Evidence-based Practice (EBP) in Physiotherapy
The World Confederation for Physical Therapy (WCPT) is the international organisation that represents the physiotherapy practice and encourages high standards of practice, research and education (www.wcpt.org). The WCPT has considered EBP, essential for effective practice and has released a declaration of principle on EBP in 2007. This principle states that "physiotherapists have a duty and responsibility to use evidence to inform practice and to ensure that the management of patients/clients, their carers and communities is based on the available evidence" ( http://www.wcpt.org/policy/ps-EBP). In this case, physiotherapists should be prepared to learn the concepts of EBP and be supported to undertake EBP related activities.
EBP in the Philippines
In the Philippines, a survey was conducted by Dizon JM in 2009 to describe the current profile of practice and basis for treatment of Filipino physiotherapists. The top three bases for treatment selection in daily practice and for new cases were doctors' prescription, use of textbooks and undergraduate education. The use of evidence coming from research studies to guide practice has been poorly considered by majority of the respondents. This is in part, due to the type of practice in the Philippines (and most of South East Asian countries), where physiotherapists are not the first contact practitioners. While this maybe the scenario, the physiotherapists play a major role in making the patients reach their optimum functional status and therefore would need to be informed and influenced by the best treatment intervention to deliver to their patients. In this case, effective physiotherapy practice needs to be guided by concepts and principles of EBP.
Effective education has been identified as a powerful tool to overcome barriers to EBP in the South Asia region (Agarwal et al 2008). Clinicians should first and foremost understand what EBP is and learn the skills related to it. In this regard, a tailored EBP training program was developed for physiotherapists in the Philippines, but may also be applicable to physiotherapists in the Asian region.
EBP Training Program
This project on EBP training program for Filipino physiotherapists was based on preliminary exploratory studies that informed its design, content and strategies.
Phase 1 of the project was designed to map current practice of Filipino physiotherapists. The general aim was to establish the context and scope of physiotherapy practice in the Philippines. In this phase, factors related to practice, such as background and origin of physiotherapy in the country, profile of practitioners and perceptions to upgrading the profession, were investigated. The findings in this phase informed the basis for the development of the tailored EBP training program in Phase 2.
Phase 2 of the project was aimed at developing the program to fill in knowledge and practice gaps related to EBP. The training program was based from what is most effective and useful as found in the literature and as applicable to the culture and scope of practice of physiotherapy in the Philippines. The program has been pilot tested to a group of Filipino physiotherapists and at present, the randomised controlled trial is being organised to assess the effectiveness of the program in a larger scale.
Phase 3 of the project aims to develop a framework for continued update in physiotherapy practice and to implement uptake of evidence in actual practice. Strategies to ensure translation of knowledge and skills learned will be formalised considering barriers and enablers.
The EBP training program is relevant and applicable to other allied health professions and can therefore be extended to other allied health professionals in the Philippines and the Asian countries.
Learn more about the EBP training program
To those interested in undergoing the training, please get in touch with Janine Dizon at Janine.Dizon@unisa.edu.au