Evidence-Based Practice Profile Questionnaire 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.

Adaptation and validation of the Evidence-based Practice Profile Questionnaire (EBP2Q) for clinical postgraduates in a Chinese context

BackgroundEvidence-based practice (EBP) is an essential approach of optimizing patient outcomes and driving progress in clinical practice. As an important reserve talent of medical staff and researchers, the clinical postgraduates are expected to become the backbones of supporting the implementation of EBP in clinical units after graduation. The assessment of their EBP learning outcomes is an important issue, yet few tools have been developed specifically in Mainland China. The purpose of this study is to adapt the Evidence-Based Practice Profile Questionnaire (EBP2Q) to Mainland China’s cultural context and to evaluate the psychometric properties of the Chinese EBP2Q in clinical postgraduates.MethodsCross-cultural modification, including translating the original EBP2Q into Chinese was implemented according to established guidelines. A pilot study was carried out in Mainland China among 30 clinical postgraduates. A subsequent validation study was conducted among 633 clinical postgraduates majoring in clinical medicine, stomatology and nursing from Mainland China. Construct validity was assessed by exploratory factor analysis (n = 313), together with confirmatory factor analysis (n = 320). Reliability was determined by internal consistency and test-retest reliability.ResultsThe Chinese EBP2Q consisted of 40 items. The content validity index of the Chinese EBP2Q achieved 0.938 at an acceptable level. Principal component analysis resulted in a four-factor structure explaining 61.586% of the total variance. All fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the four-factor structure contributed to an ideal model fit. The internal consistency appeared high for the Chinese EBP2Q, reaching a Cronbach’s alpha value of 0.926. Test–retest reliability was 0.868 and the split-half coefficient was 0.925.ConclusionChinese version of EBP2Q possesses adequate validity, test-retest reliability and internal consistency. It is a promising questionnaire to be adopted by Chinese medical educators in designing their course and curriculum, or by clinical postgraduates for self-assessment of EBP learning.

Sociodemographic and Work-Related Variables Affecting Knowledge of, Attitudes toward, and Skills in EBNP of Nurses According to an EBPPQ.

(1) This study examines sociodemographic and work-related variables to determine their impact on the knowledge of, attitudes toward, and skills in Evidence-Based Nursing Practice (EBNP). (2) The study included 830 nurses from four voivodships in Poland, Dolnośląskie, Łódzkie, Podlaskie, and Zachodniopomorskie and was conducted by the diagnostic survey method, using the questionnaire technique. The following research tools were applied in the study: an Evidence-Based Practice Profile Questionnaire (EBPPQ) and a survey questionnaire developed by the authors, containing questions on sociodemographic data and work-related variables. (3) Sociodemographic variables with an impact on the knowledge of, attitudes toward, and skills in EBNP include age, marital status, and educational background. Older nurses find it problematic to apply EBNP, and their level of relevant knowledge and skills is lower; whereas, those with university education possess the best EBNP-related skills, and they are also more eager to expand them and apply them in their work. The work-related variables with an impact on the knowledge of, attitudes toward, and skills in EBNP among nurses include work experience, which has a negative effect on applying EBNP and the skills associated with it. The type of school from which the nurses graduated and the nursing specialisation training also have a strong impact on expanding nurses’ competence in EBNP.

Changes in physiotherapists' perceptions of evidence-based practice after a year in the workforce: A mixed-methods study.

Few studies have explored evidence-based practice (EBP) knowledge, attitudes and behaviours of health professional graduates transitioning into the workforce. This study evaluated changes in these EBP domains in physiotherapists after one year of working. A mixed methods design was used. Participants completed two psychometrically-tested EBP questionnaires at two timepoints. The Evidence-Based Practice Profile questionnaire collected self-report EBP data (Terminology, Relevance, Confidence, Practice, Sympathy) and the Knowledge of Research Evidence Competencies collected objective data (Actual Knowledge). Changes were calculated using descriptive statistics (paired t-tests, 95% CI, effect sizes). Qualitative interview data collected at one timepoint were analysed using a descriptive approach and thematic analysis, to examine the lived experience of participants in the context of their first employment. The aim of the mixed methods approach was a broader and deeper understanding of participants' first year of employment and using EBP. Data were analysed from 50 participants who completed both questionnaires at the two timepoints. After one year in the workforce, there was a significant decrease in participants' perceptions of Relevance (p<0.001) and Confidence with EBP (p<0.001) and non-significant decreases in the other domains. Effect sizes showed medium decreases for Relevance (0.69) and Confidence (0.57), small decreases in Terminology (0.28) and Practice (0.23), and very small decreases in Sympathy (0.08) and Actual Knowledge (0.11). Seven themes described participants experience of using EBP in their first working year. After a year in the workplace, confidence and perceptions of relevance of EBP were significantly reduced. A subtle interplay of features related to workplace culture, competing demands to develop clinical skills, internal and external motivators to use EBP and patient expectations, together with availability of resources and time, may impact early graduates' perceptions of EBP. Workplace role models who immersed themselves in evidence discussion and experience were inspiring to early graduates.

