Educating for Evidence-Based Practice

doi:10.1016/j.profnurs.2005.10.008

Journal of Professional Nursing

Volume 21, Issue 6, November–December 2005, Pages 345-350

https://doi.org/10.1016/j.profnurs.2005.10.008 Get rights and content

Several countries have developed policy initiatives that require health care to be evidence based and health science students to study under an evidence-based curriculum as well as learn how to practice in an evidence-based way. Evidence-based nursing (EBN) is too new to have any actual research on which to base a curriculum. However, in the absence of evidence, several schools of nursing have moved or are moving forward. This article presents ideas and examples gleaned from colleagues around the world on the why's and how's of teaching EBN. Finally, this article calls for the funding and planning of an evaluation of evidence-based curricula and teaching strategies for continued development of the field.

Section snippets

Arguments Against Teaching EBN in Nursing Curricula

The first hurdle to face in moving toward an EBN curriculum is to overcome arguments against it. The most frequently encountered arguments experienced from nursing educators are explored subsequently.

Student Expectations and Evaluation Strategies

This section moves from whether to teach EBN to how to teach EBN. As noted, there is no available evidence evaluating curricula or teaching EBN. However, several people have postulated that more than a course on EBP is needed; rather, a paradigm shift is required to move from traditional education to curricula focused on the integration of EBP (Kessinich, Guyatt, & DiCenso, 1997; Fineout-Overholt & Johnston, 2005).

Curriculum possibilities across the spectrum of undergraduate and graduate

Conclusion

This article has emphasized that teaching research and statistics courses is not enough to enable graduates to practice in the evidence-based way that is demanded of current policies. The ideal curriculum revision is to integrate EBN across levels and courses, starting with deciding on expectations of student skills and performance at various levels, developing assignments that reflect those expectations, and offering faculty development as required. As with any planned change, a critical mass

References (11)

M. Banning
Conceptions of evidence, evidence-based medicine, evidence-based practice and their use in nursing: Independent nurse prescribers' views
Journal of Clinical Nursing
(2005)
A. Coomarasamy et al.
What is the evidence that postgraduate teaching in evidence based medicine changes anything?
British Medical Journal
(2004)
A. DiCenso et al.
Implementing evidence-based nursing: Some misconceptions
Evidence-Based Nursing
(1998)
E. Fineout-Overholt et al.
Teaching EBP: A challenge for educators in the 21st century
Worldviews on Evidence-Based Nursing
(2005)
K. Flemming
Asking answerable questions
Evidence-Based Nursing
(1998)

There are more references available in the full text version of this article.

Cited by (102)

