1
|
Li H, Xu R, Gao D, Fu H, Yang Q, Chen X, Hou C, Gao J. Evidence-based practice attitudes, knowledge and skills of nursing students and nurses, a systematic review and meta-analysis. Nurse Educ Pract 2024; 78:104024. [PMID: 38901274 DOI: 10.1016/j.nepr.2024.104024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/05/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
AIM/OBJECTIVE This study aims to carry out a meta-analysis of attitudes, knowledge, and skills level of nursing students and nurses in EBP, providing a reference for optimizing EBP education strategies. BACKGROUND At present, no meta-analysis has been performed to quantitatively synthesize the attitudes, knowledge and skill levels of nursing students and nurses toward EBP. This makes it difficult to precisely identify the true level of EBP among nurses, implying that there is no evidence to support the adoption of EBP teaching strategies approaches. DESIGN A total of 9 Chinese and English databases including CNKI, Wan fang, VIP, CBM, PubMed, Embase, Web of Science, Cochrane Library and CINAHL were used to search cross-sectional quantitative articles on EBP attitudes, knowledge and skills level of nurses and nursing students. The search time limit was from the inception of the database to September 2023. METHODS Two researchers independently screened the literature and extracted the data. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the quality of the included studies. Stata15.0 software was used for statistical analysis to summarize the scores of EBP attitude, knowledge and skills level of nursing students and nurses included in the study. RESULTS A total of 25 cross-sectional studies from 13 countries were included, involving 11363 nursing students and nurses. The meta-analysis results revealed that nursing students and nurses lacked evidence-based practical knowledge and skills, with pooled mean scores of 3.06 (95 % CI: 2.72, 3.39), 2.91 (95 % CI: 2.60, 3.22), 4.31 (95 % CI: 4.08, 4.54) and 4.45 (95 % CI: 4.20, 4.70). In contrast, nursing students and nurses revealed a positive attitude towards EBP, with pooled mean scores of 3.57 (95 % CI: 3.28, 3.86) and 5.11 (95 % CI: 4.80, 5.42). Subgroup analysis revealed that senior nursing students and nurses with master's degree or above had higher attitudes, knowledge and skills. CONCLUSIONS In summary, nursing students and nurses have a positive attitude towards EBP. However, they seem to lack the necessary knowledge and skills. Therefore, nursing educators should consider this as an opportunity to strengthen the teaching of their evidence-based practical knowledge and skills. This will lay a reference for developing nursing discipline.
Collapse
Affiliation(s)
- Hang Li
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - Ran Xu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - Di Gao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610032, China.
| | - Han Fu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - Qing Yang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - XinYu Chen
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - Chaoming Hou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| | - Jing Gao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
| |
Collapse
|
2
|
Haladay D, Morris Z, Tilson J, Fitzgerald C, Applebaum D, Flom-Meland C, DeWaay D, Manal TJ, Gravano T, Anderson S, Miro R, Russ D, Klein A. Development of a Novel Evidence-Based Practice-Specific Competency for Doctor of Physical Therapy Students in Clinical Education: A Modified Delphi Approach. JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00112. [PMID: 38814571 DOI: 10.1097/jte.0000000000000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 03/04/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Evidence-based practice (EBP) results in high-quality care and decreases unwarranted variation in practice. REVIEW OF THE LITERATURE Few performance criteria related to EBP are included in physical therapy clinical education (CE) performance measures, despite EBP requirements in Doctor of Physical Therapy education. The purpose of this study was to develop EBP-specific competencies that may be used for Doctor of Physical Therapy students for use throughout CE. SUBJECTS Thirteen subject matter experts (SME) participated in this study. METHODS Subject matter experts were asked to rank each core EBP competency, from a previously described framework, using a 3-point Likert scale, which included "Not Essential," "Essential," and "Not Sure." A consensus of 70% or greater for the "Essential" rating advanced the competency to the final Delphi round, whereas a consensus of 70% or greater for the "Not Essential" rating was required for competency elimination. Subject matter experts voted to either "Accept" or "Modify" the competencies that had reached the inclusion consensus threshold. All competencies that reached consensus for inclusion after all 3 rounds were included in the final EBP Domain of Competence. RESULTS Consensus was achieved in round one for 38% (n = 26) of items. In round 2, a consensus was achieved for 20% (n = 8) of items. Of the items remaining after rounds 1 and 2, 6 overarching competencies were identified, and all remaining items served as descriptions and specifications in the final EBP Domain of Competence. DISCUSSION AND CONCLUSIONS The 6 competencies developed from this study constitute the EBP Domain of Competence and may be used throughout CE to assess students' EBP competency in clinical practice.
Collapse
Affiliation(s)
- Douglas Haladay
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Zoe Morris
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Julie Tilson
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Caitlin Fitzgerald
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Donna Applebaum
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Cindy Flom-Meland
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Deborah DeWaay
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Tara Jo Manal
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Tamara Gravano
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Stephanie Anderson
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Rebecca Miro
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - David Russ
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Aimee Klein
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| |
Collapse
|
3
|
Jeong D, Park C, Sugimoto K, Jeon M, Kim D, Eun Y. Effectiveness of an Evidence-Based Practice Education Program for Undergraduate Nursing Students: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:637. [PMID: 38791851 PMCID: PMC11121330 DOI: 10.3390/ijerph21050637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
This systematic review and meta-analysis examined the impact of evidence-based practice (EBP) education programs on undergraduate nursing students, focusing on enhancing EBP competency, critical thinking, and problem-solving ability. METHODS The search, conducted through PubMed, Cochrane Library, EMBASE, CINAHL, and Web of Science up to December 2023, included studies published in English and Korean and adhered to PRISMA guidelines. Qualitative appraisal of the studies was conducted using the revised ROB II for randomized trials and the ROBINS-I for non-randomized trials. For the meta-analysis, the effect size of the intervention was calculated as a standardized mean difference. RESULTS In our study, 11 studies met our inclusion criteria, and 8 studies of those were included in the meta-analysis. The effect sizes for EBP competency, critical thinking, and problem-solving ability were 1.55, 1.29, and 0.65, respectively. The meta-regression analysis indicated that tailored education programs of 4-7 weeks and being in the 4th grade significantly enhanced EBP competency. CONCLUSION These findings support the development of a customizable and applied EBP education actively for students, preparing nursing students to effectively implement EBP in clinical settings after graduation. Despite the significant effect size of the outcome variables, the high heterogeneity suggests the need for further investigation to validate the EBP educational outcomes for nursing students.
Collapse
Affiliation(s)
- Dain Jeong
- College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA; (D.J.); (K.S.)
| | - Chang Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Keiko Sugimoto
- College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA; (D.J.); (K.S.)
| | - Miyang Jeon
- College of Nursing, Institute of Medical Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea;
| | - Dooyoung Kim
- College of Nursing, Gyeongsang National University, Jinju 52727, Republic of Korea;
| | - Young Eun
- College of Nursing, Institute of Medical Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea;
| |
Collapse
|
4
|
Passarelli AM, Gazelle G, Schwab LE, Kramer RF, Moore MA, Subhiyah RG, Deiorio NM, Gautam M, Gill P, Hull SK, King CR, Sikon A. Competencies for Those Who Coach Physicians: A Modified Delphi Study. Mayo Clin Proc 2024; 99:782-794. [PMID: 38702127 DOI: 10.1016/j.mayocp.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/11/2023] [Accepted: 01/11/2024] [Indexed: 05/06/2024]
Abstract
The rapidly evolving coaching profession has permeated the health care industry and is gaining ground as a viable solution for addressing physician burnout, turnover, and leadership crises that plague the industry. Although various coach credentialing bodies are established, the profession has no standardized competencies for physician coaching as a specialty practice area, creating a market of aspiring coaches with varying degrees of expertise. To address this gap, we employed a modified Delphi approach to arrive at expert consensus on competencies necessary for coaching physicians and physician leaders. Informed by the National Board of Medical Examiners' practice of rapid blueprinting, a group of 11 expert physician coaches generated an initial list of key thematic areas and specific competencies within them. The competency document was then distributed for agreement rating and comment to over 100 stakeholders involved in physician coaching. Our consensus threshold was defined at 70% agreement, and actual responses ranged from 80.5% to 95.6% agreement. Comments were discussed and addressed by 3 members of the original group, resulting in a final model of 129 specific competencies in the following areas: (1) physician-specific coaching, (2) understanding physician and health care context, culture, and career span, (3) coaching theory and science, (4) diversity, equity, inclusion, and other social dynamics, (5) well-being and burnout, and (6) physician leadership. This consensus on physician coaching competencies represents a critical step toward establishing standards that inform coach education, training, and certification programs, as well as guide the selection of coaches and evaluation of coaching in health care settings.
Collapse
Affiliation(s)
- Angela M Passarelli
- Institute of Coaching, McLean Hospital, Belmont, MA; Fuqua School of Business, Duke University.
| | - Gail Gazelle
- Division of General Internal Medicine and Primary Care, Harvard Medical School, Boston, MA
| | - Leslie E Schwab
- Atrius Health, Leslie Schwab, LLC: Physician Coaching Services, Newton, MA
| | | | - Margaret A Moore
- Institute of Coaching, McLean Hospital, Belmont, MA; Wellcoaches Corporation, Wellesley, MA
| | - Raja G Subhiyah
- Department of Psychometrics and Data Analysis, National Board of Medical Examiners, Philadelphia, PA
| | - Nicole M Deiorio
- Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond
| | - Mamta Gautam
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Priscilla Gill
- Health Care Administration, Mayo Clinic College of Medicine and Science, and Human Resources, Mayo Clinic, Jacksonville, FL
| | - Sharon K Hull
- Metta Solutions, LLC, Durham, NC, and Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine
| | - Cara R King
- Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH
| | - Andrea Sikon
- Department of Internal Medicine and Geriatrics, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| |
Collapse
|
5
|
Jäger P, Hirt J, Nordhausen T, Vetsch J, Balzer K, Dichter MN, Müller G, Schley A, Neyer S. [Evidence-based practice in Bachelor of Nursing programmes in Austria, Germany, and Switzerland: A survey of general conditions, teaching content and methods]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 186:77-85. [PMID: 38519358 DOI: 10.1016/j.zefq.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND/AIM 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. METHOD 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. RESULTS 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. CONCLUSIONS 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.
Collapse
Affiliation(s)
- Peter Jäger
- Fachbereich Soziales und Gesundheit, Fachhochschule Vorarlberg, Dornbirn, Österreich.
| | - Julian Hirt
- Institut für Angewandte Pflegewissenschaft, OST Ostschweizer Fachhochschule, St. Gallen, Schweiz; Departement Klinische Forschung, Universitätsspital Basel und Universität Basel, Basel, Schweiz
| | - Thomas Nordhausen
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Janine Vetsch
- Institut für Angewandte Pflegewissenschaft, OST Ostschweizer Fachhochschule, St. Gallen, Schweiz
| | - Katrin Balzer
- Institut für Sozialmedizin und Epidemiologie, Sektion für Forschung und Lehre in der Pflege, Universität zu Lübeck, Lübeck, Deutschland
| | - Martin N Dichter
- Institut für Pflegewissenschaft, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland
| | - Gerhard Müller
- Department für Pflegewissenschaft und Gerontologie, Institut für Pflegewissenschaft, UMIT TIROL - Privatuniversität für Gesundheitswissenschaften und -technologie, Hall in Tirol, Österreich
| | - Angelika Schley
- Institut für Sozialmedizin und Epidemiologie, Sektion für Forschung und Lehre in der Pflege, Universität zu Lübeck, Lübeck, Deutschland
| | - Stefanie Neyer
- Forschungsgruppe empirische Sozialwissenschaften, Fachhochschule Vorarlberg, Dornbirn, Österreich
| |
Collapse
|
6
|
Wayman LM, Walsh-Irwin C, Sullivan SC. A Comparison of Evidence-Based Practice Training With and Without Postimmersion Follow-up. J Nurs Adm 2024; 54:304-310. [PMID: 38648364 DOI: 10.1097/nna.0000000000001428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The aim of this study was to determine best practice for evidence-based practice (EBP) education that leads to implementation. BACKGROUND Current methods of teaching EBP do not reliably translate to implementation. METHODS Participants in an EBP immersion were compared with participants in EBP immersion plus a follow-up EBP course. RESULTS 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. CONCLUSION Evidence-based practice education may not be sufficient in promoting EBP implementation. Additional ongoing support may be needed to bring EBP initiatives through implementation.
