Evidence-based Practice Behaviour Research Articles

Facilitating Evidence-Based Practice among Nurses in a Tertiary General Hospital: A Six-Year Practice of an Implementation Strategy Informed by the i-PARIHS Framework

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy’s effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients’ outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p<0.05. After four years, EBP members’ scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses’ academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects.

Journal Club: An Innovative Teaching Practice to Foster Peer Connection and Enhance Information Literacy Skills

This project aimed to better understand the impact and student experience of an innovative teaching strategy focused on information literacy (IL) for first-year undergraduate nursing students. Information literacy (IL) involves the development of a set of abilities essential for higher education learners, such as the ability to identify, critically evaluate, understand, and apply scholarly literature (ACRL 2013), yet studies often demonstrate that these IL skills are lacking and need further development (Bury 2016; Saunders 2012). Traditional methods of addressing this need center around stand-alone librarian-led IL sessions, which cannot provide the time or space needed to develop critical reading and reflection practices. Within our context of nursing, this is a common challenge; one study found that 40% of second-year nursing students have difficulty reading journal articles (Chaudoir et al. 2016), despite IL being an essential skill for nursing practice (Mitchell and Pereira-Edwards 2022). In an attempt to address learner needs, a course instructor and librarian teamed up. Journal clubs, used in practice settings to maintain currency and promote EBP behavior (Wilson et al. 2015), have been used successfully in other health education contexts (Steenbeek et al. 2009; Szucs et al. 2017; Thompson 2006). This application is referred to as evidence-based practice (EBP) and is an essential component of nursing practice. Having activities for undergraduate nursing students that instill EBP aims to ensure that it will be incorporated into practice after graduation (Mitchell and Pereira-Edwards 2022). Instead of the traditional librarian-led IL sessions, a first-year nursing course was redesigned to utilize a guided journal club approach to enhance the ability to seek, read, and interpret journal literature. Journal club activities took place over eight weeks, alternating guided activities with brief IL lessons, and culminated in a group journal club assignment. Students were placed in small groups based on an area of practice they wanted to learn more about. Activities were scaffolded starting with introducing a research database and basic literature searching strategies. As students progressed through the term’s journal club activities, they were asked to find articles related aligned with course topics and their area of practice, critique and present their articles to their group members, and then apply their interpretations. A survey was used to measure the impact of journal club on student IL self-efficacy, as measured through the validated Information Literacy Self-Efficacy Scale (ILSES) developed by Kurbanoglu et al. (2006). Initial findings support journal club as an effective modality to enhance students’ self-efficacy in specific areas of IL. Additionally, other valuable outcomes of this strategy were discovered. For example, students reported becoming more comfortable collaborating with peers and anecdotal reports showed students developed friendships with peers. This scaffolded journal club approach to discipline-specific IL learning would translate well to other contexts, particularly those that require a significant grounding in reading and understanding disciplinary research. The journal club activities are available at: https://tinyurl.com/JournalClubPosterISSOTL2022, or by contacting the authors. Click here to read the corresponding ISSOTL blog post.

Athletic Training Student Core Competency Professional Behavior Implementation Between Immersive and Non-immersive Clinical Experiences: A Report From the Association for Athletic Training Education (AATE) Research Network

Context The Commission on Accreditation of Athletic Training Education requires athletic training programs to emphasize the use of professional behaviors that are associated with 6 core competencies, 5 of which were measured in this study: patient-centered care, interprofessional education and collaborative practice (IPECP), evidence-based practice (EBP), health information technology (HIT), and quality improvement (QI). The purpose of this study was to examine the association between clinical experience type and student implementation of behaviors associated with the core competencies. Design Multisite, panel design. Setting Twelve professional athletic training programs (7 graduate, 5 undergraduate). Patients or Other Participants A total of 338 athletic training students logged patient encounters for 1 academic year in the E*Value system. Main Outcome Measure(s) Students reported clinical experience type (immersive versus nonimmersive) and implementation of behaviors associated with core competencies. Counts of professional behaviors were calculated, and differences in behavior implementation between immersive (ICEs) and non-immersive (N-ICEs) clinical experiences were assessed using a generalized estimating-equations approach for patient-centered care, IPECP, EBP, HIT, and QI behaviors (P < .05). Results Students implemented more behaviors associated with IPECP (P = .002), EBP (P = .002), and HIT (P = .042) during ICEs than N-ICEs. Students implemented the QI behavior more often during N-ICEs than during ICEs (P = .001). Patient-centered care behavior did not differ between clinical experience types. Conclusions Immersive clinical experiences facilitate increased implementation of behaviors associated with EBP, IPECP, and HIT, while N-ICEs offered increased opportunities for QI behaviors. Program administrators should consider placement of ICEs and N-ICEs in the curriculum that align with students’ capability to perform core competency behaviors. Preceptors of both ICEs and N-ICEs should be encouraged to provide students with opportunities to implement all core competencies during their clinical experience.

