Randomised Trial of Two Educational Intervention for Improving Evidence-based Practice Knowledge, Atttitudes and Practice
Condition: Health Knowledge, Attitudes, Practice
Study type: Interventional

Summary: 
      This pragmatic randomised controlled trial (RCT) used a two-group parallel design with
      matched-pair stratification by type (clinician/manager) and knowledge score. The trial aimed
      to: 1) determine whether an IE was more effective than a DE for improving EBP knowledge,
      skills and use at 12 weeks, and 2) to investigate the feasibility of conducting a RCT with
      occupational therapists in a public health setting. Occupational therapists employed by the
      Western Cape Department of Health (DOH) form,ed the study population(N=98). Fifty-eight
      consented to participate and were randomly allocated to either an interactive (IE) or a
      didactic (DE) educational intervention using coin tossing. Data was collected at baseline and
      12 weeks The primary outcome was increased EBP knowledge at 12 weeks shown by an improved
      total knowledge score. Secondary outcomes were improved attitudes and behaviour. Data were
      collected at the health facilities where participants were employed. Raters for the audit
      were blinded but participants and the provider could not be blinded.

      Thirty participants were allocated to receive the IE and 28 the DE. Twenty-five participants
      in the IE and 21 in the DE completed the trial and were included in the 12 week analysis.
      Results revealed no significant difference between the groups in the primary knowledge
      outcome at 12 weeks. Examination of within-group changes revealed significant improvements in
      knowledge in both groups (IE: T=4.0, p<0.001; DE: T=12.0, p=0.002), but the IE also showed a
      significant increase in behaviour (T=64.5, p=0.044) and attitudes on one sub-scale (T=33.0,
      p=0.039). As the study was powered at 43%, it may have failed to detect significant
      differences at 12 weeks. Conducting a high-quality RCT was feasible and the risk of bias was
      assessed as low. The OTEBP trial adds strength to the existing evidence that both didactic
      and interactive educational interventions can improve knowledge, but it seems that
      interactive interventions may be more effective for changing behaviour. High-quality
      pragmatic trials can feasibly be conducted within the public health service
    


Intervention name(s): Education
Intervention type(s): Behavioral
Intervention description(s): Interactive educational intervention:
4 hour education session (with notes and 'evidence packs'); presentations, small group discussion tasks and practice of particular skills - 2 hour session (1 week later)
Emailed notes from second session
Telephonic/email follow-up (reminders)
Didactic educational intervention:
- 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Keywords: randomised controlled trial; educational intervention; occupational therapy