Perspectives on how evidence-based practice changes over time: A qualitative exploration of occupational therapy and physical therapy graduates.

Rationale: The integration of evidence-based practice (EBP) into rehabilitation education programs has been widespread, but little is known about how graduates' EBP competencies evolve over time.

Aims and objectives: To explore how and why the use of EBP by occupational therapists (OTs) and physical therapists (PTs) evolves during the first 3 years of clinical practice.

Method: We used an interpretive description methodology. We conducted semi-structured interviews with OTs and PTs who participated in a minimum of three out of four time points in a previous longitudinal pan-Canadian mixed methods study. Data analysis was guided by Braun and Clarke's approach to thematic analysis.

Results: Seventeen clinicians (13 OTs and 4 PTs) participated in the study. Our analysis identified six overarching themes: (1) evolution of "what EBP is and what it means"; (2) over time, evidence takes a back seat; (3) patients and colleagues have a vital and perennial role in clinical decision making; (4) continuing professional development plays a vital role in EBP; (5) personal attitudes and attributes influence EBP; and (6) organizational factors influence EBP.

Conclusion: Our study highlights the dynamic nature of EBP use among OTs and PTs in the first 3 years of clinical practice, emphasizing the need for contextualized approaches and ongoing support to promote evidence-informed healthcare in rehabilitation.