Use of Collaborative Online International Learning to Teach Evidence-Based Practice

Collaborative Online International Learning (COIL) is a pedagogical approach that leverages intercultural learning through digital technology with others around the world. Nurse practitioner (NP) and other advanced practice nursing students and faculty from Thailand and the United States partnered to implement a COIL project for an evidence-based practice (EBP) course. Retrospective presurvey and postsurvey results indicated that student EBP knowledge and behavior change improved after the COIL activities. Responses to open-ended questions revealed the COIL experience was meaningful and valued by student participants. COIL offers an approach for NP education to be more globally engaged and culturally aware.

Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review.

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.

Methods of teaching evidence-based practice: a systematic review

BackgroundTo identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency.MethodsElectronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool.ResultsTwenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention.ConclusionCurrent evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.

Adherence to evidence-based practice across healthcare professionals in Germany: results from a cross-sectional, nationwide survey

BackgroundAdherence to evidence-based practice (EBP) is considered a key competence to improve healthcare quality. In this study, we aimed to describe the EBP adherence of healthcare professionals working in Germany and to explore barriers and facilitators regarding the implementation of EBP in clinical practice.MethodsA nationwide online survey was performed among healthcare professionals in Germany from January to April 2018 using the German version of the Evidence-based Practice Inventory (EBPI) questionnaire for a comprehensive assessment of adherence to EBP. Univariate logistic regression analyses were performed to explore the association between demographic and professional determinants and each EBPI dimension.ResultsWe analysed data of 889 participants, including 318 physical therapists, 154 occupational therapists, 137 midwifes and 280 participants of six other healthcare professions. Approximately 70% of the participants generally demonstrated a positive attitude towards EBP and believed that EBP was useful in clinical practice. Broadly, 80% of the respondents evaluated themselves as being able to enact EBP behaviour in clinical practice. In contrast, less than 70% preferred to use quantitative information instead of their intuition to inform their habitual clinical behaviour. Still, 20 to 30% reported that EBP did not sufficiently account for their clinical experience and differences between patients.The strongest facilitators to EBP adherence across at least three dimensions of the EBPI were the availability of ≥ 60 min for scientific literature at work (OR: 9.67; 95% CI: 5.86; 16.30), followed by a master or higher academic degree (OR: 9.09, 95% CI: 5.86; 14.28) and the involvement in ≥ 1 scientific publication (OR: 7.06, 95% CI: 5.10; 9.85).ConclusionsThis study showed that healthcare professionals in Germany in general had a positive attitude towards EBP although they currently do not consider EBP principles in its entirety. The most important determinant positively influencing a healthcare professional’s decision to perform EBP was the time available for scientific literature at work. German healthcare professionals experience similar barriers towards the implementation of EBP in clinical practice compared to other international healthcare settings. These barriers should be targeted by future research.Trial registrationGerman Clinical Trials Register (DRKS00013792). Registered 19 January 2018.

