Application Of Research Evidence Research Articles

Utilizing Competency-Based Education to Evaluate the Research Skills of Nursing Students: A Systematic Review and Meta-Analysis.

Exploring and implementing competency-based education approaches to assess research skills are necessary to close the gap between research and practice, promote lifelong learning among future nurses, and improve research literacy. This study aims to assess the effectiveness of competency-based education in improving the assessment of research skills among nursing students. A systematic review and meta-analysis of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Population, Intervention, Comparison, Outcomes and Study (PICOS) eligibility criteria were used to select original studies published between 2017 and 2023. As a first step in the data-handling process, titles and abstracts of all articles retrieved by the search strategy were screened for relevance, and the irrelevant articles were discarded. The screening process was conducted by two authors independently, and the final decisions were made together. A meta-analysis was performed to assess the effectiveness of competency-based education in improving the assessment of research skills among nursing students. Five quantitative studies were appraised using the Joanna Briggs Institute checklist. The effect size was 0.69 ± 0.35 (P = 0.05), which indicates a high effect on research competency among nursing students who attend courses or training in research matters, after transforming data to correlation coefficient resulting in r = 0.5. The study encourages research literacy among nursing students. Through competency-based learning, students are exposed to a variety of research methodologies, ethical issues, and scientific writing conventions. This exposure enhances their capacity to understand, assess, and apply research evidence, empowering them to become knowledgeable consumers and field contributors. While making evidence-based decisions, nurses with research competencies can actively incorporate the most recent research findings into their clinical practice. Furthermore, nurses with strong research abilities can influence health policy and practice.

Nature of the evidence base and approaches to guide nutrition interventions for individuals: a position paper from the Academy of Nutrition Sciences.

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of food, nutrition, biology, physiology, behaviour, management, communication and society to achieve and maintain human health. Thus, there is huge complexity in delivering evidence-based nutrition interventions to individuals. This paper examines available frameworks for appraising the quality and certainty of nutrition research evidence, the development nutrition practice guidelines to support evidence implementation in practice and the influence of other sources of nutrition information and misinformation. The paper also considers major challenges in applying research evidence to an individual and suggests consensus recommendations to begin to address these challenges in the future. Our recommendations target three groups; those who deliver nutrition interventions to individuals, those funding, commissioning or undertaking research aimed at delivering evidence-based nutrition practice, and those disseminating nutritional information to individuals.

Developing an online knowledge sharing platform and community of practice for health professionals: Experiences from C-WorKS developed in North East England and Yorkshire during COVID-19.

Although knowledge sharing online has been recognised as an important strategy for health professionals to apply research findings to their practice, limited research exists on how to develop and implement these platforms to help facilitate collaboration and knowledge sharing. This study evaluated an online knowledge sharing platform and community of practice developed in the North East of England and Yorkshire during COVID-19 to support UK health and care professionals to reduce the impact of the wider consequences of COVID-19. Semi-structured interviews with stakeholders (n = 8) and users of C-WorKS (n = 13), followed by an online survey (n = 19) among a wider group of users to analyse knowledge use. Interview and survey findings highlighted several strengths, weaknesses, opportunities and threats to support future development of online knowledge sharing platforms. Online knowledge sharing supports six 'pillars' of successful research and innovation partnerships. This requires distributed forms of leadership and linking of different knowledge sharing strategies, and careful combination of platforms with communities of practice. Online knowledge sharing provides pragmatic and timely strategies for health professionals in the UK to apply research evidence to their practice. Our study provides generalisable, practical insights in how to develop and implement a knowledge sharing platform.

Optimizing therapeutic decision-making for off-label medicines use: A scoping review and consensus recommendations for improving practice and research.

