ABSTRACTCHALLENGES FOR THE IMPLEMENTATION OF EVIDENCE-BASED RESEARCH PROTOCOL INTO THE OUTPATIENT PHYSICAL THERAPY SETTINGByMarge TaylorEvidence-based practice has been identified as a vital component of clinical effectiveness which requires the clinician to select the most effective treatment based on research findings and clinical experience (Bury, 1998). While the last decade has shown a significant increase in the volume and accessibility of high-quality clinical research (Maher et al., 2004), the transition of PTs utilizing EBP clinically has not kept pace (Metcalfe et al., 2001; Turner & Mjolne, 2001). The purpose of this study was to provide PTs with a real time EBP workshop training and then qualitatively assess two main questions (1) What challenges do the PTs encounter when implementing the evidence-based graded activity for CLBP patients in the outpatient physical therapy setting? and (2) What recommendations do the PTs have to overcome the identified challenges?Semi-structured interviews were completed on a total of 28 PTs employed in outpatient physical therapy settings in the Great Plains area prior to the workshop training, midway and at the completion of implementation. Analysis of the data demonstrated four major themes. Three of the themes, (1) PT buy-in, (2) lack of fit for individual patient, and (3) administrative aspects of clinic, confirmed that the PTs encounter challenges when attempting EBP implementation. While the lack of fit for individual patient and administrative aspects of clinic were challenges previously identified in the literature, the challenge of PT buy-in was not previously mentioned. The theme, PT buy-in, noted that the transition toward improving EBP will require the PTs to alter their behavior. In addition, the subtheme, successful implementation, showed that the process of implementation is needed to further progress the PTs behavioral change and move them closer to PT buy-in. Much less information was shared by the PTs to answer the second research question to provide recommendations to overcome identified challenges. These data were shown in one major theme, requires educating others about protocol, and one subtheme, motivation to change under the theme of PT buy-in. While few in number the recommendations provided important insight. The transition toward EBP is not a solo event involving just PT and patient. Many others can influence the outcome such as the medical community, general public, co-workers, administrators and insurance companies. The subtheme, motivation to change, further highlights the need to influence the PTs level of commitment in order to transition toward EBP. Effective transition toward EBP for PTs will require altering the present continuing educational model. Further research is needed to explore which elements will effectively reach out to all concerned parties while providing motivation for PTs to change their clinical practice.
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