Effect of Education on Shared Decision-making using Clinical Practice Guidelines: A Randomized Controlled trial.

Abstract Background: To investigate the influence of the evidence–practice gap on physiotherapists and occupational therapists through shared decision making (SDM) using clinical practice guidelines (CPGs).Methods: The study was designed as a blocked, randomized controlled multicenter trial. Participants included 126 therapists with 42 continuous samplings from three institutions. Being a permanent employee from any of these institutions was a necessary inclusion criterion. However, participants with disorders (visual, auditory, attentional disorder) were excluded. An allocator was assigned to mask the participation’s attribution until the allocation was completed. The evaluator and analyzer were also masked. For the intervention group, a workshop was conducted on SDM using CPGs. Lecture on the knowledge of CPGs (CPG group) and lecture on the knowledge of SDM (SDM group) were the control groups. The primary outcomes were “education, attitudes and beliefs, and interest and perceived role in evidence-based practice (EPIC scale).” The secondary outcome included evidence-based practice (EBP) knowledge. To review the intervention effect of education on SDM using CPGs, two-factor variance analysis (mixed model) was adopted to conduct Holm’s method.Results: In each group, 42 participants were randomized and analyzed. The EPIC scale showed significant difference between the CPG with SDM and CPG groups (CPG with SDM group [mean ± standard deviation, pre/post]：2.4±0.9/4.4±1.7; CPG group： 3.0±1.5/3.5±2.0; SDM group： 2.6±1.2/ 3.3±1.8）. The question on EBP “I learned the foundations for EBP as a part of my academic preparation” showed significant differences between the CPG with SDM and CPG groups （CPG with SDM group： 1.8±0.8/2.2±1.0; CPG group： 2.3±1.1/ 2.0±1.0）.Conclusion: SDM education using CPGs for physical and occupational therapists improves EBP self-efficacy.