Collapse
Affiliation(s)
- Lisa M Wayman
- Author Affiliations: Chief of Nursing Education, Special Procedures and Clinical Outcomes, and Chair of the Veterans Health Association Office of Nursing Service Evidence Based Practice Field Advisory Committee (Dr Wayman), Phoenix VA Health Care System, Arizona; and Associate Director (Dr Walsh-Irwin), Evidence-Based Practice, and Director (Dr Sullivan), Research, Evidence-Based Practice and Analytics, Office of Nursing Services, Central Office Department of Veterans Affairs, Washington, DC
| | | | | |
Collapse
|
7
|
Chala MB, Vader K, Bisson EJ, Doulas T, Duggan S, Desmeules F, Perreault K, Donnelly C, Abebe A, McClintock C, Tawiah A, Miller J. Identifying competencies for an advanced practice physiotherapy role within an interprofessional chronic pain clinic. Musculoskelet Sci Pract 2024; 72:102965. [PMID: 38701666 DOI: 10.1016/j.msksp.2024.102965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/16/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Advanced practice physiotherapy (APP) models of care have shown success in access, safety, satisfaction, and care quality for musculoskeletal pain conditions in various settings. Yet, there is a gap in defining competencies for physiotherapists to be the initial point of contact for people with chronic pain. This study aims to identify and agree upon the competencies necessary for a physiotherapist to fulfill the role of an APP in an interprofessional chronic pain clinic. METHODS Three focus groups were conducted using a Nominal Group Technique and a modified Delphi process. Consensus on the competency, defined as agreement by ≥ 75% of participants, was sought. RESULTS Twenty-three experts (17 healthcare providers and six individuals with chronic pain) participated in the focus group discussions. Twenty completed the follow-up Delphi surveys. Ten essential competencies for an APP role in interprofessional chronic pain clinics were identified and achieved consensus: 1) use an evidence-based approach to practice; 2) communicate effectively with the patient; 3) perform a comprehensive assessment; 4) determine pain-related diagnoses; 5) develop therapeutic relationships; 6) provide appropriate care; 7) support patients through transitions in care; 8) collaborate with members of the interprofessional team; 9) advocate for the needs of the patients; and 10) use a reflective approach to practice. CONCLUSION This study identified ten competencies essential for physiotherapists to fulfill an APP role within interprofessional chronic pain clinics. These competencies serve as a foundation for informing a training program and future research evaluating the effectiveness of the APP model in this setting.
Collapse
Affiliation(s)
- Mulugeta Bayisa Chala
- The Gray Centre for Mobility and Activity, Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada.
| | - Kyle Vader
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Etienne J Bisson
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada; Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Tom Doulas
- Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Scott Duggan
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada; Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - François Desmeules
- School of Rehabilitation, Université de Montreal, Montreal, Quebec, Canada
| | - Kadija Perreault
- École des Sciences de la Réadaptation, Université Laval, Québec City, Québec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), CIUSSS de la Capitale-Nationale, Québec City, Québec, Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Abey Abebe
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Chad McClintock
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Andrews Tawiah
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jordan Miller
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| |
Collapse
|
8
|
Cheng LC, Chen CJ, Lin SC, Koo M. Factors Associated with Evidence-Based Practice Competencies among Taiwanese Nurses: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:906. [PMID: 38727463 PMCID: PMC11083054 DOI: 10.3390/healthcare12090906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Li-Chuan Cheng
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
| | - Chia-Jung Chen
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
| | - Shih-Chun Lin
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 112303, Taiwan
| | - Malcolm Koo
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| |
Collapse
|
9
|
Simons M, Fisher G, Spanos S, Zurynski Y, Davidson A, Stoodley M, Rapport F, Ellis LA. Integrating training in evidence-based medicine and shared decision-making: a qualitative study of junior doctors and consultants. BMC MEDICAL EDUCATION 2024; 24:418. [PMID: 38637798 PMCID: PMC11027546 DOI: 10.1186/s12909-024-05409-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND In the past, evidence-based medicine (EBM) and shared decision-making (SDM) have been taught separately in health sciences and medical education. However, recognition is increasing of the importance of EBM training that includes SDM, whereby practitioners incorporate all steps of EBM, including person-centered decision-making using SDM. However, there are few empirical investigations into the benefits of training that integrates EBM and SDM (EBM-SDM) for junior doctors, and their influencing factors. This study aimed to explore how integrated EBM-SDM training can influence junior doctors' attitudes to and practice of EBM and SDM; to identify the barriers and facilitators associated with junior doctors' EBM-SDM learning and practice; and to examine how supervising consultants' attitudes and authority impact on junior doctors' opportunities for EBM-SDM learning and practice. METHODS We developed and ran a series of EBM-SDM courses for junior doctors within a private healthcare setting with protected time for educational activities. Using an emergent qualitative design, we first conducted pre- and post-course semi-structured interviews with 12 junior doctors and thematically analysed the influence of an EBM-SDM course on their attitudes and practice of both EBM and SDM, and the barriers and facilitators to the integrated learning and practice of EBM and SDM. Based on the responses of junior doctors, we then conducted interviews with ten of their supervising consultants and used a second thematic analysis to understand the influence of consultants on junior doctors' EBM-SDM learning and practice. RESULTS Junior doctors appreciated EBM-SDM training that involved patient participation. After the training course, they intended to improve their skills in person-centered decision-making including SDM. However, junior doctors identified medical hierarchy, time factors, and lack of prior training as barriers to the learning and practice of EBM-SDM, whilst the private healthcare setting with protected learning time and supportive consultants were considered facilitators. Consultants had mixed attitudes towards EBM and SDM and varied perceptions of the role of junior doctors in either practice, both of which influenced the practice of junior doctors. CONCLUSIONS These findings suggested that future medical education and research should include training that integrates EBM and SDM that acknowledges the complex environment in which this training must be put into practice, and considers strategies to overcome barriers to the implementation of EBM-SDM learning in practice.
Collapse
Affiliation(s)
- Mary Simons
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
- Australian Institute of Health Innovation, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
| | - Georgia Fisher
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Samantha Spanos
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Andrew Davidson
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Marcus Stoodley
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, 2109, Australia
| | - Frances Rapport
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| |
Collapse
|
10
|
Jordan R, Watowicz RP, King C, Phillips C, Obeid R, Hand RK. Preliminary content and construct validity of a new model to differentiate research skills from evidence-based practice skills: Core, Evidence Application, Research (CEAR) Model. J Hum Nutr Diet 2024; 37:440-458. [PMID: 38014585 DOI: 10.1111/jhn.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Research is the scientific basis for the profession of dietetics, as it must be located and applied in evidence-based practice (EBP). EBP is often presented as a foundational skill for research. CEAR - Core, Evidence Application, Research - is a newly proposed model that separates Research and Evidence Application skills into distinct domains, jointly supported by a set of Core skills, thus acknowledging that education and advancement in one domain neither requires nor precipitates education and advancement in the other. The goal was to investigate the content and construct validity of the new CEAR Model. METHODS A cross-sectional online survey of randomly selected dietitians in the United States was used to collect CEAR domain scores, validated measures of research or EBP skills and self-reported characteristics. Exploratory factor analysis, Cronbach's α and Pearson correlation between various tools and CEAR domains were used to assess validity and reliability. Analysis of variance (ANOVA) and multiple linear regression between CEAR domains and participant characteristics were used to assess convergent and divergent validity. RESULTS One hundred and fifty-four responses with a valid CEAR score were received and led to a three-factor solution, supporting the theorised differentiation of research from evidence application skills (content validity). Internal reliability for the CEAR Model overall and for each domain was high. The hypothesised correlations between existing research or EBP measurement tools and the relevant CEAR domains were found (construct validity). Known groups analysis demonstrated the expected differences in CEAR domain scores based on participant characteristics. CONCLUSIONS The CEAR Model demonstrates preliminary validity and internal reliability. It adds to the current literature by acknowledging the separateness of evidence application skills from research skills.
Collapse
Affiliation(s)
- Raeanne Jordan
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rosanna P Watowicz
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Carrie King
- Dietetics and Nutrition Department, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Catherine Phillips
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rita Obeid
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
11
|
Ghosh NR, Esmaeilinezhad Z, Zając J, Creasy RA, Lorenz SG, Klatt KC, Bala MM, Beathard KM, Johnston BC. Evidence-Based Practice Competencies among Nutrition Professionals and Students: A Systematic Review. J Nutr 2024; 154:1414-1427. [PMID: 38159813 DOI: 10.1016/j.tjnut.2023.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Evidence-based practice (EBP) promotes shared decision-making between clinicians and patients. OBJECTIVE The aim was to determine EBP competencies among nutrition professionals and students reported in the literature. METHODS We conducted a systematic review by searching Medline, Embase, CINAHL, ERIC, CENTRAL, ProQuest Dissertations and Theses Global, BIOSIS Citation Index, and clinicaltrials.gov up to March 2023. Eligible primary studies had to assess one of the 6 predefined EBP competencies: formulating clinical questions; searching literature for best evidence; assessing studies for methodological quality; effect size; certainty of evidence for effects; and determining the applicability of study results considering patient values and preferences. Two reviewers independently screened articles and extracted data, and results were summarized for each EBP competency. RESULTS We identified 12 eligible cross-sectional survey studies, comprising 1065 participants, primarily registered dietitians, across 6 countries, with the majority assessed in the United States (n = 470). The reporting quality of the survey studies was poor overall, with 43% of items not reported. Only 1 study (8%) explicitly used an objective questionnaire to assess EBP competencies. In general, the 6 competencies were incompletely defined or reported (e.g., it was unclear what applicability and critical appraisal referred to and what study designs were appraised by the participants). Two core competencies, interpreting effect size and certainty of evidence for effects, were not assessed. CONCLUSIONS The overall quality of study reports was poor, and the questionnaires were predominantly self-perceived, as opposed to objective assessments. No studies reported on competencies in interpreting effect size or certainty of evidence, competencies essential for optimizing clinical nutrition decision-making. Future surveys should objectively assess core EBP competencies using sensible, specific questionnaires. Furthermore, EBP competencies need to be standardized across dietetic programs to minimize heterogeneity in the training, understanding, evaluation, and application among dietetics practitioners. This study was registered at PROSPERO as CRD42022311916.
Collapse
Affiliation(s)
- Nirjhar R Ghosh
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Zahra Esmaeilinezhad
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Joanna Zając
- Department of Hygiene and Dietetics, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Rebecca A Creasy
- Department of Food Science and Technology, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Saundra G Lorenz
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Kevin C Klatt
- Department of Nutrition Sciences and Toxicology, University of California, Berkeley, CA, United States
| | - Malgorzata M Bala
- Department of Hygiene and Dietetics, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Karen M Beathard
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States
| | - Bradley C Johnston
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, United States; Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, USA.
| |
Collapse
|
12
|
Varon B, Palacios-Baena ZR, de Kraker MEA, Rodríguez-Baño J, Leibovici L, Paul M. Universal Risk Factors for Mortality in Bloodstream Infections (UNIFORM): a systematic review and Delphi survey. Clin Microbiol Infect 2024; 30:453-461. [PMID: 38182050 DOI: 10.1016/j.cmi.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/27/2023] [Accepted: 12/31/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Significant variations in the variables collected in clinical studies focusing on bacteraemia lead to inconsistency in the evaluation of risk factors for mortality. OBJECTIVE We aimed to define a minimum set of risk factors that should be assessed and reported in all studies assessing survival in bacteraemia. STUDY ELIGIBILITY We conducted a systematic review including observational prospective and retrospective cohort studies that assessed all-cause mortality among patients with bacteraemia. We included only studies computing an adjusted analysis for mortality, with >500 participants. EXPOSURES Independently significant risk factors for all-cause, preferably 30-day, mortality. DATA SOURCES PubMed was used to identify eligible studies published between 2000 and 2020. A Delphi survey among experts was used to evaluate and prioritize the factors identified by the systematic review. RISK OF BIAS SIGN checklist complemented by risk of bias assessment of the adjusted analysis. DATA SYNTHESIS Definite universal risk factors were defined as those assessed in >50% of all included studies and significant in >50% of those. Potential universal risk factors were defined as those significant in >50% of studies evaluating the factor and a subgroup analysis was performed for studies of Staphylococcus aureus bacteraemia. RESULTS We included in the systematic review 62 studies, comprising more than 300,000 patients, from which a list of 17 risk factors was derived, whose association with all-cause mortality was statistically significant in most studies. The factors address baseline patient variables, the setting of infection acquisition, factors associated with the specific infection, the inflammatory response at onset of sepsis and management parameters where relevant. There were 14 risk factors for S. aureus bacteraemia. CONCLUSION We identified a minimum set of universal factors to be collected, reported, and assessed, in all future studies evaluating factors associated with mortality in bacteraemia to improve study quality and harmonization.
