gms | German Medical Science

Background/research question: Evidence-based practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. The Evidence-based Practice Inventory (EBPI) is a 5-dimensional questionnaire to assess adherence to EBP, and to identify barriers and facilitators for EBP [1]. In a recent systematic review, the EBPI was identified as one of the few validated instruments to assess EBP behaviour, attitude and implementation in the allied health professions [2]. Just like other health professionals, paramedics in Germany should follow the principles of EBP. The EBPI may be used to assess EBP adherence of paramedics. However, there is no available evidence for the measurement properties of the EBPI in paramedics. Thus, we aimed to analyse the internal consistency reliability of the EBPI in a sample of paramedics working in Germany.

Methods: We used cross-sectional data of a nation-wide online survey designed to assess EBP adherence and influencing factors of paramedics working in Germany (launched for 4 months in 2024; trial registration: DRKS00033964). Paramedics working in Germany were recruited using a snowball system, including professional associations and social media. The analyses are based on the data of those participants who fully completed a validated German version of the EBPI questionnaire as part of the survey [1]. For each EBPI dimension, internal consistency reliability (Cronbach’s alpha) was calculated.

Results: The EBPI was completed by 703 paramedics (mean age 35.0±9.6 years, 79.4% male). Cronbach’s alpha was 0.85 [95% confidence interval: 0.83–0.87] for “attitude”, 0.77 [0.74–0.79] for “subjective norm”, 0.89 [0.87–0.90] for “perceived behavioural control”, 0.56 [0.50–0.61] for “decision making”, and 0.81 [0.79–0.83] for “intention and behaviour”.

Conclusion: The internal consistency reliability of the EBPI, a self-reported measure of EBP adherence, varied between 0.56 and 0.89 for the 5 dimensions of the questionnaire in a sample of paramedics working in Germany. As reported by others [1], only the dimension “perceived behavioural control” (3 items) seems insufficiently reliable if alpha values between 0.70 and 0.95 are considered acceptable [3]. The EBPI appears to be a promising instrument for measuring EBP adherence of paramedics. However, further research is needed to assess the validity and test-retest reliability of the EBPI in paramedics.

Competing interests: TB and LH report no conflict of interest. TH is the first chairman of the German Society of Paramedic Science e. V.