Evidence-based Practice Self-efficacy Research Articles

Implementation of Evidence-Based Practice and Burnout Among Occupational Therapists: The Role of Self-Efficacy.

Implementing evidence-based practice (EBP) is essential for ensuring optimal quality care and obtaining positive outcome in treatment. Occupational therapists generally hold positive attitudes toward EBP; however, EBP is not always fully implemented. To explore the mediating role of self-efficacy on the relationship between implementing EBP and burnout among occupational therapists. A cross sectional study. Data were collected through social media and WhatsApp groups using an online survey accessible through Qualtrics, a secured web-based data collection system; responses were anonymous. The final sample consisted of 261 female Israeli occupational therapists (ages 24-65 yr, with 1-40 yr of clinical experience). The following questionnaires assessed EBP implementation, burnout, and self-efficacy, respectively: the EBP Implementation Scale, the Maslach Burnout Inventory, and the Occupational Therapy Self-Efficacy Questionnaire. Demographic data were also collected. EBP implementation was low (0-43 points out of a maximum 72 points), moderate levels of burnout and high levels of self-efficacy were reported. Significant associations with medium effect sizes were found between EBP implementation and burnout: the higher the levels of EBP implementation, the lower the levels of burnout frequency and intensity. Moreover, self-efficacy mediated these relationships. EBP implementation was related to elevated self-efficacy, which, in turn, was associated with lower burnout. EBP implementation may serve as an important tool to limit burnout among occupational therapists by fostering their trust in their ability to handle clinical challenges. Further research is needed. Plain-Language Summary: This study explored implementing evidence-based practice (EBP) and its relationships to burnout and work-related self-efficacy among occupational therapists. The study found that self-efficacy mediated the relationships between implementing EBP and burnout. Implementing EBP was associated with higher self-efficacy, which, in turn, was associated with lower burnout among occupational therapists.

Changes in evidence-based practice self-efficacy among nursing students and the impact of clinical competencies: Longitudinal descriptive study

IntroductionEvidence-based practice (EBP) is essential to ensure patient safety and improve the quality of nursing care. Nursing students' self-efficacy in employing EBP is crucial for the formation of a culture of EBP in healthcare organizations. ObjectiveThis study aimed to investigate the changes in nursing students' self-efficacy in employing EBP and the extent to which clinical performance affects these changes. MethodsThis study was a longitudinal descriptive study. Participants were nursing students who had received education on EBP theory and had clinical practice experience. Convenience sampling was used to select nursing students in their third year of study at a nursing college located in the southern region of Korea in 2020. The researcher measured EBP self-efficacy and clinical competence using an online survey tool at three time points (second semester of third year, first semester of fourth year, and second semester of fourth year). Multilevel modeling was used to identify factors affecting changes in EBP self-efficacy. ResultsThe results showed that nursing students' EBP self-efficacy increased over time. Nursing leadership (p = .022), nursing skills (p = .028), communication (p < .001), and nursing process (p = .003) were significant factors that affected the changes in EBP self-efficacy. Individual differences in initial levels and change rates were still observed. ConclusionSystematic education on EBP theory and practical training should be provided to nursing students from the beginning of their studies to graduation to deepen their EBP and clinical competence.

Nurse Leadership and Work Environment Association with Outcome Expectancy and Self-Efficacy in Evidence-Based Practice among Hospital Nurses in The Netherlands: A Cross-Sectional Study.

Questionnaires measuring nurses' self-efficacy, outcome expectancy, and perceived support for EBP from nurse leaders and their work environment were completed by 306 nurses in eight hospitals between March 2021 and June 2021. We used multilevel regression analyses to determine the associations and covariates. This study shows that EBP-supportive leaders and work environments positively contribute to nurses' self-efficacy and outcome expectancy in EBP, along with the covariates undertaking EBP activities and educational level. To improve nurses' active participation in EBP, nurses need to increase their self-efficacy and outcome expectancy in EBP. Supportive leaders and a supportive work environment do have an impact. Hence, these factors need attention when implementing EBP among nurses.