Collapse
Affiliation(s)
- Ben Varon
- Medicine B and H, Rambam Healthcare Campus, Haifa, Israel
| | - Zaira R Palacios-Baena
- Infectious Diseases Division, Hospital Universitario Virgen Macarena, Seville, Spain; Department of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marlieke E A de Kraker
- Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Jesús Rodríguez-Baño
- Infectious Diseases Division, Hospital Universitario Virgen Macarena, Seville, Spain; Department of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Leonard Leibovici
- Research Authority, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Mical Paul
- Infectious Diseases Institute, Rambam Healthcare Campus, Haifa, Israel; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
| |
Collapse
|
13
|
Steinberg FM. Advancing the Use of Evidence-Based Practice in Nutrition and Dietetics. J Nutr 2024; 154:1065-1066. [PMID: 38403252 DOI: 10.1016/j.tjnut.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Francene M Steinberg
- Department of Nutrition, Didactic Program in Dietetics, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, United States.
| |
Collapse
|
14
|
Nielsen LD, Løwe MM, Mansilla F, Jørgensen RB, Ramachandran A, Noe BB, Egebæk HK. Interventions, methods and outcome measures used in teaching evidence-based practice to healthcare students: an overview of systematic reviews. BMC MEDICAL EDUCATION 2024; 24:306. [PMID: 38504255 PMCID: PMC10953117 DOI: 10.1186/s12909-024-05259-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND To fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student's development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare need a systematic overview of evidence-based teaching and learning interventions. The purpose of this overview of systematic reviews was to summarize and synthesize the current evidence from systematic reviews on educational interventions being used by educators to teach evidence-based practice to professional bachelor-degree healthcare students and to identify the evidence-based practice-related learning outcomes used. METHODS An overview of systematic reviews. Four databases (PubMed/Medline, CINAHL, ERIC and the Cochrane library) were searched from May 2013 to January 25th, 2024. Additional sources were checked for unpublished or ongoing systematic reviews. Eligibility criteria included systematic reviews of studies among undergraduate nursing, physiotherapist, occupational therapist, midwife, nutrition and health, and biomedical laboratory science students, evaluating educational interventions aimed at teaching evidence-based practice in classroom or clinical practice setting, or a combination. Two authors independently performed initial eligibility screening of title/abstracts. Four authors independently performed full-text screening and assessed the quality of selected systematic reviews using standardized instruments. Data was extracted and synthesized using a narrative approach. RESULTS A total of 524 references were retrieved, and 6 systematic reviews (with a total of 39 primary studies) were included. Overlap between the systematic reviews was minimal. All the systematic reviews were of low methodological quality. Synthesis and analysis revealed a variety of teaching modalities and approaches. The outcomes were to some extent assessed in accordance with the Sicily group`s categories; "skills", "attitude" and "knowledge". Whereas "behaviors", "reaction to educational experience", "self-efficacy" and "benefits for the patient" were rarely used. CONCLUSIONS Teaching evidence-based practice is widely used in undergraduate healthcare students and a variety of interventions are used and recognized. Not all categories of outcomes suggested by the Sicily group are used to evaluate outcomes of evidence-based practice teaching. There is a need for studies measuring the effect on outcomes in all the Sicily group categories, to enhance sustainability and transition of evidence-based practice competencies to the context of healthcare practice.
Collapse
Affiliation(s)
- Lea D Nielsen
- Nursing Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark.
| | - Mette M Løwe
- Department of Oncology, Hospital of Lillebaelt, Beriderbakken 4, 7100, Vejle, Denmark
| | - Francisco Mansilla
- Biomedical Laboratory Science & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark
| | - Rene B Jørgensen
- Physiotherapy Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark
| | - Asviny Ramachandran
- Occupational Therapy Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark
| | - Bodil B Noe
- Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705, Esbjerg Ø, Denmark
| | - Heidi K Egebæk
- Centre for Clinical Research and Prevention, Section for Health Promotion and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| |
Collapse
|
15
|
Al Zoubi FM, Bussières A, Chan HW, Leung KY, Ng YY, Lau KC, Ngai SPC, Tsang SMH, Wong AYL, Thomas A. Refining and adapting the measurement properties of evidence-based practice measures for physiotherapy students. PLoS One 2024; 19:e0298611. [PMID: 38451977 PMCID: PMC10919638 DOI: 10.1371/journal.pone.0298611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE There is a lack of reliable and valid evidence-based practice (EBP) measures for physiotherapy students. This study validated EBP-student (EBP-S) measures for physiotherapy students. METHODS EBP measures developed from previous research were cross-culturally validated for use by physiotherapy students. The adapted EBP-S consisted of six measures: use of EBP, EBP activities, EBP knowledge, self-efficacy for EBP, attitudes towards EBP, and perceptions of the teaching and assessment of EBP in the curriculum. The final version was completed by physiotherapy students (n = 335). The psychometric properties for each EBP-S measure were estimated, including construct validity using Rasch model, internal consistency reliability using person separation index (PSI), test-retest reliability using intraclass correlation coefficient (ICC), and differential item functioning (DIF). RESULTS Two formative measures (use of EBP and EBP activities) were only linguistically modified for use with students. A Rasch model was applied to the other four reflective measures. For knowledge, 55% (6/11) items fit the Rasch model with chi-square fit statistic (χ2) = 34.46, p = 0.08; PSI = 0.85. For self-efficacy, 89% (8/9) items fit the Rasch model with χ2 = 25.11, p = 0.80; PSI = 0.89. For attitudes, 62% (8/13) items fit the Rasch model with χ2 = 61.49, p = 0.00; PSI = 0.71. For perception of the teaching and assessment of EBP in the curriculum, 62% (8/13) items fit the Rasch model with χ2 = 80.99, p = 0.45; PSI = 0.92. perception of the teaching and assessment of EBP in the curriculum showed DIF in three items. The ICCs ranged between 0.80 and 0.98. CONCLUSIONS The EBP-S measures were validated for physiotherapy students, including the testing of psychometric properties, which were not tested in the original studies. Further refinements should be considered for the use of the EBP-S with other groups of students or if changes are applied to the current curriculum.
Collapse
Affiliation(s)
- Fadi M. Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Hoi Wai Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Kit Yat Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Yui Yin Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Ka Chun Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Shirley P. C. Ngai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Sharon M. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Arnold Y. L. Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
16
|
Melesse GT, Amde T, Tezera R. Competency in evidence-based medicine and associated factors among medical radiology technologists in Addis Ababa, Ethiopia. J Med Radiat Sci 2024. [PMID: 38445830 DOI: 10.1002/jmrs.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Evidence-based medicine integrates clinical expertise, patient values and best research evidence in clinical decision-making. This study aimed to assess evidence-based medicine knowledge, attitudes, practices and associated factors among medical radiology technologists in Addis Ababa, Ethiopia. METHODS A cross-sectional study was conducted among 392 medical radiology technologists from May to August 2022 using a self-administered questionnaire. Bivariate and multivariate logistic regression identified factors associated with evidence-based medicine practice. RESULTS Most medical radiology technologists (57.7%) had moderate evidence-based medicine knowledge and 94.9% had favourable attitudes. However, 64.8% demonstrated poor evidence-based medicine practice. Factors significantly associated with better evidence-based medicine practice were moderate knowledge (AOR 1.949, 95% CI 1.155-3.291), good statistical understanding (AOR 1.824, 95% CI 1.135-2.930), sufficient time for evidence-based medicine (AOR 1.892, 95% CI 1.140-3.141), institutional support (AOR 2.093, 95% CI 1.271-3.440) and evidence-based medicine resource access (AOR 1.653, 95% CI 1.028-2.656). CONCLUSION Despite moderate knowledge and positive attitudes towards evidence-based medicine, most medical radiology technologists had suboptimal utilisation. Strategies to improve knowledge, ensure dedicated time, provide institutional support and resources could enhance evidence-based radiology practice.
Collapse
Affiliation(s)
- Girma Tufa Melesse
- Department of Midwifery, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Tewodros Amde
- Department of Medical Radiology, College of Medical and Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Robel Tezera
- Department of Medical Radiology, College of Medical and Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
17
|
Nicholson J, Plovnick C, van der Vleuten C, de Bruin ABH, Kalet A. Librarian-Led Assessment of Medical Students' Evidence-Based Medicine Competency: Facilitators and Barriers. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:160-168. [PMID: 38464960 PMCID: PMC10921970 DOI: 10.5334/pme.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
Introduction We must ensure, through rigorous assessment that physicians have the evidence-based medicine (EBM) skills to identify and apply the best available information to their clinical work. However, there is limited guidance on how to assess EBM competency. With a better understanding of their current role in EBM education, Health Sciences Librarians (HSLs), as experts, should be able to contribute to the assessment of medical student EBM competence. The purpose of this study is to explore the HSLs perspective on EBM assessment practices, both current state and potential future activities. Methods We conducted focus groups with librarians from across the United States to explore their perceptions of assessing EBM competence in medical students. Participants had been trained to be raters of EBM competence as part of a novel Objective Structured Clinical Examination (OSCE). This OSCE was just the starting point and the discussion covered topics of current EBM assessment and possibility for expanded responsibilities at their own institutions. We used a reflexive thematic analysis approach to construct themes from our conversations. Results We constructed eight themes in four broad categories that influence the success of librarians being able to engage in effective assessment of EBM: administrative, curricular, medical student, and librarian. Conclusion Our results inform medical school leadership by pointing out the modifiable factors that enable librarians to be more engaged in conducting effective assessment. They highlight the need for novel tools, like EBM OSCEs, that can address multiple barriers and create opportunities for deeper integration of librarians into assessment processes.
Collapse
Affiliation(s)
- Joey Nicholson
- NYU Health Sciences Library, NYU Grossman School of Medicine, NYU Langone Health, US
| | - Caitlin Plovnick
- NYU Health Sciences Library, NYU Grossman School of Medicine, NYU Langone Health, New York, US
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NL
| | - Anique B. H. de Bruin
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NL
| | - Adina Kalet
- Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Wauwatosa, Wisconsin, US
| |
Collapse
|
18
|
Hu WL, Hong Y, Wang H, Chuang YC, Ye Y, Zheng Q, Huang L. Assessing evidence-based practice competencies of undergraduate nursing students using a developed multi-criteria decision-analysis model. Nurse Educ Pract 2024; 76:103919. [PMID: 38387278 DOI: 10.1016/j.nepr.2024.103919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/27/2023] [Accepted: 02/09/2024] [Indexed: 02/24/2024]
Abstract
AIM The developed multi-criteria decision analysis model was used to identify the inter-influence relationships and key factors affecting the EBP competencies of UNSs, to assess the EBP competencies of UNSs and based on these results, to formulate an improvement strategy to enhance the EBP competencies of UNSs. BACKGROUND EBP is considered a core competency in international nursing practice. However, few studies have developed EBP evaluation models and applied them to assessing and improving the EBP competencies of UNSs. DESIGN This is a quantitative study with multi-criteria decision-analysis model. METHODS Firstly, the questionnaire was designed based on the characteristics of the DEMATEL and VIKOR-AS methods, which was completed by 17 nursing experts from a case hospital in Zhejiang Province, China. Subsequently, the DEMATEL method was used to analyze the inter-influence relationships among various criteria to determine their respective weights. Finally, the VIKOR method is utilized to integrate multiple criteria and their relative weights to assign comprehensive scores to each UNSs. RESULTS The use of the DEMATEL method reveals that "Knowledge (C1)", "Mastering the basic scientific research methods during the study of the undergraduate courses (C11)", "Being able to consult clinical experts appropriately when encountering problems in clinical practice (C23)" and "Understanding the importance of reading journals related to the nursing profession regularly (C34)" were critical influencing factors. "Skill (C2)," "Being able to explain the essential roles of the best research evidence in determining clinical practice (C15)," "Being able to apply the collected research evidence to the individual case in nursing care (C25)" and "Paying attention to using the evidence-based nursing practice concept to determine the best clinical practice (C35)" were the most influential factors. According to the VIKOR method, the performance of the UNSs in the case hospitals in terms of EBP competencies from highest to lowest was Student C, Student B and Student A. However, all of these students suffered from deficiencies at the knowledge level. CONCLUSIONS The application of the DEMATEL and VIKOR methods provides a systematic and comprehensive approach to the assessment of EBP competencies of UNSs. The lack of EBP competencies of UNSs in case hospitals is mainly reflected in knowledge level. To improve UNSs' EBP competencies, medical schools and hospital educators should propose short- and long-term strategies to improve knowledge.