Development and validation of the Chinese version of the evidence-based practice profile questionnaire (EBP2Q)

BackgroundEvidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP2Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China.MethodsBased on established guidelines for the development of questionnaires, the English EBP2Q was translated and cross-culturally adapted. The Chinese version of the EBP2Q (EBP2Q-C) was validated using a sample of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated.ResultsThe content validity index demonstrated good content validity (≥0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis (χ2/df = 2.001; RMSEA = 0.065; SRMR = 0.077; and CFI = 0.884). The Spearman’s rank correlation analysis of the EBP2Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses’ highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach’s α and the Cronbach’s α for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability.ConclusionsExcept for the convergent validity of the Sympathy domain, the EBP2Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.

"The more you did, the more it made sense": Problem-based learning to improve early evidence-based practice in an undergraduate physiotherapy professional programme.

Evidence-based practice (EBP), which integrates clinical reasoning skills, research evidence, and patient preference, has become standard in curricula for health care professional programs. Students however perceive EBP as difficult and often irrelevant to clinical practice. A problem-based learning (PBL) approach is trialled in an early stage module where EBP knowledge and skills are stated learning outcomes. Prior to this, the content-based approach to EBP teaching and learning received negative student feedback. The impact of delivering EBP through PBL is evaluated by comparing 5 standard Likert feedback scales and open-ended question responses relating to the EBP instruction in the module before and after a PBL approach was implemented. The impact of a PBL approach on EBP profiles is further examined under domains (relevance, sympathy, terminology, practice, and confidence) of the validated Evidence-based Practice Profile Questionnaire. All mean Likert scores relating to subject understanding, relevance of assessments, achievement of learning outcomes, teaching, and overall module satisfaction improved when the PBL approach was compared with the lecture-based format (p<0.05). Student comment post-PBL continued to identify EBP as a difficult concept, but now comments on the teaching and assessment approach were mainly positive, addressing the collaborative nature of PBL, identifying EBP, communication and team-working skills acquired, praising the real life, practical application of EBP taken, and commenting on improvement in EBP self-efficacy. Within group change in the Evidence-based Practice Profile Questionnaire following a PBL approach identified significant improvement in EBP domains of terminology (mean change 3.38; p<0.001); practice (mean change 16.5; p<0.001), and confidence (mean change 10.1; p=0.008). Conceptual links, based on constructivist underpinnings of PBL and EBP, are developed in the paper. Using mixed methods evaluation, PBL is effective at promoting early EBP. Students identified with the interactive, collaborative, and experiential nature of PBL to EBP instruction.

Knowledge, Behaviors, and Attitudes of Polish Nurses As Compared With Evidence-Based Practice in Relation to the Guidelines of the European Resuscitation Council.

BackgroundThe emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment.ObjectiveThe study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council.MethodsThe study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure.ResultsThe current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses’ Evidence-Based Practice and its limitations related to procedures, the lack of equipment and personnel issues, as well as the lack of scientific evidence. Furthermore, nurses saw clinical experience as being more valuable than research findings for practical decision-making than research findings, and, according to the respondents, they presented opinions that the best way to assess the effectiveness of an action was through clinical experience. In addition, the nurses gave low scores and tended to underestimate the critical literature review aspect within the domain, along with its significance for the general professional practice, believing that search for scientific evidence alone does not apply into their professional work.ConclusionsThe validated Polish version of the Evidence-Based Practice profile questionnaire is a reliable instrument. The study demonstrates that nurses are facing a multitude of limitations due to procedures, the lack of equipment, and personnel issues. Currently perceived as very poor, the ability to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure.

Promoting evidence-based practice – perceived knowledge, behaviours and attitudes of Polish nurses: a cross-sectional validation study

Purpose. Evidence-based practice (EBP) is recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. The aim was to describe nurses’ knowledge, behaviours and attitudes regarding EBP. Materials and methods. A cross-sectional approach was conducted during specialty state examinations in Poland in 2014 in a sample of 548 nurses. The self-completed reliable and valid evidence-based practice profile questionnaire (Australia) was used. Statistical analysis included Cronbach’s α coefficient, analysis of variance, the Guttman split-half method and calculations in Statistica version 12. Results. Although the participants’ beliefs about the benefits of EBP were high, their knowledge was relatively low. Statistically significant correlations were found between barriers and practice, knowledge and attitudes in relation to the level of nurses’ education (p < 0.001 to p < 0.05). Total Cronbach’s α coefficient was 0.970. Conclusions. Study findings highlight the importance of further supplementation of knowledge about EBP. The difficulties in using EBP in clinical practice are objective and require changes in the Polish system of nursing care. Additionally, life-long updating knowledge in the area of EBP by participation in various forms of postgraduate education can produce improvements in the knowledge, behaviours and attitudes of nurses in creating a positive EBP profile.