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.

A theory-based research literacy intervention for nurses: A pilot study.

Difficulties with understanding research literature can lead to nurses having low engagement with evidence-based practice (EBP). This study aimed to test the feasibility of an education intervention using an academic literacies approach to improve nurses' research literacy. An interactive workshop was devised utilizing genre analysis and tested in a pre/post pilot study. EBP self-efficacy was measured at baseline and posttest using the Self-Efficacy in Evidence-Based Practiceinstrument (26 items on an 11-point scale for total scores from 0 to 260). Research comprehension was measured with a 10-question quiz (range 0-10). When analyzed with a paired t-test, EBP self-efficacy increased significantly (MD: 56.9, SD: 39.9, t = 4.5, df = 9, p < .001). Research comprehension also improved (MD: 1.1; SD: 1.1, t = 2.9, df 9, p < .01). The workshop evaluations (n = 9) were overwhelmingly positive. This novel approach to research pedagogy aligns well with adult learning theory and social learning theory and is suitable for small group learning in continuing education. There is considerable potential for further work in this area. Genre analysis shows promise as a strategy for teaching nurses to understand research literature.

Organizational factors associated with community therapists' self-efficacy in EBP delivery: The interplay between sustainment leadership, sustainment climate, and psychological safety.

Inner context organizational factors proximally shape therapist experiences with evidence-based practice (EBP) implementation and may influence therapist self-efficacy, which has been linked to sustained use of EBPs in community mental health settings. Research has primarily focused on constructs such as implementation leadership and climate. However, the effects of such factors may depend upon other inner context dimensions, such as psychological safety. Psychologically safe environments are conducive to taking risks, speaking up about problems, and requesting feedback and may promote therapist self-efficacy during implementation. This study examines whether organizational sustainment leadership and sustainment climate relate to therapist EBP self-efficacy only under conditions of psychological safety. Data were collected from 410 clinicians in 85 programs during the sustainment phase of a system-driven implementation of multiple EBPs in children's mental health services. Therapists reported on their organization's sustainment leadership, sustainment climate, psychological safety, and their own self-efficacy in delivering specific EBPs. Multilevel regression analyses were conducted to account for nested data structure. Among program-level variables, sustainment leadership and psychological safety both significantly predicted therapist self-efficacy. However, there were no significant interactions between program-level sustainment climate and psychological safety. Exploratory post-hoc analyses revealed a significant interaction between program-level sustainment leadership and therapist-level perceptions of psychological safety such that that the conditional effect of psychological safety on EBP self-efficacy was significant at high levels of sustainment leadership, but not at low or average levels. We noted independent links between sustainment leadership, organizational psychological safety and therapists feelings of confidence and mastery with EBPs. Therapists' individual perceptions of psychological safety were linked to self-efficacy only in programs with high sustainment leadership. Thus, sustainment leadership and psychological safety may both represent implementation intervention targets, but it may not be critical to assess for perceptions of psychological safety before deploying organizational leadership strategies.Plain language abstract Therapist self-efficacy is a therapist's belief that they are capable, knowledgeable, and skilled enough to deliver evidence-based practices (EBPs), and is thought to promote improved clinical and implementation outcomes, such as therapists' sustained use of EBPs. Conditions within community mental health organizations may influence therapists' sense of EBP self-efficacy. Leaders' support and expectations for EBP implementation, and collective staff perceptions about the organization's climate to support EBPs are linked to positive therapist attitudes and EBP adoption. However, less is known about how these implementation-specific organizational factors associated with therapist EBP self-efficacy in the long-term, and how this may depend on general workplace conditions. Specifically, psychologically safe environments - where therapists feel safe taking risks such as asking questions, admitting mistakes, and trying new skills - may be needed to promote self-efficacy when therapists are tasked with learning and using complex multi-component EBP innovations. The current study tested the prediction that leader-driven and program-wide focus on EBP sustainment may promote therapist EBP self-efficacy only in organizations where conditions for learning are psychologically safe. Our findings confirmed that fostering strong sustainment focused leadership and psychologically safe environments may each be important for increasing therapists' EBP self-efficacy. The model results suggested that individual therapist perceptions of psychological safety were more strongly related to EBP self-efficacy in programs with greater implementation leadership. Findings suggest the importance of increasing EBP leadership behavior to fully potentiate other facilitating conditions for therapist learning in the sustainment phase of EBP implementation initiatives.

