Evidence-based Practice Learning Research Articles

Learning evidence-based practice by writing the bachelor's thesis – A prospective cohort study in undergraduate nursing education

BackgroundEvidence-based practice has been the desirable healthcare standard for decades. To ensure evidence-based healthcare in the future, nursing education curricula must include strategies for teaching evidence-based practice to nursing students. Learning outcomes about evidence-based practice might be incorporated into courses like the bachelor's thesis. AimThis study investigates whether writing a bachelor's thesis influences nursing students' practice, skills, and attitudes towards evidence-based practice, and explores whether there are differences between students writing the thesis as a literature study and students conducting empirical studies. DesignThis Nationwide Prospective Cohort Study collects data on students' practice, skills, and attitudes towards evidence-based practice through the Student Evidence-Based Practice Questionnaire and two questions from the Norwegian version of the Evidence-Based Practice profile questionnaire. ParticipantsThe sample consists of 314 nursing students writing their bachelor's thesis in the last term of their nursing education. The responding students represent all institutions of higher education in Norway. MethodsPaired t-tests were used to examine changes in the subscales practice, retrieving/reviewing, sharing/applying, attitudes and total scale for the Student Evidence-Based Practice Questionnaire from before they started to submission of the bachelor's thesis. Linear multiple regression analyses were conducted to explore differences between students writing a literature study and students conducting empirical studies. ResultsThe analysis showed that the nursing students significantly increased in the three subscales practice, retrieving/reviewing, and sharing/applying, in addition to the total scale for the questionnaire, while writing the bachelor's thesis. Further, the analysis showed no difference on the scales between the groups of students writing a literature study or conducting an empirical study. ConclusionsThe results indicate that writing the bachelor's thesis leads to increased learning about evidence-based practice and does not depend on the kind of thesis the students write.

Using Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study

Background A multifaceted and interactive teaching approach is recommended for achieving proficiency in evidence-based practice, with critical thinking considered vital for connecting theory and practice. In this context, we advocate the strategic use of health claims in media to promote critical thinking and provide an accessible entry point to evidence-based practice for early-stage university healthcare students. Method We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at the Faculty of Health Sciences, Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor’s students in bioengineering, physiotherapy, social education, and occupational therapy. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around health news. The outcome measures included students’ experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches, including the group exam. Results Out of 446 participants, 136 (30.5%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, both the blended learning design and the group exam were identified as contributors to a positive perception of learning outcomes from the course. Conclusions Integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial for educating bachelor’s healthcare students. However, further rigorous study designs are needed to assess the effect of the course on learning outcomes. Registration DOI 10.5281/zenodo.6985449

Making evidence-based practice actionable in the social service context: experiences and implications of workplace education

PurposeResearch and experience show that evidence-based practice (EBP), i.e. using the best available knowledge in daily professional work, is difficult to achieve in social services. The purpose of this study is to understand the development of organizational EBP learning processes in daily work through workplace education for staff and managers of supported homes for people with cognitive disabilities. The authors examine how the EBP model and new knowledge are understood and made actionable in the workplace, applying theories of organizational learning.Design/methodology/approachThe authors used empirical material collected from an EBP workplace education pilot in Sweden, as well as documents on national EBP implementation in Swedish social services. Before the pilot, a focus group interview was conducted with regional senior managers. Participating managers and staff were individually interviewed two to three years after the pilot.FindingsThe study illustrates how knowledge-based action emerged from education where EBP was interpreted, understood, reflected on, and tested, supported by codified EBP tools in the work context. The participants, when supervised, and when observing and questioning their own behaviors in practice, contributed to double-loop learning (DLL) processes. Codification of EBP knowledge into useful tools and socialization processes during education and workplace meetings was crucial in developing individual and group DLL and knowledge-based actions.Originality/valueThe bottom-up approach to EBP development and the adaptive contextual learning at the workplace gave new insights into organizational learning in social service workplaces.

Ambulance clinicians implementing evidence-based practice: mind the gap! Attitudes, perceptions and experiences of student paramedics.

