Current state of the experience of receiving evidence-based practice education and its relationship with evidence-based practice knowledge and skills among hospital nurses: A cross-sectional questionnaire survey in Western Japan

While nurses' evidence-based practice (EBP) knowledge and skills are critical for its implementation, various factors may act as effect modifiers, potentially influencing the strength of the relationship between EBP knowledge and skills and EBP implementation. To quantitatively evaluate whether various professional and work environment factors modify the strength of the association between EBP knowledge and skills and EBP implementation. This cross-sectional study was conducted between June and September 2022 among 2672 nurses in Japan. EBP knowledge and skills and EBP implementation were measured using the Japanese version of the EBP Questionnaire. Professional factors, such as years of experience and position, and work environment factors such as organizational attitude toward EBP were measured. Multiple regression analyses evaluated whether the association between EBP knowledge and skills and implementation varied across subgroups. Seven hundred seventeen nurses (26.8%) were included in the final analysis. After adjusting for potential confounding factors, EBP knowledge and skills were positively associated with the EBP implementation. Among the seven factors tested, a statistically significant interaction effect on the relationship between EBP knowledge and skills and EBP implementation was observed only for organizational attitude toward EBP. The findings suggest that the association between EBP knowledge and skills and implementation may vary depending on the level of organizational support. It may be beneficial for nurse managers and educators to consider integrating EBP into education frameworks to enhance access to EBP learning opportunities. Promoting a workplace culture that prioritizes EBP may also help strengthen its implementation in clinical settings.

To develop a clinical scenario-based educational program incorporating five evidence-based practice (EBP) steps and evaluate its effects on EBP knowledge and skills and EBP implementation among hospital nurses. This study employed a randomized controlled trial design. Eighty-seven registered nurses were recruited from 22 hospitals across Japan and randomly assigned to either the Intervention group (n = 44) or the Control group (n = 43). The Intervention group received a clinical scenario-based education program incorporating the five EBP steps, utilizing the Prevention of Delirium in Elderly Hospitalized Patients scenario. EBP knowledge and skills and EBP implementation were measured at baseline (T1), immediately post-intervention (T2), and 2 months later (T3). Linear mixed models were used to assess the between-group differences in EBP knowledge and skills, as well as EBP implementation. No significant differences were found between groups at T1 in EBP knowledge and skills (25.4 [22.6-28.1] vs. 27.9 [25.0-30.7], p = .219) and implementation scores (14.8 [12.7-16.9] vs. 15.0 [12.8-17.3], p = .882). At T2 and T3, the Intervention group had significantly higher knowledge and skills (T2: 33.8 [31.4-36.3] vs. 27.6 [25.1-30.2], p = .001; T3: 36.8 [34.3-39.3] vs. 27.2 [24.7-29.7], p < .001) and higher implementation scores at T3 (21.5 [19.5-23.5] vs. 14.5 [12.5-16.5], p < .001). A clinical scenario-based educational program incorporating the five steps of EBP effectively enhanced EBP knowledge and skills as well as promoted EBP implementation among hospital nurses. Trial registration number UMIN000053457 (1/27/2024).

Promoting evidence-based practice (EBP) among nurses may be a valuable component of improving health care. However, a comprehensive analysis of the factors associated with the knowledge and skill EBP in nurses has not been performed to date. This is essential for facilitating the acquisition of relevant knowledge and skills to effectively implement EBP. The aim of the study was to determine the factors related to the knowledge and skills of EBP among nurses. We searched various literature databases up to October 25, 2021, for relevant studies that investigated the factors associated with the knowledge and skills of EBP in nurses. The authors, year of study, country, study design, study subject information, instruments used for the assessment EBP knowledge and skills, use of multivariable analysis, and factors significantly associated with the knowledge and skills of EBP among nurses were extracted from each eligible study and collated to identify commonly reported factors. We identified 47 eligible studies conducted in a wide range of countries. Nine articles applied multivariable analyses, and 38 articles did not perform any multivariable analyses. The factors related to the knowledge and skill levels of EBP among nurses were classified into two categories: personal and work-environment factors. In the nine articles that conducted multivariable analysis, personal factors, which included educational level, participation in EBP education, and experience conducting research, and work-environment factors, such as resources and organizational support for EBP, were related to the knowledge and skills of EBP among nurses. Our review highlighted educational level, participation in EBP education, experience conducting research, and resources and organizational support for EBP as important factors that are associated with the knowledge and skills of EBP in nurses worldwide. Focusing on these factors may help improve nurses' understanding of EBP and facilitate the implementation of EBP.

