Engagement In Evidence-based Practice Research Articles

Predicting Habits of Engaging in Evidence-Based Practice

Abstract Date Presented 03/21/24 Predictor models can identify potential causal mechanisms. This session will discuss the predictor model for evidence-based practice (EBP) engagement and its implications for increasing implementation. Increasing EBP engagement may be achieved by targeting reflection. Primary Author and Speaker: Angela M. Benfield Contributing Authors: Scott Bleakley, Cheryl Miller

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review.

Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP. The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs. The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis. Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal. Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Predictors of Social Work Practitioner Engagement in Evidence-Based Practice: A Cross-Sectional Survey

ABSTRACT Purpose : There has been a sustained effort to integrate the evidence-based practice (EBP) process within social work over the past few decades, yet it is unclear whether these efforts have increased the adoption of this process in social work practice. This study describes predictors of master’s level social work practitioners’ engagement in the EBP process. Method : A cross-sectional survey with NASW-Texas members (N = 258) was conducted to assess social workers’ understanding, attitudes, and implementation (and perceived difficulty) of the EBP process. Results : Most respondents endorsed the multistep process definition of EBP, were favorable to EBP and viewed its application as easy or very easy. However, only 27% of the respondents reported engaging in all the steps of the EBP process often or very often. Greater years as a licensed practitioner, more positive attitudes about and less perceived difficulty with EBP predicted increased engagement. Discussion : While it appears progress may have been made compared to prior Texas NASW samples regarding views of and engagement in EBP, the discrepancy between higher engagement in specific EBP steps and engagement in the entire process is recommended for future research.

The Doctor of Nursing Practice help desk: An innovative approach to developing evidence-based practice competency and providing DNP project support.

The 2021 American Association for Colleges of Nursing (AACN) Essentials for Professional Nursing Education identifies evidence-based practice (EBP) as a core concept meant to be integrated across curricula. Integrating EBP in Doctor of Nursing Practice (DNP) programs is challenging because of barriers including persistent confusion between research, EBP, and quality improvement; low faculty confidence and competence in their EBP skills and mentoring; increased faculty workload with growing program enrollments; and limited opportunities for students and faculty to practice EBP skills. The aim of this initiative was to implement and evaluate an innovative education strategy to build DNP students' and faculty's EBP competency and confidence while mitigating barriers faced by DNP programs. A DNP Help Desk was created and implemented at a large, Midwestern college of nursing with participation and support from EBP experts. Student and faculty participation were tracked, and perceptions of the help desk were evaluated. Opportunities to evolve the help desk were identified and implemented. Outcomes included a self-reported increase in student and faculty confidence and EBP competency, increased integration, and utilization of EBP in project work, elevated DNP project quality, and decreased demands on DNP project advisors. Engaging in innovative strategies aimed at increasing EBP competency and confidence may lead to increased EBP engagement and positive outcomes for students, faculty, and DNP programs.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: a scoping review protocol.

The objective of this scoping review is to identify and map the evidence reporting the knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries. Evidence-based practice aims to improve health care quality, safety, and health system efficiency. Numerous research studies have explored nurses' engagement in evidence-based practice in high-income countries. Developing nations have recently joined the evidence-based practice movement, and primary research about nurses' engagement with it are emerging. The scoping review will include primary studies (quantitative, qualitative, and mixed methods) and gray literature addressing knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses. Participants will include registered nurses working in low- and middle-income countries. Studies conducted in all health care settings, including acute and community settings, in low- and middle-income countries will be included. We will search MEDLINE, Embase, CINAHL, Scopus, ERIC, JBI Evidence-based Practice Database, Cochrane Library, LILACS, and AIM. Gray literature will be sourced from ProQuest Dissertations and Theses Global and Google Scholar for primary studies. Studies published in the English language will be included, with no limit on publication date. Titles, abstracts, and full-text articles will be assessed against the inclusion criteria by 2 independent reviewers. The extracted data will be analyzed quantitatively using frequencies and counts. Textual data from qualitative studies will be analyzed using descriptive content analysis. Results of the data analysis will be presented using graphs, tables, and a narrative format. Open Science Framework ( https://osf.io/hau5y ).

