Insights Gained from Assessment of Research Bias and Reported Utilization of Evidence after a Specialized Training Program
Knowledge Translation of disability and rehabilitation research to practice, consumers, and policy
This study assessed clinician bias toward research, and examined the relationship between self-reported bias and reported utilization of evidence in the clinic after attending a NIDRR-funded training program as part of the Rehabilitation Research and Training Center on Secondary Conditions in Individuals with SCI (H133B0900, PI James Krause, PhD).
Purpose: The purpose of this study was to evaluate the utilization of evidence provided to clinicians during a specialized training program. The goal of the conference was to train clinicians in Level I, II and III trauma centers in South Carolina regarding prevention of secondary conditions prior to the rehabilitation hospitalization and in the years and decades following SCI onset (long term secondary conditions among those who present for services as outpatients).
Methods: Participants who attended the conferences (n=2) provided by Shepherd Center investigators and educators were asked to participate in this study, and consent was based on completion of the written questionnaires. Immediately prior to the conference, participants completed the “Research Utilization Questionnaire (RUQ)” ,developed by Champion and Leach in 1989 (Sudsawad 2007) to assess the attitudes of clinicians toward research, the use of research, the support the clinician has in their work environment, and the availability of resources to obtain current evidence. The RUQ addresses some of the barriers to utilization of evidence in the clinic, and allowed us to assess whether the use of research and knowledge of research can change a clinicians’ attitude or behavior toward obtaining and using new evidence in practice. Immediately prior to the half-day conference, immediately following, and within one year after attending the conference, participants also completed the “Clinical Practice Questionnaire (CPQ)”. The CPQ is based on the “Nurse Practitioner Questionnaire” (Brett 1987) and assesses the clinicians’ awareness, attitude, implementation, and understanding of policies/procedures in a specific clinical area, or particular clinical practice. The conference focused on management in four clinical areas for people with spinal cord injury (SCI): bowel/bladder, skin care, spasticity, and autonomic dysreflexia. The CPQ poses seven questions about each of these clinical areas. Information was collected immediately on paper at the conference, and via electronic (email) interaction in the time following the conference. All data was entered into a spreadsheet and analyzed for trends and statistically significant changes pre, post and post-post (within one year) training.
Results: Data was collected on-site at the conference from 95 participants (both pre-and post), and from 21 participants within one year after the conference (post-post). Participants included occupational therapists, physical therapists, registered nurses, licensed practitioners, physicians, physical therapist assistants, and certified athletic trainers. The data suggest a difference in attitudes and bias toward research across the different disciplines of care, as well as different patterns of utilization of the information provided during the conference in clinical care.
Conclusion: Although our findings support the mechanism of training used in these conferences for translating evidence into practice for some participants, they also suggest that research bias, and availability of resources and administrative support impact the utilization of evidence in clinical practice. This information can be used to tailor the development of resources and educational programs for the different disciplines so as to improve translation and utilization of research findings into clinical practice for the best outcomes for our patients.