From Research to Real Patients: Strengthening Evidence-Based Practice in Physical Therapy Education
Evidence-based practice is central to physical therapy education. In a Doctor of Physical Therapy (DPT) program, students learn how to ask clinical questions, search for research, evaluate evidence, and apply findings to patient care. Those skills matter most when students see them used in clinical settings.
Clinical instructors play a major role in that process. During clinical education, they help students connect coursework to patient care. They model how physical therapists reason through decisions, weigh evidence, and adapt care to a patient’s goals, needs, and response to treatment.
A recent study in the Journal of Physical Therapy Education examined how clinical instructors report modeling evidence-based practice during physical therapy student clinical experiences. The study surveyed 308 clinical instructors affiliated with physical therapy programs and found strengths and gaps.
What Clinical Instructors Model Well
The study found that many clinical instructors model the early steps of evidence-based practice. Most respondents reported helping students develop clear clinical questions tied to patient-specific problems. In fact, 89% said they model how to form a focused clinical question during a student’s clinical experience.
Many instructors reported helping students take the first step toward evidence-informed care:
- 89% modeled how to develop a focused clinical question.
- 82% reported using evidence from reliable databases during student clinical experiences.
- 84% used clinical practice guidelines while mentoring students.
These reported practices show how clinical instructors can connect classroom learning to the questions that arise during patient care. A patient’s difficulty climbing stairs, for example, can become the starting point for a focused question, a search for relevant evidence, and a discussion about treatment options.
Where the Gaps Remain
The findings highlight an opportunity to strengthen how instructors help students interpret and apply research. Only 26.8% reported using a standardized critical appraisal template. Although 59.8% modeled diagnostic accuracy measures, far fewer discussed likelihood ratios (18.9%) or used nomograms (5%)—tools that help determine how test results change the likelihood of a diagnosis.
In treatment planning, instructors commonly modeled measures of real or clinically meaningful change, but less often used relative risk, absolute risk, or number needed to treat to explain treatment benefits and harms (Dashottar et al., 2025).
Why This Matters for Physical Therapy Students
Clinical education brings evidence-based practice to life. By explaining how research informs patient care, clinical instructors help students connect classroom concepts to decisions about examination, treatment, and patient education. Repeated exposure to this reasoning helps students learn to weigh research alongside clinical expertise and each patient’s goals.
The gaps identified in the study highlight an opportunity to support instructors in this teaching role. Limited time and challenges interpreting research may make some concepts harder to model during patient care. Practical resources and focused training could help instructors make their reasoning more visible to students.
An Opportunity for DPT Programs
Physical therapy education can strengthen evidence-based practice by supporting clinical instructors more intentionally. DPT programs can help by creating practical resources that fit the pace of clinical care.
These supports may include quick-reference tools, refresher materials, examples of how to explain common statistical terms, or short guides that connect evidence-based metrics to patient cases. Rather than ask clinical instructors to do more with less, programs can make evidence-based teaching easier to integrate into everyday patient care.
Strengthening the Clinical Learning Environment
Clinical instructors often model important foundations of evidence-based practice, especially asking clinical questions and finding relevant evidence. The gaps appear in more advanced areas, such as critical appraisal and the use of evidence-based metrics during diagnosis and intervention planning.
That distinction shows that physical therapy education has a foundation to build on. Clinical instructors already help students connect research to care in meaningful ways. With targeted support from academic programs, they can help students develop greater confidence in the more complex parts of evidence-based practice.
About the University Author
Devashish Tiwari, PT, PhD, DPT, NCS, is an associate professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at Mass General Brigham University of Health Professions. A board-certified clinical specialist in neurology, Dr. Tiwari brings more than 15 years of clinical experience in neurologic and pediatric physical therapy, with research focused on pediatric concussion and the development and validation of outcome measures in brain injury.
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