and at follow‐up (six to eight months). Data were analysed within subject. Results: Thirty‐five Aboriginal Health Professionals have completed the program, most from rural or remote WA. All confidence items significantly improved at course completion (p<0.005), but improvements for only two items, ‘I know what cancer is’ and ‘I can describe the different common cancers’, were sustained at follow‐up (p<0.05). Knowledge of treatment (p<0.05), screening (p<0.05) and the most common cancers in women (p<0.005) were significantly greater after course completion, but increased knowledge was not sustained at follow‐up. Conclusion: Demand for places suggests that Aboriginal Health Professionals are interested in developing knowledge, skills and confidence in cancer control. Attendance increased understanding of cancer and improved cancer knowledge however this was not maintained. Implications: A short, culturally relevant training course increases cancer knowledge and confidence, however, ongoing education is needed to maintain this.     

Consumer knowledge and attitudes about genetically modified food products and labelling policy

Abstract

The purpose of this study was to examine the relationship between consumer knowledge, attitudes and behaviours towards foods containing genetically modified organisms (GMOs) and the prevalence of GMO labelling in northern New Jersey supermarkets. This cross-sectional study surveyed 331 adults, New Jersey supermarket customers (mean age 26 years old, 79.8% women). The results show a strong, positive correlation between consumer attitudes towards foods not containing GMOs and purchasing behaviour (Pearson’s r?=?0.701, p?<?0.001) with lesser correlations between knowledge and behaviour (Pearson’s r?=?0.593, p?<?0.001) and knowledge and attitudes (Pearson’s r?=?0.413, p?<?0.001). GMO labelling would assist consumers in making informed purchase decisions.     

Analysis of risk and protective factors for psychosocial distress among in-school adolescents in Tanzania

Introduction

Psychosocial distress has emerged as one of the world’s major public health problems, especially among adolescents in both low- and middle-income countries. This study used data from the 2015 version of the Global School-Based Health Survey to determine the risk and protective factors for psychosocial distress among in-school adolescents in Tanzania.

Materials and methods

Chi-square and logistic regression analyses were used to estimate the magnitude of associations. A total of 2936 students participated in the study, of which 52.3% were female.

Results

Psychosocial distress was found in 16.9% of the students at similar rates for both males and females. The risk factors associated with psychosocial distress were hunger (OR?=?1.57, p?<?0.001), being bullied (OR?=?1.92, p?<?0.001), being attacked (OR?=?1.31, p?<?0.05), engaging in physical activity (OR?=?1.33, p?<?0.05), truancy (OR?=?1.28, p?<?0.05) and tobacco use (OR?=?2.40, p?<?0.01). However, the protective factors were grade (OR?=?0.55, p?<?0.01) and having one or two (OR?=?0.56, p?<?0.01) and three or more close friends (OR?=?0.57, p?<?0.01).

Conclusions

The prevalence of psychosocial distress among adolescents in Tanzania is relatively high and appears to be common among both sexes. To reduce psychosocial distress among in-school adolescents, more attention needs to be paid to the risk factors whiles encouraging healthy relationships among adolescents and their close friends.

     

The association between undergraduate occupational therapy students’ listening and interpersonal skills and performance on practice education placements

Background: Communication skills such as listening, empathy and body language are core competencies that entry level occupational therapy students must demonstrate when completing practice placements.

Objective: To investigate if interpersonal skills taught to undergraduate occupational therapy students predict their practice performance.

Methods: Second, third and fourth year occupational therapy students (n?=?132) completed the Active-Empathetic Listening Scale (AELS); the Listening Styles Profile-Revised (LSP-R); and the Interpersonal Communication Competence Scale (ICCS). The Student Practice Evaluation Form–Revised (SPEF-R) measured students’ performance at the completion of a placement. Regression analysis examined the relationships between students’ interpersonal and listening skills and their fieldwork performance.

Results: Higher ICCS Interaction Management subscale scores were significantly associated with better SPEF-R Communication Skills at final evaluation (β?=?1.46, p?<?0.05). Higher AELS Sensing subscale scores were predictive of greater Self-Management Skill performance on the SPEF-R (β?=?0.84, SE?=?0.42). Student’s demographic characteristics were also predictive of their SPEF-R scores. The ICCS and LSP-R’s subscale scores were not predictive of SPEF-R scores.

Conclusion: This preliminary evidence identified several interpersonal skills that were predictive of some key SPEF-R competencies. To better prepare students to successfully complete practice placements, these interpersonal skills should be incorporated into occupational therapy education curriculum.     

The Effect of AIDS Peer Health Education on Knowledge,Attitudes, and Practices of Secondary School Students in Khartoum,Sudan

BackgroundPeer education seeks to enroll students in persuasive communication programs aiming at AIDS prevention. Providing information about AIDS prevention methods can lead to behavioral change and also a potential reduction in unsafe sexual behavior, particularly among young people.ObjectiveThis study aims to assess the role of peer education interventions in improving awareness, attitudes, and practices of secondary school students and peer educators towards AIDS.MethodsThis is a pre-and post-study. The study was conducted among 400 students who were randomly selected from 10 gender-balanced schools. They received the information from trained peer educators. 200 peers carried out the intervention (20 peers from each school), which was conducted in phases. The intervention required coordinating with official concerned stakeholders, preparing teaching aids, and four days of training workshops for the peer educators. The data was analyzed using the Statistical Package for Social Science program (SPSS). A paired sample t-test was obtained and utilized to interpret the changes observed in pre- and post-intervention knowledge, attitude, and practice.ResultsThe study showed that the intervention program improved participants'' knowledge from 75.5% to 83.2%. This improvement was with specific regard to the following: the causative agent of AIDs (p = 0.017), which improved from 77.7% to 81.5%; the spread of HIV through mosquitos (p = 0.001), which showed an increase from 12.7% to 23.8%; the program focused on the concept of the HIV carrier (p = 0.001), and also on the AIDS risk when having multiple sex partners, (p = 0.001), showing an increase of 47.5% to 83.5%. Following the knowledge test, the attitudes of students significantly increased from 70% to 83% with regards to youth vulnerability to HIV (p = 0.001), while scored dropped from 15.7% to 8.5% concerning the topic of HIV voluntary testing (p = 0.001). The practices of students changed from 70% to 83% when prompted about shaking the hands of an HIV infected person and also from 84.8% to 87.7% about sharing food with an HIV infected person (p > 0.05).ConclusionThe study concluded that school peer education is an effective approach to inform students of unsafe sexual behavior with regards to HIV/AIDS. It is clear that peer education enables significant improvements to be made with regards to the knowledge, attitudes, and practices of the students.