Collapse
Affiliation(s)
- Wei-Ling Hu
- School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China; Tarim Polytechnic, Alar, Xinjiang 843300, China
| | - Youyou Hong
- Taizhou Hospital of Traditional Chinese Medicine, Taizhou, China
| | - HongMei Wang
- School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, China
| | - Yen-Ching Chuang
- Business College, Taizhou University, Taizhou, Zhejiang 318000, China; Institute of Public Health & Emergency Management, Taizhou University, Taizhou, Zhejiang 318000, China; Key Laboratory of evidence-based Radiology of Taizhou, Linhai, Zhejiang 317000, China
| | - Yong Ye
- Business College, Taizhou University, Taizhou, Zhejiang 318000, China; Institute of Public Health & Emergency Management, Taizhou University, Taizhou, Zhejiang 318000, China.
| | - Qingzhu Zheng
- Zhejiang College of Security Technology, Wenzhou, Zhejiang 325000, China
| | - Lizhen Huang
- School of Economics and Management, Fuzhou University, Fujian, Fuzhou 350108, China.
| |
Collapse
|
19
|
Ruco A, Morassaei S, Di Prospero L. Development of Research Core Competencies for Academic Practice Among Health Professionals: A Mixed-Methods Approach. Qual Manag Health Care 2024:00019514-990000000-00070. [PMID: 38414261 DOI: 10.1097/qmh.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND OBJECTIVES Of the 4 pillars of academic practice for nursing and allied health, research has been the least developed and no standard competency framework exists that is embedded in health professional scopes of practice. The objective of this article is to report on the preliminary development and pilot-testing of research and academic scholarship core competencies for nonphysician health professionals working within a large urban academic health sciences center. METHODS We conducted an internal and external environmental scan and multiphase consultation process to develop research and academic core competencies for health professionals working within an interprofessional setting. RESULTS The final framework outlines 3 levels of research proficiency (novice, proficient, and advanced) and the relevant roles, specific competencies, and observable actions and/or activities for each proficiency level. CONCLUSIONS Organizations should consider the integration of the framework within performance management processes and the development of a road map and self-assessment survey to track progress over time and support health professionals with their academic practice goals.
Collapse
Affiliation(s)
- Arlinda Ruco
- Author Affiliations: Interdisciplinary Health Program, St Francis Xavier University, Antigonish, Nova Scotia, Canada (Dr Ruco); Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Ontario, Canada (Dr Ruco); Practice-Based Research and Innovation, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Mss Morassaei and Di Prospero); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (Ms Morassaei); and Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Ms Di Prospero)
| | | | | |
Collapse
|
20
|
Valera-Gran D, Campos-Sánchez I, Prieto-Botella D, Fernández-Pires P, Hurtado-Pomares M, Juárez-Leal I, Peral-Gómez P, Navarrete-Muñoz EM. Enhancing evidence-based practice into healthcare: Exploring the role of scientific skills in occupational therapists. Scand J Occup Ther 2024; 31:2323205. [PMID: 38447524 DOI: 10.1080/11038128.2024.2323205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Research utilization and evidence-based practice (EBP) in occupational therapy rely on essential scientific skills. Despite prior research exploring factors influencing EBP, a gap remains in understanding the specific scientific competencies crucial for effective EBP application. OBJECTIVES To (1) describe the level of scientific skills for EBP and research application, and (2) investigate the factors influencing higher scientific competence among 1159 Spanish-speaking occupational therapists. MATERIAL AND METHODS We assessed the scientific skills using the HACTO-Screen online survey. Recruitment was conducted through a non-probability convenience sampling method between April to June 2020, using social networks and email dissemination to education and professional organizations in Spain and Spanish-speaking Latin American countries. RESULTS Out of a total score of 115 points, participants showed a moderate level of scientific skills (mean: 62.7, SD: 21.6), with literature searching skills ranking the highest and scientific writing skills ranking the lowest. Associations were found between greater scientific competence and advanced degrees, ongoing research training, and on-the-job research. CONCLUSIONS Continuous research training, higher academic degrees, and active research engagement are essential for enhancing scientific competence among occupational therapists. SIGNIFICANCE Targeted training to enhance scientific skills and promote research utilization are crucial in advancing EBP in occupational therapy.
Collapse
Affiliation(s)
- Desirée Valera-Gran
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Irene Campos-Sánchez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | | | - Paula Fernández-Pires
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- B + D+b Occupational Research Group, Miguel Hernández University, Alicante, Spain
| | - Miriam Hurtado-Pomares
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Iris Juárez-Leal
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Paula Peral-Gómez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- B + D+b Occupational Research Group, Miguel Hernández University, Alicante, Spain
| | - Eva María Navarrete-Muñoz
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| |
Collapse
|
21
|
Johnson SG, Espehaug B, Larun L, Ciliska D, Olsen NR. Occupational Therapy Students' Evidence-Based Practice Skills as Reported in a Mobile App: Cross-Sectional Study. JMIR MEDICAL EDUCATION 2024; 10:e48507. [PMID: 38381475 PMCID: PMC10918542 DOI: 10.2196/48507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/18/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Evidence-based practice (EBP) is an important aspect of the health care education curriculum. EBP involves following the 5 EBP steps: ask, assess, appraise, apply, and audit. These 5 steps reflect the suggested core competencies covered in teaching and learning programs to support future health care professionals applying EBP. When implementing EBP teaching, assessing outcomes by documenting the student's performance and skills is relevant. This can be done using mobile devices. OBJECTIVE The aim of this study was to assess occupational therapy students' EBP skills as reported in a mobile app. METHODS We applied a cross-sectional design. Descriptive statistics were used to present frequencies, percentages, means, and ranges of data regarding EBP skills found in the EBPsteps app. Associations between students' ability to formulate the Population, Intervention, Comparison, and Outcome/Population, Interest, and Context (PICO/PICo) elements and identifying relevant research evidence were analyzed with the chi-square test. RESULTS Of 4 cohorts with 150 students, 119 (79.3%) students used the app and produced 240 critically appraised topics (CATs) in the app. The EBP steps "ask," "assess," and "appraise" were often correctly performed. The clinical question was formulated correctly in 53.3% (128/240) of the CATs, and students identified research evidence in 81.2% (195/240) of the CATs. Critical appraisal checklists were used in 81.2% (195/240) of the CATs, and most of these checklists were assessed as relevant for the type of research evidence identified (165/195, 84.6%). The least frequently correctly reported steps were "apply" and "audit." In 39.6% (95/240) of the CATs, it was reported that research evidence was applied. Only 61% (58/95) of these CATs described how the research was applied to clinical practice. Evaluation of practice changes was reported in 38.8% (93/240) of the CATs. However, details about practice changes were lacking in all these CATs. A positive association was found between correctly reporting the "population" and "interventions/interest" elements of the PICO/PICo and identifying research evidence (P<.001). CONCLUSIONS We assessed the students' EBP skills based on how they documented following the EBP steps in the EBPsteps app, and our results showed variations in how well the students mastered the steps. "Apply" and "audit" were the most difficult EBP steps for the students to perform, and this finding has implications and gives directions for further development of the app and educational instruction in EBP. The EBPsteps app is a new and relevant app for students to learn and practice EBP, and it can be used to assess students' EBP skills objectively.
Collapse
Affiliation(s)
- Susanne G Johnson
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Birgitte Espehaug
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Lillebeth Larun
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Donna Ciliska
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nina Rydland Olsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| |
Collapse
|
22
|
Robinson J, Jagiello KP, McElroy L, LoVerde J, Jowell V, Good P, Brink S. Competency-Based Education in RN to BSN Programs. Nurse Educ 2024:00006223-990000000-00410. [PMID: 38324446 DOI: 10.1097/nne.0000000000001604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND The call for nursing education reform has never been louder. National organizations recognize the urgent need to prepare nursing students to practice competently, moving away from traditional teaching and curricula and to competency-based education (CBE) strategies to prepare future nurses for independent clinical practice. PROBLEM The 2021 American Association of Colleges of Nursing Essentials do not account for the competencies achieved in registered nurse (RN) associate degree and diploma programs. This presents a challenge for RN to bachelor of science in nursing (BSN) program administrators and faculty when designing curricula to meet the new Essentials. APPROACH The Essentials crosswalk created by the National RN-Baccalaureate Faculty Forum serves as a foundational guide for the development of the template models discussed in this article. CONCLUSION This article provides a template of instructional models for implementing CBE in RN to BSN programs.
Collapse
Affiliation(s)
- Jamie Robinson
- Author Affiliations: Associate Professor (Dr Robinson), School of Nursing, James Madison University, Harrisonburg, Virginia; Assistant Professor (Dr Jagiello), School of Nursing, James Madison University, Harrisonburg, Virginia; Assistant Professor (Dr McElroy), School of Nursing, University of Oklahoma, Oklahoma City; Assistant Professor (Dr LoVerde), Benedictine University, Lisle, Illinois; Clinical Senior Instructor (Ms Jowell), School of Nursing, University of Texas at Tyler, Tyler; Professor (Dr Good), School of Nursing, Polk State College, Winter Haven, Florida; and Dean (Ms Brink), School of Health Professions, Central Methodist University, Fayette, Missouri
| | | | | | | | | | | | | |
Collapse
|
23
|
Campbell KA, Cammer A, Moisey LL, Orr E, Whitmore C, Jack SM. Critically appraising and utilising qualitative health research evidence in nutrition practice. J Hum Nutr Diet 2024; 37:377-387. [PMID: 37964644 DOI: 10.1111/jhn.13259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Evidence-based decision-making and practice recommendations are commonly based on findings from quantitative studies or reviews. In the present study, we provide an overview of how to incorporate findings from qualitative research into the evidence-based decision-making process. METHODS To illustrate how qualitative evidence can be integrated into the decision-making process, we have outlined a clinical nutrition scenario and the process for sourcing credible evidence to inform decision-making. A qualitative health research study was selected and appraised using the Critical Appraisal Skill Programme (CASP) appraisal tool for qualitative research. Based on the results of the critical appraisal, the study quality is considered, and we discuss whether the qualitative evidence can be applied to practice. RESULTS A detailed description of how the qualitative findings can be used conceptually and instrumentally in practice to address the clinical nutrition scenario is provided. CONCLUSIONS Developing skills in critically appraising findings from qualitative studies will increase awareness and utilisation of this type of evidence in practice and policy, with a goal to ensure that patient/client perceptions are considered, leading to enhanced person-centred care or systems.
Collapse
Affiliation(s)
| | - Allison Cammer
- University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, SK, Canada
| | - Lesley L Moisey
- University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, SK, Canada
| | - Elizabeth Orr
- Department of Nursing, Brock University, St Catharines, ON, Canada
| | - Carly Whitmore
- McMaster University, School of Nursing, Hamilton, ON, Canada
| | - Susan M Jack
- McMaster University, School of Nursing, Hamilton, ON, Canada
| |
Collapse
|
24
|
Nielsen LD, Castano FM, Jørgensen RB, Ramachandran A, Egebæk HK, Noe BB. Teaching evidence-based practice to undergraduate healthcare students Educators' knowledge, skills, attitudes, current practice, perceived barriers, and facilitators: A Danish cross-sectional study. NURSE EDUCATION TODAY 2024; 133:106082. [PMID: 38141368 DOI: 10.1016/j.nedt.2023.106082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Evidence-Based Practice is recognized as a standard practice and a core competence for clinical healthcare professionals and therefore educators' competences in teaching Evidence-Based Practice are essential. Yet only little is known about the knowledge, skills, attitudes, and teaching practices around Evidence-Based Practice among educators of Danish undergraduate healthcare students. OBJECTIVES The objectives of this study were to describe: 1) the Evidence-Based Practice profiles regarding attitudes, knowledge, skills, and teaching practices among educators who teach in undergraduate healthcare educations; 2) the current state of teaching Evidence-Based Practice in undergraduate program curricula; 3) the perceived barriers and facilitators to teach Evidence-Based Practice; and 4) the educators` needs regarding teaching Evidence-Based Practice. DESIGN, SETTING AND PARTICIPANTS A cross-sectional survey using a self-administrated online questionnaire among 81 educators at University College South Denmark. METHODS The survey covered 1) Demographic questions, 2) Educators Evidence-Based Practice profiles measured by the Evidence-Based Practice Questionnaire for teachers, 3) perceived state of Evidence-Based Practice teaching 4) perceived barriers and facilitators and 5) educators´ needs for competence development regarding teaching Evidence-Based Practice. RESULTS The translated version of the Evidence-Based Practice Questionnaire showed that respondents had a mean of 3,6 regarding practicing Evidence-Based Practice when asked to rank on a scale of 1-7 (higher score indicating higher degree). The respondents showed positive attitudes towards Evidence-Based Practice and had a high self-perception of their Evidence-Based Practice skills and knowledge, scoring an overall average value of 5 on these items. In open ended questions educators gave a variety of examples of their Evidence-Based Practice teaching in terms of content, teaching methods and cooperation with clinical practice. CONCLUSIONS Educators report limitations to teaching Evidence-Based Practice; however, attitudes, knowledge and skills were perceived generally high. Main facilitator was partnership with clinical practice and main barrier was time lack. MESH: Evidence-Based Practice, Health Educators, Knowledge, Attitude.
