Evidence-based Practice Training Research Articles

Effectiveness of a virtual patient simulation training on improving provider engagement in suicide safer care.

Health care providers have a critical opportunity to mitigate the public health problem of suicide. Virtual patient simulations (VPS) allow providers to learn and practice evidence-based suicide prevention practices in a realistic and risk-free environment. The purpose of this study was to test whether receiving VPS training increases the likelihood that providers will engage in effective suicide safer care practices. Behavioral health and non-behavioral health providers (N = 19) at a Federally Qualified Health Center who work with patients at risk for suicide received the VPS training on risk assessment, safety planning, and motivation to engage in treatment. Providers' electronic health records were compared 6months pre- and post-VPS training on their engagement in suicide safer care practices of screening, assessment, safety planning, and adding suicide ideation to the problem list. Most behavioral health providers were already engaging in evidence-based suicide prevention care prior to the VPS training. Findings demonstrated the VPS training may impact the likelihood that non-behavioral health providers engage in suicide safer care practices. VPS training in evidence-based suicide prevention practices can optimize and elevate all health care providers' skills in suicide care regardless of role and responsibility, demonstrating the potential to directly impact patient outcomes.

Evidence-based practice in respiratory healthcare professionals in Latin America:

Background:Evidence-based practice (EBP) is a systematic approach to professional practice using the best available evidence to make informed clinical decisions in healthcare. It is necessary to measure and identify strengths and opportunities for improvement. Objective: To assess the knowledge and application of EBP in respiratory health professionals in Latin America. Methods: A cross-sectional study was conducted. The questionnaire was distributed online to health professionals in Latin American countries. Demographic data, professional characteristics, EBP training, and questionnaire responses were collected. Descriptive and inferential statistical analyses were performed. Results: A total of 448 respiratory health professionals participated in the study. Responses were obtained from 17 countries where the majority were female, with an average age of 42. Participants included physicians, physiotherapists, nurses, respiratory therapists, speech therapists, and occupational therapists. Overall scores indicated moderate to high levels of EBP knowledge and application. However, variations were observed in different dimensions. Factors such as EBP training, reading scientific articles, and professional characteristics were associated with higher scores. Barriers to implementing EBP were identified mostly related to institutional support. Conclusions: This study provides information on the knowledge and implementation of EBP in respiratory health professionals in Latin America. Although the overall levels of knowledge and application of EBP were moderate to high, there are options for improvement, especially in addressing barriers to implementation.

Strengthening Bhutanese Traditional Medicine in healthcare service delivery in Bhutan

Bhutanese Traditional Medicine, known as Sowa Rigpa, deeply rooted in the country’s cultural and religious heritage, plays a significant role in healthcare service delivery in Bhutan. This commentary explores the evolution and current landscape of Sowa Rigpa within the context of the nation’s healthcare system. While traditional medicine services have expanded over the years, challenges such as scepticism regarding scientific validity, inadequate infection control measures and concerns about the sustainability of medicinal plants persist. To address these challenges, recommendations, including the integration of modern technology in quality assurance, comprehensive training in infection control, evidence-based practice and conservation efforts for medicinal plants have been adopted. By embracing these strategies, Sowa Rigpa can enhance its efficacy, safety and sustainability, ensuring its continued relevance in meeting the healthcare needs of the Bhutanese population while contributing to the global advancement of Traditional Medicine practices.

Implementation of evidence-based medicine in dietetic practice: Current status and hurdles in Italy.

