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However, our results indicate that respondents favored social interactions about evidence (“sharing evidence from a research study with patients and the families” and “informally discussing evidence from a research study”) over activities associated with individually acquiring evidence by accessing written sources. This result is also similar to that of Stokke, et al. [32]. Earlier studies also indicate that learning for many health care practitioners more often occurs through workplace interactions with colleagues and patients than through written sources [37,38]. Physicians were more likely than other professional groups to engage in research, being seven times more likely to implement EBP compared with our reference group. Still, professional affiliation had a proportionately low association with our study outcome, compared with other factors. In a study of different professional groups, Weng, et al. [26] observed significant professional differences, with physicians perceiving fewer barriers to implementing EBP than other groups and implementing EBP most. As the availability and relevance of research evidence for practice may vary for different professions, different professional groups may implement EBP differently. Our study was not able to show clearly that an EBP climate and leadership affected EBP implementation although respondents with a more EBP-supportive work climate were more likely to belong to the high EBP-implementing group. Respondents reported trust in their leadership’s knowledge about EBP and evaluated leadership support of EBP implementation in positive terms. In contrast, the respondents expressed doubts concerning how leaders proactively operationalize EBP implementation. In effect, there seems to be a perceived lack of an explicit strategy (clear standards, facilitation plan, removal of obstacles) to effectuate EBP in actual practice. Respondents perceived that they received no financial or other compensation for implementing EBP. Climate and leadership are perceived to be important to facilitate EBP [11,39-41]. However, the mechanisms by which leadership affects implementation success are as yet unclear, which is reflected in difficulties in operationalizing and measuring leadership influence [42,43]. Further research is needed to identify the specific actions that leaders at different levels could engage in to support EBP implementation. This study has some limitations that must be considered when interpreting the findings. The wide confidence intervals in the regression analyses were most likely caused by the relatively small sample size. The overall response rate was 32%, which reduces our ability to make generalizations about the entire rheumatology population. Non-respondents in survey research tend to be different from those who participate; the latter are typically more motivated, opinionated, and well organized [44]. As EBP is generally considered important, participants’ perceptions of what they are expected to think may have additionally had a positive impact on scores. It is therefore likely that our findings do not exaggerate the extent to which EBP is implemented in rheumatology: the scores may be inflated because of both selection bias and social desirability bias. The study applied a broad theory-based approach, incorporating several factors that may potentially influence EBP implementation, using valid and reliable instruments. Even so, all potential factors of importance could not be included within the scope of this study. One Table 4: Sex- and age-adjusted multiple regression model explaining the study outcome (score on EBP Implementation Scale). The model demonstrated good model fit according to the Hosmer and Lemeshow goodness-of-fit test (Chi-sq (8) = 4.90, p = 0.77). Nagelkerke R Square = 0.41. Sig Exp (B) CI (95%) Experience of research activities COVID-19 is responsible for many things, including placing public attention on clinical trials and the worldwide race to approve a vaccine. The words rushed to market usually strike fear in the minds and hearts of clinical research coordinators. Many have seen investigational products with aggressive timelines withdrawn mid-study or during late-stage trials.
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