Collapse
Affiliation(s)
- Lea D Nielsen
- Nursing Education & Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705 Esbjerg Ø, Denmark.
| | - Francisco M Castano
- Biomedical Laboratory Science, Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705 Esbjerg Ø, Denmark.
| | - René B Jørgensen
- Physiotherapy Education, Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705 Esbjerg Ø, Denmark.
| | - Asviny Ramachandran
- Occupational Therapy Education, Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705 Esbjerg Ø, Denmark..
| | - Heidi K Egebæk
- Centre for Clinical Research and Prevention, Section for Health Promotion and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Bodil B Noe
- Department for Applied Health Science, University College South Denmark, Degnevej 17, 6705 Esbjerg Ø, Denmark.
| |
Collapse
|
25
|
Björklund M, Massoumi R, Ohlsson B. From master's thesis to research publication: a mixed-methods study of medical student publishing and experiences with the publishing process. BMC MEDICAL EDUCATION 2024; 24:75. [PMID: 38245755 PMCID: PMC10800057 DOI: 10.1186/s12909-024-05060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Medical student master's theses are often carried out as research projects, and some are published as research papers in journals. We investigated the percentage of master's theses conducted by 5th -year students at the Medical Degree Program at Lund University, Sweden, that subsequently served as the basis for research publications. In addition, we explored both student and supervisor experiences with the publishing process. METHODS A cohort of four semesters of student data covering the period from 2019 to 2020 (n = 446) was searched in PubMed, Embase and the Web of Science to assess whether they had been published as research papers. Surveys were sent to students (n = 121) and supervisors (n = 77) to explore their experiences with the publishing process. RESULTS We found that 33% (149 of 446) of the students in the 2019-2020 cohort subsequently published their theses, and 50% of these students were listed as first authors. Most students published original research. Students (n = 21) and supervisors (n = 44) reported that the publishing process was time-consuming and that students needed multilevel support from supervisors to achieve successful publication. The publishing process was reported by 79% of the students to have led to additional learning. Most of the papers (126 of 149, 85%) had a clinical or patient-oriented focus. CONCLUSION A high percentage of the student publications in which students are listed as first authors require engagement from both students and supervisors. Supervisors play an essential role in supporting students in a successful publication process. Most of the published papers were either clinical or patient-oriented research.
Collapse
Affiliation(s)
- Maria Björklund
- Library & ICT, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Ramin Massoumi
- Translational Cancer Research, Department of Laboratory Medicine, Lund University, Medicon Village, Lund, Sweden
| | - Bodil Ohlsson
- Department of Clinical Sciences, Lund University, Malmö, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
26
|
Demont A, Vervaeke R, Bourmaud A. Required competencies for French physiotherapists for direct access to primary care for patients with musculoskeletal disorders: consensus statement based on a Delphi survey. Physiother Theory Pract 2024:1-12. [PMID: 38189315 DOI: 10.1080/09593985.2023.2301437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Physiotherapists who will practice in direct access model of care must acquire the required competencies to ensure adequate and safe patient care. There is no set of required competencies for French physiotherapists. OBJECTIVE To develop a consensus on a minimum set of competencies that French physiotherapists should acquire to practice in direct access to primary care with patients with musculoskeletal disorders. METHODS The survey was conducted by 1) definition of an initial set of competencies based on a scoping review up to September 2021, 2) implementation of a two-round Delphi survey from October 2021 to January 2022 to obtain consensus on the domains and competencies required in the French context, and 3) consultation at group meeting on February 2022 to finalize and validate the final set of competencies. RESULTS Five domains and 52 competencies were identified from the scoping review. Twenty health-care professionals' experts (i.e. family physicians, emergency physicians, and physiotherapists) and two health-care users took part in the Delphi survey. A consensus was reached on 27 required competencies grouped within five domains. CONCLUSION A consensus-based, contemporary set of competencies required for direct access practice with patients with musculoskeletal disorders has been identified that may contribute to the update of entry-level and lifelong learning curricula for French physiotherapists.
Collapse
Affiliation(s)
- Anthony Demont
- Centre de Recherche Épidémiologique et Statistique Sorbonne Paris Cité, INSERM UMR-S 1153, Paris, France
| | - Robin Vervaeke
- Physiotherapy Department, Physiotherapy Clinic, Mulhouse, France
| | - Aurélie Bourmaud
- Clinical Epidemiology Unit, Robert Debré university hospital, AP-HP, INSERM CIC 1426 and Paris Cité University, Paris, France
| |
Collapse
|
27
|
Redmond C, Farrell R, Cunningham C, Dineen A, Foley S, O'Donnell D, O'Reilly S, Stokes D, O'Neill E. Development of the EVIBEC Learning Outcomes Framework to support the delivery of evidence-based practice curricula in health care professional programmes: a codesign approach. BMC MEDICAL EDUCATION 2024; 24:3. [PMID: 38172823 PMCID: PMC10763008 DOI: 10.1186/s12909-023-04972-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND All healthcare professional education programmes must adopt a systematic approach towards ensuring graduates achieve the competencies required to be an evidence-based practitioner. While a list of competencies for evidence-based practice exist, health care educators continue to struggle with effectively integrating the necessary competencies into existing curricula. The purpose of this project was to develop an open access cross-discipline, learning outcomes framework to support educators in integrating the teaching, learning and assessment required to ensure all graduates of health care professional programmes can achieve the necessary evidence-based practice competencies. METHODS An interdisciplinary team of health care professional educators and a librarian completed a review of the health professions literature on the teaching and assessment of evidence-based practice. The literature, coupled with the teams' collective experiences in evidence-based education and research, were used to identify relevant teaching, learning and evidence-based competency frameworks to inform the project design. The guide and toolkit for experience-based co-design developed by the National Health Service Institute for Innovation and Improvement was adopted for this study ( Institute for Innovation and Improvement: Experience Based Design: Guide & Tools In. Leeds: NHS; 2009.). A four-step approach involving three online participatory co-design workshops and a national validation workshop was designed. Students (n = 33), faculty (n = 12), and clinical educators (n = 15) participated in formulating and mapping learning outcomes to evidence-based competencies. RESULTS Through a rigorous, systematic co-design process the Evidenced-based Education Collaborative (EVIBEC) Learning Outcomes Framework was developed. This framework consists of a series of student-centred learning outcomes, aligned to evidence-based practice competencies, classified according to the 5 As of EBP and mapped to the cognitive levels of Bloom's taxonomy. Associated learning activities for each step of EBP are suggested. CONCLUSIONS A consensus-based, student-centred learning outcomes framework aligned to a contemporary set of EBP core competencies has been developed. The freely accessible EVIBEC framework may support entry level health care professional EBP education, by informing EBP curriculum development and offering the potential for interdisciplinary approaches to and sharing of valuable teaching and learning resources. Co-design proved an effective method in creating and refining this framework.
Collapse
Affiliation(s)
- Catherine Redmond
- UCD School of Nursing, Midwifery & Health Systems, Belfield, Dublin, Dublin 4, Ireland
| | - Robin Farrell
- UCD School of Veterinary Medicine, Area: Veterinary Nursing, Belfield, Dublin, Dublin 4, Ireland
| | - Catriona Cunningham
- UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Dublin 4, Ireland
| | - Andrea Dineen
- UCD School of Veterinary Medicine, Area: Veterinary Nursing, Belfield, Dublin, Dublin 4, Ireland
| | - Shane Foley
- UCD School of Medicine, Belfield, Dublin, Dublin 4, Ireland
| | - Deirdre O'Donnell
- UCD School of Nursing, Midwifery & Health Systems, Belfield, Dublin, Dublin 4, Ireland.
| | - Sharleen O'Reilly
- UCD School of Agriculture and Food Science, Area: Dietetics and Human Nutrition, Belfield, Dublin, Dublin 4, Ireland
| | | | - Emma O'Neill
- UCD School of Veterinary Medicine, Belfield, Dublin, Dublin 4, Ireland
| |
Collapse
|
28
|
Marques A, Matos C, Nikiphorou E, Livermore P, Ferreira RJO. Towards a consensus for nurse education of methotrexate for people with rheumatic and musculoskeletal diseases: A scoping review. Musculoskeletal Care 2023; 21:1227-1237. [PMID: 37587575 DOI: 10.1002/msc.1804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Patient education (PE) is a key role of nurses, which includes providing information, training, and support about methotrexate (MTX), an anchor drug in rheumatology. However, there is a wide variation in the access to rheumatology nurse consultations in Europe, and there is a lack of consensus regarding the delivery, context and timing of PE in these cases. This study aimed to provide a comprehensive overview of the existing research on nurse education of MTX for children/youth and adults with Rheumatic and Musculoskeletal Diseases (RMDs). METHODS This scoping review was conducted in accordance with Arksey and O'Malley's framework. A search on PubMed (MEDLINE), Scopus and Cochrane Database, and CINAHL, from inception until March 2022 was conducted. Articles on PE with a focus on MTX exclusively were included. Published and unpublished studies, from any world region, conducted with a qualitative, quantitative, or mixed-methods design and focused on defined research questions, were eligible for inclusion. Broad inclusion criteria were used if a research paper on PE focused on MTX for people with RMDs (PE or patient engagement, self-management, medication knowledge, or health literacy in patients). The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist. Two independent reviewers performed standardized data extraction and synthesis. RESULTS From 292 references identified, the total number of studies which met the inclusion criteria was relatively small (n = 14). The results identified that knowledge of MTX improves when education by nurses is provided. CONCLUSION This scoping review showed that there is no universal worldwide strategy for MTX education of children/youths and adults with RMDs. However, PE regarding MTX can be delivered in different forms, resulting in better satisfaction and adherence. More randomized controlled trials with powered samples are required.
Collapse
Affiliation(s)
- Andréa Marques
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Cristiano Matos
- Instituto Politécnico de Coimbra, Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal
- QLV Research Consulting, Coimbra, Portugal
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College London, London, UK
- Rheumatology Department, King's College Hospital, London, UK
| | - Polly Livermore
- Rheumatology Department, Great Ormond Street Children's Hospital, London, UK
- GOSH NIHR BRC, Institute of Child Health and University College London, London, UK
| | - Ricardo J O Ferreira
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- QLV Research Consulting, Coimbra, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal
| |
Collapse
|
29
|
Vervaeke R, Lafrance S, Demont A. Core competencies for first contact physiotherapists in a direct access model of care for adults with musculoskeletal disorders: A scoping review. Musculoskeletal Care 2023; 21:1353-1363. [PMID: 37641476 DOI: 10.1002/msc.1813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION To optimise the management of Musculoskeletal disorders (MSKDs), many countries have implemented direct access to physiotherapy; however, the core competencies required for first contact physiotherapists (PTs) have not been precisely defined. The aim of this scoping review is to identify and describe the core competencies required for first contact PTs treating adults with MSKDs. METHODS We conducted a scoping review of the literature by searching eight databases and grey literature up to July 2023. We performed a thematic analysis of the competencies identified based on predefined themes relevant to first contact physiotherapy in direct access models in primary or emergency care settings. RESULTS Sixty-five articles were included. Seventeen core competencies were identified and grouped into 5 themes: (1) Assessment and examination; (2) Management and interventions; (3) Communication; (4) Cooperation and collaboration; and (5) Professionalism and leadership. CONCLUSIONS Our findings provide an international perspective on the core competencies required for first contact PTs.