Background: Health professionals, including dietitians, should adapt their clinical daily practice to evidence-based practice (EBP), but this does not happen often in daily practice. The aim of this study was to investigate the current status and barriers to evidence-based practice among dietitians. Methods: This was a mixed-method, cross-sectional, national study (questionnaire and focus group) performed on working and registered dietitians, both self-employed and employed by public hospitals. The main outcomes were EBP knowledge, frequency of use, and proficiency scores. Barriers to EBP implementation were also collected, as well as qualitative information from the focus group. Results: Forty-three dietitians were enrolled from August to November 2021 in Italy. Overall, EBP knowledge was moderate/good. Younger dietitians (< 50 years old) obtained better results than their older colleagues. A similar trend was observed in terms of seniority. There was a discrepancy between EBP knowledge and perception of EBP implementation: the worst scores were obtained by participants who claimed an already complete integration of EBP. The average frequency of EBP use was moderate, with higher scores in dietitians ≥ 50 years old and with seniority ≥ 20 years. EBP proficiency instead was poor. The focus group revealed a lack of time and resistance to change as the main barriers. Conclusion: The importance of EBP is well-acknowledged, but it is not correctly implemented yet, because of identified barriers that need to be fixed. These barriers include a lack of dedicated time, inadequate EBP training, and resistance to change, especially in hierarchical environments.

A Comparison of Evidence-Based Practice Training With and Without Postimmersion Follow-up.

The aim of this study was to determine best practice for evidence-based practice (EBP) education that leads to implementation. Current methods of teaching EBP do not reliably translate to implementation. Participants in an EBP immersion were compared with participants in EBP immersion plus a follow-up EBP course. The EBP immersion group implemented 18% of their initiatives. The EBP immersion plus the follow-up EBP course implemented 35% of their initiatives, and an additional 22% were in the process of implementation. Evidence-based practice education may not be sufficient in promoting EBP implementation. Additional ongoing support may be needed to bring EBP initiatives through implementation.

Factors Associated with Evidence-Based Practice Competencies among Taiwanese Nurses: A Cross-Sectional Study.

Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = -0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan.

Effect of evidence-based nursing practices training programme on the competency of nurses caring for mechanically ventilated patients: a randomised controlled trial

BackgroundEvidence-Based Practice (EBP) has been recognised worldwide as a standardised approach for enhancing the quality of healthcare and patient outcomes. Nurses play a significant role in integrating EBP, especially in Intensive Care Unit (ICU). Consequently, this study aims to examine the effect of an adapted evidence-based nursing practices training programme on the competency level of nurses caring for mechanically ventilated patients.MethodsA prospective open-label parallel 1:1 randomised controlled trial was conducted on 80 nurses caring for ICU patients at the National Hepatology and Tropical Medicine Research Institute, Egypt. The trial was carried out between November 2022 and February 2023 under the registration number NCT05721664. The enrolled nurses were randomly divided into intervention and control groups. The intervention group received the evidence-based nursing practice training programme (EBNPTP) in accordance with the Johns Hopkins EBP conceptional model, whereas the control group received traditional in-service education. Four assessments (one pre- and three post-assessments) were conducted to evaluate nurses’ competency level over time using the adapted evidence-based nursing competency assessment checklist. The primary endpoint was an increase the competency levels among nurses caring for mechanically ventilated patients.ResultsThe current study results revealed statistically significant differences between intervention and control groups in relation to their level of competency across the three post-assessments, with (p <.001). The study also demonstrated that the nurses’ competency level continued to decline significantly over time, with (p <.001). Additionally, a significant correlation was found between the nurses’ pre-assessment and educational level, acting as independent variables (predictors), and the third endpoint assessment (p <.01), indicated by multiple linear regression.ConclusionThe EBP training programme demonstrated a significant increase in the nurses’ level of competency compared with traditional in-service education. This suggests that by training the nurses in various settings with the essential skills and knowledge for EBP, their competency level can be enhanced, leading to the delivery of effective care and improving patient outcomes. However, the long-term sustainability of the EBP adoptions was insufficient; further studies are needed to investigate the factors that affect the durability of EBP adoption.Trial registrationThe study was registered with Clinical Trials.gov (Registration # NCT05721664) on 10/02/2023.