Emergency care clinicians are expected to use the latest research evidence in practice. However, emergency nurses do not always consistently implement evidence-based practice (EBP). An educational intervention on EBP was implemented to promote emergency nurses' use of EBP, and the effectiveness of it was evaluated. This study aimed to evaluate the effectiveness of an EBP educational intervention on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The study also examined learners' satisfaction with the EBP educational intervention. A randomized controlled trial with parallel groups with evaluations before the education, immediately after it, and 6 and 12months after the education was conducted at four emergency departments in two university hospitals. The experimental group (N=40) received EBP education while the control group (N=40) completed self-directed EBP education. The primary outcomes were emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior, while the secondary outcome was satisfaction with the EBP education. Thirty-five participants of an experimental and 29 participants of a control group completed the study. There were no statistically significant (p<.05) improvements and differences between groups in EBP attitude, self-efficacy, or behavior immediately after the EBP education. At the 6-month measurement point, the experimental group showed significantly better EBP attitudes, behavior, knowledge, and self-efficacy than the control group. At the 12-month measurement point, the improvements began to decrease. The groups also differed significantly in terms of participant satisfaction with how the teacher encouraged learners to ask clinical questions. The EBP educational intervention implemented in this study had a positive effect on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The effects of the education appeared the best 6months after the education. After this point, the results began to decrease and approached baseline levels. EBP educational interventions designed for emergency nurses should apply various teaching strategies to improve their EBP attitude, knowledge, self-efficacy, skills, behavior, and satisfaction with the education.

Evidence-based practice (EBP) combines the best available evidence with clinician expertise and patient preference to improve patient outcomes. Recent evidence indicates that Canadian Naturopathic Doctors (NDs) are interested in EBP skill development. The primary objective of the present study was to assess the feasibility and acceptability of a co-designed EBP Continuing Education (CE) course for Canadian NDs. Secondary objectives included assessing changes in EBP skill, use, attitudes, and knowledge. The CE course was evaluated using a pre-post design involving licensed Canadian NDs. The CE course consisted of five weekly, one-hour sessions that were delivered virtually. On course completion, participants reported on their level of satisfaction and provided suggestions for improvement. EBP skill, attitudes and use were assessed using the validated Evidence-Based Practice Attitudes and Utilization Survey. EBP knowledge was objectively assessed using a quiz. Changes in EBP skill, attitudes, use and knowledge were compared between baseline and the end of the course. Use of evidence was reassessed at a 2-month follow up. Sixty-one NDs met eligibility criteria. Eighty-nine percent of participants agreed or strongly agreed that they were satisfied with the course. There was a significant increase in self-reported skill and objectively measured EBP knowledge, but no substantive change in EBP attitudes or use of evidence over time. Some participants indicated the level of difficulty was too high while others reported that it could have been more difficult. Participants also wanted more opportunities to practice the skills being taught in the course. Delivery of the co-designed EBP CE course was found to be both feasible and acceptable. Preliminary evidence suggests that participation in the course was associated with improvements in EBP knowledge and skill. Participants provided actionable suggestions to improve the course in future iterations.