Evidence-based practice (EBP) represents the conscientious and judicious use of the best contemporaneous evidence in partnership with patient values and clinical expertise to guide healthcare professionals. As a result, EBP is a recommended component of undergraduate education and considered fundamental for improving patient outcomes. EBP principles have thus become deeply rooted in higher education curricula, but only in recent years has this begun to permeate the world of paramedic practice. Despite this paradigm, the impact of EBP may be limited because ambulance clinicians may struggle with implementation, as a variety of barriers influence translation and application. A survey study aimed to gain insight into the epistemological and metacognitive barriers impacting student experience in order to help improve teaching and learning practices. A sample of 64 students, across two different undergraduate paramedic science programmes, were recruited. Of these, 70% of BSc (Hons) students versus 33% of DipHE students agreed to some extent or greater that EBP represented minimal benefit in real-world practice due to Trust policy and the guidelines set out by the Joint Royal Colleges Ambulance Liaison Committee (Welch's t = 2.571, df = 26, p = 0.016 two-sided). Furthermore, 25% felt standard operating procedures negatively impacted their ability to implement EBP, and 39% reported their EBP learning had improved their ability to implement improved levels of patient care. A disparity between theoretical learning and EBP implementation was identified. EBP may not dovetail with standard operating procedure within UK ambulance Trusts, resulting in confusion among student paramedics as to the true worth of EBP.

Reliability and Validity of the Japanese Version of the Implementation Leadership Scale for Nurse Managers and Staff Nurses: A Cross-Sectional Study

Background. Strategic leadership is key to implementing evidence-based practice (EBP). Evaluating the readiness and processes necessary to implement EBP using the Japanese version of the implementation leadership scale (ILS) may be useful to systematically promote the implementation of EBP in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the ILS for nurse managers and staff nurses. Methods. Data were collected in a cross-sectional study. The original ILS was translated into Japanese and back-translated into English. Clinical nurses reviewed it and confirmed its face validity. We distributed a web questionnaire to 119 nurse managers and 2,858 staff nurses working at three university hospitals in Japan’s metropolitan areas. Construct validity was assessed for nursing managers and staff nurses, respectively, using confirmatory factor analysis. Known-group validity for nurse managers was assessed by verifying differences in ILS scores by educational background and experience of learning EBP and working on EBP. We evaluated reliability using Cronbach’s alpha and test-retest reliability. Results. The response rates for nurse managers and staff nurses were 56.3% and 16.9%, respectively. Data from 67 nursing managers and 484 staff nurses were analyzed, excluding duplicate responses. Confirmatory factor analyses of both samples supported the four-factor structure of ILS. The ILS total score of nurse managers with experience learning EBP or experience working on EBP was statistically significantly higher than that of those with no experience, and known-group validity was supported. Across both samples, internal consistency reliability was strong (Cronbach’s alpha: 0.91–0.97) and test-retest reliability was moderate. Conclusion. This study illustrated the reliability and validity of Japanese versions of the ILS for both nurse managers and staff nurses. This study enabled international comparisons of the leadership required for EBP implementation and may support the development of intervention programs and strategies to promote EBP’s implementation in different countries. Trial Registration. UMIN Clinical Trials Registry (UMIN-CTR). This trail is registered with UMIN000045782.

Improving the Evidence-Based Practice Skills of Entry-Level Physiotherapy Students through Educational Interventions: A Scoping Review of Literature.

Evidence-based practice (EBP) is an essential approach in healthcare, attracting growing interest among both practitioners and researchers. This scoping review aims to (1) systematically investigate the effectiveness of pedagogical methods used to facilitate learning of the EBP approach, and (2) explore the perceptions, experiences, and issues related to these learning methods. The overarching purpose is to identify the state of the art in pedagogical methods, instruments, influences, and barriers in teaching and learning EBP within entry-level physiotherapy education programs. This scoping review was conducted following PRISMA guidelines, with PubMed and Eric databases being searched for peer-reviewed original research articles using a combination of keywords. Excluding non-pertinent articles from the initial 465 identified, 12 were eligible for final inclusion (5 quantitative, 3 qualitative, and 4 mixed-methodology studies). A range of pedagogical methods and instruments for teaching EBP in physiotherapy education were detected, all of which having the capability to positively affect physiotherapy outcomes. Findings from this study support the significant influence that EBP exerts on the improving of the quality of teaching, together with the necessities that the involvement of EBP in physiotherapy education programs provide. Several barriers were identified, which should be taken into consideration when designing population-specific EBP strategies tailored to these particular needs.

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

AimTo examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students. BackgroundThe competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students. DesignA quasi-experimental study. MethodsBased on Astin’s Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor’s program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students’ EBP competence, learning experience and satisfaction and score of team-based research protocol assignment. ResultsCompared with conventional teaching, the innovative teaching characterized by EBP improved students’ EBP competence in terms of attitudes and skills and enhanced student’s comprehensive ability in nursing research. Students’ learning experience and satisfaction were similarly favorable between the two groups. ConclusionsFor undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.

