Evidence-Based Practice Among Italian Physiotherapists: A National Cross- Sectional Survey on Competencies and Contextual Determinants

Background Evidence-Based Practice (EBP) is internationally recognized as a cornerstone of high-quality physiotherapy, yet its systematic implementation remains inconsistent. Previous national surveys in Italy suggested positive attitudes toward EBP but highlighted substantial gaps in practical skills. This study aimed to provide an updated and comprehensive overview of EBP attitudes, knowledge, behaviours, and contextual factors among Italian physiotherapists, using a validated questionnaire and targeting a nationally representative sample. Methods A cross-sectional online survey was distributed to physiotherapists formally registered with the national professional body. The questionnaire included demographic and professional variables, the Evidence-Based Practice Questionnaire (EBPQ), and nine additional items assessing contextual factors related to workplace support, patient expectations, interdisciplinary competencies, and economic influences. Likert-scale items were analysed as continuous variables. Descriptive statistics summarized respondent characteristics. Independent samples t-tests and one-way ANOVA were used to assess differences in EBPQ and contextual factor scores across socio-demographic and professional groups. Pearson correlations explored relationships between EBP competencies and contextual factors. Results A total of 289 physiotherapists completed the survey. Respondents expressed strong attitudinal support for EBP but reported modest practical skills, particularly in formulating structured clinical questions and critically appraising research. Higher EBPQ scores were associated with postgraduate education, prior research experience, teaching experience, younger age, and high English proficiency. Research and teaching experience exhibited the strongest and most consistent associations across practice-, attitude-, and knowledge-related domains. Contextual factor such as a supportive work environment and regular engagement in research-oriented continuing education were positively correlated with critical appraisal skills, the application of evidence to individual cases, and the capacity for self-monitoring of clinical practice. In contrast, economic pressures and concerns regarding patient expectations exerted a comparatively weaker influence. Conclusions Italian physiotherapists demonstrate favourable attitudes toward EBP but face substantial challenges in operationalizing key competencies. Strengthening EBP in Italian physiotherapy requires coordinated initiatives in undergraduate and postgraduate education, targeted continuing professional development, structured opportunities for research and teaching exposure, and workplace cultures that support evidence-informed decision-making. Future research should evaluate interventions aimed at reducing the gap between knowledge and practice.