Sandra E. Zwolsman

Sicily statement on classification and development of evidence-based practice learning assessment tools

BackgroundTeaching the steps of evidence-based practice (EBP) has become standard curriculum for health professions at both student and professional levels. Determining the best methods for evaluating EBP learning is hampered by a dearth of valid and practical assessment tools and by the absence of guidelines for classifying the purpose of those that exist. Conceived and developed by delegates of the Fifth International Conference of Evidence-Based Health Care Teachers and Developers, the aim of this statement is to provide guidance for purposeful classification and development of tools to assess EBP learning.DiscussionThis paper identifies key principles for designing EBP learning assessment tools, recommends a common taxonomy for new and existing tools, and presents the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework for classifying such tools. Recommendations are provided for developers of EBP learning assessments and priorities are suggested for the types of assessments that are needed. Examples place existing EBP assessments into the CREATE framework to demonstrate how a common taxonomy might facilitate purposeful development and use of EBP learning assessment tools.SummaryThe widespread adoption of EBP into professional education requires valid and reliable measures of learning. Limited tools exist with established psychometrics. This international consensus statement strives to provide direction for developers of new EBP learning assessment tools and a framework for classifying the purposes of such tools.

Tools to assess Evidence-Based Practice behaviour among healthcare professionals

Objective To identify and compare tools to assess Evidence-Based Practice (EBP) behaviour among healthcare professionals. Design Systematic review. Data sources MEDLINE, EMBASE, Cochrane Library, PsychInfo and CINAHL up to July 2011. Study selection Titles, abstracts and eligible full text articles were screened by two reviewers independently. Data extraction Relevant data were extracted by one reviewer and checked by a second reviewer. Eligibility criteria for selecting studies: original studies among all healthcare professionals that described the development or use of EBP behaviour assessment tools. Results Of 19 310 identified articles, 172 studies were included. We identified 117 questionnaires, 10 interviews or focus groups, nine observational studies, 27 chart evaluations and nine studies used a combination of methods. Psychometric properties of the questionnaires used were reported in about half of the studies, in seven studies that assess a single EBM step and in six studies that assess a combination of EBM steps. One of these assessed all five steps of EBP. Conclusions Valid and reliable EBP behaviour assessment tools are available. However, only one questionnaire validly assessed all five EBP steps, covering the entire concept of EBP.

Measuring evidence-based medicine knowledge and skills. The Dutch Berlin Questionnaire: translation and validation

on the reporting quality of the reviews. What is not reported is considered not to have been done by the authors. Therefore, the tools might be considered too unfair toward mixed-methods reviews. It is possible that mixed-methods reviews are published more frequently in journals that impose a maximum number of words to authors. This is a situation where authors tend to report less methodological aspects of their work and are more fluent on results and discussion sections [9]. Moja et al. [9] found that nearly 50% of published systematic reviews did not specify how the methodological quality of primary studies was evaluated or how it was considered in the interpretation of results, contrary to quantitative Cochrane reviews. Although systematic approaches have been proposed to achieve mixed-methods reviews [1], at present days, there is no specific guideline. The realization of mixed-methods reviews is a methodological challenge in terms of study selection, assessment of quality of different types of primary studies, and synthesis of results [2]. Because the methodological aspects of qualitative studies and quantitative studies can be considerably different, it might be necessary to consider as many critical appraisal tools as there are types of systematic reviews. Our experience emphasizes the need for a consensus on standards for reporting quality of mixed-methods reviews. Without such a consensus, assessing this type of systematic review should be done with caution.

Prolapse surgery with or without incontinence procedure: a systematic review and meta‐analysis

To reduce the risk of postoperative stress urinary incontinence (POSUI) prolapse repair might be combined with incontinence surgery.

Hysteroscopic resection of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

To compare the effectiveness of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting and a uterine caesarean scar defect.

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Women with pelvic organ prolapse without symptoms of urinary incontinence (UI) might demonstrate stress urinary incontinence (SUI) with or without prolapse reduction. We aimed to determine the value of demonstrable SUI during basic office evaluation or urodynamics in predicting SUI after vaginal prolapse repair in these women.

Results of an innovative bulking agent in patients with stress urinary incontinence who are not optimal candidates for mid-urethral sling surgery

To assess the efficacy and safety of peri‐urethral bulking injections (PBI) with an innovative bulking material (PDMS‐U) in women with stress‐urinary incontinence (SUI) who are not optimal candidates for mid‐urethral sling surgery.

Patients’ perspectives on urethral bulk injection therapy and mid-urethral sling surgery for stress urinary incontinence

Introduction and hypothesisThe aim of this study was to identify all treatment decision factors that determined the preference for peri-urethral bulk injection therapy (PBI) or mid-urethral sling (MUS) surgery in patients with primary stress urinary incontinence (SUI). Second, we explored what patients expect from treatment for SUI and whether patients would consider PBI as a primary treatment option.MethodsIn a qualitative design, 20 semi-structured, face-to-face interviews were conducted in women with primary SUI. Exclusion criteria were: previous PBI or MUS surgery; predominating urgency. Interviews were guided by three open-ended questions and a topic list. PBI treatment and MUS surgery were described in detail, and the efficacy was stated as 70% and 90%, respectively. Data saturation was reached when no new treatment decision factors were identified in three consecutive interviews. Interviews were audiotaped and fully transcribed. Thematic analysis by a coding process was done independently by two researchers.ResultsSixteen procedural, personal, professional, social and external treatment decision factors were identified. Regarding expectations about treatment for SUI, women believed ‘becoming dry’ was wishful thinking. The majority of patients accepted a small degree of persistent urinary incontinence after treatment. Regardless of their treatment preference, patients indicated that women should be informed about PBI as a primary treatment option.ConclusionPatients with primary SUI are open to PBI as an alternative treatment option even with lower cure rates compared with MUS surgery performed under general or spinal anesthesia. Patients indicated that women with primary SUI seeking treatment should be informed about PBI as a treatment option.