INTRODUCTION: Evidence-based practice (EBP) is crucial for delivering optimal client care. Although healthcare sciences students, including occupational therapy students at the University of Pretoria, receive the same evidence-based practice training, their attitudes, knowledge, skills and practices in EBP remain mostly unknown. Determining these aspects in final-year students is important as it may impact their future practice. METHODS: A non-experimental cross-sectional study was conducted using the Student Evidence-Based Practice Questionnaire. The survey was electronically distributed and completed by 50 final-year healthcare sciences students. Data analysis was performed using measures of central tendency. RESULTS AND DISCUSSION: Participants have positive attitudes related to the implementation of evidence-based practice. However, gaps in practice remain. Students rate their evidence-based practice knowledge as "average", which may impact their practice after graduation. Students report that they are more skilled in certain steps of EBP than others. CONCLUSION: The survey results can be used to strengthen evidence-based practice training for healthcare sciences students, potentially improving their ability to implement evidence-based practice after graduation. Several identified barriers to the implementation of evidence-based practice may be overcome through more purposeful training. IMPLICATIONS FOR PRACTICE • Positive attitudes towards EBP do not necessarily translate into increased practice and skills in EBP. • Educators should be aware of the challenges students experience with the different steps of EBP. • Training of healthcare science students should be developed to include all five steps of EBP. • Educating students on how to effectively use resources provided by their institutions can improve the evidence they find and apply.

BackgroundDespite the established interest in evidence-based practice (EBP) as a core competence for clinicians, evidence for how best to teach and evaluate EBP remains weak. We sought to systematically assess coverage of the five EBP steps, review the outcome domains measured, and assess the properties of the instruments used in studies evaluating EBP educational interventions.MethodsWe conducted a systematic review of controlled studies (i.e. studies with a separate control group) which had investigated the effect of EBP educational interventions. We used citation analysis technique and tracked the forward and backward citations of the index articles (i.e. the systematic reviews and primary studies included in an overview of the effect of EBP teaching) using Web of Science until May 2017. We extracted information on intervention content (grouped into the five EBP steps), and the outcome domains assessed. We also searched the literature for published reliability and validity data of the EBP instruments used.ResultsOf 1831 records identified, 302 full-text articles were screened, and 85 included. Of these, 46 (54%) studies were randomised trials, 51 (60%) included postgraduate level participants, and 63 (75%) taught medical professionals. EBP Step 3 (critical appraisal) was the most frequently taught step (63 studies; 74%). Only 10 (12%) of the studies taught content which addressed all five EBP steps. Of the 85 studies, 52 (61%) evaluated EBP skills, 39 (46%) knowledge, 35 (41%) attitudes, 19 (22%) behaviours, 15 (18%) self-efficacy, and 7 (8%) measured reactions to EBP teaching delivery. Of the 24 instruments used in the included studies, 6 were high-quality (achieved ≥3 types of established validity evidence) and these were used in 14 (29%) of the 52 studies that measured EBP skills; 14 (41%) of the 39 studies that measured EBP knowledge; and 8 (26%) of the 35 studies that measured EBP attitude.ConclusionsMost EBP educational interventions which have been evaluated in controlled studies focus on teaching only some of the EBP steps (predominantly critically appraisal of evidence) and did not use high-quality instruments to measure outcomes. Educational packages and instruments which address all EBP steps are needed to improve EBP teaching.

BackgroundDespite the recognition of integrating evidence-based practice (EBP) in educational programs, there is limited research about bachelor students’ EBP profiles (EBP knowledge, attitudes and behaviour) in the health disciplines nursing, occupational therapy, physiotherapy and radiography. The aim of this study was to assess EBP profiles among bachelor students in health disciplines, and explore differences between health disciplines, educational institutions, students’ assessment of EBP teaching and expectations of EBP performance.MethodsA survey using the ‘Evidence-Based Practice Profile - Norwegian version’ (EBP2-N) was conducted among final year bachelor students in health disciplines from four educational institutions. The questionnaire consisted of five domains (Relevance, Terminology, Confidence, Practice and Sympathy) and assessed the five steps of EBP. We performed regression analyses to analyse mean differences in domain scores between health disciplines, Cohen’s d to illustrate the magnitude of the largest difference in each domain, Omega squared to describe portion of variance in domain scores, and Spearman’s rho (rs) to assess the monotonic relationship between EBP2-N domains and assessment of EBP teaching and expectations of EBP performance, respectively.ResultsStudents reported highest overall mean score for Relevance, with an estimated standardized mean of 81.2 (CI 95% = 80.4–82.0). The other EBP2–N domains had estimated standardized means of 54 and less. Statistically significant differences (p < 0.03) between health disciplines were observed for all domains. The largest mean difference was found for Relevance with highest score for occupational therapy and lowest for radiography, with an estimated Cohen’s d of 1.11. Moderate positive associations were observed between Relevance scores and students’ assessment of EBP teaching (rs = 0.31), and expectations of EBP performance from teachers (rs = 0.36). We also observed a moderate positive correlation between Confidence and students’ assessment of EBP teaching (rs = 0.46).ConclusionBachelor students in health disciplines found EBP relevant, but revealed low understanding of EBP terminology, low confidence with EBP skills, and low use of EBP in clinical situations. We observed differences in EBP profiles between health disciplines and between educational institutions. The differences in scores raise questions about the understanding of EBP within disciplines, and the complexity of EBP in educational settings.