Knowledge, attitude and behaviour to evidence-based practice among psychiatric nurses: A cross-sectional survey

ObjectiveTo identify the status of knowledge, attitude, and behaviour toward evidence-based practice (EBP) among Chinese psychiatric nurses, and to examine the influencing factors of EBP behaviour. MethodsWe utilised a cross-sectional design. A total of 923 psychiatric nurses from 168 hospitals in 27 provinces in the mainland of China participated in our survey. The EBP questionnaire, the barriers to research utilisation scale and the facilitators to research utilisation scale were used for data collection via WeChat group from July 2018 to April 2019. Multiple regression analysis was used to analyse the influencing factors of psychiatric nurses’ evidence-based practice behaviour. ResultsThe score of Chinese psychiatric nurses’ EBP attitude, behaviour and knowledge were 4.81 ± 1.34, 4.11 ± 1.36 and 3.53 ± 1.29, respectively. Multiple regression analysis showed that nurses’ EBP behaviour was mainly determined by knowledge and attitude, which together explained 61.8% of the variance. The two top barriers were the dimensions of presentation and research. Facilitators include managerial support, employing nurses with research skills as models and providing advanced education on evidence-based nursing. ConclusionPsychiatric nurses have positive attitudes toward EBP, but their level of knowledge and behaviour is insufficient. Heavy workload, insufficient time, and a lack of knowledge and skills is the main barrier. Managerial support, employing nurses with research skills as models and providing advanced education are the main facilitators.

Evidence-based practice by physiotherapists in UAE: Investigating behavior, attitudes, awareness, knowledge and barriers.

Evidence-based practice (EBP) is an important factor determining the quality of healthcare. The field of physiotherapy is still limited by indirect access in several countries including the United Arab Emirates (UAE) which creates added pressure to justify the merit in its practitioner's capabilities. This study explores the behavior, attitudes, awareness and knowledge towards EBP among practicing physiotherapists in the UAE. It also enquires about their perception of the barriers in the implementation of EBP. Using a questionnaire survey of 258 physiotherapists, results show that the awareness of EBP is limited to a few terms including EBP, systematic literature review, and random trials while other terms associated with scientific studies are not known well. The attitude towards EBP was found to be significantly related to the knowledge of EBP (r = 0.208) and the perception of barriers to it (r = 0.156). The EBP behavior was found positively related to its knowledge (r = 0.134) and the perception of barriers (r = 0.216). The physiotherapists prefer to use their own experience and books and research articles to apply EBP but do not consider their peers to be as worthy sources as the others. However, their attitudes towards EBP are largely positive though their perception of barriers grows with better knowledge and understanding of EBP. The barriers in the implementation of EBP are a lack of research knowledge and skills, time, support, and resources which indicate opportunities for the decision-makers to improve the adoption of EBP among these professionals. This study concluded that although physiotherapists in the UAE claim awareness about EBP, their knowledge is limited to a few key terms whereas, attention is needed to improve EBP knowledge and practice.

Effectiveness of Evidence-Based Practice (EBP) Education on Emergency Nurses' EBP Attitudes, Knowledge, Self-Efficacy, Skills, and Behavior: A Randomized Controlled Trial.

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.

Barriers to and Facilitators of Evidence-Based Practice in Psychiatry Core Trainees in Northwest England.

Barriers and facilitators of evidence-based practice (EBP) in psychiatrists in training have only been researched with reference to prescribing decisions. We sought to quantitatively describe general EBP barriers and facilitators perceived by psychiatry core trainees (CTs) in England. A cross-sectional survey of CTs from a single English region in their 1st to 3rd year of specialist training (CT1-3) uses the EBP inventory, a 26-item questionnaire subdivided into the domains of attitudes, social norms, perceived behavioral control (PBC), decision-making preferences, and intention and behavior. This was analyzed using a multiple indicators multiple causes model. The response rate was 42.9% (72/168 CTs). In all, domain's responses overall tended to be positive toward EBP. The most commonly reported barriers were rarely discussing research literature, feeling incapable of staying up to date, aversion to statistics, a preference for intuition or experience, and a perception that EBP disregards the individual differences between patients. Attitudes, norms, and behavior all loaded onto their intended factors. The decision-making factor was not present and PBC subdivided into 2 factors: clinical and knowledge self-efficacy. Regression coefficients for predicting behavior from the other factors were attitudes - 0.16 (p = 0.34), norms 0.34 (p = 0.24), clinical PBC - 0.28 (p = 0.10), and knowledge PBC 0.613 (p = 0.01). Additionally, question 5 (EBP respects individual patients) and question 13 (discusses research literature with colleagues) independently predicted behavior (β = 0.388; p = 0.05 and β = 0.433; p = 0.01). EBP intention and behavior were associated with perceiving EBP as relevant to individual patients, discussion about research with colleagues, and knowledge self-efficacy.

