Bakgrund: Övergången från student till kliniskt verksam innebär en stor omställning för hälso- och sjukvårdsprofessioner, men det finns bristfällig information om ämnet gällande fysioterapeuter i en svensk primärvårdskontext. Det finns också utmaningar med att implementera evidensbaserad praktik i ett fysioterapeutiskt arbete trots en positiv inställning. Syfte: Syftet var att kartlägga fysioterapeuters upplevelser i och med övergången från student till kliniskt verksam fysioterapeut inom primärvården under det första arbetsåret samt att undersöka möjligheter och utmaningar gällande evidens och dess implementering i arbetet. Design och metod: En kvalitativ studie genomfördes med fem semistrukturerade intervjuer av fysioterapeuter inom primärvården vilka rekryterats genom ett bekvämlighetsurval. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Elva kategorier identifierades. Sex rörande övergången i sig från student till kliniker (“Tiden som kritisk faktor för att komma in i jobbet”, “Arbetsgivarens förväntningar på nyutexaminerade kan både vara hindrande och stöttande”, “Kollegornas viktiga roll”, “Inre föreställningar kan både hjälpa och stjälpa”, “Kunskapsluckor som behöver fyllas”, “Att växa in i sin profession”) och fem kategorier rörande evidens och dess implementering (“Svårt att veta vad som ska implementeras”, “Förutsättningar från arbetsgivaren är avgörande”, “Kollegornas inflytande på den formbara fysioterapeuten” “Grundkunskaper och tankesätt för evidensbaserad praktik från utbildningen”, “Personliga egenskaper och erfarenheters inverkan på evidensbaserad praktik”). Konklusion: Resultaten belyser betydelsen av arbetsplats-, person- och utbildningsfaktorer från olika vinklar i både underlättande och utmanande bemärkelse. Faktorerna var bland annat kopplade till tid, kollegor, förväntningar från arbetsplatsen samt personliga erfarenheter och egenskaper. / Background: The transition from student to clinical practitioner represents a significant adjustment for healthcare professionals, but there is insufficient information about physiotherapists in a Swedish primary care context. There are also challenges in implementing evidence-based practice in physiotherapy despite a positive attitude. Purpose: To explore physiotherapists' experiences related to their transition from student to clinical practitioner in primary care during their first year of work and investigate opportunities and challenges regarding evidence and its implementation in practice. Design and method: A qualitative study was conducted with five semi-structured interviews of physiotherapists in primary care, recruited through convenience sampling. The material was analyzed using qualitative content analysis. Results: Eleven categories were identified. Six categories were related to the transition from student to clinical practitioner ("Time as a critical factor in getting into the job”, “Employer expectations of new graduates can be both hindering and supportive”, “The important role of colleagues”, “Internal beliefs can both help and hinder”, “Knowledge gaps that need to be filled”, “Growing into one's profession”), and five categories related to evidence and its implementation (“Difficulty in knowing what to implement”, “Employer expectations are crucial”, “The influence of colleagues on the moldable physiotherapist”, “Basic knowledge and mindset for evidence-based practice from education”, “The impact of personal characteristics and experiences on evidence-based practice”).  Conclusion: The results highlight the importance of workplace, personal, and educational factors from different perspectives, both facilitating and challenging. The factors were linked to time, colleagues, workplace expectations, personal experiences and traits.

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A number of research studies have highlighted the importance of using empirically supported treatment (evidence-based practices (EBPs)) as the most effective means to reduce addiction. Even though significant federal funding has been committed to support implementation of EBPs in community-based treatment organizations (CBOs) (Glasner-Edwards & Rawson, 2010; NIDA, 2006; IOM, 2003) systematic study of the policy-components of EBP implementation is limited to date. This study examined whether the federal-funder-specific activities (measured as: recommending specific EBPs rather than promoting CBO selection of EBPs, activities associated with specific funding mechanisms, and providing training through ATTCs) were associated with staff perception of level of barriers to implementing federally-funded EBPs. Data sources included interviews with 510 clinical staff from CBOs nationwide who received SAMHSA funding (2003-2008) to implement EBPs. Bivariate analysis and regression modeling methods examined the relationship between federal-funder specific activities and three dependent variables: level of barriers experienced when implementing the EBP, level of modifications made to the EBP that was implemented, and a series of questions regarding attitudes about the usefulness of EBPs. In the regression models, the study controlled for staff, geographic and treatment unit characteristics. It also controlled for variables related to organizational capacity. Findings include: 1. whether or not federal-funders promoted the use of a specific EBP or whether the organization self-selected the EBP to implement was not significantly associated with the level of barriers experienced, the modifications made to the EBP or the attitudes about EBPs. 2. Staff receiving funding from different federal funding mechanisms was associated with reporting different levels of barriers, modifications and attitudes toward EBP implementation. 3. Finally, having received ATTC training was not significantly associated with having more positive attitudes about specific EBPs or the level of modifications or barriers to EBP implementation.

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In the past decade the push for utilization of evidence-based practice (EBP) in mental health has increased dramatically. Due to managed healthcare, lowered spending on state and federal mental health budgets, and requirements by funding agencies such as Medicaid, it is imperative that mental health clinicians (MHCs) be trained in and utilize EBPs to improve funding and ensure continuity of best practice in clinical interventions with clients. Minimal research exists on MHCs and their knowledge and use of EBPs. The present study examined MHCs' perceptions, knowledge, training, and utilization of EBPs, with a specific focus on Dialectical Behavior Therapy (DBT). To date, it is the most prominent and effective EBP for treating Borderline Personality Disorder (BPD) and associated parasuicidal and suicidal behaviors. Current research supports its effectiveness in treating a myriad of other commonly treated disorders. The exploratory study provides insight into MHCs level of interest in receiving more EBP awareness and DBT training. Results indicate that though clinicians have received training in EBP and DBT, most of that training has been encouraged through career settings. Age of the clinician, years in practice, and type of training background are predictors of level of education, knowledge and training. Results show the majority of clinicians are interested in EBP, aware of the impact EBP can have on treatment effects, and report desire to have more training in EBPs and DBT specifically. These results could provide a necessary bridge between disciplines to allow clinicians, irrespective of training, to provide the most clinically effective treatments to clients. / Ph. D.

