Does self-efficacy influence the application of evidence-based practice: A survey and structural equation model

Abstract

Background: Implementation of Evidence-Based Practice (EBP) is complex and consequently, even within organizations that have made efforts to promote EBP use, EBP is often underutilized by individual clinicians.

Purpose: The aim of our study was to better understand the relationship between self-efficacy and EBP implementation in clinical environments that have undergone efforts to increase EBP utilization. We suggest that EBP is a set of behaviors that result from individuals acquiring, applying, and sharing new knowledge with others in the organization. We hypothesize, based upon a social cognitive theoretical approach, that these behaviors are influenced by clinician perception of self-efficacy.

Methods: We analyzed data provided by a 2011 survey of clinicians working within a national sample of hospitals that were actively participating in the Clinical Practice Model Resource Center (CPMRC), a collaborative consortium of health care organizations working to guide the implementation of EBP into the work worlds of clinicians. Structural equation modeling was used to examine the relationships between the acquisition, application, and sharing of evidence, and self-efficacy.

Results: Self-efficacy increased the acquisition of evidence and application of evidence. Self-efficacy did not exert a significant influence on sharing evidence. Acquisition of evidence increased both application of evidence and sharing of evidence. Application of evidence then increased sharing of evidence among sampled clinicians.

Conclusions: Efforts to promote self-efficacy in clinicians are powerful in that they directly promote the acquisition and application of evidence, and indirectly encourage communication between clinicians in an effort to justify and reinforce new knowledge. Efforts to boost self-efficacy would benefit from a focus on helping clinicians become more comfortable with actions related to acquiring evidence and generating new knowledge.