AbstractsEducation Research & Administration

Evidence-based practice (EBP) requires the integration of individual clinical expertise with the best available evidence, accounting for patient perspective as well as practice context. The five-step EBP process of ‘Ask, Acquire, Appraise, Apply and Audit’ has been well described but does not include considerations of practitioners’ attitudes, self-efficacy, knowledge and skills, which also affect clinical decision-making. The Sicily expert consensus statement recently proposed the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework that considers both of these aspects. The need for EBP in the field of optometry has been widely discussed, but the extent to which EBP is adopted or practiced by optometrists is unknown. The aim of this thesis is to investigate EBP understanding, barriers and attitudes among optometrists, and to measure optometrists’ EBP knowledge and skills. To achieve this aim, focus groups and individual telephone interviews were conducted to gauge optometrists’ EBP understanding and opinions and analysed using NVivo software. To measure EBP skills and knowledge, an existing instrument, the Fresno test (FT), was modified for use in optometry and validated using Rasch analysis. A convenience sample of 92 optometrists in two geographical locations – Sydney, Australia, and Riyadh, Saudi Arabia – was used. Optometrists reported that they valued and were confident in their ability to use EBP but demonstrated an incomplete understanding of the definition and process of EBP. Optometrists reported that lack of time, poor access to information and poor translation of research into practice were the principal barriers to implementing EBP in everyday practice. The 13-item optometry FT was validated as a knowledge and skills assessment tool, able to discriminate between EBP novices and experts, when scored and interpreted on a 30-subcategory basis. These results suggest that the optometry FT may be used to inform future optometry EBP training and education programs. Optometrists demonstrated competency in the first two steps of the EBP process (‘Ask’ and ‘Acquire’) but limited ability in critical appraisal of the scientific literature (step 3 – ‘Appraise’). Taken together, these results suggest that optometrists believe they understand and practice EBP but do not demonstrate commensurate levels of EBP knowledge and skills.