Twenty-five Years After the Introduction of Evidence-based Medicine: Knowledge, Use, Attitudes and Barriers Among Physiotherapists in Italy - A Cross-Sectional Study

BMJ Open. 2020 Jun 3;10(6):e037133. doi: 10.1136/bmjopen-2020-037133.


Objectives: To explore the knowledge, use, attitudes towards Evidence-based Medicine, also known as Evidence-based Practice (EBP), and perceived barriers to its dissemination among physiotherapists.

Design: Cross-sectional study.

Setting and participants: Members of the Italian Association of Physiotherapists (n=2000) were invited to participate in an online survey about EBP knowledge and use.

Primary outcome measures: The survey questionnaire comprised four sections: (1) respondent characteristics; (2) knowledge of EBP principles; (3) attitude, use and perceived effectiveness of EBP; (4) perceived barriers to implementing EBP in clinical practice.

Results: Out of 2000 physiotherapists, 1289 participated in the survey (64.5% response rate). Overall, 90% perceived EBP as useful and necessary for their clinical practice. More than 85% stated that they were familiar with the principles of EBP, 75% reported that they were able to search online databases for relevant information and 60% reported that they were able to understand statistical analyses. However, 56% believed that patient preferences and 39% that clinical expertise are not part of the EBP model. Half stated that they understood and could explain the term 'meta-analysis' but only 17% knew what a forest plot is and just 20% correctly judged the finding of a given meta-analysis. Lack of time was reported as the main barrier to EBP.

Conclusion: The majority of Italian physiotherapists overrated their knowledge about EBP, demonstrating a gap between perceived and actual knowledge of EBP in this population.

Keywords: epidemiology; medical education & training; rehabilitation medicine.