Characterizing Provider Readiness for Meeting Engagement Challenges in Youth Psychotherapy

ABSTRACT Despite significant efforts to increase the delivery of evidence-based practice (EBP), little is known about provider readiness to address challenges with treatment engagement, and it is unclear whether provider characteristics, such as EBP training history and attitudes toward EBP, relate to such readiness. This study aimed to characterize provider knowledge of engagement strategies – one aspect of readiness – and to estimate the association between that knowledge and other provider characteristics. Data came from a multisite, cluster-randomized trial examining a coordinated system for integrating evidence-based engagement strategies into school-based mental health services. Providers (N = 93) received one of two levels of training in engagement strategies and completed pre- and post-training engagement knowledge tests. Pre-training knowledge was not significantly correlated with EBP training history (r = .11, p = .29) or attitudes toward EBP (r = .20, p = .06). Linear mixed model analysis revealed a significant interaction of training and time when accounting for provider site (B = 2.21, SE=.74, t(1,89) = 2.98, p < .005), such that at post-training, providers trained in a coordinated system for applying engagement strategies showed significantly increased knowledge compared with those who received training on a list of the same engagement strategies and their definitions (F(1,285.3) = 71, p < .001). Findings suggest that providers’ readiness to act on the evidence base may be focally limited to their specific training experiences. Additionally, training providers in a coordinated system for using engagement strategies may be a promising approach to enhancing provider knowledge and delivery of engagement strategies, thus promoting the public health impact of EBP for youth mental health.

Assessment of Evidence-Based Practice (EBP) among physiotherapists in Cameroon: a cross-sectional survey

BackgroundEvidence-Based Practice (EBP) is reported to ease effective and adequate decision making for all works of life including health professionals. Investigating the level of implementation of EBP among physiotherapists helps to identify barriers and propose solutions for its extensive implementation. Despite available data on EBP elsewhere, it remains limited or non-existent in Cameroon. This study was designed to establish the current state of EBP among physiotherapists in Cameroon, by assessing knowledge, practice, and barriers to its implementation.MethodsA cross-sectional survey was conducted online among French- and English-speaking physiotherapists in Cameroon over a period of six months from April to July 2023, using the EBP2 questionnaire. This enabled us to collect socio-demographic data from participants and information on their knowledge, understanding and practice of EBP and possible barriers to EBP according to 5 domains (Confidence, Relevance, Terminology, Practice, Compatibility) scored out of 100. Data were analysed using IBM SPSS 25.0 software and Pearson correlations (95% CI) and significance (p < 0.05).ResultsA total of 110 physiotherapists practising in the 10 regions of Cameroon participated in the study. The majority were male (54.5%), the median age was 34 years (age range 20 to 50), the median year of graduation was 2019 (range 2004 to max 2022) with 72.7% never having knowledge or training in EBP. Participants scored below 50/100 for 3 domains (confidence, relevance, and compatibility) showing poor general knowledge and understanding of EBP, although they generally had a positive attitude towards EBP. The use of EBP in practice was low (26.3/100 SD. 6.5), despite that they appeared to have a good understanding of research terminology (55.4 SD. 17.2). Level of study of participants did not appear to significantly influence domain scores (P > 0.05). The main barriers to practice were lack of time (75.1%), workload (66%), cost of access to information resources like databases for seek informations about recent support protocols (60%), ease of access to computers (49%), and lack of resources or skills (49%).ConclusionPhysiotherapists in Cameroon have a poor knowledge of EBP and a low level of practice of EBP, despite an overall positive attitude towards it. These results could inform stakeholders of higher education on the need to improve training of physiotherapy students in the domain of EBP in Physiotherapy. Also, it will help in raising the level of scientific research and promoting the implementation of EBP in Cameroon.

A mixed-methods study of training in evidence-based practice in psychology among students, faculty, and practitioners in India and the United States.

A mixed-methods study of training in evidence-based practice in psychology among students, faculty, and practitioners in India and the United States.

Supplemental Material for A Mixed-Methods Study of Training in Evidence-Based Practice in Psychology Among Students, Faculty, and Practitioners in India and the United States

Supplemental Material for A Mixed-Methods Study of Training in Evidence-Based Practice in Psychology Among Students, Faculty, and Practitioners in India and the United States

Cost-effectiveness of Intervention Implementation Support for Reducing Eating Disorder Symptoms Among College Students.

