Self-reported Attitudes, Skills and Use of Evidence-based Practice Among Canadian Doctors of Chiropractic: A National Survey

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SOURCE:   J Can Chiropr Assoc. 2015 (Dec); 59 (4): 332–348

André E. Bussières, DC, PhD, Lauren Terhorst, PhD,
Matthew Leach, RN, BN (Hons), ND, PhD,
Kent Stuber, DC, MSc, Roni Evans, DC, PhD, and
Michael J. Schneider, DC, PhD

Assistant Professor,
School of Physical and Occupational Therapy,
McGill University
Département Chiropratique,
Université du Québec à Trois-Rivières.

OBJECTIVES:   To identify Canadian chiropractors’ attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs).

OBJECTIVES:   7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evidence Based practice Attitude & utilisation SurvEy (EBASE); a valid and reliable measure of participant attitudes, skills and use of EBP.

RESULTS:   Questionnaires were completed by 554 respondents. (7.7% of those invited) Most respondents (>75%) held positive attitudes toward EBP. Over half indicated a high level of self-reported skills in EBP, and over 90% expressed an interest in improving these skills. A majority of respondents (65%) reported over half of their practice was based on evidence from clinical research, and only half (52%) agreed that chiropractic CPGs significantly impacted on their practice.

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CONCLUSIONS:   While most Canadian chiropractors held positive attitudes towards EBP, believed EBP was useful, and were interested in improving their skills in EBP, many did not use research evidence or CPGs to guide clinical decision making. Our findings should be interpreted cautiously due to the low response rate (7.7%).

KEYWORDS:   chiropractic; complementary and alternative medicine; evidence-based practice; survey


From the FULL TEXT Article:


Evidence-based practice (EBP) refers to ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients’. [1] Essentially, EBP involves the integration of three key components:

1)   the use of the best available research evidence,

2)   knowledge arising from one’s clinical expertise/clinical reasoning, and

3)   patients’ preferences and values. [1]

Evidence-based practice is associated with improved clinical decision-making and patient care. [2, 3] Since the establishment of evidence-based medicine at McMaster University in the 1980s, EBP principles have been embraced in other health disciplines, including nursing [4, 5] occupational therapy and physical therapy. [6] Complementary and alternative medicine (CAM) professionals, including Doctors of Chiropractic (DC), are increasingly expected to use EBP principles to guide clinical decision making. [7]

A number of indicators suggest a possible shift toward the adoption of EBP in chiropractic, including the relatively recent creation of evidence-based clinical practice guidelines (CPGs) in chiropractic [8–12], EBP educational programs [13–16], and the adoption of an ‘Evidence-Informed Practice statement’ by nine out of ten Canadian provincial associations and eight of ten provincial regulatory boards (status pending in three organizations). ( The statement reads as follows:

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