Measuring self-efficacy and outcome expectancy in evidence-based practice: A systematic review on psychometric properties.

Evidence-based practice has developed over the last 30 years as a tool for the best possible nursing care. Nevertheless, many nurses do not regularly participate in the evidence-based practice process. Barriers to participation include nurses' self-perceived ability in successfully fulfilling evidence-based practice-related tasks (self-efficacy) and their expectations of the positive outcomes of such tasks (outcome expectancy). To evaluate progress and provide feedback to professionals, monitoring the levels of self-efficacy and outcome expectancy with validated instruments is desirable. A comprehensive overview of the psychometric properties of such instruments is lacking. To determine the psychometric properties of instruments designed to measure nurses' self-efficacy and outcome expectancy in evidence-based practice. This systematic review was performed on studies reporting psychometric properties of instruments that measure self-efficacy and outcome expectancy in EBP. MEDLINE, EMBASE and CINAHL databases were searched up to March 2020. Studies that reported psychometric properties on eligible scales and studied nurses or other healthcare professionals were included. Psychometric properties included content validity, construct validity, reliability, and responsiveness. The COSMIN risk of bias checklist and criteria for good measurement properties were applied independently by two reviewers. This review is registered with PROSPERO (CRD42020183069). Eleven scales measuring self-efficacy or a similar construct and one scale measuring outcome expectancy were identified. The vast majority of the research focused on nurses. Internal consistency and structural validity were the most frequently reported properties, though the recommended confirmative factor analysis to verify the structural validity was rarely performed correctly. In addition, most studies that reported on construct validity did not hypothesise on the expected strength or direction of an effect before the data analysis. Responsiveness was not typically reported or was incorrectly studied. The included articles showed a high quality of evidence for four scales on structural validity and internal consistency. The Self-Efficacy in Evidence-Based Practice Activities scale showed the best content validity and was accompanied by an Outcome Expectations of Evidence-Based Practice scale. Both scales met the COSMIN standards for construct validity with high-quality evidence. In light of the evidence, the Self-Efficacy in Evidence-Based Practice Activities scale is considered promising, and along with the accompanying Outcome Expectations of Evidence-Based Practice scale, appears capable of accurately measuring both self-efficacy and outcome expectancy. The use of these scales is recommended, and further research should be conducted on the responsiveness of the scales.

Evidence-based practice training in nurse residency programs: Enhancing confidence for practice implementation

BackgroundResearch on evidence-based practice (EBP) training demonstrates effectiveness in increasing the knowledge and attitudes of nurses toward EBP, but does not consistently result in willingness to implement EBP. PurposeThe purpose of this quality improvement project was to examine how EBP training of nurse residents affects their EBP self-efficacy and outcome expectancy. MethodA survey of EBP self-efficacy was obtained for a convenience sample of nurses at the beginning, middle and end of their residency program. ResultsImproved confidence in implementing EBP was demonstrated in posttest self-efficacy scores (M = 182.24; SD = 33.68; p < 0.001) and improved expectations of the benefits of use of EBP in post-test outcome expectancy scores (M=54.09; SD=12.77; p < 0.001). ConclusionIn 12-month nurse residency programs providing EBP training, increases in EBP self-efficacy and outcome expectancy were noted as measures positively associated with willingness to implement EBP.

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.

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.

When Do Therapists Stop Using Evidence-Based Practices? Findings from a Mixed Method Study on System-Driven Implementation of Multiple EBPs for Children.