An exploration of evidence-based practice work files for occupational therapy students during clinical placements: a descriptive cross-sectional study

BackgroundBachelor students of occupational therapy are expected to work in accordance with evidence-based practice (EBP). The EBP work file, a learning tool in a Word document format, covering all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine the attitudes and behaviours of occupational therapy students’ in relation to applying evidence-based practice during their second-year clinical placement. We compared cohorts who received training in EBP work files with those who did not receive such training.MethodsA descriptive, cross-sectional comparative study was conducted. Five cohorts of second-year occupational therapy students took part in the study. The students answered two questionnaires, the EBP Beliefs Scale and the EBP Implementation Scale, after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, mean and standard deviations of all participating students’ scores across both questionnaires. ANOVA with Bonferroni correction was conducted to analyse the differences between the mean totals of the questionnaires.ResultsIn this study, 126 occupational therapy students participated (response rate = 57.3%). The students reacted positively to EBP, although few were practicing EBP. The students believed that EBP resulted in the best clinical care for patients, but they lacked confidence in their own ability to apply EBP. The students in Cohort 5, who received extra instruction and assignments via the EBP work file, rated their EBP behaviour statistically lower than the students in Cohort 1, who did not receive extra training on the EBP work file.ConclusionsAdditional EBP work file assignments were insufficient in terms of supporting students in the implementation of EBP during clinical placements. It is, therefore, important to facilitate the learning strategies of EBP skills and demonstrate how students can practise this competency during clinical placements. Including clinical instructors in EBP teaching and learning seems essential.

Emergency nurses’ Evidence-Based Practice attitudes, self-efficacy, knowledge, skills and behaviors before an educational intervention – Baseline of a Randomized Controlled Trial

BackgroundEmergency nurses are expected to follow recent research findings and ensure that their practice is based on evidence. Yet, during busy work-shifts in overcrowded emergency departments, evidence-based practice (EBP) is not always implemented. AimTo describe emergency nurses’ EBP attitudes, self-efficacy, knowledge, skills and behaviours at the baseline of a RCT. MethodsA baseline study as a part of a randomised, single-blind controlled multicentre intervention trial (RCT). The study population consisted of 300 emergency nurses employed in two university hospitals’ emergency departments in Finland. The total sample size (n = 80) was estimated using a simulation approach. The data were collected from voluntary emergency nurses by using four structured questionnaires. FindingsEmergency nurses’ EBP attitudes, self-efficacy, knowledge and skills were above the average level, and their EBP behaviour was below the average level when measured with the other of the two sum variables measuring behaviour. A significant correlation was found between age, years since graduation, the length of working experience in health care and EBP attitudes, behaviour, knowledge and self-efficacy. Younger emergency nurses who had recently graduated and had shorter work experience showed more positive attitudes towards EBP than older counterparts. No correlation was found between gender, educational background or prior exposure to EBP and EBP attitudes, self-efficacy, knowledge, skills or behaviours. ConclusionsThis study showed that to promote emergency nurses’ use of EBP in future, tailored educational interventions on EBP are needed. This would ensure implementation of EBP in daily clinical practice for quality and effective patient care.

Engaging with evidence-based practice in the osteopathy clinical learning environment: A mixed methods pilot study

IntroductionEvidence-based medicine (EBM) requires that patient management decisions include deliberations on the best available evidence. However, engagement with EBM appears to be inconsistent. This pilot study used a mixed-methods approach to evaluate clinical educator and learner engagement with evidence in the clinical learning environment (CLE) through the SNAPPS-Plus clinical supervision model. MethodsSouthern Cross University (Australia) senior osteopathy students and their clinical educators were invited to complete the Evidence-Based Practice Questionnaire (EBPQ) and participate in a series of focus groups following use of the SNAPPS-Plus model in the CLE. Inferential statistics were used to explore EBPQ responses and focus groups were transcribed and thematically analysed. ResultsAttitudes to EBM and practice were largely positive. The student EBPQ Practice subscale was significantly improved pre-post intervention. None of the other subscales were significantly different. Focus groups confirmed the increased use of EBM and the SNAPPS-Plus model provided a structure that improved the efficiency and effectiveness of students’ literature searches. Focus groups highlighted the different value educators and students placed on research evidence and clinical experience. ConclusionThis pilot study suggests learners and clinical educators engage with evidence in the CLE, including co-learning. PICO, within the SNAPPS-Plus model, may be an appropriate vehicle for promoting learner use of EBM. This work suggests the SNAPPS-Plus model is a promising strategy for encouraging evidence-based practice behaviours and could be used to inform future research. Further research is required to evaluate whether the model creates a sustained habit of searching for evidence to inform practice.

