Engaging with evidence-based practice in the osteopathy clinical learning environment: A mixed methods pilot study

Abstract

Introduction: Evidence-based medicine (EBM) requires that patient management decisions include deliberations on the best available evidence. However, engagement with EBM appears to be inconsistent. This pilot study used a mixed-methods approach to evaluate clinical educator and learner engagement with evidence in the clinical learning environment (CLE) through the SNAPPS-Plus clinical supervision model. Methods: Southern Cross University (Australia) senior osteopathy students and their clinical educators were invited to complete the Evidence-Based Practice Questionnaire (EBPQ) and participate in a series of focus groups following use of the SNAPPS-Plus model in the CLE. Inferential statistics were used to explore EBPQ responses and focus groups were transcribed and thematically analysed. Results: Attitudes to EBM and practice were largely positive. The student EBPQ Practice subscale was significantly improved pre-post intervention. None of the other subscales were significantly different. Focus groups confirmed the increased use of EBM and the SNAPPS-Plus model provided a structure that improved the efficiency and effectiveness of students’ literature searches. Focus groups highlighted the different value educators and students placed on research evidence and clinical experience. Conclusion: This pilot study suggests learners and clinical educators engage with evidence in the CLE, including co-learning. PICO, within the SNAPPS-Plus model, may be an appropriate vehicle for promoting learner use of EBM. This work suggests the SNAPPS-Plus model is a promising strategy for encouraging evidence-based practice behaviours and could be used to inform future research. Further research is required to evaluate whether the model creates a sustained habit of searching for evidence to inform practice.