Off-label medicines use is a common and sometimes necessary practice in many populations, with important clinical, ethical and financial consequences, including potential unintended harm or lack of effectiveness. No internationally recognized guidelines exist to aid decision-makers in applying research evidence to inform off-label medicines use. We aimed to critically evaluate current evidence informing decision-making for off-label use and to develop consensus recommendations to improve future practice and research. We conducted a scoping review to summarize the literature on available off-label use guidance, including types, extent and scientific rigor of evidence incorporated. Findings informed the development of consensus recommendations by an international multidisciplinary Expert Panel using a modified Delphi process. Our target audience includes clinicians, patients and caregivers, researchers, regulators, sponsors, health technology assessment bodies, payers and policy makers. We found 31 published guidance documents on therapeutic decision-making for off-label use. Of 20 guidances with general recommendations, only 35% detailed the types and quality of evidence needed and the processes for its evaluation to reach sound, ethical decisions about appropriate use. There was no globally recognized guidance. To optimize future therapeutic decision-making, we recommend: (1) seeking rigorous scientific evidence; (2) utilizing diverse expertise in evidence evaluation and synthesis; (3) using rigorous processes to formulate recommendations for appropriate use; (4) linking off-label use with timely conduct of clinically meaningful research (including real-world evidence) to address knowledge gaps quickly; and (5) fostering partnerships between clinical decision-makers, researchers, regulators, policy makers, and sponsors to facilitate cohesive implementation and evaluation of these recommendations. We provide comprehensive consensus recommendations to optimize therapeutic decision-making for off-label medicines use and concurrently drive clinically relevant research. Successful implementation requires appropriate funding and infrastructure support to engage necessary stakeholders and foster relevant partnerships, representing significant challenges that policy makers must urgently address.

Information literacy and its link to evidence-informed policymaking in Zimbabwe

This paper explored the link between information literacy (IL) and other factors that enable or inhibit the utilisation of research evidence in policymaking in Zimbabwe. The study assumes that if policymakers possess appropriate IL skills to access, assess, synthesise, and apply research evidence, they will naturally use the evidence to inform their policy decisions. Face-to-face interviews with 26 policymakers — technocrats selected from the Parliament of Zimbabwe and two ministries, Industry and Commerce, and Youth, Sport, and Recreation — produced evidence to inform the findings and conclusions. Data synthesis using thematic content analysis confirmed the findings. The results show that while IL skills are critical in enabling policymakers' use of research evidence, multiple other factors also influence the use of research evidence in policymaking due to the complexity of the process. The political and socioeconomic context plays a profound role because of the intricate and nonlinear nature of the policymaking process. Therefore, enhancing evidence use in policymaking revolves around strengthening IL skills at the individual level, including institutional and the broader policy ecosystem, by acknowledging and leveraging personal and institutional relationships. This insight illuminates the need to reorient IL programmes to link them to these other factors.

A mapping exercise to identify the strengths, and gaps in knowledge translation activities at Cochrane South Africa.

Knowledge translation (KT) is a set of activities or processes for synthesising, disseminating, and applying research evidence in decision-making for the benefit of society. For KT to be successful, it is paramount for researchers to play an active role in encouraging evidence uptake and use in decision-making. We carried out a mapping exercise and interviews with research cluster heads at Cochrane South Africa (CSA) of the KT activities and processes being implemented (or are planned for implementation). We organized the mapping and interview results according to the KT themes described in the Cochrane KT framework. The KT framework comprises six themes, namely, (i) prioritization and co-production of research evidence; (ii) building a sustainable infrastructure for knowledge translation; (iii) engaging with audiences for knowledge exchange or dialogue; (iv) packaging, communication and dissemination which entails disseminating research to users; (v) building audience capacity to use evidence or training activities; and (vi) advocacy or improving the culture of using evidence. Through the mapping exercise and interviews, we learned that CSA researchers excelled in implementing activities and processes linked to most of the KT themes, including producing different types of systematic reviews and providing reliable evidence for health decision-making. Cochrane South Africa (CSA) researchers are also involved in mentoring and training postgraduate students and various health decision-makers (e.g., health professionals, guideline panels and policy-makers). While they excel in the above-mentioned activities, "packaging, communication, and dissemination of research evidence" (theme iv) was identified as an area of improvement.

