Understanding the impact of an evidence-based practice curriculum on oral health graduates

Grace Wai-Lin Wong; Murray Print; Tania Gerzina

doi:10.11157/fohpe.v20i2.328

Authors

Grace Wai-Lin Wong The University of Sydney School of Dentistry, Faculty of Medicine and Health http://orcid.org/0000-0003-1364-6866
Murray Print The University of Sydney School of Education and Social Work http://orcid.org/0000-0003-0750-6891
Tania Gerzina The University of Sydney School of Dentistry, Faculty of Medicine and Health http://orcid.org/0000-0002-0894-6429

DOI:

https://doi.org/10.11157/fohpe.v20i2.328

Keywords:

evidence-based practice, triangulation, health education, clinical decision making, qualitative research

Abstract

Background: The explosion of health information accessible to consumers through multimedia has supported the merit and value of evidence-based practice (EBP). Both informed interest from patients and medico-legal considerations of patient care and safety have also contributed to the increased importance of EBP for health practitioners. An EBP curriculum was implemented at the [blinded]. The evaluation of the student perspectives was previously completed by using questionnaires and focus group interviews. Objectives: To further explore and analyse the potential impact of the EBP curriculum on [blinded] graduates’ clinical practice. Methods: Semi-structure interviews were conducted to allow for elaboration and clarification to assess understanding of oral health graduates’ perception of EBP. Graduates (n=12) from both the private and public sectors were invited to participate. Qualitative responses were transcribed and analysed using thematic analysis. Triangulation was used to cross-validate and confirm findings with previous quantitative data and focus group responses on providing a broader understanding of the subject. Results: Graduates reported they felt confident and were empowered by EBP in making clinical decisions. Challenges included limited online resources for literature search, lack of evidence in some aspects of dentistry, and gaining full-text access. Conclusion: The triangulation approach has enhanced the analysis and interpretation of the impact of the EBP curriculum on oral health graduates’ clinical practice. This study can serve as a pathfinder to introduce and implement EBP in other healthcare educational institutions and support translational science by bridging the gap between research and clinical practice.

References

Austin, M. J., & Claassen, J. (2008). Impact of organizational change on organizational culture: Implications for introducing evidence-based practice. Journal of Evidence-Based Social Work, 5(1–2), 321–359. doi:10.1300/ J394v05n01_12

Australian Dental Council (ADC). (2016). Professional competencies of the newly qualitifed dental hygienist, dental therapist and oral health therapist. Retrieved from https://www.adc.org.au/sites/default/files/Media_Libraries/PDF/Accreditation/ Professional%20Competencies%20of%20the%20Newly%20Qualified%20 Dental%20DH%20DT%20OHT_rebrand%20Final.pdf

Azarpazhooh, A., Mayhall, J. T., & Leake, J. L. (2008). Introducing dental students to evidence-based decisions in dental care. Journal of Dental Education, 72(1), 87–109.

Beke-Harrigan, H., Hess, R., & Weinland, J. A. (2008). A survey of registered nurses' readiness for evidence-based practice: A multidisciplinary project. Journal of Hospital Librarianship, 8(4), 440–448. doi:10.1080/15323260802382802

Carter, N., Bryant-Lukosius, D., DiCenso, A., Blythe, J., & Neville, A. J. (2014). The use of triangulation in qualitative research. Oncology Nursing Forum, 41(5), 545–547. doi:10.1188/14.ONF.545-547

Ciarocco, N. J., Lewandowski, G. W., & Van Volkom, M. (2013). The impact of a multifaceted approach to teaching research methods on students’ attitudes. Teaching of Psychology, 40(1), 20–25. doi:10.1177/0098628312465859

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Los Angeles, CA: Sage.

Dawes, M., Summerskill, W., Glasziou, P., Cartabellotta, A., Martin, J., Hopayian, K., . . . Osborne, J. (2005). Sicily statement on evidence-based practice. BMC Medical Education, 5(1), 1.

Duffy, M. E. (1987). Methodological triangulation: A vehicle for merging quantitative and qualitative research methods. Image: The Journal of Nursing Scholarship, 19(3), 130–133.

Farmer, T., Robinson, K., Elliott, S. J., & Eyles, J. (2006). Developing and implementing a triangulation protocol for qualitative health research. Qualitative Health Research, 16(3), 377–394.

