'What scientific evidence supports this?' how do physiotherapists in private practice use evidence-based practice and what are the main challenges? A convergent parallel mixed-methods study

PurposeEvidence-based practice (EBP) has been defined as the integration of best available scientific evidence, patient preferences, and individual clinical expertise. A range of barriers for implementing EBP in physiotherapy practice have been identified, but little is known about the underlying causes. The objective was to explore how physiotherapists in private practice perceive EBP, how they use, and what their main challenges are.Materials and methodsThis study used a convergent parallel mixed-methods design. It consisted of a 28-item questionnaire informed by systematic reviews with a deductive approach and semi-structured interviews with a phenomenological and inductive approach.ResultsThe results from the questionnaire (n = 216) and the interviews (n = 9) showed that physiotherapists are more likely to implement EBP if they have sufficient flexibility in time allocation to facilitate shared decision-making and increase the integration of patient preferences. Support from colleagues and the workplace culture were identified as both a challenge and a potential facilitator for increased use of EBP.ConclusionParticipants in this study experienced several modifiable challenges, including lack of flexibility in time allocation and insufficient time to build rapport with the patient. Physiotherapists show inconsistency in their understanding of what EBP is - this ultimately becomes an additional and yet undescribed barrier for implementation of EBP.