Implementation support for prevention interventions is receiving increased attention, as many organizations receive training in evidence-based practices but do not deliver the interventions optimally. The Body Project, a four-session program, significantly reduces eating disorder symptoms and future disorder onset among group participants when delivered by peer educators at colleges/universities. Costs and cost-effectiveness of the program were examined using data from a randomized trial that compared three levels of implementation support at 63 colleges: (1) a train-the-trainer (TTT) workshop alone, (2) TTT plus a technical assistance (TA) workshop, or (3) TTT plus TA plus monthly quality assurance (QA) consultations. Effectiveness was measured by the production of reliable change in eating disorder symptoms from pretest to posttest. Costs and cost-effectiveness of two levels of implementation support are reported, comparing TTT-only with TTT + TA + QA (effectiveness of the TTT + TA condition did not differ from TTT-only) and using results from an earlier study as a proxy for a no-treatment control. Two perspectives are considered: a sponsoring organization providing the training at multiple sites and a college delivering the intervention to its eligible students. From the perspective of a sponsoring organization, adding both the TA training and QA support improves the cost-effectiveness per eligible student receiving the intervention. From the perspective of costs for a college to deliver the intervention, receiving TA training and QA support is also more cost-effective than the training workshop alone, whether the peer educators are paid or unpaid and whether costs of group supervision are included or excluded. Results converge with previous research showing that more intensive implementation support can be more cost-effective.

Determinants of Evidence Implementation by Nurses: #Evidencer Model for the Use of Evidence-Based Practice (#EvidencerMUSEBP)—A Structural Equation Model

Existing studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses’ characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ2/df = 3.20, p&lt;0.001; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center’s affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses.

Mental Health Provider Reach and Engagement in a Countywide Training Initiative.

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

Evidence-based practice education in physical medicine and rehabilitation residency programs: A Canadian national survey.

The current extent and quality of evidence based practice (EBP) training for physiatrists is unclear at this time. Training of EBP is also available to residents in Canada. The extent, quality and impact of the training was explored. Cohort study Results: about half of the Canadian programs reported a formal EBP curriculum. The most frequently reported method of providing EBP education were resident participation in journal club. Despite the increasing integration of EBP into residency program education, there remains a critical lack of knowledge and skills for implementation of EBP into clinical practice among Canadian PM&R residency programs.

Critical care nurses' decision-making regarding verification of blindly inserted gastric tubes: A cross-sectional questionnaire study

Critical care nurses' decision-making regarding verification of blindly inserted gastric tubes: A cross-sectional questionnaire study Abstract: Background: The placement and verification of the correct position of blindly applied gastric tubes is regularly performed by nurses in clinical practice. International guidelines recommend a radiological verification as a "first-line" method or if pH measurement is not possible. For Germany, neither evidence-based recommendations nor current data are available. Question: Which methods are used by nurses in German intensive care units for verification of the correct position of blindly applied gastric tubes and how do they assess the reliability of different methods? Methods: Multicenter questionnaire survey. Intensive care units in a non-probability, citeria-based sampling of hospitals in and around Cologne, Germany were included. One nurse was included per participating ward. Analyses were mostly descriptive. Results: In 22 hospitals, 38 wards agreed to participate and 32 (84%) responded to the survey. Auscultation of the upper abdomen with simultaneous air insufflation and aspiration of gastric secretions are frequently used methods for determining the position of gastric tubes. Participants consider auscultation, aspiration of gastric secretions, and radiological control as reliable methods. Conclusions: The findings are in contrast to international recommendations and support the need for evidence-based best practice recommendations and training. Likewise, there is a need for research on feasible bedside methods.