Collapse
Affiliation(s)
| | - Simon Lafrance
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Maisonneuve-Rosemont Hospital Research Center, Université de Montréal Affiliated Research Center, Montreal, Quebec, Canada
| | - Anthony Demont
- INSERM UMR-S 1153, Centre de Recherche Épidémiologique et Statistique Sorbonne Paris Cité, Paris, France
| |
Collapse
|
30
|
Abstract
Background The Informed Health Choices (IHC) Key Concepts is a framework that provides a basis for developing educational resources and evaluating people's ability to think critically about health actions. We developed the original Key Concepts framework by reviewing texts and checklists for the public, journalists, and health professionals and collecting structured feedback from an international advisory group. We revised the original 2015 framework yearly from 2016 to 2018 based on feedback and experience using the framework. The objectives of this paper are to describe the development of the framework since 2018 and summarise their basis. Methods For the 2019 version, we responded to feedback on the 2018 version. For the current 2022 version, in addition to responding to feedback on the 2019 version, we reviewed the evidence base for each of the concepts. Whenever possible, we referenced systematic reviews that provide a basis for a concept. We screened all Cochrane methodology reviews and searched Epistemonikos, PubMed, and Google Scholar for methodology reviews and meta-epidemiological studies. Results The original framework included 32 concepts in six groups. The 2019 version and the current 2022 version include 49 concepts in the same three main groups that we have used since 2016. There are now 10 subgroups or higher-level concepts. For each concept, there is an explanation including one or more examples, the basis for the concept, and implications. Over 600 references are cited that support the concepts, and over half of the references are systematic reviews. Conclusions There is a large body of evidence that supports the IHC key concepts and we have received few suggestions for changes since 2019.
Collapse
Affiliation(s)
- Andrew D. Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Iain Chalmers
- Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, Oxford, UK
| | - Astrid Dahlgren
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
31
|
Boltena MT, Woldie M, Siraneh Y, Steck V, El-Khatib Z, Morankar S. Adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in sub-Saharan Africa: a systematic review and meta-analysis. J Pharm Policy Pract 2023; 16:137. [PMID: 37936215 PMCID: PMC10629154 DOI: 10.1186/s40545-023-00634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/12/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Adherence to evidence-based standard treatment guidelines (STGs) enable healthcare providers to deliver consistently appropriate diagnosis and treatment. Irrational use of antimicrobials significantly contributes to antimicrobial resistance in sub-Saharan Africa (SSA). The best available evidence is needed to guide healthcare providers on adherence to evidence-based implementation of STGs. This systematic review and meta-analysis aimed to determine the pooled prevalence of adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in SSA. METHODS The review followed the JBI methodology for systematic reviews of prevalence data. CINAHL, Embase, PubMed, Scopus, and Web of Science databases were searched with no language and publication year limitations. STATA version 17 were used for meta-analysis. The publication bias and heterogeneity were assessed using Egger's test and the I2 statistics. Heterogeneity and publication bias were validated using Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis. The summary prevalence and the corresponding 95% confidence interval (CI) of healthcare professionals' compliance with evidence-based implementation of STG were estimated using random effect model. The review protocol has been registered with PROSPERO code CRD42023389011. The PRISMA flow diagram and checklist were used to report studies included, excluded and their corresponding section in the manuscript. RESULTS Twenty-two studies with a total of 17,017 study participants from 14 countries in sub-Saharan Africa were included. The pooled prevalence of adherence to evidence-based implementation of antimicrobial treatment guidelines in SSA were 45%. The pooled prevalence of the most common clinical indications were respiratory tract (35%) and gastrointestinal infections (18%). Overall prescriptions per wards were inpatients (14,413) and outpatients (12,845). Only 391 prescribers accessed standard treatment guidelines during prescription of antimicrobials. CONCLUSIONS Healthcare professionals' adherence to evidence-based implementation of STG for antimicrobial treatment were low in SSA. Healthcare systems in SSA must make concerted efforts to enhance prescribers access to STGs through optimization of mobile clinical decision support applications. Innovative, informative, and interactive strategies must be in place by the healthcare systems in SSA to empower healthcare providers to make evidence-based clinical decisions informed by the best available evidence and patient preferences, to ultimately improving patient outcomes and promoting appropriate antimicrobial use.
Collapse
Affiliation(s)
- Minyahil Tadesse Boltena
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Knowledge Translation Division, Knowledge Management Directorate, Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia.
| | - Mirkuzie Woldie
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
- University of Technology Sydney, Sydney, Australia
| | - Yibeltal Siraneh
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Veronica Steck
- Department of Pharmacology and Therapeutics, Faculty of Life Sciences, McGill University, McGill, Montreal, Canada
| | - Ziad El-Khatib
- Global Public Health Department, Karolinska Institute, Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, Quebec, Canada
| | - Sudhakar Morankar
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
32
|
Khilnani NM, Wasan SM, Pappas PJ, Deol Z, Schoonover JP, Daugherty SF, Attaran RR, Cartee TV, Straight TM, Fish J, Granzow JW, Winokur RS, Desai KR, Salazar G, Stoughton J, Gibson K, Jones AD, Lohr JM, Vayuvegula S, Meissner MH. Core content for venous and Lymphatic Medicine: 2022 revision. Phlebology 2023:2683555231212302. [PMID: 37934910 DOI: 10.1177/02683555231212302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners. In order to inform the standard setting bodies and other stakeholders of the current scope of VLM, a task force of VLM experts from cardiology, dermatology, emergency medicine, general surgery, interventional radiology, vascular medicine, and vascular surgery was formed to revise a 2014 consensus document defining the core content of the specialty of VLM.
Collapse
Affiliation(s)
- N M Khilnani
- Division of Interventional Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - S M Wasan
- REX Vascular Speicalists, UNC Health, Raleigh, NC, USA
| | - P J Pappas
- Center for Vein Restoration, Morristown, NJ, USA
| | - Z Deol
- Center for Vein Restoration, Toledo, Ohio and Detroit, MI, USA
| | | | | | - R R Attaran
- Department of Cardiology, Yale School of Medicine, Norwich, CT, USA
| | - T V Cartee
- Division of Dermatology, Penn State College of Medicine, Hershey, PA, USA
| | | | - J Fish
- Department of Medicine, Jobst Vascular Instituteof Promedica, Toledo, OH, USA
| | - J W Granzow
- Granzow Lymphedema and Lipedema Center, Jacksonville, FL, USA
| | - R S Winokur
- Division of Interventional Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - K R Desai
- Division of Interventional Radiology, Northwestern UniversityFeinberg School of Medicine, Chicago, IL, USA
| | - G Salazar
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Stoughton
- Department of Vascular Surgery, Massachusetts General Hospital, Stoneham, MA, USA
| | - K Gibson
- Lake Washington Vascular Surgeons, Bellevue, WA, USA
| | - A D Jones
- Inova Vein Specialty Center, Bend, OR, USA
| | - J M Lohr
- Division of Vascular and Endovascular Surgery, William Jennnings Bryan Dorn VA, Columbia, SC, USA
| | | | - M H Meissner
- Department of Surgery, University of WashingtonSchool of Medicine, Seattle, WA, USA
| |
Collapse
|
33
|
Romney W, Salbach NM, Perry SB, Deutsch JE. Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study. BMC MEDICAL EDUCATION 2023; 23:839. [PMID: 37936143 PMCID: PMC10630997 DOI: 10.1186/s12909-023-04821-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation. METHODS One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman's test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis. RESULTS There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0). CONCLUSIONS EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.
Collapse
Affiliation(s)
- Wendy Romney
- Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, CT, USA.
- RiVERS lab, Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, Temerity Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The KITE-Research Institute, University Health Network, Toronto, ON, Canada
| | - Susan B Perry
- Department of Physical Therapy, Chatham University, Pittsburgh, PA, USA
| | - Judith E Deutsch
- RiVERS lab, Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA
| |
Collapse
|
34
|
Alsop T, Lehman E, Brauer S, Forbes R, Hanson CL, Healy G, Milton K, Reid H, Rosbergen I, Gomersall S. What should all health professionals know about movement behaviour change? An international Delphi-based consensus statement. Br J Sports Med 2023; 57:1419-1427. [PMID: 37793699 DOI: 10.1136/bjsports-2023-106870] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
The WHO has called for action to integrate physical activity promotion into healthcare settings, yet there is a lack of consensus on the competencies required by health professionals to deliver effective movement behaviour change support. The objective of this study was to establish key competencies relevant for all health professionals to support individuals to change their movement behaviours. Consensus was obtained using a three-phase Delphi process. Participants with expertise in physical activity and sedentary behaviour were asked to report what knowledge, skills and attributes they believed health professionals should possess in relation to movement behaviour change. Proposed competencies were developed and rated for importance. Participants were asked to indicate agreement for inclusion, with consensus defined as group level agreement of at least 80%. Participants from 11 countries, working in academic (55%), clinical (30%) or combined academic/clinical (13%) roles reached consensus on 11 competencies across 3 rounds (n=40, n=36 and n=34, respectively). Some competencies considered specific to certain disciplines did not qualify for inclusion. Participants agreed that health professionals should recognise, take ownership of, and practise interprofessional collaboration in supporting movement behaviour change; support positive culture around these behaviours; communicate using person-centred approaches that consider determinants, barriers and facilitators of movement behaviours; explain the health impacts of these behaviours; and recognise how their own behaviour influences movement behaviour change support. This consensus defines 11 competencies for health professionals, which may serve as a catalyst for building a culture of advocacy for movement behaviour change across health disciplines.
Collapse
Affiliation(s)
- Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Emily Lehman
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Sandra Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Coral L Hanson
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Genevieve Healy
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research and Innovation, The University of Queensland, St Lucia, Queensland, Australia
| | - Karen Milton
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Hamish Reid
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Ingrid Rosbergen
- Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Sjaan Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research and Innovation, The University of Queensland, St Lucia, Queensland, Australia
| |
Collapse
|
35
|
Estalella I, Román Ó, Reichenberger TN, Maquibar A. Impact of a teaching strategy to promote evidence-based practice on nursing students' knowledge and confidence in simulated clinical intervention choices. BMC Nurs 2023; 22:361. [PMID: 37803349 PMCID: PMC10559451 DOI: 10.1186/s12912-023-01540-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Nurses self-efficacy, confidence and their competency for evidence-based practice have a relevant impact in the quality of care provided to patients. However, the implementation of evidence-based practice continues to be limited to date and the relationship between these elements has not been thoroughly understood. Thus, the aim of this study was to analyze the impact on confidence levels of a teaching strategy to promote evidence incorporation into clinical decisions made by student nurses in hypothetical scenarios. Besides, students' satisfaction with the new teaching strategy was assessed. METHODS The teaching strategy was asynchronous, on-line and based on multiple-choice questionnaires related to decision making on an intensive care unit patient. Confidence levels were assessed by introducing the scoring tool confidence-based marking. Changes between pre- and post-tests in correct answers, confidence levels and expected-observed ranges of accuracy at each level of certainty were analyzed through non-parametric McNemar's sign tests for paired-samples differences. To assess students' satisfaction with the teaching strategy, a mixed-methods approach was followed. Descriptive statistical methods and Qualitative Content Analysis were followed respectively in order to analyze students' satisfaction. RESULTS A total of 165 students completed the assignment, 101 answered the satisfaction survey and 7 participated in the interviews. Statistically significant better scoring and higher confidence levels were found in the post-intervention. Statistically significant differences in expected-observed ranges of accuracy were found for the three levels of certainty. Students were highly satisfied with the proposed task. In the qualitative analysis one category was elaborated which illustrated the students' perceived added value of this new assignment. CONCLUSIONS On-line teaching strategies based on clinical scenarios that focus on evidence-based decision-making have the potential to increase the confidence of nursing students. Additionally, interventions designed by teams incorporating clinical nurses, university librarians and academic nurses have the potential to bridge the evidence-practice gap in nursing education.
Collapse
Affiliation(s)
- Itziar Estalella
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, B° Sarriena s/n, Leioa, Bizkaia, 48940, Spain
| | - Óscar Román
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, B° Sarriena s/n, Leioa, Bizkaia, 48940, Spain
| | - Theo Norbert Reichenberger
- University Library, University of the Basque Country UPV/EHU, B° Sarriena s/n, Leioa, Bizkaia, 48940, Spain
| | - Amaia Maquibar
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, B° Sarriena s/n, Leioa, Bizkaia, 48940, Spain.
| |
Collapse
|
36
|
Piano L, Chiarotto A, Mascarello M, Turolla A, Cecchetto S, Gianola S, Castellini G. Teaching evidence-based practice to physiotherapy students in Italy: a cross sectional study. Arch Physiother 2023; 13:19. [PMID: 37779190 PMCID: PMC10544500 DOI: 10.1186/s40945-023-00174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is being rapidly adopted by the Italian physiotherapy community, although a knowledge gap persists at clinical level with consequent lack of integration of EBP into ground roots practice. Teaching of EBP during the Bachelor of Science (BSc) undergraduate course in physiotherapy likely has a vital role to play in the spread of knowledge, providing a grounding in the fundamental concepts of EBP. The aim of the present study was to investigate the prevalence of EBP educational content in Italian BSc courses in physiotherapy. METHODS This is a cross-sectional study during which characteristics of EBP teaching in BSc degree courses of physiotherapy in Italy were collected from institutional websites during the period May to September 2021 with an update in August 2022. We used the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for our manuscript. RESULTS Forty-two physiotherapy BSc degree programs were retrieved, accounting for all the BSc delivered in the 2021-2022 academic year. Fourteen of these (33.3%) did not report EBP content. Northern universities provided EBP content in 16 out of 18 (88%) degree courses. Central Italian universities provided EBP content in 6 out of 9 (66.6%) degree courses. Southern universities delivered EBP content in 3 out of 9 (33.3%) degree courses. The universities of Sicily and Sardinia provided EBP content in 2 out of 5 (40%) degree courses. The degree courses taught in public universities were more likely to contain EBP material (25 out of 37, 67.4%), compared to those taught within the private system (3 out of 5, 60%). CONCLUSIONS The prevalence of EBP content within physiotherapy BSc degree programs in Italy can be considered suboptimal, with both regional differences and according to the system (public vs private). The results of this study could be used as a stimulus for increasing investment in the teaching of EBP in Italian physiotherapy degree courses, thereby improving educational standards.
