# Readiness and Implementation of Evidence-Based Practice Among Physiotherapists: A Cross-Sectional Study and Evidence-Based Practice Questionnaire Validation

## TL;DR

This study explores how physiotherapists in Estonia apply evidence-based practice and identifies factors that influence their readiness and ability to implement it.

## Contribution

The study validates the Estonian version of the Evidence-Based Practice Questionnaire and identifies key factors influencing EBP implementation.

## Key findings

- Physiotherapists showed strong attitudes toward EBP but weaker critical appraisal and knowledge sharing.
- Readiness to implement EBP was linked to supervisory experience and working with colleagues.
- Daily EBP was primarily explained by EBP competencies, not by years of experience.

## Abstract

Background/Objectives: Evidence-based practice (EBP) is a core competence in physiotherapy, yet its implementation in routine clinical practice remains inconsistent. This study aimed to describe self-reported EBP competencies among physiotherapists and to examine factors associated with daily EBP and readiness to implement EBP. Methods: A cross-sectional analytic survey was conducted among 337 practicing Estonian physiotherapists (75% female) between 2022 and 2024. EBP competencies were assessed using the Estonian version of the Evidence-Based Practice Questionnaire (EBPQ-E). Two multiple linear regression models examined associations of demographic and professional characteristics and EBP competencies with (1) daily EBP and (2) readiness to implement EBP. Results: The mean total EBPQ-E score was 4.72 (SD = 0.89), with the highest scores in Attitude, followed by Knowledge/Skills, Practice, and Sharing. While physiotherapists strongly endorsed the value of EBP, critical appraisal and knowledge sharing were less frequent. Readiness to implement EBP was associated with supervisory experience, dual employment, and working with colleagues (p < 0.05), explaining 7.5% of the variance. Daily EBP was primarily explained by EBP competencies (40.8% variance), whereas 5–10 years of qualification showed a negative association. Conclusions: While professional and contextual factors support readiness for EBP, sustained implementation relies on continuous competency development and career-long support for practicing physiotherapists, shifting focus away from static background characteristics, workload, and time constraints.