Therapist discontinuation of delivering an evidence-based practice (EBP) is a critical outcome in the community implementation of EBPs. This mixed methods study examined factors associated with therapist discontinuation within a large reimbursement-driven implementation of multiple EBPs in public children's mental health services. The study integrated quantitative survey data from 748 therapists across 65 agencies, and qualitative interviews from a subset of 79 therapists across 14 agencies. Therapists adopted, on average, 2.41 EBPs (SD = 1.05, range = 1-5), and nearly half (n = 355, 47.5%) reported discontinuing at least one EBP. Multi-level models were used to predict the binary outcome of discontinuation, and qualitative analyses were used to expand upon quantitative findings. Quantitative models revealed that therapist factors, including fewer direct service hours per week, a greater number of EBPs adopted, higher emotional exhaustion, and more negative attitudes toward EBPs in general were associated with discontinuation. In addition, EBP-specific factors including more negative perceptions of the particular EBP and lower self-efficacy for delivering the specific EBP predicted discontinuation. Themes from interview responses highlighted the importance of fit of the EBP with the agency's client base, as well as therapist perceptions of adequate EBP training supports, and the alignment of an EBP with therapists' professional goals. Together, the findings suggest the need for strategic sustainment planning interventions that target EBP fit (i.e., fit between adopted EBPs and agency target population, fit between EBP and therapist preferences and career goals) and support therapist self-efficacy in delivering EBPs.

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 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.

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

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

School Nurses' Perceptions, Knowledge, and Related Factors Associated with Evidence-Based Practice in Taiwan.

The implementation of evidence-based practice (EBP) in health care has been focused mainly on hospital settings and there is little research on EBP adoption and implementation among school nurses in Taiwan. This study aimed to determine primary school nurses’ perceptions regarding EBP and to explore the factors that influence EBP in Taiwan. A cross-sectional design was used and the School Nurse Evidence-Based Practice Questionnaire was developed to collect data. A total of 2679 elementary school nurses in Taiwan were invited to participate in this study, and 1200 completed questionnaires were returned, with a 45% response rate. Participants’ mean age was 37.5 (range: 31–62) years and the mean duration of employment as a school nurse was 8.4 (range: 1–20) years. The majority of participants had a Bachelor’s degree (56%). The results revealed that participants had insufficient EBP knowledge and skills. However, they had a positive attitude toward and moderate self-efficacy in EBP. The demographic data positively correlated with knowledge, attitudes, skills, self-efficacy, and influencing factors. Certain influencing factors were highlighted. As school nurses play a crucial role in promoting children’s health, they ought to embrace EBP so as to provide more effective services. School organization should play a supportive role with regard to EBP implementation.

Evidence-based practice self-efficacy of undergraduate speech pathology students following training

Aim: The aims of this study were to determine the self-efficacy of speech pathology students in conducting evidence-based practice before and after a comprehensive evidence-based practice course, and the impact of timing of the course (Semester 1/2).Method: Students attended a 13-week course in their final year of study. The evidence-based practice confidence scale (EPIC) was used to measure the students’ self-efficacy pre- and post-training.Results: Ninety-two percent of students enrolled over six semesters participated. Students began the evidence-based practice course with high confidence in asking patients their preferences but low confidence in interpreting and analysing statistics. A significant improvement in confidence in all evidence-based practice areas was found, with greatest improvement occurring in the critical appraisal of research. Overall, the teaching had greatest effect on a group of skills for finding valid EBP information. There were significant differences between semester one and two students in only 18% of responses. Semester two students were more confident in half of these responses.Conclusions: An evidence-based practice course made a significant difference to student self-efficacy across all aspects, with few differences related to timing of the course. Implications are discussed.Implications for RehabilitationHealth professionals must be confident implementing evidence-based practice throughout the course of their careers, as best practice changes over time.A capstone unit of study/course for undergraduate speech pathology students significantly improved their self-efficacy in implementing evidence-based practice.This has positive implications for evidence-based practice across a wide range of clinical settings including rehabilitation and disability as the graduate entry level students enter the workforce.For on-going success, graduate entry level students must continue to implement evidence-based practice as clinicians if they are to maintain their confidence and further develop their skill set.