Factors Influencing Undergraduate Students' Intention to Use Evidence-Based Practice After Graduation: Development and Validation of a Theory-Based Prediction Model.

Despite curriculum requirements for evidence-based practice (EBP) to be a key component of undergraduate health students' training, few studies have investigated factors influential to students' intention to use EBP after graduation. Self-efficacy is known to mediate and motivate behavior; therefore, it may be a crucial factor linking undergraduate students' EBP education and adoption of positive EBP behaviors. To develop, test, and validate a multivariate, theory-based prediction model with the outcome of students' intention to use EBP after graduation. A correlational study with structural equation modeling was conducted. Model factors were determined from Bandura's self-efficacy theory and previous literature. An online survey comprised of seven validated scales and a demographic tool was distributed to a sample of undergraduate nursing and paramedic students. Two episodes of data collection were conducted to test and validate the model. Evidence-based practice beliefs directly and significantly influenced student intention to use EBP in both models. Sources of EBP self-efficacy also had significant but indirect influence on the outcome variable. Overall variance for intention to use EBP was 25% for the initial model and 18% for the validated model. Evidence-based practice curriculum that supports positive EBP beliefs and integrates Bandura's sources of self-efficacy has potential to positively influence students' intention to use EBP after graduation.

The effectiveness of written communication for decision support in clinical practice.

The application of various tools suggests limitations in the usage of drug information provided to medical professionals. Concurrent views of utility and suggested improvements for written information by health care practitioners are lacking. This study's objectives were to: (1) assess practice-based perspectives on the relative efficacy and utility of different medication-related written materials for health care practitioners, (2) discern aspects of written communications that are valued for actionable information and merit health care practitioners' attention, (3) determine common or unique themes of clinicians practicing as physicians, pharmacists, physician assistants, and nurses regarding medication-related written information; and (4) organize constructs and themes as a cogent array of current deficiencies in written communications to guide improvements. Two focus group panels (physicians, physician assistants, pharmacists, nurses) were convened to address clinical decisional balance and the utility of written information about medicines in assisting them with those decisions. A facilitated dialogue followed a semi-structured interview guide including overarching questions and tap-root probes derived from the literature. Comparative analyses were used to interpret data. An a priori coding framework informed the interview guide and served as a basis for initial identification of themes. Panelists from diverse practices and settings voiced convergent agreement on the limited utility of written materials, attributed primarily to current structure, formatting, content, and design. Recommendations thematically supported the need for greater accuracy, recency, adaptability, sequencing, and accessibility of information in formats more frequently digitalized. Focus group panels of practitioners provided rich information on how current written information such as Dear Doctor letters and package inserts could be improved to facilitate real-time decision-making. Overall, improvements could contribute to an improved capacity for efficient, effective, and sustained evidence-based practice behavior.

Effect of Evidence‐Based Practice (EBP) Courses on MSN and DNP Students’ Use of EBP

The purpose of this study was to evaluate the effect of evidence-based practice (EBP) courses on nursing students' attitudes, perceived support from their professional network, self-efficacy, knowledge, and implementation of EBP. This study utilized a two-group, pre- and posttest design with 190 Masters of Science in Nursing (MSN) and 37 Doctorate of Nursing Practice (DNP) students. An EBP instrument based on the theory of planned behavior was administered both before and after the EBP course (the intervention). Both the pre- and posttest were completed by 126 students for a 56% response rate. No significant differences between the MSN (n=102) and DNP (n=24) students were found in precourse scores on any of the subscales except behavior, with the DNP students reporting they performed more EBP behaviors in the clinical setting. Overall, student scores on three of the four subscales of the EBP instrument (attitudes, self-efficacy, and behavior) significantly increased pre- to postcourse. The self-efficacy subscale demonstrated the greatest pre- to postcourse change scores. When the DNP and MSN students were compared, change scores on attitudes and self-efficacy remained significant in both groups. There was a significant positive change in EBP behavior only for the MSN students. Knowledge scores increased significantly only for the DNP students. EBP courses can increase self-reported EBP behaviors in the clinical setting, especially in MSN students. A precourse student evaluation will help faculty determine their learning needs in order to develop appropriate learning activities to support their acquisition of the essential knowledge, skills, and abilities to use EBP in the clinical setting. Administering the same evaluation postcourse can help faculty evaluate the effectiveness of their teaching. As a result, advanced practice nurses will be better equipped to facilitate and promote the implementation of EBP to support high-quality care and improved health outcomes.

