Swedish nursing students report that campus education supports research utilisation more than clinical education, but support varies between universities
- Correspondence to: Dr Janice Christie
Early Years Division, School of Community and Health Sciences, 20 Bartholomew Close, London, EC1A 7QN, UK;
Implications for practice and research
■ Nursing students can have varied views of the educational support they receive for research utilisation skill developments from different universities’ programmes.
■ Students appear to report lower levels of educational support for research utilisation from practice-based than academic settings.
■ Students may report lower capabilities in implementing and evaluating evidence-based practice (EBP) in clinical settings, than searching for and critically appraising evidence.
■ Further research may be undertaken to determine the nature and extent of differences between pre-registration nursing education institutions’ support for learning in research utilisation skills.
■ Additional studies may consider an in-depth evaluation of the relationship between perceived educational support for research utilisation and self-evaluated EBP.
EBP is important for quality healthcare.1 EBP requires that practitioners have the ability to critically appraise evidence (including research evidence) and effectively use evidence during clinical decision-making.2
This commentary discusses a study which investigated students’ experiences of educational support for research use. The authors also studied nursing students’ views about their self-assessed EBP capabilities. The study sample was all 26 Swedish universities and university colleges offering pre-registration nursing programmes. All educational establishments offered a 3-year programme (generally at degree level). While there are national Swedish guidelines regarding the content of nurse education, there is local variation in how these are integrated into local curricula.
This study used a cross-section survey design with data collected using a postal questionnaire. All final semester Swedish pre-registration students in 2006 were invited to participate in the research. Following three reminders 1440 (68%) responded. The data presented in this report is based on answers to nine questionnaire items. Three items rated on a four-point Likert-like format, concerned educational support for research skills in campus and clinical settings. Six questions (based on Sackett et al's3 EBP process) assessed respondents’ self-rated EBP capabilities using an 11-point Likert-like score. Data was analysed using statistical tests of mean difference (analysis of variance (ANOVA) and paired t tests) and correlations.
The mean age of respondents was 30 years old, 89% were women and 6% had already obtained a degree prior to starting nursing. Students rated university versus clinical-based learning as more supportive in campus settings for all the research utilisation items: ‘development of knowledge in areas of interest’ (mean difference=0.6, t=22.1, p<0.001), ‘using research-based knowledge’ (mean difference 0.5, t=20.1, p<0.001) and ‘how to pursue changes in clinical practice’ (mean difference=0.2, t=5.9, p<0.001). While there were no differences found between universities in terms of support for research use during clinical-based education, differences were found between ratings of support gained from different universities’ support for all three of the research utilisation items.
Analysis of the self-rated EBP capabilities items identified that students reported lowest self-belief for ‘participating in implementation of research-based knowledge in practice’ and ‘participating in evaluating if practice reflects current research-based knowledge’ (mean=7.5). Students reported highest self-belief in their ability to seek out knowledge from sources other than databases (mean 8.9). The researchers calculated multiple Pearson's correlations between the educational support for research utilisation and EBP capability beliefs. They identified weak to moderately weak correlations for every combination of responses.
This is an interesting, exploratory survey that describes and provides analysis of the potential relationship between educational support and students’ EBP self-beliefs in Sweden. The authors acknowledge that their self-rated questionnaire may have produced socially desirable results; however, they also argue that the students’ current beliefs of EBP capabilities can predict what the respondents may do in future.
The researchers offer a full discussion of the potential implications of their findings; this is useful for suggesting direction for future research on this topic. Only limited evidence is presented about the validity of the educational support for the EBP capability scale; however, a score for all the items in this ‘scale’ is not presented or analysed in the paper. The researchers collected clustered information from students at different universities, using an ANOVA to analyse differences between these institutions. The sample size for each university is not known, if sample sizes were small for some universities the analysis may not be accurate.4 Future studies may consider adopting a multilevel model approach which would enable a more flexible analysis of between university differences.