Evidence-based practice in Bachelor of Nursing programmes in Austria, Germany, and Switzerland: A survey of general conditions, teaching content and methods
2024, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
Evidenzbasierte Praxis (EBP) stellt eine wichtige Grundlage für die Verbesserung der Qualität der Pflege und der Sicherheit von Menschen mit Pflegebedarf dar. Die Formulierung einer Forschungsfrage, die Literaturrecherche und die kritische Bewertung sind entscheidend für die Entwicklung einer evidenzbasierten Praxis. Ziel dieser Studie war es, einen Überblick darüber zu gewinnen, wie diese Themen in die Bachelor-Pflegestudiengänge in Österreich, Deutschland und der deutschsprachigen Schweiz integriert sind und wie Lehrende die Inhalte umsetzen bzw. die Umsetzung erleben und einschätzen.
Wir führten eine explorative Querschnittstudie mit Online-Befragung unter den Studiengangsleitungen und Lehrpersonen aller 58 Bachelor-Pflegestudiengänge in Österreich, Deutschland und der deutschsprachigen Schweiz durch. Dazu wurde ein Fragebogen zu den allgemeinen Rahmenbedingungen, Lehrinhalten und -methoden der evidenzbasierten Pflegepraxis sowie zum thematischen Interesse der Studierenden entwickelt. Die Ergebnisdaten wurden deskriptiv analysiert.
Die Studiengangsleitungen schickten 24 Fragebögen (41 %) zurück. Von 75 Fragebögen, die an die Lehrpersonen weitergeleitet wurden, gingen 17 (23 %) aus neun Studiengängen ein. Im Durchschnitt stehen 5,6 Lehreinheiten (LE) à 45 Minuten (SD 2,6) für die Formulierung einer Forschungsfrage, 10 LE (SD 4,1) für die Literaturrecherche und 11,3 LE (SD 6,9) für die kritische Bewertung zur Verfügung. Die Hälfte der Lehrenden gab an, dass Verknüpfungen mit der Praxis stattfinden. Überwiegend wird die traditionelle Lehrmethode Frontalunterricht angewandt. Das thematische Interesse der Studierenden wurde von den meisten Lehrenden als mittelmäßig eingeschätzt.
Themen zur evidenzbasierten Praxis sind fester Bestandteil von Bachelor-Pflegestudiengängen im deutschsprachigen Raum. Eine Erhöhung der Lehreinheiten, aktive Lernmethoden und eine zunehmende Verknüpfung mit der Praxis könnten den Erwerb von Kompetenzen und Einstellungen bei Studierenden bezüglich EBP verbessern und deren Implementierung in der Praxis stärken.
Evidence-based practice (EBP) provides an important basis for improving both the quality of care and patient safety. Formulating a research question, searching the literature, and critical appraisal are crucial to developing evidence-based practice. The aim of this survey was to provide an overview of how these topics are integrated into bachelor's degree programs in nursing in Austria, Germany, and the German-speaking part of Switzerland. We also aimed to show how teachers implement these subjects and how they experience and assess the implementation.
We conducted an exploratory cross-sectional study using an online survey sent out to program directors and teaching staff of all 58 bachelor's degree programs in nursing in Austria, Germany and the German-speaking part of Switzerland. For data collection, a questionnaire was developed containing items on general teaching conditions, contents, and methods of evidence-based nursing practice, as well as on the estimated thematic interest of students. The data were analysed descriptively.
The program directors returned 24 questionnaires (41 %). Of 75 questionnaires forwarded to the faculty, 17 (23 %) were received from nine programs. On average, 5.6 teaching units (SD 2.6) are used for formulating a research question, 10 teaching units (SD 4.1) for literature review, and 11.3 teaching units (SD 6.9) for critical appraisal. Half of the teaching staff indicated that linkages between education and nursing care practice have been established. The traditional teaching method of frontal teaching is used predominantly. Student interest in topics was rated as moderate by most teachers.
Topics on evidence-based practice are an integral part of bachelor's degree programs in nursing in German-speaking countries. An increase in teaching units, active learning methods and the growing interconnection between education and practice could improve the acquisition of competencies and attitudes of students regarding EBP and further advance its implementation in practice.
Capability beliefs and the intention to adopt evidence-based practices in the future among nursing students: An international study
2020, Journal of Professional Nursing
Citation Excerpt :
In addition to challenges in English-language comprehension, many Saudi students also reported finding the research process to be difficult, particularly with regard to interpreting evidence (Al Furaikh, Al Omairi, & Ganapathy, 2017). Other factors such as faculty strategies in teaching EBP, the nature and extent of integration of EBP in clinical training sites, the duration of clinical training, and the overall state of health care systems may also be associated (Ciliska, 2005; Saunders & Vehviläinen-Julkunen, 2016). One of the most important steps for a positive implementation of EBP is the ability to search and retrieve good-quality evidence.
Capability beliefs and the intention to adopt EBP in future nursing practice have been identified as strong antecedents of subsequent utilization of EBP. Despite this, a multicountry comparison may yield interesting findings that can be useful in designing empirically based and culturally tailored strategies to facilitate and enhance students' capability beliefs as well as their intentions to integrate evidence into nursing practice.
This report sought to compare capability beliefs and intentions to adopt EBP in the future among student nurses from four countries—specifically, Oman, India, Nigeria, and Saudi Arabia—and to identify specific variables that predict the intention to adopt EBP.
This study employed a descriptive, cross-sectional, comparative research design to gather data from a convenience sample of 1387 nursing students from four countries using self-report questionnaires that captured their EBP capability beliefs and their intention to adopt EBP in clinical practice upon graduation. This study adhered to STROBE guideline for cross-sectional studies.
