Pilot project for evidence-based physical therapy reveals the difficulty of applying evidence in the real world.

A new report, Strategies to Promote Evidence-Based Practice in Pediatric Physical Therapy: A Formative Evaluation Pilot Project, shows just how hard it can be to take research from theory to practice. The authors, Joe Schreiber, Perri Stern, Gregory Marchetti, and Ingrid Provident, discovered that even well-meaning people say they have little time -- and few incentives -- to follow evidence-based practices. *Sigh.*

The article is being published in Physical Therapy Online. Here are some highlights: "The physical therapy profession has been perceived as one that bases its practice largely on anecdotal evidence.... Physical therapists have been urged to increase evidence-based practice behaviors as a means to address this perception and to enhance the translation of knowledge from research evidence into clinical practice." This project evaluated strategies for encouraging people to integrate scientific evidence into their decision-making. In this pilot project, five participants collaborated on implementing techniques to enhance their use of evidence. Outcomes were analyzed qualitatively.

Show me the evidence. I wonder how the evidence was made available to the therapists? Was it at their fingertips, and did they have access to synthesized summaries? The abstract mentions "modest self-reported improvements in evidence-based practice behaviors, such as reading journal articles and completing database searches." Since I don't know the details of the situation, I can't conclude anything -- though at first glance, this doesn't sound like the ideal way to get evidence into practitioners' hands, and to get them to actually apply it.

Findings: "The participants were able to implement several, but not all, of the strategies and made modest self-reported improvements in evidence-based practice behaviors, such as reading journal articles and completing database searches. They identified several barriers, including a lack of time, other influences on clinical decision making, and a lack of incentives for evidence-based practice activities." The researchers say participating therapists "had positive attitudes toward evidence-based practice" and that they made modest improvements. Based on their findings, they've concluded that it's "critical for the profession to continue to investigate optimal strategies to aid practicing clinicians in applying research evidence to clinical decision making."