Canadian Naturopathic Doctor Engagement, Preparedness, and Perceptions of Evidence-Based Practice: A National Cross-Sectional Study.

Background: Despite the reported benefits of evidence-based practice (EBP), there are concerns that some practitioners, including naturopathic doctors (NDs), may be cautious about its use. The objective of this study was to explore Canadian ND perceptions, preparedness, and engagement in EBP, and the barriers and enablers to EBP uptake. Methods: The study was a national cross-sectional survey. NDs practicing in Canada were invited to complete the validated 84-item Evidence-Based Practice Attitudes and Utilization Survey between February and May 2020. Results: A total of 252 Canadian NDs were recruited. Participant attitudes toward EBP were predominantly positive, with three-quarters of participants indicating that >50% of their practice was informed by clinical research evidence. One-half of participants self-reported a medium-high to high level of skill across most EBP-related activities. Notable barriers to EBP uptake were lack of clinical evidence in naturopathy, and lack of time. Access to the internet and online databases were identified as useful enablers to improving EBP engagement. Conclusions: By shedding light on Canadian ND engagement with, preparedness for, and perceptions of EBP, the findings will help guide the development of strategies to support EBP uptake in NDs with the expectation of improving quality of care.

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

Your Quest Begins Now! EBMQuest, a Digital Interactive Fiction Module for Medical Student Engagement in Evidence-Based Practice.

Although evidence-based medicine (EBM) has gained increasing focus in medical education, there remains considerable need for innovative approaches to engage learners. We developed a novel online interactive fiction module "EBMQuest", where students navigate three clinical scenarios requiring use of EBM resources for successful progression. Student feedback was strongly positive, with an overall program rating of 4.64 (Good-Very Good). Online interactive fiction should be further explored as a means of delivering innovative medical education.

Registered Nurses' experiences of reading and using research for work and education: a qualitative research study

BackgroundConsiderable resources have been expended, both in universities and health workplaces to improve nurses' abilities to interact with research and research literature to enable their engagement with evidence-based practice. Despite these efforts, a considerable number of nurses experience difficulty with research literature and are reluctant to use it in practice.AimsThis study aimed to explore the experiences and perceptions of Registered Nurses when they have been required to read and understand research literature for work or education.DesignA qualitative descriptive study using online and in-person focus groups.MethodsFocus groups (online and in-person) were conducted between June and November 2020. Forty participants were included. We used focus group recordings and field notes to collect data. Transcribed records of these focus groups were coded on the basis of similarity of meaning and then subjected to thematic analysis.ResultsThree distinct themes were identified from the data: 'coming into learning about research', fitting research into the reality of nursing life', and 'working towards using research.' Participants described their early experiences in learning about research, experiences both positive and negative in integrating research into practice, and their personal strategies for reading and using research, particularly in the context of significant anxiety about understanding the content of methods and results sections of quantitative research articles.ConclusionThis study goes beyond the barriers and facilitators dichotomy that has been the majority of the conversation about nurses' evidence-based practice engagement previously, and explores the issues underlying aversion to research literature. Many nurses struggle with the language, numbers, and/or statistics used in research and this requires educational interventions suited to the problem and the population.

Implementation science in New Zealand naturopathic practice: a cross-sectional study.