Using a digital escape room to engage first year pre-registration nursing students in evidence-based practice learning: a case study

If health professionals are to deliver care which reflects the best evidence available, they need to develop an understanding of how to find, appraise and use research to inform their clinical practice.
 A digital escape room activity was designed for a first-year undergraduate module, to develop nursing students’ skills in the first three stages of evidence-based practice: developing a question, searching and appraising the literature. The escape room was hosted on the university’s virtual learning environment.
 The evaluation of the activity is based on the feedback from a digital survey used with three consecutive first year undergraduate cohorts (n = 83) and the staff involved in the design and delivery of the activity.
 Over 99% of students found the activity fun, with over 90% declaring that it was more engaging and motivating than other group learning activities. Almost 90% of students were looking forward to completing another DER type activity.
 The feedback indicates that both staff and students were motivated by the digital learning experience, with a positive impact on group engagement and students’ perception of learning.

English

Evidence-Based Practice (EBP) in health is important for patient safety and quality care while Critical Thinking (CT) is a vital prerequisite to evidence based nursing. Despite their importance, in some settings neither EBP nor CT is taught assessed or implemented. This scoping review examined literature related to teaching, learning, assessment and implementation of EBP and application of CT by nursing students and graduates. Arksey and O’Malley framework was used to conduct the scoping review.  PubMed, CINAHL, EMBASE and Joanna Briggs Institute for EBP data bases were searched for studies conducted between 2000 and 2020. Inclusion criteria were adapted from the -Population, Intervention, Professionals and Patients, Outcomes, Health Care settings (PIPOH) framework. Search terms included; evidence based practice, nursing education, nursing practice, critical thinking, methods, barriers, facilitators to teaching, learning, assessing and implementing EBP and CT. A total of 2,303 articles were retried, eventually 37 met the inclusion criteria. Use of non-traditional instructional methods for teaching EBP and CT were documented including Problem Based Learning, concept mapping, simulation, think aloud, critical incidence technique, debates and role-plays, reflective journaling, article analysis, nursing journal clubs and multidisciplinary clinical rounds. Validated tools for assessing EBP and CT Skills included; California Critical Thinking Skills Test, Upton and Upton 2006 EBP questionnaire and Yoon’s 2004 Critical Thinking Disposition Inventory. Teaching, assessing EBP and applying CT skills is challenging. Therefore  innovative teaching methods are required to promote learning while successful implementation require strategies to minimize detractors and sustain enablers of the process. Key words: Evidence-Based Practice nursing, critical thinking, teaching, learning, assessment and implementation.

Preparing students for an evidence-based health service – a collaboration between the University Library and faculty

The Faculty of Health Sciences, OsloMet (Oslo Metropolitan University), first launched the joint course ‘Introduction to Evidence-Based Practice in Health Care’ in the fall semester 2020, with University Librarians as collaborative partners. The aim of the course is to ensure that OsloMet undergraduate students in the health sciences will be given the same platform for building their ability for evidence-based work. This best practice article is based on our presentation at the conference ‘Creating Knowledge 2021’. Here we shared some of our experiences of the collaboration with the faculty in the planning and implementation of this course, and the course design featuring flipped classroom structure and digital, student active teaching sessions. We will present examples of student course assignments, evaluation from students and faculty staff, and some course adjustments based on the feedback. This course gives both the library, the faculty and all our different health care students a common platform for teaching and learning evidence-based practice.

Effectiveness of Digital Flipped Learning Evidence-Based Practice on Nurses' Knowledge, Attitude, and Practice: A Quasi-Experimental Trial.

