Knowledge, attitudes and behaviours of evidence-informed practice in respiratory therapy: A cross-sectional survey

Using evidence to guide clinical practice is recognized as the cornerstone of safe, effective, and patient-centred care and is embedded within the national competency framework of respiratory therapists (RTs) as evidence-informed practice (EIP). However, how this competency is enacted in practice remains unclear. RTs, like many health professionals, encounter challenges in enacting EIP and are influenced by individual, contextual, and organizational factors. As part of a broader program of research, our team conceptualized EIP in respiratory therapy as comprising three interrelated components: reflective practice, shared decision-making, and research awareness. In this study, we examined the current knowledge, attitudes, and behaviours of RTs in Canada related to these three core components of EIP.

We surveyed credentialed RTs across Canada to assess their knowledge, attitudes and behaviours relating to three components of EIP: reflective practice, shared decision-making, and research awareness. Participants were randomly assigned to complete one of three surveys, each of which related to one of the components. We used a simple-randomized, stratified sampling to enhance generalizability, and analyzed the data using descriptive statistics, one-way ANOVA, and exploratory analyses of demographic and practice-related variables. We analyzed open-ended responses using qualitative content analysis.

The three surveys were accessed 442 times. After removing non-responses and incomplete data, we analyzed the data from 288 participants (response rate = 10.2%). Out of the possible 100 score, shared decision-making yielded the highest mean knowledge score (M = 86.4, SD = 6.4), while research awareness scored highest for attitudes (M = 81.4, SD = 13.4) and behaviours (M = 78.3, SD = 10.4). Reflective practice showed the lowest mean scores across domains (knowledge M = 40.6; attitudes M = 53.3; behaviours M = 61.3). ANOVAs indicated significant group differences across all domains (p < .001). Using the open-ended responses, 79.2% of participants emphasized that research evidence is the most significant feature of EIP. The open-ended responses related to training needs for EIP focused on condition- or population-specific application (29.5%), preferred formats, such as journal clubs, webinars, and modules (24.7%), and skills for engaging with research (21.2%). Exploratory analyses suggested some differences in knowledge, attitudes and behaviours of EIP by gender, race, geography, practice setting, age, and years in practice.

RTs in Canada demonstrated variable knowledge, attitudes and behaviours across all components of EIP. While reflective practice stood out as the component with the lowest scores across knowledge, attitudes, and behaviours, scores in all three components indicated room for improvement. Together, these findings highlight that all areas of EIP require strengthening through contextually relevant educational strategies to better support RTs in enacting EIP.