Understanding and addressing the barriers to evidence-based practice (EBP) falls within the realm of implementation science. To date, disciplines such as naturopathy have paid little attention to implementation science, meaning the obstacles to delivering best practice care have largely been ignored. This study addresses this knowledge gap by examining the determinants of evidence implementation in New Zealand naturopathic practice. This cross-sectional study was open to all New Zealand naturopaths who had Internet access, and were fluent in the English language. Participants were invited to complete the 84-item Evidence-Based practice Attitude and utilization Survey (EBASE) online between February and July 2020. The survey was completed in full by 104 naturopaths (86% female; 55% aged 40-59 years). While attitudes toward EBP were generally favourable, engagement in EBP activities was reported at a moderate-low level. Factors potentially contributing to the modest uptake of EBP were the moderate level of self-reported EBP-related skill, lack of clinical evidence in naturopathy and lack of time. Enablers of EBP uptake that were supported by the majority of participants were access to the Internet, online databases, EBP education materials, and full-text journal articles. This study has provided much-needed insight into the level of EBP engagement among New Zealand naturopaths, as well as the various factors impacting evidence implementation. Attitude did not pose a major barrier to evidence implementation; rather, the barriers were largely structural, cognitive and cultural. This suggests that the barriers to EBP uptake in naturopathy are not unsurmountable.

Exploring Evidence Based Practice Implementation by Occupational Therapists: Implications for Fieldwork

A fieldwork education model is used in occupational therapy to develop competency of professional skills, including evidence-based practice (EBP) and clinical reasoning. This quantitative study explored factors influencing implementation rates of EBP in New Zealand registered occupational therapists to better understand students’ experience of evidence-based practice while on fieldwork. An online survey exploring beliefs and practices related to clinical competence, professional reasoning and EBP was conducted. The survey included questions about related beliefs, the measure of Evidence Informed Professional Thinking (EIPT; Benfield & Johnston, 2020), and the Implementation Climate Scale (ICS; Ehrhart et al., 2014). The mean scores on the scales were entered into a linear regression model and backward stepwise regression was used to build a predictive model ascertaining primary influences for EBP implementation. On the measure of EIPT respondents reported infrequent engagement in clinical reasoning and EBP activities. Scores on the ICS results indicate some support of EBP practices in respondents’ workplaces. Habits of critical reflection have the strongest relationship to habits of implementing EBP in daily practice The only other factors significant in the predictive model were focus on EBP, and respondents’ level of education. Habits of critical reflection on practice and clinical reasoning activities have the strongest relationship with EBP engagement. Fieldwork students are likely to observe fieldwork educators who are infrequently engaging in critical activities of reflection and EBP. Development of strategies to enhance and habitualize critical reflection and clinical reasoning will increase EBP implementation rates. Pragmatic strategies between fieldwork educators, educational institutions, and students will likely enhance students’ learning and ultimately enhance overall EBPs in the profession.

Norwegian Social Work and Child Welfare Students’ Attitudes Toward Research-Supported Treatments

ABSTRACT Purpose: Evidence-based practice (EBP) has increasingly become a part of social work education, but there is a lack of knowledge about students’ attitudes toward it. This study evaluated Norwegian social work students’ attitudes toward research-supported treatments (RSTs). Method: Attitudes were measured with the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), a validated measure including 12 subscales. Results: The findings suggest that master’s students are more positive toward RSTs compared to bachelor’s students. Having less educational training in EBP was associated with more skepticism toward the concept, suggesting that educational training in EBP contributes to facilitating a positive attitude toward RSTs. Discussion: These findings indicate a need to emphasize EBP in social work education. To enable EBP engagement in practice, we argue that emphasis should be put on teaching students to critically appraise research.

What about research and evidence? Teachers’ perceptions and uses of education research to inform STEM teaching

The use of research evidence to inform practice has become an expectation of those working in many professions. There is a dearth of research on teacher use of scholarship to inform their practice. While there is an abundance of research that can be used to inform teacher practice, there are unknowns about how much teachers seek, access, read, apply and share evidence from research to inform their teaching. We address this gap in the literature by surveying inservice teachers about their perceptions and practices for using education research. In our analysis of the data collected from 452 teachers, we found teachers are interested in research and perceive value in research to inform their work. However, we also found that teachers struggle to identify sources of quality research and how to translate research to inform their teaching. Our findings have implications for school administrators seeking to promote teacher engagement in evidence-based practice and educational researchers hoping to have their research translated into K-12 teacher practice.

