Evidence-based Practice, Research Utilization, and Knowledge Translation in Chiropractic:
A Scoping Review

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SOURCE:   BMC Complement Altern Med. 2016 (Jul 13); 16 (1): 216

André E. Bussières, Fadi Al Zoubi, Kent Stuber,
Simon D. French, Jill Boruff, John Corrigan,
and Aliki Thomas

School of Physical and Occupational Therapy,
Faculty of Medicine,
McGill University,
Montréal, Canada.

BACKGROUND:   Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic.

METHODS:   A scoping review using the Arksey and O’Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted.

RESULTS:   Nearly 85% (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely.

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CONCLUSION:   Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for chiropractors to routinely apply evidence into clinical practice. Educational strategies aimed at practicing chiropractors can lead to more EBP and improved patient care. The chiropractic profession requires more robust dissemination and implementation research to improve guideline adherence and patient health outcomes.

KEYWORDS:   Chiropractic; Evidence-based practice; Knowledge translation; Research utilization; Scoping review


From the FULL TEXT Article


Evidence-based practice (EBP), research utilization (RU), and knowledge translation (KT) are interrelated concepts that pertain to the identification, utilization and application of knowledge from research sources to clinical practice. EBP has been defined as “the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care”. [1]

RU is a sub-set of EBP, which refers to “that process by which specific research-based knowledge is implemented in practice”. [2]

KT, on the other hand, emphasizes the synthesis, dissemination, exchange and application of knowledge from research findings, and from other sources, to influence changes in practice and improve health outcomes. [3] Thus, KT aims to help bridge the gap between research findings and what is routinely done in practice.

Although there have been an increasing number of KT activities in recent years, much remains to be done to effectively translate research findings targeting healthcare professionals, consumers, and other stakeholders into clinical practice. However, one important initial step is to determine what is known about EBP, RU and KT among healthcare professionals.

A number of articles have been published on EBP and determinants associated with the use of evidence in different healthcare professions, including medicine [4-7], nursing [8, 9], dentistry [10], physical therapy [11-14], and occupational therapy. [13, 15] However, to date this area has not been reviewed comprehensively in the chiropractic profession. [16] Chiropractic is a regulated health profession serving approximately 10–15% of the population annually. [17] Several barriers to implementing evidence in chiropractic practice have been previously proposed.

These include:

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