Background: Evidence-based care has become critical in raising the quality of medical facilities. The implementation of evidence-based practice helps medical practitioners make better clinical decisions. Objective: The objective of this study was to investigate whether the innovative flipped teaching model could be as effective as the conventional teaching model in terms of knowledge, attitude, and practice and to confirm the continuous effect. Design: A quasi-experimental design using the flipped and conventional learning groups concurrently with repeat measurements was used. Setting: The setting was a 475-bed regional teaching hospital in Taiwan, from March to July 2020. Participants: The study included 114 licensed nurses who had worked longer than three months, with 57 participants each in two groups. Methods: The participants were assigned to two groups using a block randomization method. All participants completed questionnaires related to knowledge, attitude, and practice of EBP at four-time points: pre-test (T0) and immediately after intervention (T1), at month 1 (T2), and at month 3 (T3). Analysis of repeated generalized estimating equations was used. Results: The flipped and conventional learning groups had significant differences in knowledge, attitude, and practice at the T0 and T1 (p < 0.05). The flipped group was higher than the conventional group at T3 in the knowledge score (p = 0.001) and lower than the conventional group at T2 in the attitude score (p = 0.010). There were no significant differences between the two groups’ practice scores at different time points. There were no significantly different score changes for knowledge, attitude, and practice (p > 0.05). The interaction term only at T3 vs. T0 in the knowledge score was slightly different (p = 0.049) in primary outcome. Conclusion: The intervention methods of both groups were effective. Flipped learning is more flexible and has more time for discussion, which nurses favor. Under the policy promoted in the hospital, EBP combined with the nursing advancement system was standardized, and conventional learning also improved the learning effect.

From Evidence Synthesis to Transfer: Results from a Qualitative Case Study with the Perspectives of Participants.

The increase in health research brings challenges to the production, synthesis, and use of research findings in clinical practice. In the case of undergraduate training in nursing, it is necessary to think about the curricular contents and create opportunities to develop skills for learning evidence-based practice. The objective of this study was to analyze nurses’ perspectives regarding the effects of their participation in a project of translation of knowledge into clinical practice during undergraduate nursing education, specifically involving knowledge, attitudes, and competencies related to the use of evidence. This is a qualitative case study grounded in the knowledge-to-action theoretical framework. The participants were 13 nurses who were involved in a project about the translation of knowledge into clinical practice during the last term of their undergraduate course. The data were collected by applying interviews between December 2020 and April 2021. Content analysis was carried out by using the qualitative data analysis software tool webQDA®. The following categories emerged from the content analysis carried out on the material gathered during the interviews: understanding evidence; learning how to use evidence; transferring evidence; adjusting to the context; and observing the advantages of evidence-based practice. Extracurricular activities were perceived as an opportunity to understand what evidence is and observe in loco the advantages of health care for clients, teams, and services. During the project, the participants developed cross-sectional competencies and envisaged changes to their professional activity as a result of changes in their attitude regarding evidence and its use. We concluded that the opportunity to develop evidence-related activities allows for the development of skills and influences the attitude towards evidence-based practice and knowledge use.

Teaching evidence-based practice: Knowledge to implementation in a BSN program, part 1.

Despite increased recognition for the importance of evidence-based practice (EBP), nurses still identify a need for more education and skill-building in the process used to provide evidence-based care. Nurse educators play a vital role in addressing these needs. This article is part 1 of a two-part series. To describe an interactive learning process regarding EBP taught over two courses that allow students to not only appraise evidence but also implement evidence on a clinical unit. Part 1 focuses on course one, Evidence-Based Practice, which takes place during junior year. In course one, students learn about EBP steps 1-3. Faculty assign students to teams of three to four for an evidence-based project. Project scenarios are written ahead of time by faculty, and student teams are given class time for project completion. After course completion, an anonymous survey was distributed to measure the student perceived achievement for the EBP learning objectives. Students responded to statements using a 5-point Likert scale for level of agreement (1 = strongly disagree to 5 = strongly agree) regarding achieving course objectives. The evidence-based project culminated with a PowerPoint presentation to the class with recommendations for nursing practice based on the best evidence for the scenario they were provided. Eighty students responded to the evaluation survey, and mean scores were 4.0 or higher. This finding indicates that students had a high degree of perceived achievement. Interactive learning in teams promotes discussion and understanding of EBP and mimics real-life EBP implementation. Implementing EBP steps should be tied to clinical scenarios or clinical situations to enhance student learning.

Nursing students' insights of learning evidence-based practice skills using interactive online technology: Scoping review.

This scoping review aims to explore nursing students' insights of learning evidence-based practice skills through the use of interactive online technology. Studies were obtained from seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global) until May 2021. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews and was guided by the Arksey and O'Malley framework (Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 2005, 8(1), 19-32). Findings were analyzed using thematic analysis. Three themes were derived from the 22 included studies: (1) embracing new changes, (2) challenges to tackle, and (3) towards future improvement. Many nursing students reported positive learning experiences of evidence-based practice skills using interactive online technology. The challenges faced by students and suggestions for improvement were discussed. Future online evidence-based practice courses should consider blended pedagogies, providing students with effective scaffolding (step-by-step guidance) and allowing students to choose their preferred instructional strategies. Thorough planning, testing, and orientation should be conducted before the programs' implementation. Lastly, future studies should aim to achieve higher study rigor to obtain more accurate results.