Strategies to promote evidence use for health programme improvement: learning from the experiences of embedded implementation research teams in Latin America and the Caribbean

BackgroundTo achieve global health targets, innovative approaches are needed to strengthen the implementation of efficacious interventions. New approaches in implementation research that bring together health system decision-makers alongside researchers to collaboratively design, produce and apply research evidence are gaining traction. Embedded implementation research (EIR) approaches led by decision-maker principal investigators (DM PIs) appear promising in this regard. Our aim is to describe the strategies study teams employ in the post-research phase of EIR to promote evidence-informed programme or policy improvement.MethodsWe conducted a prospective, comparative case study of an EIR initiative in Bolivia, Colombia and Dominican Republic. Guided by a conceptual framework on EIR, we used semi-structured key informant interviews (n = 51) and document reviews (n = 20) to examine three decision-maker-led study teams (“cases”). Focusing on three processes (communication/dissemination, stakeholder engagement with evidence, integrating evidence in decision-making) and the main outcome (enacting improvements), we used thematic analysis to identify associated strategies and enabling or hindering factors.ResultsAcross cases, we observed diverse strategies, shaped substantially by whether the DM PI was positioned to lead the response to study findings within their sphere of work. We found two primary change pathways: (1) DM PIs implement remedial measures directly, and (2) DM PIs seek to influence other stakeholders to respond to study findings. Throughout the post-research phase, EIR teams adapted research use strategies based on the evolving context.ConclusionsEIR led by well-positioned DM PIs can facilitate impactful research translation efforts. We draw lessons around the importance of (1) understanding DM PI positionality, (2) ongoing assessment of the evolving context and stakeholders and (3) iterative adaptation to dynamic, uncertain circumstances. Findings may guide EIR practitioners in planning and conducting fit-for-purpose and context-sensitive strategies to advance the use of evidence for programme improvement.

Engaging with research: practical advice for nurses at every level.

Nurses at every level can reflect on their active engagement with clinical research. This article aims to support nurses to understand how they can facilitate and lead research. It provides practical advice to support the integration of research evidence into care delivery and increase the opportunities for patients to participate in clinical research. This is important because patients can benefit from nurses who are knowledgeable, confident and supported in applying research evidence. Furthermore, nurses can support and inform patient choice through increased confidence and competence in engaging with research and implementing research findings. Organisational culture and leadership are also important elements in fostering environments where evidence and research are promoted throughout the nursing workforce.

The debate over rational decision making in evidence-based medicine: implications for evidence-informed policy

Many of the resources developed to promote the use of evidence in policy aspire to an ideal of rational decision making, yet their basis in the decision sciences is often unclear. Tracing the historical development of evidence-informed policy to its roots in evidence-based medicine (EBM), we distinguish between two understandings of how research evidence may be applied. Advocates for EBM all seek to use research evidence to optimise clinical care. However, some proponents argue that ‘uptake’ of research evidence should be direct and universal, for example through wide-scale implementation of ‘evidence-based practices’. In contrast, other conceptualisations of EBM are rooted in expected utility theory, which defines rational decisions as choices that are expected to result in the greatest benefit. Applying this theory to medical care, clinical decision-making models clearly demonstrate that rational decisions require not only a range of relevant evidence, but also expertise to inform judgments regarding the credibility of estimates and to assess fit-to-context, and stakeholder preferences and values to weigh trade-offs among competing outcomes. Using these models as exemplars, we argue that attempts to apply research evidence directly to practice or policy without consideration of expert judgement or preferences and values reflect fundamental misconceptions about the theory of rational decision making that can impede implementation. In turn, the decision sciences highlight the need to consider the role of expertise and judgment when interpreting research evidence, the role of preferences and values when applying it to specific decisions, and the practical limits imposed by the uncertainty inherent in each.

