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Engagement in Evidence-Based Practice Activities and Thinking by Rehabilitation Therapists: Predictive Factors

Angela Benfield¹, Mark V Johnston², Cheryl Miller³

¹University of Wisconsin-La Crosse, La Crosse, WI.

Archives of Rehabilitation Research and Clinical Translation

|January 1, 2026

Abstract

Objective:

To explore relationships between therapists' recurrent, self-regulated evidence-related activities and antecedent factors that may influence these habits.

Design:

Secondary analysis of survey data using multivariate regression/correlations analyses.

Setting:

Representative sample of 30 inpatient rehabilitation clinics across the United States.

Participants:

163 rehabilitation therapists (N=163), specifically physical and occupational therapists and speech-language pathologists.

Interventions:

Not applicable.

Main Outcome Measures:

Evidence-informed professional thinking, which is comprised of measures of recurrent, self-regulated evidence-informed practice (EIP) and reflective critical clinical reasoning (CCR) activities by therapists.

Results:

Scores indicate infrequent engagement in EIP activities (mean=4.22, SD=0.93), with somewhat greater engagement in CCR (mean=5.00, SD=0.920). Therapists generally had positive attitudes toward evidence-based practice (EBP) on the Evidence-Based Practice Attitude Scale-36. The EIP and CCR were highly related (r=.651, P=.001). Even after linear controls for other possible predictors, beliefs that EBPs lead to greater Job Security predicted greater engagement in both EIP and CCR (P<.001). Openness was also independently related to engagement in EIP (P<.001) and to CCR (P<.011), apparently mediated by Feedback, Professional Education, and awareness of Limitations (of EBP). Specialty certification was clearly related to EIP (P<.016), but many common educational and experience background variables had weak or nonsignificant relationships with therapists' EIP or CCR habits.

Conclusions:

Self-regulated engagement in EIP and CCR are predicted by identifiable but somewhat complex antecedents. CCR was more strongly related to EIP than any other variable. Results suggest that implementation strategies that engage therapists' reflective critical clinical reasoning will be more successful at increasing therapists' engagement in self-regulated EBP habits than in strategies that do not.

Keywords:

Clinical competence Clinical reasoning Evidence-based practice Health occupations Implementation science Rehabilitation

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