Knowledge, Practice and Self-Efficacy in Evidence-Based Practice among Midwives in East Iran.

The successful implementation of evidence-based practice (EBP) can lead to appropriate and effective midwifery care during pregnancy, childbirth and in the postnatal period. However, levels of knowledge and confidence in one's ability to apply EBP are related to its effective implementation. This study aimed to investigate levels of knowledge, practice of and self-efficacy towards the use of EBP among midwives in East Iran. This cross-sectional study took place between January and February 2016 and involved 98 midwives employed at two hospitals and all four urban health care centres in Torbat-e Heydariyeh, Iran. Two subscales of the Evidence-Based Practice Questionnaire were used to assess participants' knowledge and practice of EBP, respectively, while a modified version of a previously described scale was used to determine self-efficacy. A total of 76 midwives participated in the study (response rate: 77.6%). Mean knowledge, practice and self-efficacy scores were 4.48 ± 0.94, 3.53 ± 0.68 and 2.80 ± 0.81, respectively. Significant relationships were found between mean self-efficacy, practice and knowledge scores and proficiency in English language (P = 0.001 each) and statistical methods (P <0.050 each). Additionally, significant relationships were found between knowledge and practice of EBP and proficiency in the use of databases (P <0.050 each). Knowledge and self-efficacy scores were significantly correlated with practice (P = 0.001 each). These findings demonstrate a need for improvement in the self-efficacy, practice and knowledge of EBP among midwives in East Iran. Interventions that promote these factors may help increase the use of EBP in this population.

Students\u2019 attitudes and perceptions of teaching and assessment of evidence-based practice in an occupational therapy professional Master\u2019s curriculum: a mixed methods study

BackgroundMost health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students’ attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students’ perceptions towards the teaching and assessment of evidence-based practice within a professional master’s curriculum and their self-efficacy for evidence-based practice.MethodsThe study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings.ResultsAll student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous education had less favourable perceptions. Students’ self-efficacy for evidence-based practice was significantly higher across cohorts. Four main themes emerged from the focus group data: (a) Having mixed feelings about the value of evidence-based practice (b) Barriers to the application of evidence-based practice; (c) Opposing worlds and (d) Vital and imperfect role of the curriculum.ConclusionThis study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.

What Makes Social Work Students Implement Evidence-Based Practice Behaviors?

ABSTRACTThe purpose of the present study was to recognize the factors influencing social work students’ evidence-based practice (EBP) behaviors. The authors sought to examine the roles of attitudes, EBP feasibility, and familiarity with EBP in implementing EBP behaviors. Social work students (161 in total) completed a self-report questionnaire measuring EBP behaviors, feasibility to engage in the EBP process, sense of EBP self-efficacy, and attitudes toward EBP as well as a computerized task measuring implicit attitudes toward research. Self-efficacy and feasibility were found to predict EBP behaviors. EBP behavior was not influenced by explicit or implicit attitudes. Policy makers striving to promote the use of EBP should enhance the level of social workers’ EBP knowledge and promote EBP feasibility in the workplace.

Improving Competence and Confidence With Evidence-Based Practice Among Nurses: Outcomes of a Quality Improvement Project.

Evidence-based practice (EBP) is an integral part of quality patient care, reduction in practice variation, and increased nursing autonomy. Yet, EBP is not a consistent standard in many organizations. Although many barriers to EBP have been cited, this project focused on poor knowledge of the EBP process and a lack of available EBP mentors or experts. A bundled set of educational interventions to improve the EBP confidence and self-efficacy of nurses was developed and implemented. Comparison of pre/post data showed improvement in all categories and questions. Committee members expressed greater confidence with the process and comfort level with leading EBP projects following the intervention. The educational bundle used in this project can serve as a model for others looking to develop competent EBP mentors within their organization.