Revisited: Effective use of the large body of research on the effectiveness of programs for juvenile offenders and the failure of the model programs approach

AbstractElliott et al.'s essay is part of what is now a series of papers in Criminology and Public Policy on contrasting ways that the evidence base on effective interventions with juvenile offenders can be used to improve juvenile justice programming. Their paper has two themes—(a) a defense of the model programs approach as promoted by the Blueprints for Healthy Youth Development evidence‐based program registry, and (b) an attack on the Standardized Program Evaluation Protocol scheme for assessing programs for juvenile offenders and the meta‐analysis on which it is based. I address both those themes in this commentary in the context of the broader cross‐disciplinary conversation about ways to apply research evidence to improve the effectiveness of the programs used in actual practice.

Perceived benefits and risks of developing mixed communities in New Zealand: implementer perspectives

Abtsract In New Zealand, mixed communities are developed on green fields or to replace existing public housing as a way of increasing housing supply, and, in some views, improving outcomes for low-income residents. This paper identifies the effects of developing mixed communities as perceived by implementers of these projects – politicians, officials, developers, and housing providers – and places these in the context of the international evidence. The range of perspectives on potential benefits and risks of mixed-income development for public tenants, the mixed evidence base, and uncertainty about the applicability of research evidence across different urban contexts should inform a research agenda.

Preventing Fractures in Long-Term Care: Translating Recommendations to Clinical Practice

The Ontario Osteoporosis Strategy for long-term care (LTC) aims to support fracture risk-reduction. LTC specific recommendations for fracture prevention were developed in 2015. This article describes the use of the Knowledge-to Action framework to guide the development and application of research evidence on fracture prevention in older adults. Knowledge translation activities highlighted fractures as a significant source of morbidity in LTC, significant gaps in fracture risk assessment and treatment, and barriers and facilitators to guideline implementation. Multifaceted knowledge translation strategies, targeting staff in LTC homes in Ontario, Canada to support fracture guideline implementation have included education, audit and feedback, team-based action planning, and engagement of LTC residents, their families, and health professionals. Provincial administrative databases were accessed to monitor fracture rates between 2005 and 2015. Our research has identified enablers and barriers to knowledge use such as limited knowledge of osteoporosis, fracture risk, and prevention. Province-wide over a 10-year period, hip fracture rates in LTC decreased from 2.3% to 1.9%, and any fracture rates decreased from 4% to 3.6%. This body of work suggests that multifaceted knowledge translation initiatives are feasible to implement in LTC and can improve the uptake of clinical recommendations for fracture prevention. A key aspect of our fracture prevention knowledge translation activities has been the full engagement of key stakeholders to assist in the co-development and design of knowledge translation products.

Avoid the “Southern Diet”? What, Really, Do You Mean?

As far as eating patterns go, the southern diet is often viewed as synonymous with poor food choices. But is it really? How do we know? When attempting to balance patient beliefs, habits, and cultural norms with best evidence, we must interpret and apply research evidence regarding dietary patterns such as the “Southern Diet.” We address the complexities of interpreting dietary pattern–based research evidence and present the cases of 2 born and bred southern adults with potential to benefit from culturally appropriate nutrition and dietary counseling.

Therapist effects vary significantly across psychological treatment care sectors.

Psychological intervention outcomes depend in part on the therapist who provides the intervention (a therapist effect). However, recent reviews suggest that therapist effects may vary as a function of the context in which care is provided and therefore should not be generalized beyond that context. This study statistically analysed therapist effect differences between care sectors delivering psychological interventions. The sample comprised routine clinical data from 26,814 patients (69% female; mean age 38) and 466 therapists in five care sectors: primary care, secondary care, university, voluntary, and workplace. Therapist effects were analysed using multilevel models and Markov chain Monte Carlo credible intervals. The therapist effect was significantly larger in primary care (8.4%) than in any other sector (1.1%-2.3%) except secondary care (4.1%), after controlling for explanatory baseline and process variables as well as accounting for differences between clinics. There were no other significant differences detected between care sectors. These findings support the hypothesis that differences in effectiveness between therapists vary depending on the context in which psychological treatment is provided. Differences in relative therapist impact can vary by a factor of 4-8 across treatment sectors. This should be considered in the application of research evidence, treatment planning, and the design and delivery of psychological care provision.