Changes in physiotherapy students\u2019 knowledge and perceptions of EBP from first year to graduation: a mixed methods study

BackgroundDedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs. It is important to understand the effectiveness of this training. This study investigated EBP outcomes in entry-level physiotherapy students from baseline to completion of all EBP training (graduation).MethodsMixed methods with an explanatory sequential design. Physiotherapy students completed two psychometrically–tested health professional EBP instruments at baseline and graduation. The Evidence-Based Practice Profile questionnaire collected self-reported data (Terminology, Confidence, Practice, Relevance, Sympathy), and the Knowledge of Research Evidence Competencies instrument collected objective data (Actual Knowledge). Focus groups with students were conducted at graduation to gain a deeper understanding of the factors impacting changes in students’ EBP knowledge, attitudes, behaviour and competency. Descriptive statistics, paired t-tests, 95% CI and effect sizes (ES) were used to examine changes in outcome scores from baseline to graduation. Transcribed focus group data were analysed following a qualitative descriptive approach with thematic analysis. A second stage of merged data analysis for mixed methods studies was undertaken using side-by-side comparisons to explore quantitatively assessed EBP measures with participants’ personal perceptions.ResultsData were analysed from 56 participants who completed both instruments at baseline and graduation, and from 21 focus group participants. Large ES were reported across most outcomes: Relevance (ES 2.29, p ≤ 0.001), Practice (1.8, p ≤ 0.001), Confidence (1.67, p ≤ 0.001), Terminology (3.13, p ≤ 0.001) and Actual Knowledge (4.3, p ≤ 0.001). A medium ES was found for Sympathy (0.49, p = 0.008). Qualitative and quantitative findings mostly aligned but for statistical terminology, participants’ self-reported understanding was disparate with focus group reported experiences. Qualitative findings highlighted the importance of providing relevant context and positive role models for students during EBP training.ConclusionsFollowing EBP training across an entry-level physiotherapy program, there were qualitative and significant quantitative changes in participants’ knowledge and perceptions of EBP. The qualitative and quantitative findings were mainly well-aligned with the exception of the Terminology domain, where the qualitative findings did not support the strength of the effect reported quantitatively. The findings of this study have implications for the timing and content of EBP curricula in entry-level health professional programs.

Increasing Rehabilitation Therapists’ Confidence Utilizing Evidence-Based Interventions: Pilot Study

Evidence-based practice enables rehabilitation therapists to provide the best quality of care and outcomes for patients. However, rehabilitation therapists are often not confident in using evidence in many settings. Purpose. The objective of this evidence-based practice project was to determine if educational small group sessions enhanced occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and a speech and language pathologist’s confidence in utilizing and applying evidence. Method. Eleven rehabilitation therapists of multiple disciplines (occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and a speech and language pathologist) from a skilled nursing facility participated in six educational sessions designed to increase evidence-based practice. A pre- and post-test utilizing the Evidence-Based Practice Profile Questionnaire (EBPPQ), measured change in therapists’confidence regarding evidence-based practice. Results. Results on the Evidence-Based Practice Profile Questionnaire concluded that 7 of 11 rehabilitation therapists reported an increase in confidence levels. Conclusion. Educational small group sessions can be an effective method to assist rehabilitation therapists in developing this confidence. KEYWORDS: Evidence-based practice, confidence levels, rehabilitation therapists, educational sessions, skilled nursing facility

Validation study of the Polish version of the Evidence-Based Practice Profile Questionnaire

BackgroundDecisions about patient care in clinical practice should be made based on proven scientific evidence of efficacy and safety (i.e., evidence-based practice [EBP]). Currently, there are no available tools in Poland for assessing the knowledge and attitudes of specialists in health sciences towards EBP. Therefore, by validating the Polish version of the original English Evidence-Based Practice Profile Questionnaire (EBP2Q), we may provide an appropriate instrument for assessing EBP.MethodsThe validation group consisted of 1,362 people, including nurses and midwives taking the specialization exam, second-degree students in nursing/midwifery, and staff of selected municipal and clinical hospitals in Warsaw, Pruszkow, and Chelm. The study was conducted from March to June 2014. The following psychometric properties of the EBP2Q were assessed: reliability (Cronbach’s alpha coefficient, and test-retest), validity (exploratory factor analysis, Spearman’s r correlation coefficient, and assessment of inter-group differences), as well as unidimensionality of domains (principal component analysis).ResultsAll domains of the EBP2Q were characterized by high reliability (Cronbach’s alpha ranging from 0.800 to 0.972). The Polish version showed a strong similarity of factor structure with the original English EBP2Q, indicating that the condition for theoretical validity is fulfilled. Maintenance of the theoretical and discriminative validity and unidimensionality of five domains of the EBP2Q was confirmed.ConclusionsThe Polish version of the EBP2Q is comparable in terms of psychometry to the original English version. This questionnaire can be used to assess knowledge, attitudes, and skills concerning EBP among students and practicing professional nurses and midwives. The future validation of the EBP2Q in other groups of specialists in health sciences may increase the scope of applicability of this tool.

Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts.

BackgroundTraining in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce.MethodsA prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2), which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts), Confidence, Practice (EBP implementation), Sympathy (disposition towards EBP)]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES) (95% CI) were calculated for all changes.ResultsEffect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42). While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29) followed by an improvement in the second year (ES +0.27). Scores in Terminology improved (ES +0.19 to +0.26) in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19) in the first year and improved minimally in the second year (ES +0.04). Confidence scores improved during the second workforce year (ES +0.27). Scores for Sympathy showed little change.ConclusionsDuring the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown.

Entry-Level Evidenced-Based Practice Training in Physiotherapy Students: Does It Change Knowledge, Attitudes, and Behaviours? A Longitudinal Study

Evidence-based practice (EBP) is an integral part of health professionals’ training. However, there is little research concerning learning outcomes in the allied health student population. This study explored changes in self-reported EBP knowledge, attitudes, and behaviours, and actual EBP knowledge of entry-level physiotherapy students following exposure to formal EBP training. Methods: Entry-level Bachelors and Masters physiotherapy students were surveyed before and after completing EBP training courses. Two validated and reliable surveys, the Evidence-Based Practice Profile Questionnaire (EBP2) and the Knowledge of Research Evidence Competencies (K-REC) survey were used. The EBP2 included self-reported domains: relevance, sympathy, terminology (knowledge), practice, and confidence. The K-REC survey measured actual EBP knowledge. Paired t-tests and effect sizes (ES) were used to assess the change in scores after exposure to one or both EBP training courses. Mixed design between-within ANOVAs were performed to assess the impact of EBP training on participants’ scores in the two different student groups (Masters and Bachelors). Results: In the group of 77 students, completion of EBP courses resulted in significant change in all self-reported domains: relevance p &lt; 0.001 (ES = 0.49), sympathy p = 0.005 (ES = 0.30), terminology p &lt; 0.001 (ES = 1.07), practice p &lt; 0.001 (ES = 1.34) and confidence p &lt; 0.001 (ES = 0.89), and also actual knowledge p &lt; 0.001 (ES = 1.13). There were no interaction effects between time and the student sub-group (Masters or Bachelors) for relevance, terminology, confidence, and sympathy (p≥ 0.05). There was a significant interaction between time and the student sub-group for practice and actual knowledge (p&lt; 0.05). Conclusion: These findings allow identification of the size of changes likely to result from current EBP courses in entry-level training. The results provide a basis for measuring the effect of modifications to EBP courses and for future EBP training interventions.

Development and psychometric testing of a trans-professional evidence-based practice profile questionnaire

Background: Previous survey tools operationalising knowledge, attitudes or beliefs about evidence-based practice (EBP) have shortcomings in content, psychometric properties and target audience.Aims: This study developed and psychometrically assessed a self-report trans-professional questionnaire to describe an EBP profile.Methods: Sixty-six items were collated from existing EBP questionnaires and administered to 526 academics and students from health and non-health backgrounds. Principal component factor analysis revealed the presence of five factors (Relevance, Terminology, Confidence, Practice and Sympathy). Following expert panel review and pilot testing, the 58-item final questionnaire was disseminated to 105 subjects on two occasions. Test–retest and internal reliability were quantified using intra-class correlation coefficients (ICCs) and Cronbach's alpha, convergent validity against a commonly used EBP questionnaire by Pearson's correlation coefficient and discriminative validity via analysis of variance (ANOVA) based on exposure to EBP training.Results: The final questionnaire demonstrated acceptable internal consistency (Cronbach's alpha 0.96), test–retest reliability (ICCs range 0.77–0.94) and convergent validity (Practice 0.66, Confidence 0.80 and Sympathy 0.54). Three factors (Relevance, Terminology and Confidence) distinguished EBP exposure groups (ANOVA p < 0.001–0.004).Conclusion: The evidence-based practice profile (EBP2) questionnaire is a reliable instrument with the ability to discriminate for three factors, between respondents with differing EBP exposures.