Cultural adaptation and reliability testing of the Chinese version of evidence-based practice knowledge assessment in nursing: A cross-sectional study

ObjectiveThe EKAN is a reliable and validated tool for objectively measuring the evidence-based practice (EBP) knowledge of nurses. Thus, we set out to translate and culturally modify the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN), and then evaluate its validity and reliability among Chinese practicing nurses. MethodsThis cross-sectional study consisted of two phases. The first phase involved translating the EKAN into Chinese (EKAN-Chinese), using a process of forward translation, back translation, review, cultural adjustment as well as a pilot study. The second phase aimed to assess the psychometric properties of the EKAN-Chinese and establish a baseline measure of EBP knowledge among 120 nurses from a large general hospital in Beijing, China. Data were collected from August to November 2022 and analyzed with Rasch software. This study was reported using the cross-sectional STROBE checklist. ResultsThe newly translated, EKAN-Chinese was pilot-tested after slight modification of four items without altering the intended meaning. The outfit unweighted mean square was 1.03 (SD = −0.13), the infit weighted mean square was 1.00 (−0.17), and the mean difficulty index ranged from −3.43 to 2.85 according to validity indices. The results of the reliability indices revealed low person reliability (0.49), high item reliability (0.96), moderate person separation index (0.99), and sufficient item separation index (4.71). The mean EKAN-Chinese sum score was 9.8 (max score = 20, SD = 2.9). ConclusionThe newly translated EKAN-Chinese showed sufficient psychometric evidence to support use in practicing Chinese nurses. The EKAN-Chinese can be used by nurse leaders in China as a potential screening tool to 1) objectively identify nurses who need educational training in evidence-based nursing practice, and 2) gauge the effectiveness of education and training programs to improve EBP knowledge and ultimately, evidence-based care.

Climates and associated factors for evidence-based practice implementation among nurses: a cross-sectional study

BackgroundThe organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses.AimsTo clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices.MethodsThis study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate.ResultsThe nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate.ConclusionThe climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices.Relevance to clinical practiceUnderstanding nurses’ perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation.Patient or public contributionClinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate.

Cross-cultural adaptation of the Knowledge of Research Evidence Competencies questionnaire in French

Background: The Knowledge of Research Evidence Competencies questionnaire (K-REC) stands out as one of the only quick, easy to administer, valid and reliable tests to measure respondents’ actual evidence-based practice (EBP) knowledge. Such reliable and valid tools to assess actual EBP knowledge do not exist in French. Objective: The purpose of this study is to translate, cross-culturally adapt and validate the K-REC questionnaire to assess EBP knowledge in French languages. Methods: A committee of experts followed the five-step adaptation and validation process recommended in the guidelines to translate the K-REC from English to French. A preliminary psychometric test was conducted among 21 French physiotherapists (PT). Results: The respondents rated the instrument as being very clear (99% of the ratings). Members of the expert panel were in perfect agreement (Cohen’s kappa inter-rater coefficient equal to 1) in judging the instrument to be content valid (S-CVI/Ave = 1.00). Conclusion: The K-REC has been successfully adapted and validated in French. Pilot testing provided a preliminary description of internal reliability estimates and respondents’ scores. More complete descriptions of EBP among French health professions will be possible with this new instrument and contribute to the refinement of EBP training programs.

Clinical Consultation During a Trauma-Focused Cognitive Behavioral Therapy Community-Based Learning Collaborative: Examination of Consultation Content, Consultative Strategies, and Provider Engagement

Consultation following evidence-based practice (EBP) training enhances the uptake of EBPs. Yet, little is known about what occurs during consultation, and it is often difficult for providers to engage in consultation. This study examined provider engagement in consultation and the content and strategies used during consultation following training in Trauma-focused Cognitive Behavioral Therapy (TF-CBT) as part of a community-based learning collaborative (CBLC). Minute-to-minute live coding of consultation calls revealed most content was clinically-oriented and the most common strategies used by consultants were didactic in nature. Providers with more years of professional experience and those with greater TF-CBT knowledge attended significantly more consultation calls. Providers with a greater average weekly caseload and providers who were supervisors presented significantly more cases on calls. Providers with greater TF-CBT knowledge spoke significantly more minutes on calls. Consistent with previous work, findings highlight difficulties with provider engagement in consultation and that providers with more baseline expertise are most likely to be engaged. Findings suggest tailoring EBP training efforts to better engage providers at greatest risk for low engagement.