Fink, R., Thompson, C. J., & Bonnes, D. (2005). Overcoming barriers and promoting the use of research in practice. JONA: The Journal of Nursing Administration, 35(3), 121–129.

Foss, C., & Ellefsen, B. (2002). The value of combining qualitative and quantitative approaches in nursing research by means of method triangulation. Journal of Advanced Nursing, 40(2), 242–248.

Gerzina, T. M., McLean, T., & Fairley, J. (2005). Dental clinical teaching: Perceptions of students and teachers. Journal of Dental Education, 69(12), 1377–1384.

Glasgow, R. E., & Emmons, K. M. (2007). How can we increase translation of research into practice? Types of evidence needed. Annual Review of Public Health, 28(1), 413–433.

doi:10.1146/annurev.publhealth.28.021406.144145

Gonzales, R., Handley, M. A., Ackerman, S., & O’Sullivan, P. S. (2012). A framework for training health professionals in implementation and dissemination science.

Academic Medicine, 87(3), 271–278. doi:10.1097/ACM.0b013e3182449d33

Gopalakrishnan, S., & Ganeshkumar, P. (2013). Systematic reviews and meta-analysis: Understanding the best evidence in primary healthcare. Journal of Family Medicine and Primary Care, 2(1), 9–14. doi:10.4103/2249-4863.109934

Greiner, A. C., & Knebel, E. (Eds.). (2003). Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press.

Grol, R. (2001). Successes and failures in the implementation of evidence-based guidelines for clinical practice. Medical Care, 39(8, Suppl. 2), 46–54.

Hinton, R. J., Dechow, P. C., Abdellatif, H., Jones, D. L., McCann, A. L., Schneiderman, E. D., & D’Souza, R. (2011). Creating an evidence-based dentistry culture at Baylor College of Dentistry: The winds of change. Journal of Dental Education, 75(3), 279–290.

Kersten, H. W., Vervoorn, J. M., Zijlstra, A. E., Blok, B. S., & van Eijden, T. M. (2007). Development and implementation of new educational concepts in a dental curriculum. European Journal of Dental Education, 11(1), 2–9.

Kishore, M., Panat, S. R., Aggarwal, A., Agarwal, N., Upadhyay, N., & Alok, A. (2014). Evidence based dental care: Integrating clinical expertise with systematic research. JCDR: Journal of Clinical and Diagnostic Research, 8(2), 259–262. doi:10.7860/JCDR/2014/6595.4076

Kulier, R., Gee, H., & Khan, K. S. (2008). Five steps from evidence to effect: Exercising clinical freedom to implement research findings. BJOG, 115(10), 1197–1202. doi:10.1111/j.1471-0528.2008.01821.x

Kyriakoulis, K., Patelarou, A., Laliotis, A., Wan, A. C., Matalliotakis, M., Tsiou, C., & Patelarou, E. (2016). Educational strategies for teaching evidence-based practice to undergraduate health students: Systematic review. Journal of Educational Evaluation for Health Professions, 13, 34. doi:10.3352/jeehp.2016.13.34

Legare, F., Ratte, S., Gravel, K., & Graham, I. D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: Update of a systematic review of health professionals' perceptions. Patient Education & Counseling, 73(3), 526–535.

Long, K. A. (2003). The Institute of Medicine report: Health professions education. A bridge to quality. Policy, Politics, & Nursing Practice, 4(4), 259–262. doi:10.1177/1527154403258304

Marinho, V. C., Richards, D., & Niederman, R. (2001). Variation, certainty, evidence, and change in dental education: Employing evidence-based dentistry in dental education. Journal of Dental Education, 65(5), 449–455.

McCluskey, A., & Lovarini, M. (2005). Providing education on evidence-based practice improved knowledge but did not change behaviour: A before and after study. BMC Medical Education, 5(1), 1.