Nurses face ongoing difficulties in using evidence and making a reality of evidence-based practice. Studies of the factors that facilitate or impede evidence-based practice suggest that nurse managers should have a key role, but the nature of this role has not yet been fully articulated. This study aimed to explore and explain the roles of nurse managers in relation to evidence-based practice implementation. Four case studies in Scottish NHS Acute Trusts provide rich data on evidence-based practice implementation, drawing on interviews (n = 51), observation and documentary analysis. A wide literature on evidence use in nursing suggests that implementation is hindered by confusion and debate about what counts as evidence, and by an incomplete understanding by staff of the complexity of implementation processes. This study confirms such conclusions. Moreover, the study reveals that the roles of nurse managers in facilitating evidence use are currently limited, largely passive and under-articulated. As such, the findings expose significant discrepancies between nurse managers' roles in practice and those espoused in much of the literature. Partial explanation for this can be found in the organisational contexts in which nurses and their managers work (e.g. competing demands; confused communication; diffuse and overloaded roles and limits to authority and autonomy). In particular, the role of the contemporary nurse manager is one that places considerable emphasis on aspects of general management to the detriment of clinical practice issues. More positively, the study uncovered genuine facilitation in two study sites where hybrid roles of nurse manager and clinical nurse specialist were in place. In both sites, these roles had been successful in supporting and progressing implementation in discrete areas of practice and show some potential for advancing evidence-based practice more widely. These findings have significant implications for research, policy and practice in relation to evidence-based practice in nursing.

Nursing is a permanently developing field of activity. Research plays an irreplaceable role in this field. We moreover more and more often see the term Evidence Based Practice nowadays. However a lot of general nurses do not know that this term also relates to the field of nursing, where it is called Evidence Based Nursing. Quantitative research was chosen for this thesis. The research was performed in South Bohemian and Central Bohemian regions among general nurses with bachelor degree. The aim of the questionnaire research was to confirm or refute the hypotheses set for this thesis. The first goal of the thesis was to find out whether general nurses with bachelor degree were willing to participate in research in nursing. The second goal was to find out whether general nurses with bachelor degree had come across the term Evidence Based Practice. The third goal was focused on finding whether general nurses with bachelor degree knew the names of databases that might be used in planning nursing care based on evidence. The fourth goal was to find out whether general nurses with bachelor degree were willing to participate on application of research results to nursing practice. The fifth goal was to find out whether general nurses with bachelor degree had met with application of research results to nursing practice. The goals of the thesis have been met. Five hypotheses were set for achievement of the above goals. H1: General nurses with bachelor degree are willing to participate in research in nursing. H2: General nurses with bachelor degree are able to define the term Evidence Based Practice. H3: General nurses with bachelor degree know the names of databases they may use in planning nursing care based on evidence. H4: General nurses with bachelor degree are willing to participate in introduction and application of research results to nursing practice. H5: General nurses with bachelor degree meet application of research results to nursing practice. The first, second and fourth hypotheses were confirmed, the third and fifth ones were not confirmed. Although the issues of Evidence Based Practice appear more and more often in literature, and we might expect nurses with tertiary education to apply the practice based on evidence in nursing, there are still general nurses who have lack of information in this sphere. Nevertheless there are a lot of general nurses with tertiary education who would like to participate in research and application of the research results to nursing practice. A proposal for a whole-life educational course focused on application of Evidence Based Practice to nursing was elaborated upon the research results. The results may also be used in hospital seminars and in education of nursing students.

The use of research evidence to improve the practices of teachers is considered one of the ways of improving the educational outcomes for children. This study was focussed on determining how an online approach could be used to increase knowledge mobilisation in education, by giving teachers better access to research knowledge that they could use to support and develop their practices. This study had two aims. The first aim was to investigate what research knowledge and research practices teachers were using and what value they ascribed to those practices; the second was to explore teachers' views and opinions of a new online approach to the presentation of research knowledge. This was a mixed method study using questionnaires, interviews and focus groups to gather a range of both qualitative and quantitative data. The findings of this study show that practitioners value research practices more than they are able to participate in them, and that there is a consistent valuepractice gap across the range of research practices. Exploratory factor analysis revealed five underlying factors; engagement with research, engagement with the research community, promotes professional discussion of research, promotes teacher knowledge generation, and promotes wider engagement of the school with research and the research community. These factors showed that teachers and their schools want to engage both with research knowledge and with the wider research community so that the use of research knowledge can be enhanced in education. The findings also show that practitioners were receptive to the use of an online approach to the delivery of research knowledge and the piloted approach was accessible and intuitive. Practitioners exhibited interest in using the approach in a range of collaborative interactions with colleagues. Overall this study revealed that online approaches to knowledge mobilisation have potential but that teachers need to be supported in their engagement with research and the wider research community. This thesis is a contribution to the knowledge of how online approaches can be developed and deployed to enhance knowledge mobilisation towards teaching being an evidence informed profession. Equally school leaders and policy-makers need to create environments that are supportive of teachers' use of research, if they want teachers to use research knowledge to inform their practices.