Perceptions of competency with evidence-based medicine among medical students: changes through training and alignment with objective measures.

AIMS: To identify whether medical students' self-perception of competence with evidence-based medicine (EBM) increases throughout their senior years of medical training. Furthermore, to identify whether their self-perception aligns with their true competence measured using a validated tool. This investigation also outlines whether students report observation of and participation in the process of EBM in clinical practice. METHODS: A cross-sectional survey was undertaken with a convenience sample of medical students in their fourth, fifth and sixth years of training at one campus site of Otago Medical School between February and April 2018. Self-perceived competence with EBM was measured using a 10-item questionnaire. True competence was measured using the Assessing Competency in Evidence-Based Medicine (ACE) tool. Students were asked to self-report their observation of and participation in the process of EBM in clinical settings. RESULTS: Out of 99 students invited to participate, we received a response rate of 97%. Participants included 37 fourth-year, 32 fifth-year and 27 sixth-year students. Mean self-perceived EBM competence was higher in sixth-year compared to fourth-year students. True competence was not significantly different between year groups. Medical students reported little observation of EBM in clinical settings, and few students reported to have participated in the process of EBM during clinical encounters. CONCLUSION: The lack of explicit role modelling of EBM in clinical environments may be a barrier to students improving EBM competence in the senior years of medical training.

What electronic information resources do physiotherapists prefer to use to support their CPD?

BACKGROUND AND PURPOSE: The way health professionals consume that informal professional education is changing. Physiotherapists are relying more on using electronic sources of information, including social media, to answer clinical questions. This study aims to identify the sources of electronic information physiotherapists in New Zealand use within their informal professional education. METHODS: A cross-sectional survey of 203 physiotherapists and physiotherapy students was undertaken at the National Physiotherapy New Zealand Conference in 2018. RESULTS: One hundred and seventy nine participated in the survey providing a response rate of 88%. Median engagement in electronic professional learning was 1-3 h per week (82/179, 47%). Search engines were the most frequently used resource for accessing professional learning (171/179, 98%). Electronic Journal articles and webinars were seen as the most useful electronic learning resources. Social media sites, such as Twitter and Facebook, were used less frequently. Just over half (94/179, 53%) of participants in the survey reported to regularly critically appraising information. CONCLUSION: Physiotherapists in New Zealand embark on a significant amount of electronic professional learning. Electronic journal articles are seen as the most valuable resource. Critical appraisal of learning material was not always completed by physiotherapists when consuming informal professional education.

Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

INTRODUCTION: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing pain and improving function pre and post-operatively is equivocal. This observational cohort study used a mixed-methods approach to investigate whether 8 weeks of physiotherapy led exercise and education ('prehabilitation') would change pain and functional outcomes prior to surgery, and if patients' expectations and satisfaction post-surgery were influenced. METHODS: Participants awaiting THR or TKR were recruited (n = 75). Fifty two opted into the 'prehabilitation' group while twenty three opted for usual care. The prehabilitation group included a 45 min exercise and 15 min education session twice weekly for 8 weeks. All participants completed the WOMAC, NRS, Health Thermometer, 5xSTS and TUG outcome measures. Data were collected before and after prehabilitation and 6 weeks after surgery. Qualitative data were collected from 22 participants via telephone interviews and analysed inductively. RESULTS: Both groups improved post surgery. The prehabilitation group showed statistically significant improvements in all outcome measures after prehabilitation (pre-surgery). Participants' felt prehabilitation prepared them well for surgery and influenced expectations post-operatively. Group education talks and the experience of friends and family appeared highly valued information sources. CONCLUSION: Prehabilitation improved patients' pain and function before hip or knee replacement surgery.