To develop an objective instrument to measure nurses' entry-level knowledge of and skills in evidence-based practice, and to evaluate the validity and reliability of the instrument. To promote evidence-based practice in nursing, nurses should initially receive education about evidence-based practice knowledge and learn the skills, and this should be followed by measurement with an instrument that was developed to evaluate the extent to which they are prepared to use evidence-based practice knowledge and skills. Although some self-report instruments have been developed to measure evidence-based practice in nursing, an objective instrument to evaluate nurses' evidence-based practice knowledge and skills is not available at present. A methodological study. This study was conducted in two stages: the instrument development and its psychometric evaluation, including its validity and reliability. An instrument, 'Knowledge and Skills of Evidence-based Nursing,' was developed. Content validity was assessed by five experts in evidence-based nursing, and the construct validity was evaluated by the known-groups method. Reliability was examined with internal consistency reliability and inter-rater reliability. A content validity index >0·80 was achieved. For construct validity, there were statistically significant differences between the evidence-based practice and nonevidence-based practice groups in total scores and in the scores on each subscale of the Knowledge and Skills of Evidence-based Nursing. Cronbach's alpha was 0·96, and the inter-rater reliability was excellent. The Knowledge and Skills of Evidence-based Nursing is a valid and reliable instrument for objectively assessing nurses' evidence-based practice knowledge and skills; it is quick to complete and to score the answers. Because the Knowledge and Skills of Evidence-based Nursing objectively assesses nurses' evidence-based practice knowledge and skills, it can be used to examine the effects of evidence-based practice education. Moreover, the Knowledge and Skills of Evidence-based Nursing may contribute to the promotion of evidence-based practice projects in clinical settings because it can measure the extent to which nurses are prepared to use their evidence-based practice knowledge and skills.

Evidence-based practice (EBP) prevents unsafe/inefficient practices and improves healthcare quality, but its implementation is challenging due to research and practice gaps. A focused educational program can assist future nurses to minimize these gaps. This study aims to assess the effectiveness of an EBP educational program on undergraduate nursing students’ EBP knowledge and skills. A cluster randomized controlled trial was undertaken. Six optional courses in the Bachelor of Nursing final year were randomly assigned to the experimental (EBP educational program) or control group. Nursing students’ EBP knowledge and skills were measured at baseline and post-intervention. A qualitative analysis of 18 students’ final written work was also performed. Results show a statistically significant interaction between the intervention and time on EBP knowledge and skills (p = 0.002). From pre- to post-intervention, students’ knowledge and skills on EBP improved in both groups (intervention group: p < 0.001; control group: p < 0.001). At the post-intervention, there was a statistically significant difference in EBP knowledge and skills between intervention and control groups (p = 0.011). Students in the intervention group presented monographs with clearer review questions, inclusion/exclusion criteria, and methodology compared to students in the control group. The EBP educational program showed a potential to promote the EBP knowledge and skills of future nurses.