Collapse
Affiliation(s)
- Leonardo Piano
- Unit of Rehabilitation and Functional Recovery, Fondazione Dei Santi Lorenzo E Teobaldo, 12050, Rodello, Italy.
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marco Mascarello
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater Studiorum, Università Di Bologna, 40138, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, 40138, Bologna, Italy
| | | | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Lombardia, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Lombardia, Italy
| |
Collapse
|
37
|
Ban JW, Perera R, Williams V. Influence of research evidence on the use of cardiovascular clinical prediction rules in primary care: an exploratory qualitative interview study. BMC PRIMARY CARE 2023; 24:194. [PMID: 37730553 PMCID: PMC10512575 DOI: 10.1186/s12875-023-02155-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Cardiovascular clinical prediction rules (CPRs) are widely used in primary care. They accumulate research evidence through derivation, external validation, and impact studies. However, existing knowledge about the influence of research evidence on the use of CPRs is limited. Therefore, we explored how primary care clinicians' perceptions of and experiences with research influence their use of cardiovascular CPRs. METHODS We conducted an exploratory qualitative interview study with thematic analysis. Primary care clinicians were recruited from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). We used purposeful sampling to ensure maximum variation within the participant group. Data were collected by conducting semi-structured online interviews. We analyzed data using inductive thematic analysis to identify commonalities and differences within themes. RESULTS Of 29 primary care clinicians who completed the questionnaire, 15 participated in the interview. We identified two main themes relating to the influence of clinicians' perceptions of and experiences with cardiovascular CPR research on their decisions about using cardiovascular CPRs: "Seek and judge" and "be acquainted and assume." When clinicians are familiar with, trust, and feel confident in using research evidence, they might actively search and assess the evidence, which may then influence their decisions about using cardiovascular CPRs. However, clinicians, who are unfamiliar with, distrust, or find it challenging to use research evidence, might be passively acquainted with evidence but do not make their own judgment on the trustworthiness of such evidence. Therefore, these clinicians might not rely on research evidence when making decisions about using cardiovascular CPRs. CONCLUSIONS Clinicians' perceptions and experiences could influence how they use research evidence in decisions about using cardiovascular CPRs. This implies, when promoting evidence-based decisions, it might be useful to target clinicians' unfamiliarity, distrust, and challenges regarding the use of research evidence rather than focusing only on their knowledge and skills. Further, because clinicians often rely on evidence-unrelated factors, guideline developers and policymakers should recommend cardiovascular CPRs supported by high-quality evidence.
Collapse
Affiliation(s)
- Jong- Wook Ban
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK.
- Department for Continuing Education, University of Oxford, Oxford, UK.
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | |
Collapse
|
38
|
Aucoin M, Newton G, Leach M, Cooley K. Co-Design of an Evidence-Based Practice Continuing Education Course for Canadian Naturopathic Doctors. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:592-601. [PMID: 37093154 DOI: 10.1089/jicm.2022.0730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Objectives: Evidence-based practice (EBP) is a clinical decision-making process combining the best available scientific evidence with clinician expertise and patient preference. While EBP has been associated with a range of benefits, it is recognized that EBP is used suboptimally by a range of health professionals, including naturopathic doctors (NDs). Canadian NDs have expressed a high level of interest in opportunities to improve their EBP skills; however, barriers exist, including those that apply broadly to health professionals, and those that are unique to the naturopathic profession. The objective of the present project was to co-design an EBP continuing education (CE) course tailored to the needs and preferences of Canadian NDs. Design: These needs were solicited through the use of focus groups. Groups were stratified based on participants' use of evidence at baseline. The focus groups asked NDs about their definition of EBP, and their interest in an EBP course, including preferred content, and method of delivery. The focus group discussions were transcribed, and thematic analysis was completed. Subjects: Twenty-two Canadian NDs participated. Results: Participants reported a high level of understanding of EBP, a high level of interest in participating in an EBP course and provided actionable recommendations about course content and delivery. Some of the themes that emerged were consistent across the groups while others differed by stratification. Conclusions: The findings of this project will inform the development and evaluation of a future CE course.
Collapse
Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Canada
- University of Guelph, Guelph, Canada
| | | | | | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Canada
- Southern Cross University, Lismore, Australia
- University of Technology Sydney, Ultimo, Australia
- Pacific College of Health and Science, Chicago, IL, USA
| |
Collapse
|
39
|
Nickum AN, Hanneke R, Shannon R. Knowing What We Don't Know: A Survey of School Nurse Information Needs. J Sch Nurs 2023:10598405231193361. [PMID: 37559379 DOI: 10.1177/10598405231193361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Providing complex care for students requires an informed school nurse workforce. However, school nurses, many of whom work independently, may not know where to find necessary information. This study seeks to understand the information needs of school nurses by conducting a needs assessment survey within the state of Illinois. A survey was disseminated through three statewide professional listservs to determine the types of care-related questions school nurses ask as part of their regular duties and which resources they use to answer those questions. School nurses' information needs vary widely, and they rely on numerous sources to answer clinical questions. They are responsible for the well-being of hundreds to thousands of children. While they are comfortable searching for information, they are motivated to further develop research skills.
Collapse
Affiliation(s)
- Annie Nicky Nickum
- Information Services and Research, University of Illinois Chicago, Chicago, IL, USA
| | - Rosie Hanneke
- Information Services and Research, University of Illinois Chicago, Chicago, IL, USA
| | - Robin Shannon
- Population Health Nursing Science Department, University of Illinois Chicago, Chicago, IL, USA
| |
Collapse
|
40
|
Watowicz RP, Hand RK. Call for Standardized Language and Training to Bridge the Appraise/Apply Gap in Evidence-Based Dietetics Practice. J Acad Nutr Diet 2023; 123:1121-1126. [PMID: 37164109 DOI: 10.1016/j.jand.2023.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/21/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Rosanna P Watowicz
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio.
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
41
|
Yune SJ, Kim Y, Lee JW. Data Analysis of Physician Competence Research Trend: Social Network Analysis and Topic Modeling Approach. JMIR Med Inform 2023; 11:e47934. [PMID: 37467028 PMCID: PMC10398558 DOI: 10.2196/47934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Studies on competency in medical education often explore the acquisition, performance, and evaluation of particular skills, knowledge, or behaviors that constitute physician competency. As physician competency reflects social demands according to changes in the medical environment, analyzing the research trends of physician competency by period is necessary to derive major research topics for future studies. Therefore, a more macroscopic method is required to analyze the core competencies of physicians in this era. OBJECTIVE This study aimed to analyze research trends related to physicians' competency in reflecting social needs according to changes in the medical environment. METHODS We used topic modeling to identify potential research topics by analyzing data from studies related to physician competency published between 2011 and 2020. We preprocessed 1354 articles and extracted 272 keywords. RESULTS The terms that appeared most frequently in the research related to physician competency since 2010 were knowledge, hospital, family, job, guidelines, management, and communication. The terms that appeared in most studies were education, model, knowledge, and hospital. Topic modeling revealed that the main topics about physician competency included Evidence-based clinical practice, Community-based healthcare, Patient care, Career and self-management, Continuous professional development, and Communication and cooperation. We divided the studies into 4 periods (2011-2013, 2014-2016, 2017-2019, and 2020-2021) and performed a linear regression analysis. The results showed a change in topics by period. The hot topics that have shown increased interest among scholars over time include Community-based healthcare, Career and self-management, and Continuous professional development. CONCLUSIONS On the basis of the analysis of research trends, it is predicted that physician professionalism and community-based medicine will continue to be studied in future studies on physician competency.
Collapse
Affiliation(s)
- So Jung Yune
- Department of Medical Education, Pusan National University, Busan, Republic of Korea
| | - Youngjon Kim
- Department of Medical Education, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Jea Woog Lee
- Intelligence Informatics Processing Lab, Chung-Ang University, Seoul, Republic of Korea
| |
Collapse
|
42
|
Ragusa M, Tortosa F, Rada G, Vergara C, Zaragoza L, Farrell J, Torres M, Abdala V, Izcovich A, Haby M, Schunemann HJ, Garcia-Saiso S, Reveiz L. The BIGG-REC database makes available all WHO/PAHO evidence informed recommendations. J Clin Epidemiol 2023; 159:257-265. [PMID: 37059238 DOI: 10.1016/j.jclinepi.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To build and maintain a living database of the Pan American Health Organization/World Health Organization (PAHO/WHO) recommendations developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). STUDY DESIGN AND SETTING Guidelines are identified from WHO and PAHO databases. We periodically extract recommendations, according to the health and well-being targets of sustainable development goal 3 (SDG-3). RESULTS As of March 2022, the International database of GRADE guidelines (https://bigg-rec.bvsalud.org/en) database hosted 2,682 recommendations contained in 285 WHO/PAHO guidelines. Recommendations were classified as follows: communicable diseases (1,581), children's health (1,182), universal health (1,171), sexual and reproductive health (910), noncommunicable diseases (677), maternal health (654), COVID-19 (224), use of psychoactive substances (99), tobacco (14) and road and traffic accidents (16). International database of GRADE guidelines allows searching by SDG-3, condition or disease, type of intervention, institution, year of publication, and age. CONCLUSION Recommendation maps provide an important resource for health professionals, organizations and member states that use evidence-informed guidance to make better decisions, providing a source for the adoption or adaptation of recommendations to meet their needs. This one-stop shop database of evidence-informed recommendations built with intuitive functionalities undoubtedly represents a long-needed tool for decision-makers, guideline developers, and the public at large.
Collapse
Affiliation(s)
- Martín Ragusa
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Fernando Tortosa
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago de Chile, Chile
| | | | - Leslie Zaragoza
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Jenee Farrell
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Marcela Torres
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Veronica Abdala
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Ariel Izcovich
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Michelle Haby
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Holger J Schunemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St West, Hamilton, ON L8S 4L8, Canada; Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Dipartimento di Scienze Biomediche Humanitas University, Milan, Italy; Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Garcia-Saiso
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Ludovic Reveiz
- Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA.
| |
Collapse
|
43
|
van Melick N, Dietvorst M, van Oort MI, Claessens RL, Janssen RP, Bogie R, Claussen W, Greenberg EM, Grindem H, Kearney S, van Keulen M, Lips M, Macrina L, McWilliam D, Moksnes H, Norris R, Paterno MV, Picot B, Piskulic D, Prato LF, Sayer TA, Sethi F, Silvers-Granelli H, Truong L, Whalan M, Witvrouw E. Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete: Practice Guidelines Based on International Delphi Consensus. Orthop J Sports Med 2023; 11:23259671231172454. [PMID: 37492781 PMCID: PMC10363891 DOI: 10.1177/23259671231172454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 07/27/2023] Open
Abstract
Background There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries-rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation. Purpose To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel. Study Design Consensus statement. Methods A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members. Results Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria. Conclusion Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity.
