Randomised Trial of Two Educational Intervention for Improving Evidence-based Practice Knowledge, Atttitudes and Practice (OTEBP)
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Purpose
This pragmatic randomised controlled trial (RCT) used a two-group parallel design with matched-pair stratification by type (clinician/manager) and knowledge score. The trial aimed to: 1) determine whether an IE was more effective than a DE for improving EBP knowledge, skills and use at 12 weeks, and 2) to investigate the feasibility of conducting a RCT with occupational therapists in a public health setting. Occupational therapists employed by the Western Cape Department of Health (DOH) form,ed the study population(N=98). Fifty-eight consented to participate and were randomly allocated to either an interactive (IE) or a didactic (DE) educational intervention using coin tossing. Data was collected at baseline and 12 weeks The primary outcome was increased EBP knowledge at 12 weeks shown by an improved total knowledge score. Secondary outcomes were improved attitudes and behaviour. Data were collected at the health facilities where participants were employed. Raters for the audit were blinded but participants and the provider could not be blinded.
Thirty participants were allocated to receive the IE and 28 the DE. Twenty-five participants in the IE and 21 in the DE completed the trial and were included in the 12 week analysis. Results revealed no significant difference between the groups in the primary knowledge outcome at 12 weeks. Examination of within-group changes revealed significant improvements in knowledge in both groups (IE: T=4.0, p<0.001; DE: T=12.0, p=0.002), but the IE also showed a significant increase in behaviour (T=64.5, p=0.044) and attitudes on one sub-scale (T=33.0, p=0.039). As the study was powered at 43%, it may have failed to detect significant differences at 12 weeks. Conducting a high-quality RCT was feasible and the risk of bias was assessed as low. The OTEBP trial adds strength to the existing evidence that both didactic and interactive educational interventions can improve knowledge, but it seems that interactive interventions may be more effective for changing behaviour. High-quality pragmatic trials can feasibly be conducted within the public health service
| Condition | Intervention |
|---|---|
|
Health Knowledge, Attitudes, Practice |
Behavioral: Education |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) |
| Official Title: | Randomised Trial of the Effectiveness of Two Educational Interventions to Improve Evidence-based Practice Knowledge, Attitudes and Behaviour in Occupational Therapists |
- Shortened Fresno Test of Competence in Evidence-based Practice (SAFT) [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]Modified from the Adapted Fresno Test of Competence in EBP (AFT) (McCluskey and Bishop, 2009), the SAFT consists of three items testing knowledge of writing a PICO question based on a clinical scenario, ability to identify the most suitable study design to answer the question, and knowledge of possible sources of information. The total possible score is 30 points. The test is scored using a grading rubric. Two versions are availbale for measuring outcomes of educational interventions.
- Audit checklist [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]9-item checklist for auditing patient records to determine the extent to which occupational therapists monitor the effectiveness of their interventions.
| Enrollment: | 58 |
| Study Start Date: | November 2007 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | January 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Interactive educational intervention
Two education sessions (four-hours and two-hours respectively), emailed notes and reminders
|
Behavioral: Education
Interactive educational intervention:
Didactic educational intervention: - 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills |
|
Experimental: Didactic educational intervention
Education alone
|
Behavioral: Education
Interactive educational intervention:
Didactic educational intervention: - 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills |
Eligibility| Ages Eligible for Study: | 21 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Occupational therapists employed by the Western Cape Department of Health (DOH)
- Working at least 20 hours per week
Exclusion Criteria:
- Working at a distance of more than 1½ hours from Cape Town
- Therapists who would be leaving the DOH before December 2008 or taking leave during the time of the intervention
Contacts and Locations| South Africa | |
| University of Cape Town | |
| Cape Town, Western Cape, South Africa, 7925 | |
| Principal Investigator: | Helen Buchanan, PhD | University of Cape Town |
| Study Director: | Nandi Siegfried, PhD | South African Cochrane Centre & University of Cape Town |
| Study Director: | Jennifer Jelsma, PhD | University of Cape Town |
More Information
No publications provided
| Responsible Party: | Helen Buchanan, Principal investigator, University of Cape Town |
| ClinicalTrials.gov Identifier: | NCT01512823 History of Changes |
| Other Study ID Numbers: | REC REF: 259/2006 |
| Study First Received: | January 13, 2012 |
| Last Updated: | February 3, 2012 |
| Health Authority: | South Africa: University of Cape Town |
Keywords provided by University of Cape Town:
|
randomised controlled trial educational intervention occupational therapy |
ClinicalTrials.gov processed this record on May 16, 2013