Instruments for assessing healthcare professionals' knowledge and skills of evidence-based practice: A scoping review.

OBJECTIVE: The aim of this scoping review was to describe the instruments used to assess the knowledge and skills of evidence-based practice (EBP) in healthcare settings. METHODS: A scoping review was undertaken. Three electronic databases (CINAHL, PubMed and Cochrane) were searched in January 2022. The search phrases consisted of the following terms: healthcare professionals, EBP, competence and instrument and their synonyms, keywords and MeSH terms. The database search was run without any limitations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to support reporting. RESULTS: Ultimately, 39 studies were included; most of them (35) were cross-sectional studies. The studies were conducted in 17 countries. A total of 17 evidence-based knowledge and skills instruments were identified. The Upton and Upton instrument was used in 19 studies. Twelve self-reported instruments were used only once. The psychometric properties of the instruments varied. The reliability was typically reported with Cronbach's alpha coefficient. The content of the EBP knowledge/skills instruments consists of five main categories: EBP, evaluation of current practice, preparation for the implementation of EBP, implementation of evidence and active participation in the development of EBP. CONCLUSION: Almost all instruments are self-assessment instruments. Validated knowledge tests should be further developed. The instruments emphasise the preparation for the implementation of EBP. Further research is needed to develop instruments for healthcare professionals to assess the knowledge and skills of the implementation of evidence.

Self-evaluated ethical competence of a practicing physiotherapist: a national study in Finland.

BACKGROUND: Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff's behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists. METHOD: A self-evaluation instrument (Physiotherapist's Ethical Competence Evaluation Tool) based on an analysis of a concept "ethical competence" was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire. RESULTS: Based on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct. CONCLUSIONS: This was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients' viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient.

Ethical competence - exploring situations in physiotherapy practice.

INTRODUCTION: Ethical competence is a key area of professional expertise in physiotherapy. It is needed for successful interaction and rehabilitation - most physiotherapists encounter ethical situations weekly, but the ability to recognize and meet these situations varies. OBJECTIVE: This study describes physiotherapists' ethical competence in situations in which they experience they have succeeded to act ethically competently. The study also seeks to verify an existing conceptual frame, developed through a concept analysis of ethical competence. METHOD: All together 164 physiotherapists responded to open-ended questions by writing short narratives of an ethically challenging situation. The narratives which were analyzed using deductive-inductive content analysis to discover meaningful underlying categories under the existing analysis frame's themes. RESULTS: Responses were related to advocating and supporting patients, identifying barriers in own knowledge and implementing physiotherapy according to the patient's needs, even if the treatment wasn't in line with the actual goals or organization's guidelines. Ethical awareness as an attribute of ethical competence was emphasized in physiotherapists' responses. CONCLUSION: This study provided new knowledge about ethically challenging situations that physiotherapists encounter and their abilities to work within these. As all the attributes of ethical competence were present in the situations described, it can be stated that the analysis frame at this point is adequate. Further testing of the frame should be done to gain data-driven trustworthiness and credibility.