Evidence-based practice (EBP) has been widely studied and adopted in allied health professions education. Current practitioners may have challenges in adopting EBP into current practice. EBP skills have not been previously assessed in perfusionists, therefore, the purpose of this study is to identify a preliminary analysis of perfusionists' EBP knowledge and its possible relationship to clinical behavior and educational level A non-randomized convenience study using the Evidence-Based Practice Questionnaire (EBPQ) was used to measure EBP of practicing U.S. perfusionists. The EBPQ is a validated survey instrument designed to measure EBP practice, attitude and knowledge subscales. The EBPQ consisted of 24 items on a 1 to 7 Likert Scale, with higher numbers indicating frequent use of skill. Practitioner experience, educational background and employment type were also collected. Two hundred and fifty-four responses met the inclusion criteria and were analyzed. The mean EBPQ score was 5.0 (SD = 0.9) with similar means for the subscales. There were important differences found in the EBPQ scores, depending on the educational level and work status. There was a positive correlation between the knowledge and practice subscales, demonstrating a relationship in the sample and a possible relationship in the population as a whole. The results suggest that perfusionists' use of EBP in practice does vary, based upon educational level and employment type. The findings also demonstrated areas of lower EBP aptitude. The correlation between EBP knowledge and practice may guide educational efforts at improving EBP practice.

BackgroundJournal clubs (JC) may increase clinicians’ evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, however there is a lack of research into their effectiveness in allied health. We investigated the effectiveness of a structured JC that is Tailored According to Research Evidence And Theory (TREAT) in improving EBP skills and practice compared to a standard JC format for allied health professionals. Concurrently, we explored the feasibility of implementing TREAT JCs in a healthcare setting, by evaluating participating clinicians’ perceptions and satisfaction.MethodsWe conducted an explanatory mixed methods study involving a cluster randomised controlled trial with a nested focus group for the intervention participants. Nine JCs with 126 allied health participants were randomly allocated to receive either the TREAT or standard JC format for 1 h/month for 6 months. We conducted pre-post measures of EBP skills and attitudes using the EBP questionnaire and Assessing Competence in Evidence-Based Medicine tool and a tailored satisfaction and practice change questionnaire. Post-intervention, we also conducted a focus group with TREAT participants to explore their perceptions of the format.ResultsThere were no significant differences between JC formats in EBP skills, knowledge or attitudes or influence on clinical practice, with participants maintaining intermediate level skills across time points. Participants reported significantly greater satisfaction with the organisation of the TREAT format. Participants in both groups reported positive changes to clinical practice. Perceived outcomes to the TREAT format and facilitating mechanisms were identified including the use of an academic facilitator, group appraisal approach and consistent appraisal tools which assisted skill development and engagement.ConclusionsIt is feasible to implement an evidence-based JC for allied health clinicians. While clinicians were more satisfied with the TREAT format, it did not significantly improve their EBP skills, attitudes, knowledge and/or practice, when compared to the standard format. The use of an academic facilitator, group based critical appraisal, and the consistent use of appraisal tools were perceived as useful components of the JC format. A structured JC may maintain EBP skills in allied health clinicians and facilitate engagement, however additional training may be required to further enhance EBP skills.Trial registrationACTRN12616000811404 Retrospectively registered 21 June 2016.

The importance and value of the principles of evidence-based practice (EBP) in the decision-making process is recognized by speech-language therapists (SLTs) worldwide and as a result curricula for speech-language therapy students incorporated EBP principles. However, the willingness actually to use EBP principles in their future profession not only depends on EBP knowledge and skills, but also on self-efficacy and task value students perceive towards EBP. To investigate the relation between EBP knowledge and skills, and EBP self-efficacy and task value in different year groups of Dutch SLT students. Students from three year groups filled in a tool that measured EBP knowledge and skills: the Dutch Modified Fresno (DMF). EBP self-efficacy and task value were assessed by using a 20-item questionnaire. Both tools were validated for this population. Mean scores for the three year groups were calculated and tested for group differences using a one-way analysis of variance (ANOVA) with a post-hoc Games-Howell procedure. With a multiple linear regression technique it was assessed whether EBP self-efficacy and task value predict learning achievement scores on the DMF. Other possible predictors included in the model were: level of prior education, standard of English, having had mathematics in prior education and the SLT study year. A total of 149 students filled in both measurement tools. Mean scores on EBP knowledge and skills were significantly different for the three year groups, with students who were further along their studies scoring higher on the DMF. Mean scores on the EBP self-efficacy and task value questionnaire were the same for the three year groups: all students valued EBP positive but self-efficacy was low in all groups. Of the possible predictors, only the year in which students study and EBP self-efficacy were significant predictors for learning achievements in EBP. Despite a significant increase in EBP knowledge and skills over the years as assessed by the DMF, the integrated EBP curriculum did not raise levels of EBP self-efficacy and task value. This lack of feeling competent might have an impact on students' willingness actually to use EBP. In curricula, therefore, there should be a focus on how to raise EBP self-efficacy in SLT students. This goes even beyond the educational department because a professional culture in which professionals are competent and confident EBP users would have a positive effect on EBP self-efficacy in students.