Collapse
Affiliation(s)
- Nicky van Melick
- Nicky van Melick, PhD, Sports & Orthopedics Research Center, Anna Hospital, Bogardeind 2, 5664 EH Geldrop, the Netherlands ()
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Agarwal A, Rao AM, Alhazimi AM, Ismail MM, Fahmy EK. Integrating High-Impact Practices (HIPs) In Medical Curriculum At Northern Border University: Strengths, Challenges, and Examples. Cureus 2023; 15:e39938. [PMID: 37409202 PMCID: PMC10319360 DOI: 10.7759/cureus.39938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND High-Impact Practices (HIPs) are educational practices that have been shown to increase rates of student retention, engagement, and persistence to graduation which help them to become high achievers and lifelong learners. Universities strongly encourage faculty members to incorporate one or more of these HIPs in order to improve active learning among students. Students are met with a variety of experiences that are not entirely of their choice, including expectations for academic performance, interactions with faculty, staff, and peers, and extracurricular activities that may or may not match their expectations and skills. Higher retention and high-grade achievement rates are attributed to HIPs. The mechanism by which HIPs improve retention is poorly understood. AIMS AND OBJECTIVES There are numerous analyses of the objectives particular to undergraduate medical education in recent years. There have been proposed three major target categories. Undergraduate medical education has been positioned within a liberal education framework, where the main objective is to equip students with the critical thinking abilities, broad general education, and subject-specific knowledge they will need to be able to effectively problem-solve, adapt to new roles, and apply public health thinking and practices to a variety of situations. We tried to incorporate HIPs in a medical curriculum at the Faculty of Medicine, Northern Border University, by giving them topics that can be used to create public awareness about the selected objectives which may help the community greatly. METHODOLOGY Students were asked to make posters or videos on the topics and were asked to write reflections about their experience and give feedback to the coordinators for improvements and to make these HIPs better so that they can be included uniformly in the other courses as well. RESULTS AND CONCLUSIONS Based on results from a random sample of undergraduate students, we draw the conclusion that HIPs are correlated with engagement, which is the alignment of the student's critical thinking and ability to work in effective teams, group projects, learning communities, and sequence courses. HIPs have an impact on involvement among students across the world. HIPs are effective to the extent that they engage pupils, encouraging a greater commitment, which is one way to understand their success.
Collapse
Affiliation(s)
- Anshoo Agarwal
- Pathology, College of Medicine, Northern Border University, Arar, SAU
| | - Anil M Rao
- Pathology, Faculty of Medicine, Northern Border University, Arar, SAU
| | - Awdah M Alhazimi
- Physiology, Faculty of Medicine, Northern Border University, Arar, SAU
| | | | - Eslam K Fahmy
- Medical Education and Physiology, Faculty of Medicine Northern Border University, Arar, SAU
| |
Collapse
|
45
|
Chen M, Wang A, Zhou B. Exploring the core competencies of clinical nurses in chinese tertiary hospitals: a qualitative content analysis. BMC Nurs 2023; 22:166. [PMID: 37198571 DOI: 10.1186/s12912-023-01337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/13/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND With the changes in social and medical environments and people's health needs, the nursing core competency should be updated and developed promptly. This study aimed to explore the core competencies of nurses in Chinese tertiary hospitals under the new health development strategy. METHODS Descriptive qualitative research was conducted using qualitative content analysis. 20 clinical nurses and nursing managers from 11 different provinces and cities were interviewed via purposive sampling. RESULTS Data analysis revealed 27 competencies, which were grouped into three major categories according to the onion model. These categories were motivation and traits (responsibility, enterprise, etc.), professional philosophy and values (professionalism, career perception, etc.), and knowledge and skills (clinical nursing competency, leadership and management competency, etc.). CONCLUSION Based on the onion model, core competencies for nurses in Chinese tertiary hospitals were established, revealing three layers of core competencies and giving a theoretical reference for nursing managers to conduct competency training courses based on the competency levels.
Collapse
Affiliation(s)
- Meihan Chen
- Department of Public Utility, the First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Aiping Wang
- Department of Public Utility, the First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China.
| | - Baosen Zhou
- Department of Clinical Epidemiology and Evidence-Based Medicine, the First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| |
Collapse
|
46
|
Adams WE, Rogers ES, McKnight L, Lynde D. Examination of Adaptations to the Evidence Based Supported Employment Model: Individual Placement and Support. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01267-w. [PMID: 37162603 DOI: 10.1007/s10488-023-01267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/11/2023]
Abstract
Individual Placement and Support (IPS) is a long-standing and innovative employment service for individuals with mental illness with dozens of clinical trials demonstrating effectiveness. Little is known, however, about intentional adaptations to IPS, especially those outside of the context of research studies. Using an implementation science framework, we conducted an exploratory study to better understand the characteristics of stakeholder-reported adaptions to IPS, the impetus for their development, and perceived impacts. We conducted qualitative interviews to analyze and describe these adaptations. Numerous adaptations of IPS were found that address the needs of new and underserved populations both within and outside of the mental health field. Programs reported adapting IPS because of the dearth of other evidence-based employment services, to serve diverse populations in need, and based on financial incentives. Benefits of adaptations were weighed against impacts on fidelity. As evidence-based practices (EBPs) are adapted, developers of EBPs should determine how fidelity of a program or service can be assessed or preserved in light of adaptations. This is critical with the increase in different service delivery methods, new populations, new service recipient needs, and new settings in need of EBPs.
Collapse
Affiliation(s)
- Wallis E Adams
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
- Department of Sociology, California State University, East Bay, Hayward, USA
| | - E Sally Rogers
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Lauren McKnight
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
| | - David Lynde
- Independent Mental Health Consultant, Concord, NH, USA
| |
Collapse
|
47
|
McDonough CM, Poploski KM, Anderson CA, Annaswamy TM, Clark MA, Douglas NF, Flores AM, Freburger JK, Hafner BJ, Hoffman JM, Kinney AR, Ressel K, Sánchez J, Whitten MJ, Resnik L. Learning Health Systems Research Competencies: A Survey of the Rehabilitation Research Community. Phys Ther 2023; 103:pzad010. [PMID: 37079888 PMCID: PMC10118298 DOI: 10.1093/ptj/pzad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The Learning Health Systems Rehabilitation Research Network (LeaRRn), an NIH-funded rehabilitation research resource center, aims to advance the research capacity of learning health systems (LHSs) within the rehabilitation community. A needs assessment survey was administered to inform development of educational resources. METHODS The online survey included 55 items addressing interest in and knowledge of 33 LHS research core competencies in 7 domains and additional items on respondent characteristics. Recruitment targeting rehabilitation researchers and health system collaborators was conducted by LeaRRn, LeaRRn health system partners, rehabilitation professional organizations, and research university program directors using email, listservs, and social media announcements. RESULTS Of the 650 people who initiated the survey, 410 respondents constituted the study sample. Respondents indicated interest in LHS research and responded to at least 1 competency item and/or demographic question. Two-thirds of the study sample had doctoral research degrees, and one-third reported research as their profession. The most common clinical disciplines were physical therapy (38%), communication sciences and disorders (22%), and occupational therapy (10%). Across all 55 competency items, 95% of respondents expressed "a lot" or "some" interest in learning more, but only 19% reported "a lot" of knowledge. Respondents reported "a lot" of interest in a range of topics, including selecting outcome measures that are meaningful to patients (78%) and implementing research evidence in health systems (75%). "None" or "some" knowledge was reported most often in Systems Science areas such as understanding the interrelationships between financing, organization, delivery, and rehabilitation outcomes (93%) and assessing the extent to which research activities will improve the equity of health systems (93%). CONCLUSION Results from this large survey of the rehabilitation research community indicate strong interest in LHS research competencies and opportunities to advance skills and training. IMPACT Competencies where respondents indicated high interest and limited knowledge can inform development of LHS educational content that is most needed.
Collapse
Affiliation(s)
- Christine M McDonough
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathleen M Poploski
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine A Anderson
- Department of Counseling, Rehabilitation and Human Services, College of Education, Hospitality, Health and Human Sciences, University of Wisconsin, Stout, Wisconsin, USA
| | - Thiru M Annaswamy
- Department of Physical Medicine and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Penn State Health Rehabilitation Hospital, Hershey, Pennsylvania, USA
| | - Melissa A Clark
- Departments of Health Services Policy and Practice and Obstetrics and Gynecology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Natalie F Douglas
- Department of Communication Sciences and Disorders, The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Ann Marie Flores
- Departments of Physical Therapy and Human Movement Sciences and Medical Social Sciences, Feinberg School of Medicine, Northwestern University; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - Janet K Freburger
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian J Hafner
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Jeanne M Hoffman
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Adam R Kinney
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC); Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Kristin Ressel
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer Sánchez
- Department of Counselor Education, College of Education, Florida Atlantic University, Boca Raton, Florida, USA
| | - Margarite J Whitten
- Departments of Health Services Policy and Practice and Obstetrics and Gynecology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Linda Resnik
- Departments of Health Services Policy and Practice and Obstetrics and Gynecology, School of Public Health, Brown University, Providence, Rhode Island, USA
| |
Collapse
|
48
|
Al Jabri F, Kvist T, Turunen H. Core competencies of healthcare professionals in Oman: Research and evidence-based practice needs attention. Nurs Open 2023; 10:2053-2065. [PMID: 36323624 PMCID: PMC10006615 DOI: 10.1002/nop2.1453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 05/14/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
AIM The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency. DESIGN A cross-sectional design. METHODS Healthcare Professional Core Competency Instrument, consisting of 11 sub-scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t-test, ANOVA and linear regression were used for data analysis. RESULTS Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence-based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts.
Collapse
Affiliation(s)
- Fatma Al Jabri
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
49
|
Fernandez-Guzman D, Caira-Chuquineyra B, Baca-Rondan F, Yucra-Sosa MC, Ccami-Bernal F, Soriano-Moreno DR, Nieto-Gutierrez W, Benites-Zapata VA. Association between self-reported evidence-based medicine competencies and prescribing of drugs without scientific evidence against mild COVID-19 among recently graduated physicians in Peru. Heliyon 2023; 9:e15366. [PMID: 37064449 PMCID: PMC10082469 DOI: 10.1016/j.heliyon.2023.e15366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/18/2023] Open
Abstract
Objective To evaluate the association between self-rated evidence-based medicine (EBM) competencies and the prescription of drugs without scientific evidence against mild COVID-19 (present with any of the signs and symptoms of COVID-19 but who do not have shortness of breath, dyspnea, or abnormal chest imaging) among recently graduated physicians in Peru. Methods We conducted an analytical cross-sectional study where we evaluated a non-probability sample of recently graduated physicians during June and July 2021 (end of second wave of COVID-19 in Peru). Self-rated EBM competencies were assessed by four domains (formulation of a clinical question, search, analysis, and application) using a Likert scale with scores from zero to four ("Very inadequate" = 0, to "Very Adequate" = 4), it was considered as "Adequate" if the score was three or four. In addition, the variable "General competence on EBM" was rated as "Adequate" if in all domains evaluated it presented an adequate self-rating. For the outcome, drug prescription, we considered the use of ivermectin, azithromycin, other antibiotics, hydroxychloroquine, dexamethasone, and anticoagulants (drugs with no efficacy demonstrated for patients with mild COVID-19). To assess the association, we used Poisson regression models with robust variances and obtaining crude (cPR) and adjusted (aPR) prevalence ratios with their 95% confidence intervals (95%CI). Results Of a total of 239 physicians included 70.7% prescribed at least one drug without scientific evidence. A total of 51.1% reported adequate ratings in all evaluated domains of EBM. Self-rating the "Clinical Question Formulation" competency as adequate was associated with a lower frequency of prescribing medications for mild COVID-19 (aPR: 0.93; 95% CI: 0.91-0.95). While self-rating as adequate the competency of "Identify possible implications of investigations" was associated with an increase in the prescription of such drugs (aPR: 1.14; 95% CI: 1.09-1.20). Additionally, self-rating all domains as adequate were associated with less prescription (aPR: 0.93; 95% CI: 0.90-0.96). Conclusion Seven out of ten recently graduated physicians prescribed some type of medication without scientific evidence to treat patients with mild COVID-19. Having adequate self-perceived EBM competencies was associated with a lower frequency of prescribing medications without scientific evidence to manage patients with mild COVID-19.
Collapse
Affiliation(s)
| | | | - Fiorella Baca-Rondan
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Maria Cristina Yucra-Sosa
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | - Fabricio Ccami-Bernal
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | | | - Vicente A Benites-Zapata
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| |
Collapse
|
50
|
Halm MA. An objective test to measure evidence-based practice knowledge and skill competency of acute care nurses: A psychometric validation study. Worldviews Evid Based Nurs 2023. [PMID: 36916411 DOI: 10.1111/wvn.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/17/2022] [Accepted: 02/12/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. AIM The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. METHODS A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. RESULTS The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha = 0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. LINKING EVIDENCE TO ACTION The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.
Collapse
Affiliation(s)
- Margo A Halm
- Nursing Research & Evidence-Based Practice, VA Portland Health Care System, Portland, Oregon, USA
| |
Collapse
|