Evaluating the reliability of the oBSTACLES Instrument

ObjectivesEach health profession has a responsibility to generate and implement evidence to support its practices; however, many obstacles continue to impede such progress. The 32-item BarrierS To the Application and Conduct of rEsearch (oBSTACLES) instrument was developed and subsequently validated to help identify these obstacles in complementary and alternative medicine (CAM) practice. The objective of this study was to assess the test–retest reliability of the oBSTACLES instrument. DesignTest–retest data were collected at baseline (round 1) and two-weeks later (round 2) from researchers and practitioners in CAM (n = 23). Intraclass correlation coefficients were used to measure test-retest reliability. Cronbach's alpha was used to assess internal consistency. ResultsThe majority (29/32, 91%) of oBSTACLES items achieved intraclass correlation coefficients ranging between 0.441 and 0.913 (“excellent”, “good” to “fair”). A high degree of internal consistency (α = 0.78) was demonstrated for the instrument overall, as well as for the conduct (α = 0.79) and application (α = 0.88) parts of the instrument. ConclusionsThe results indicate the oBSTACLES instrument is a reliable measure of the barriers to the conduct and application of research evidence in complementary and alternative medicine. Access to such psychometrically sound tools can enable future surveys of CAM practitioners and researchers to identify the extent to which each of these barriers impacts the generation and application of evidence in CAM within the various complementary and alternative medicine disciplines.

EBP e-Toolkit: Providing a Teaching and Learning Open and Innovative Toolkit for Evidence-Based Practice to Nursing European Curriculum – the second transnational project meeting in Warsaw

Abstract Introduction. Although European healthcare systems differ from country to country, almost all are currently going through profound changes and are becoming increasingly complex. New tasks and growing social expectations towards healthcare build high expectations of medical professionals regarding their competences. Knowledge and skills allowing for choosing the safest and most efficient option for patient care are particularly welcome. The idea of Evidence-based Nursing Practice (EBP) combines the best available research evidence on the one hand and clinical expertise and patients’ expectations on the other, allowing for solving problems in making clinical decisions. EBP is a tool used for making clinical decisions in nursing care that helps to reduce the cost of healthcare by increasing efficiency and safety. Under the Directive 2013/55/EU European Federation of Nurses Associations developed qualifications framework that provides requirements for nursing training, with the ability to apply research evidence in clinical practice being one of its key elements. Despite the aforementioned recommendations, the actual implementation of EBP into clinical practice is hindered by various obstacles. In addition, the existing European resources enhancing EBP teaching for nursing students are very limited. Summary. The EBP e-Toolkit Project is a response to high needs of the academic world and nursing practitioners, involving six institutions whose cooperation and expertise aim to ensure the development and implementation of high-quality learning tools tailored to the educational needs of modern nursing personnel. The six higher education institutions that jointly implement the aforementioned project involve: the University of Murcia (coordinating institution, Spain), Technological Educational Institute of Crete (Greece), University of Modena e Reggio Emilia (Italy), University of Ostrava (Czech Republic), Medical University of Warsaw (Poland), and Angela Boskin Faculty of Health Care (Slovenia).

Are the police embracing evidence-informed practice? A view from England and Wales

ABSTRACTThe What Works Centre for Crime Reduction (WWCCR) in the UK’s College of Policing has a key role in promoting the use of research in policing. Since 2014, the WWCCR has aimed to review – and make accessible – research to better inform and target crime reduction and to build police capacity to identify, evaluate and apply research evidence to practice. This comes amidst significant changes to entry requirements for policing in the UK as part of efforts to further professionalise the service and prepare for future challenges in policing. We report findings from in-depth interviews with senior police officers from forces across England and Wales, conducted as part of a three-year evaluation of the WWCCR. These interviews explored the traction of ‘evidence-based practice’ among senior officers and showed shifts over time in their accounts of the value placed on research and how it is promoted and used within their force. Additionally, an online survey across policing ranks, conducted in 2016, found differences by seniority in perceptions about the relevance of research for policing, and the level of organisational support for it. Findings are used to consider the status of research evidence in policing and its development within a policing profession.