SPN 2021 Poster Abstract Awards

SPN 2021 Poster Abstract Awards

Experiences with using a mobile application for learning evidence-based practice in health and social care education: An interpretive descriptive study.

Health and social care students are expected to apply evidence-based practice (EBP). An innovative mobile application, EBPsteps, was developed to support learning EBP. The aim of this study was to explore health and social care students' experiences of learning about EBP using the mobile application EBPsteps during their clinical placements. An interpretive description approach guided the exploration of student experiences. Four focus groups were conducted with a convenience sample of students from three undergraduate degree programs: occupational therapy, physical therapy, and social education. The constant comparison method was used to categorize and compare the qualitative data. Three integrated themes were generated: "triggers for EBP", "barriers to EBP", and "design matters". Information needs, academic requirements, and encouragement from clinical instructors triggered the students to use EBPsteps. Lack of EBP knowledge, lack of academic demand, and lack of emphasis on EBP in clinical placement were barriers to using EBPsteps. Design issues mattered, as use of the app was motivated by design features such as the opportunity to practice EBP in one place and taking notes in a digital notebook. The use of the app was hindered by anticipation that the use of phones during clinical placements would be viewed negatively by others and by specific design features, such as unfamiliar icons. The students perceived the EBPsteps app as a relevant tool for learning EBP, although they also suggested specific changes to the design of the app. Requirements must be embedded in the curriculum to ensure that the app is used. Our findings bring important information to developing and implementing mobile applications as a teaching method in health and social care educations.

Student perspectives on factors that influence the implementation of evidence-based practice in occupational therapy.

Evidence-based practice (EBP) is perceived as an integral component of contemporary allied health practice. While allied health clinicians (such as occupational therapists) have generally positive attitudes towards EBP, research suggests that they find its implementation consistently challenging. The professional literature increasingly suggests that more effective EBP learning takes place when social constructivist approaches to learning are adopted. The authors of this study sought to use the pre-existing knowledge and perceptions of occupational therapy students to inform a curriculum review of an EBP unit. Therefore, the aim of this content analysis study was to investigate how occupational therapy students perceive and critically analyse factors that influence the implementation of EBP, specifically strengths, weaknesses, opportunities and threats (SWOT). The study sampled students in the third year of a 4-year, Bachelor level Australian Occupational Therapy Program. The students were undertaking the first of two EBP units, and data were collected from the first assignment they submitted for these units. The assignment required the students to complete a SWOT analysis of EBP in occupational therapy, and response to a statement around whether it should be mandatory. Data were collected over 2 consecutive years from a total of 64 occupational therapy students. All data collected were subjected to content analysis, with themes identified by at least 25% of students in each cohort retained for analysis and formation into overall themes. Participating occupational therapy students identified five strengths, four weaknesses, six threats but only one opportunity for EBP. Three key themes were identified within the data: first, the role and purpose of EBP; second, the resources it requires and third, factors that influence its success. The students perceived the main purpose of EBP as supporting positive practice change, and highlighted its roles in building clinician capacity and professional credibility. They also characterized EBP as a separate and specialist practice that requires specific training and resourcing to achieve, and questioned its feasibility as an integrated part of daily practice. Along with previously identified challenges around time and resourcing, the students also highlighted negative attitudes and beliefs from senior colleagues as an important negative influence on the success of EBP. The current study consolidates a growing body of international literature about the value of social constructive approaches to EBP in undergraduate education. Vertical constructive alignment that embeds EBP through undergraduate education, rather than the provision of 'EBP'-specific units, should now be considered best practice. However, this embedded approach requires the explicit and repeated communication of the presence of EBP in all learning opportunities, to enable students to recognize opportunities to deploy their existing knowledge and skills.

Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements.

BackgroundConsensus on evidence‐based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context.AimsTo establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries.MethodsA multi‐phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two‐round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated.ResultsIn Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two‐round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others.Linking Evidence to ActionThe set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students’ and nurses’ perception of competencies required for EBP processes.

Intraprofessional Collaboration in Learning Evidence-Based Practice

Intraprofessional Collaboration in Learning Evidence-Based Practice

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.