Overall, nursing students reported a high intent to adopt EBP in their future nursing practice; however, the exact rate varied according to the country of origin. Students' gender, student track, education, country of origin, access to the internet, and capability beliefs were seen as important in explaining the likelihood of future implementation of evidence in clinical nursing practice. Capability beliefs among students were moderate, with large differences observed between countries.
Although the surveyed nursing students reported moderate capability beliefs, their intention to adopt and integrate EBP in their future nursing practice was relatively high.
The findings of this study highlight the critical role of nurse educators and nurse administrators in fostering EBP capability beliefs and future intentions to adopt among students through curricular review, implementation of evidence-based strategies, and the promotion of EBP culture within the clinical learning sites.
Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project)
2018, Nurse Education Today
Citation Excerpt :
Research integration will enhance the capacity of nurses to collaborate in local and international contexts with stakeholders such as non-governmental organisations (NGOs), educational institutions, government, professional associations and civil society (World Health Organisation, 2010). Such collaboration could facilitate Masters level nurse requirements to utilise research evidence at an institutional level in the adaptation, revision or development of relevant practice guidelines and protocols; and assess the readiness of individuals and organisations for practice change, including the development of appropriate strategies to achieve this end (Burke et al., 2005; Ciliska, 2005). A strategy for knowledge translation could be the design of a Masters Capstone project that caters to the needs of either the academic organisation, or the clinical organisation and area of specialty in which the student is based (Segrott et al., 2006).
The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment.
To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities.
Systematic review that conforms to the PRISMA statement. Sample: Master's Nursing programs that include elements of a capstone project within a university setting.
MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English.
Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements.
There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.
How a more detailed understanding of culture is needed before successful educational change can be made
2017, Currents in Pharmacy Teaching and Learning
The profession of pharmacy is being afforded many important opportunities, and continues to face many challenges. To successfully address these issues schools and colleges of pharmacy must have a complete understanding of their current context, which includes culture. However, little of the work on culture in pharmacy education specifically defines what these cultures are, and equally importantly how this understanding of culture can be used to make changes, improve student learning, and ultimately develop pharmacists better prepared to improve patient outcomes.
Organizational culture has been defined in a multitude of ways in the literature. Martin's three-perspectives approach, which combines integrated, differentiated, and fragmented understandings, offers one way to approach defining culture and leveraging that definition of change. Furthermore, the organizational culture profile (OCP), is one tool that can be used to identify and differentiate between Martin's three perspectives.
Culture plays an important role in academic pharmacy, but before it can reach its highest potential in improving student outcomes, and faculty experience, it must be completely understood. Martin's approach and the OCP offer one way to achieve this objective.
Evidence-based practice knowledge, attitudes, and practice of online graduate nursing students
2017, Nurse Education Today
This study aimed to evaluate changes in evidence-based practice (EBP) knowledge, attitudes, and practice of nursing students before and after completing an online, graduate level, introductory research/EBP course.
A prospective one-group pretest-posttest design.
A private university in the Midwestern, USA.
Sixty-three online nurse practitioner students in Master's program.
A convenient sample of online graduate nursing students who enrolled in the research/EBP course was invited to participate in the study. Study outcomes were measured using the Evidence-Based Practice Questionnaire (EBPQ) before and after completing the course. Descriptive statistics and paired-Samples t-test was used to assess the mean differences between pre-and post-test scores.
Overall, students' post-test EBP scores were significantly improved over pre-test scores, t(63) = − 9.034, p < 0.001). Statistically significant differences were found for practice of EBP mean scores t(63) = − 12.78, p = 0.001). No significant differences were found between pre and post-tests on knowledge and attitudes toward EBP scores. Most frequently cited barriers to EBP were lack of understanding of statistics, interpretation of findings, lack of time, and lack of library resources.
The impact of curricular changes on BSCN students' clinical learning outcomes
2016, Nurse Education in Practice
Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology.
Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.

View all citing articles on Scopus

View full text

Original ArticleEducating for Evidence-Based Practice

Section snippets

Arguments Against Teaching EBN in Nursing Curricula

Student Expectations and Evaluation Strategies

Conclusion

Conceptions of evidence, evidence-based medicine, evidence-based practice and their use in nursing: Independent nurse prescribers' views

Journal of Clinical Nursing

What is the evidence that postgraduate teaching in evidence based medicine changes anything?

British Medical Journal

Implementing evidence-based nursing: Some misconceptions

Evidence-Based Nursing

Teaching EBP: A challenge for educators in the 21st century

Worldviews on Evidence-Based Nursing

Asking answerable questions

Evidence-Based Nursing

Original Article
Educating for Evidence-Based Practice