Capacity for evidence-informed policymaking across Europe: development and piloting of a multistakeholder survey.

Evidence-informed policymaking (EIP) is increasingly viewed as a complex endeavour that requires integration of research evidence with available resources and the preferences of those affected by the policy. The first technical expert meeting to enhance EIP in the World Health Organization (WHO) European Region identified the scope to develop and conduct a survey to gather insights into the generation, translation and application of research evidence across the region. This article describes the process of developing and piloting a multistakeholder survey (promoted and technically supported by WHO/Europe) on the topic of capacity for EIP. Rapid review and pilot cross-sectional survey. A survey instrument was developed based on findings from the published literature and refined with input from EIP experts/champions. The online survey was then piloted using various recruitment strategies designed to maximise its reach among the key target groups (senior researchers, knowledge brokers and members of civil society). The rapid review revealed a clear gap in the evidence base in relation to broader surveys of capacity for EIP, as opposed to evidence-based practice at an individual level. Thirteen responses to the pilot survey were received from individuals in 10 European countries. Reported barriers to EIP included a lack of understanding among policymakers and a lack of interaction with researchers. There were examples of efforts to enhance capacity for EIP, both at region or country level and through membership of international networks and collaborations. However, few examples were given of the application and impact of research evidence on the policymaking process. This research has demonstrated the feasibility of developing and piloting a multicountry, multistakeholder survey to generate better understanding of evidence use in health policymaking. Next steps include incorporating the lessons learned into a revised version of the survey to be implemented with all 53 WHO/Europe Member States.

Integrated knowledge translation in population health intervention research: a case study of implementation and outcomes from a school-based project

BackgroundIntegrated knowledge translation (IKT) is encouraged in population health intervention research (PHIR) to ensure the co-production of policy-relevant research, yet there is little published literature that reports its implementation and outcomes. The purpose of this study was to describe and evaluate the IKT approach used in a school-based PHIR project to understand how the research informed policy and practice and identify what influenced the IKT process.MethodsA case study approach was used to provide an in-depth description of the IKT process and understand the co-production and application of research evidence. Data were collected through document review, a survey with all elementary school principals in the school board (n = 18) following dissemination of School Reports and interviews with the IKT research team (including two researchers and three knowledge users).ResultsApproximately half of the principals reported reading their School Report (52%) and almost all of these principals attributed the partial or full adoption, or implementation, of a new practice as a result of using the information (89%). Key themes related to the IKT process emerged across the interviews, including supportive relationships, role clarity, competing priorities and the complexities of population health interventions.ConclusionsThe findings suggest that, while IKT can support policy and practice, it can be challenging to maintain engagement due to differing priorities and role ambiguity. Additional recognition, investment and research would enable better implementation of the approach, thereby bridging the gap between research, policy and practice.

Information literacy skills and training of licensed practical nurses in Alberta, Canada: results of a survey.

Although information literacy skills are recognized as important to the curriculum and professional outcomes of two-year nursing programs, there is a lack of research on the information literacy skills and support needed by graduates. To identify the information literacy skills and consequent training and support required of Licensed Practical Nurses (LPNs) in Alberta, Canada. An online survey using a random sample of new graduates (graduated within 5years) from the registration database of the College of Practical Nurses of Alberta (CLPNA). There was a 43% response rate. Approximately 25-38% of LPNs felt they were only moderately or to a small extent prepared to use evidence effectively in their professional practice. LPNs use the internet and websites most frequently, in contrast to library resources that are used least frequently. Developing lifelong learning skills, using information collaboratively, and locating and retrieving information are areas where LPNs desire more effective or increased training. The results suggest there are significant gaps in the preparedness and ability of LPNs to access and apply research evidence effectively in the workplace. There are several areas in which the training provided by Librarians appears either misaligned or ineffective.