Randomised Trial of Two Educational Intervention for Improving Evidence-based Practice Knowledge, Atttitudes and Practice

NCT01512823 | Completed

• 1 other identifier: REC REF: 259/2006
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

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

Conditions

Health Knowledge, Attitudes, Practice

Keywords

randomised controlled trial; educational intervention; occupational therapy

Outcome Measures

Primary Outcomes (1)

• Shortened Fresno Test of Competence in Evidence-based Practice (SAFT)

  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.

  12 weeks

Secondary Outcomes (1)

• Audit checklist

  12 weeks

Study Arms (2)

Interactive educational intervention

EXPERIMENTAL

Two education sessions (four-hours and two-hours respectively), emailed notes and reminders

Behavioral: Education

Didactic educational intervention

EXPERIMENTAL

Education alone

Behavioral: Education

Interventions

Education BEHAVIORAL

Interactive educational intervention: * 4 hour education session (with notes and 'evidence packs'); presentations, small group discussion tasks and practice of particular skills - 2 hour session (1 week later) * Emailed notes from second session * Telephonic/email follow-up (reminders) Didactic educational intervention: \- 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills

Didactic educational intervention; Interactive educational intervention

Eligibility Criteria

• Age: 21 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Occupational therapists employed by the Western Cape Department of Health (DOH)
• Working at least 20 hours per week

You may not qualify if:

• 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

Sponsors & Collaborators

• University of Cape Town: lead
• National Research Foundation of South Africa: collaborator

Study Sites (1)

University of Cape Town

Cape Town, Western Cape, 7925, South Africa

Location

Related Publications (2)

• Buchanan H, Jelsma J, Siegfried N. Measuring evidence-based practice knowledge and skills in occupational therapy--a brief instrument. BMC Med Educ. 2015 Oct 30;15:191. doi: 10.1186/s12909-015-0475-2.

  PMID: 26519165 DERIVED

• Buchanan H, Siegfried N, Jelsma J, Lombard C. Comparison of an interactive with a didactic educational intervention for improving the evidence-based practice knowledge of occupational therapists in the public health sector in South Africa: a randomised controlled trial. Trials. 2014 Jun 10;15:216. doi: 10.1186/1745-6215-15-216.

  PMID: 24916176 DERIVED

MeSH Terms

Conditions

Behavior

Interventions

Educational Status

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics

Study Officials

• Helen Buchanan, PhD

  University of Cape Town

  PRINCIPAL INVESTIGATOR

• Nandi Siegfried, PhD

  South African Cochrane Centre & University of Cape Town

  STUDY DIRECTOR

• Jennifer Jelsma, PhD

  University of Cape Town

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: January 13, 2012
• First Posted: January 19, 2012
• Study Start: November 1, 2007
• Primary Completion: January 1, 2009
• Study Completion: March 1, 2011
• Last Updated: February 6, 2012

Record last verified: 2012-02

Locations

ZA (1)