Background: Evidence-Based Practice (EBP) is crucial in enhancing patient outcomes, improving clinical decision-making, and ensuring high-quality care. However, the integration of EBP into nursing practice remains a challenge due to barriers such as limited knowledge, skills, and institutional support. Educational interventions, particularly small-group learning programs, have been shown to be effective in promoting EBP adoption among healthcare professionals (Saunders et al., 2019). This pilot study aims to evaluate the impact of a small-group educational program on nurses' EBP knowledge, skills, and attitudes. Objectives: The primary objective of this study is to assess the effectiveness of a four-week small-group educational program in improving nurses' understanding of EBP concepts, their ability to apply EBP in clinical practice, and their attitudes toward the practice. Secondary objectives include identifying the barriers to EBP implementation and gathering feedback on the educational program's content and delivery. Methods: A mixed-methods approach was employed, involving both quantitative and qualitative data collection. Nurses were recruited from a hospital setting and completed pre- and post-intervention surveys to measure changes in EBP knowledge, skills, and attitudes. Qualitative data were gathered through focus group discussions to explore participants’ experiences and perceived barriers to EBP adoption. The intervention consisted of four weekly sessions covering the EBP process, formulation of clinical questions, searching for evidence, critical appraisal, and integrating evidence into practice (Melnyk &amp; Fineout-Overholt, 2022).Results: The results showed a significant increase in participants' EBP knowledge and confidence in applying EBP in their clinical practice. Participants reported improvements in their ability to formulate clinical questions using the PICO framework and to critically appraise research evidence. Attitudes toward EBP became more positive, with nurses expressing greater motivation to use evidence in their clinical decision-making. Barriers identified included lack of time, limited access to resources, and resistance to change among colleagues. Feedback on the program indicated that the small-group format and hands-on activities were highly valued (Chua et al., 2020).Conclusion: This pilot study suggests that small-group educational programs are an effective method for improving nurses' EBP knowledge, skills, and attitudes. The findings support the need for continued efforts to incorporate EBP training into nursing education and practice, addressing barriers to successful implementation. Future research should focus on larger-scale studies and exploring long-term outcomes of such educational interventions.

Using evidence-based practice (EBP) improves the implementation of safe, high-quality healthcare for patients, reduces avoidable costs, and plays a crucial role in bridging knowledge-action gaps and reducing health inequities. EBP combines the best available evidence in the relevant literature with patient preferences and values and healthcare professionals' (HCPs) expertise. Systematic searches of ten bibliographic databases, unpublished works, and the Grey Literature Report sought studies published up to 30 September 2022. The 15 studies retained involved 2712 nurses. Three types of effective educational interventions were identified: (1) multifaceted educational strategies incorporating mentoring and tutoring; (2) single educational strategies, often delivered online; and (3) multifaceted educational strategies using the five steps of EBP. Eleven primary outcomes (EBP beliefs, EBP self-efficacy, perceived EBP implementation, EBP competencies, EBP knowledge, EBP skills, EBP attitudes, EBP behaviors, EBP desire, EBP practice, and perceptions of organizational culture and readiness) were assessed using 13 qualitative and quantitative instruments. Ensuring the successful implementation of EBP requires effective educational strategies. Computer-based learning seems the most cost-effective and efficient strategy, when considering caregivers' characteristics, the clinical field, and educational interventions across the pre-, peri-, and post-implementation processes.