Home Healthcare Nurses' Attitudes, Confidence, and Engagement in Evidence-Based Practice.

Evidence-based practice (EBP) is becoming standard in today's healthcare arena and home care organizations are not exempt from integrating evidence into practice to improve patient outcomes. There is a scarcity of research literature that examines the behaviors and attitudes of home healthcare nurses (HHNs) regarding EBP. In this study, a descriptive survey design was used to investigate HHNs' a) information-seeking behaviors when providing nursing care, b) administrative support for EBP (as perceived by HHNs), c) attitudes toward EBP, and d) EBP engagement and confidence in providing EBP nursing care. Self-reported data were collected by internet and paper survey. The survey consisted of a 65-item questionnaire that included the Nurses' Attitudes Toward Evidence-Based Practice Scale, which has previously established validity and reliability. A convenience sample of 95 HHNs participated in the study. Results suggest HHNs' EBP attitudes are positive. A positive and significant relationship was found between attitudes and hours worked (r = 0.21, p = 0.047) and educational level (r = 0.45, p = 0.0001); 95% confidence level. Confidence levels in providing EBP care were moderate, and HHNs did not perceive EBP as an agency priority. HHNs need to be supported and encouraged in the facilitation of EBP, a task made easier when they are knowledgeable about EBP, have confidence in their EBP skills, and have the support of their organizations.

Five-Year Program Evaluation of an Evidence-Based Practice Scholars Program.

The purpose of this article is to describe the findings of a 5-year program evaluation of a hospital-based Evidence-Based Practice (EBP) Scholars Program. The EBP Scholars Program was developed in 2011 to (a) educate and engage staff in the EBP process and (b) develop a cadre of EBP mentors within each clinical unit of the organization. The evaluation of the EBP Scholars Program examined both the feasibility and the impact of the program. The findings suggest that not only is the program feasible to implement and highly acceptable to the participants, but it also significantly increases staff EBP self-efficacy and promotes staff engagement in EBP, organizational leadership, and professional development. Most importantly, this program has been foundational to motivating and sustaining a strong culture of inquiry at our Magnet® designated organization. [J Contin Educ Nurs. 2018;49(12):547-554.].

Developing Student Evidence-Based Practice Questionnaire (S-EBPQ) for undergraduate nursing students: Reliability and validity of a Chinese adaptation.

The assessment of evaluating undergraduate nursing students' evidence-based practice engagement is an important issue, yet few tools have been developed specifically in Mainland China. The purpose of this study was to adapt the Student Evidence-based Practice Questionnaire (S-EBPQ) to Mainland China's cultural context and to evaluate the psychometric properties of the newly adapted Chinese S-EBPQ. Cross-cultural adaptation, including translation of the original S-EBPQ into Mandarin Chinese language, was performed according to published guidelines. A pilot study was conducted in Mainland China with 25 Chinese undergraduate nursing students. A subsequent validation study was conducted with 400 undergraduate nursing students from Mainland China. Construct validity was assessed by exploratory factor analysis (n=190) and confirmatory factor analysis (n=210). Reliability was determined using internal consistency and test-retest reliability. The split-half coefficient for the overall Chinese S-EBPQ was 0.858. A content validity index of 0.986 was achieved. Principal component analysis resulted in a 4-factor structure explaining 68.285% of the total variance. The comparative fit index was 0.927, and the root mean squared error of approximation was 0.072 from the confirmatory factor analysis. Known-group validity was supported by the significant differences according to various characteristics of participants. Internal consistency was high for the Chinese S-EBPQ reaching a Cronbach α value of 0.934. Test-retest reliability was 0.821. The newly cross-culturally adapted S-EBPQ possesses adequate validity, test-retest reliability, and internal consistency and therefore may be utilized in nursing education to assess EBP of undergraduate nursing students in Mainland China.