The impact of a small-group educational intervention for allied health professionals to enhance evidence-based practice: mixed methods evaluation

BackgroundHealthcare professionals are recommended to use evidence-based practice (EBP) principles to update and improve clinical practice. Well-designed educational initiatives, together with practice and feedback opportunities can improve individuals’ EBP knowledge, skills and attitudes.MethodsA concurrent mixed methods assessment was designed to evaluate the effectiveness and feasibility of four monthly workshops on allied health professionals’ knowledge, skills, self-efficacy and behaviour. In between workshops, professionals were encouraged to practice and integrate EBP learnings with colleagues in their workplace.Participants completed three pre and post intervention assessments: Evidence-based Practice Confidence Scale; adapted Fresno test; and an adapted EBP Implementation Scale. A purpose designed satisfaction questionnaire was completed immediately after the educational intervention and follow up focus groups were conducted after 3 months.Mean change in assessment data was quantitatively assessed and comments from the clinician satisfaction questionnaire and focus groups were thematically analysed and interpreted together with quantitative data using the Classification Rubric for EBP Assessment tools in Education (CREATE).ResultsSixteen allied health professionals participated in the EBP workshops and completed all baseline and post intervention assessments. Seven clinicians participated in follow up focus groups. All clinicians reported a positive reaction to the learning experience, preferring short monthly workshops to a full day session. They self-reported improvements in self-efficacy (mean change 15 p < 0.001) and implementing EBP behaviours (mean change 7, p < 0.001) from pre- to post-intervention. Although the positive change in EBP knowledge measured by the adapted Fresno test was not statistically significant (mean change 10, p = 0.21), clinicians described examples of improved knowledge and skills across all five key steps of EBP during the focus groups. A further, post hoc analysis of individual questions in the two self-reported scales indicated consistent improvement across key EBP knowledge and skills.ConclusionsA tailored small group EBP education intervention can enhance AHPs’ self-efficacy to develop answerable questions, search the literature, critically appraise, apply and evaluate research evidence. Through practicing these behaviours and sharing new learning with their peers, allied health professionals can enhance their capability and motivation to use research evidence to potentially improve clinical practice.

Evidence-Based Practice Competence in Nursing Students: An Exploratory Study With Important Implications for Educators.

Evidence-based practice (EBP) is a core pillar of nursing education and an expectation in clinical practice. Students struggle to conceptualize the use of EBP into actual clinical practice despite the development of EBP competencies. This study explored perceptions of EBP education and competence in baccalaureate students using Melnyk's (Worldviews on Evidence-Based Nursing, 11, 2014 and 5) EBP competencies for practicing registered nurses as a basis for comparison. The researchers used a sequential, mixed-methods design. A survey was developed to assess information sources and patterns of use, and semistructured interviews explored factors affecting students' understanding of EBP and information-seeking behaviors in the clinical setting. There were 118 participants in the survey and 12 in follow-up interviews. A major theme was that participants had difficulties distinguishing between EBP and research. Students were able to identify experiences that fostered attainment of basic EBP competencies, such as searching for evidence, but were less able to describe higher-order activities such as integrating evidence to plan EBP changes or disseminating best practices. Clinical learning environments are an ideal place to apply and see EBP in action, but nurse educators cannot assume students arrive ready to apply EBP knowledge and skills to clinical practice. Nurse educators need evidence-based tools to assess student EBP competence across a variety of settings. Research examining the generalizability of the EBP competencies in varying curricular models as well as didactic and clinical settings is needed.

Evidence-based practice profiles among bachelor students in four health disciplines: a cross-sectional study

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.