Melnyk, B. M., Fineout-Overholt, E., Fischbeck Feinstein, N., Li, H., Small, L., Wilcox, L., & Kraus, R. (2004). Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: Implications for accelerating the paradigm shift. Worldviews on Evidence-Based Nursing, 1(3), 185–193.

doi:10.1111/j.1524-475X.2004.04024.x

Miles, A., Loughlin, M., & Polychronis, A. (2007). Medicine and evidence: Knowledge and action in clinical practice. Journal of Evaluation in Clinical Practice, 13(4), 481–503. doi:10.1111/j.1365-2753.2007.00923.x

O'Connor, S., & Pettigrew, C. M. (2009). The barriers perceived to prevent the successful implementation of evidence-based practice by speech and language therapists. International Journal of Language & Communication Disorders, 44(6), 1018–1035.

Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health, 42(5), 533–544. doi:10.1007/s10488-013-0528-y

Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2005). Readiness of U.S. nurses for evidence-based practice. The American Journal of Nursing, 105(9), 40–51.

Ratner, N. B. (2006). Evidence-based practice: An examination of its ramifications for the practice of speech-language pathology. Language, Speech, and Hearing Services in Schools, 37(4), 257–267. doi:10.1044/0161-1461(2006/029)

Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71–72.

Saint, D. A., Horton, D., Yool, A., & Elliott, A. (2015). A progressive assessment strategy improves student learning and perceived course quality in undergraduate physiology. Advances in Physiology Education, 39(3), 218–222.

Sargeant, J. (2012). Qualitative research part II: Participants, analysis, and quality assurance. Journal of Graduate Medical Education, 4(1), 1–3. doi:10.4300/ JGME-D-11-00307.1

Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. Milbank Quarterly, 87(2), 368–390.

Schardt, C. (2011). Health information literacy meets evidence-based practice. Journal of the Medical Library Association, 99(1), 1–2.

Seçkin, G., Yeatts, D., Hughes, S., Hudson, C., & Bell, V. (2016). Being an informed consumer of health information and assessment of electronic health literacy in a national sample of internet users: Validity and reliability of the e-HLS instrument. Journal of Medical Internet Research, 18(7), e161–e161. doi:10.2196/jmir.5496

Smith, D. W. (2018). Phenomenology. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Summer 2018 ed.). Retrieved from https://plato.stanford.edu/archives/sum2018/entries/phenomenology/

Spek, B., Wieringa-de Waard, M., Lucas, C., & van Dijk, N. (2013). Teaching evidence-based practice (EBP) to speech-language therapy students: Are students competent and confident EBP users? International Journal of Language & Communication Disorders, 48(4), 444–452.

Starks, H., & Trinidad, S. B. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research, 17(10), 1372–1380.

Tagney, J., & Haines, C. (2009). Using evidence-based practice to address gaps in nursing knowledge. British Journal of Nursing, 18(8), 484–489.

Teddlie, C., & Tashakkori, A. (2011). Mixed methods research: Contemporary issues in an emerging field. In N. K. Denzin & Y. S. Norman (Eds.), The Sage handbook of qualitative resrearch (4th ed.) (pp. 285–300). Thousand Oaks, CA: Sage.

Teich, S. T., Demko, C. A., & Lang, L. A. (2013). Evidence-based dentistry and clinical implementation by third-year dental students. Journal of Dental Education, 77(10), 1286–1299.

Titler, M. G. (2014). Overview of evidence-based practice and translation science. Nursing Clinics of North America, 49(3), 269–274.

Vranceanu, A.-M., Cooper, C., & Ring, D. (2009). Integrating patient values into evidence-based practice: Effective communication for shared decision-making. Hand Clinics, 25(1), 83–96. doi:https://doi.org/10.1016/j.hcl.2008.09.003

Werb, S. B., & Matear, D. W. (2004). Implementing evidence-based practice in undergraduate teaching clinics: A systematic review and recommendations. Journal of Dental Education, 68(9), 995–1003.

Wong, G., Monatzerolghaem, M., & Gerzina, T. (2018). Integrating evidence- based practice into oral health clinical practice: Students’ perspectives. Journal of Evidence-Based Dental Practice, 19(1), 79–85. doi:10.1016/j.jebdp.2018.11.002

Wong, S. S., Wilczynski, N. L., & Haynes, R. B. (2006). Comparison of top- performing search strategies for detecting clinically sound treatment studies and systematic reviews in MEDLINE and EMBASE*. Journal of the Medical Library Association, 94(4), 451.

Young, T., Rohwer, A., Volmink, J., & Clarke, M. (2014). What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PloS one, 9(1).