Targeted Interventions to Advance a Culture of Inquiry at a Large, Multicampus Hospital Among Nurses.

The aim of this study is to assist nurse leaders in developing innovative structures to foster a culture of inquiry among professional nurses. Critical to nurse's engagement in evidence-based practice (EBP) is a culture of inquiry, in which nurses critically evaluate patient care activities and actively review existing evidence to address identified clinical issues. A bundle of structural interventions was implemented across a large, multisite hospital to advance a culture of inquiry. We measured the impact of these interventions on nurses' library use and on nurses' knowledge, attitudes, and practices towards EBP. Structural interventions included: 1) EBP and Research Committee meetings, in which nurses were educated on how to formulate a clinical question and critically appraise a research article; 2) Academic Partners Program, in which nurse academicians provided scholarly mentorship and guidance during monthly committee meetings; 3) hiring of clinical nurse scientists who provided 1-on-1 education and mentorship to clinical nurses in EBP and research; and 4) a Nurse Residency Program partnership, in which newly graduated nurses were required to complete an EBP project. We examined the impact of these structural interventions on nurses' use of library resources and nurses' knowledge, attitudes, and practices toward EBP. The implementation of structural interventions to support nurses' engagement in EBP was associated with a significant increase in the number of nurse-generated library consultative requests over time. Results showed high levels of nurse knowledge, attitudes, and practices in EBP. Nurse leaders may advance a culture of inquiry by providing the infrastructure to support EBP activities and by empowering nurses to question and seek answer to identified practice questions. Infrastructures should include access to scientific articles and partnerships with schools of nursing. Additional research is needed to validate nurse library use as a measure of nurse engagement in EBP.

Staff views on supporting evidence based practice for children with ASD

Purpose: A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD.Materials and methods: We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis.Results: Two central themes, comprising six categories, emerged to account for the participants’ views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring.Conclusions: The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model.Implications for RehabilitationClinicians and educators recognise the importance of evidence-based practice.Efforts to support evidence-based practice have focused mostly on access to research evidence.Clinicians and educators in this study were developing their own strategies based on intuition.They identified a need for organisation-wide approaches to supporting evidence-based practice.Peer-to-peer mentoring appears to be an acceptable and viable strategy.

Evidence-Based Practice in Clinical Nursing Education: A Scoping Review.

Nursing students require education that integrates evidence-based practice (EBP) knowledge across classroom and clinical settings. This study was conducted to identify and examine the literature related to nursing students' use of evidence in clinical education and to identify associated research gaps. A scoping review describing the extent, range, and nature of the research activity focused on students' use of evidence in clinical education. Included studies (N = 37) describe the barriers and facilitators to nursing students' EBP and describe the evaluation of strategies that support nursing students' engagement in EBP. Most commonly identified barriers include a lack of knowledge and skills for EBP; negative attitudes toward EBP in students, faculty, and nurses; and lack of support in the clinical setting. Evaluated strategies included educational sessions and EBP projects, either alone or in combination, as well as other stand-alone interventions. All but two of the intervention studies reported positive subjective or objective outcomes. On the basis of these results, educators can engage in combined educational strategies that focus on addressing described barriers. [J Nurs Educ. 2017;56(9):534-541.].

Clarifying the Conundrum: Evidence-Based Practice, Quality Improvement, or Research?: The Clinical Scholarship Continuum.

Nurses' active involvement in clinical scholarship is necessary to advance the nursing profession and improve patient outcomes. Yet, definitional confusion and numerous barriers exist to clinical scholarship in and across academic and patient care settings. We discuss factors that pose barriers to the continuum of clinical scholarship and suggest opportunities for clinician-researcher collaborations that promote nurses' engagement in evidence-based practice, quality improvement, and research.