The evidence-based practice profiles of academic and clinical staff involved in pre-registration nursing students' education: a cross sectional survey of US and UK staff

Teaching evidence-based practice to undergraduate healthcare students Educators' knowledge, skills, attitudes, current practice, perceived barriers, and facilitators: A Danish cross-sectional study

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.

The evidence-based practice teaching competence of clinical preceptors at different stages of innovation-decision process: A cross-sectional survey in traditional Chinese medicine hospitals

BACKGROUND

Traditional Chinese Medicine Nursing Clinical Preceptors (TCMN-CPs) are crucial to cultivate undergraduates' evidence-based practice (EBP) competence during clinical practicum in traditional Chinese Medicine (TCM) hospitals. However, the TCMN-CPs' EBP teaching competence is unclear. Underpinned by Rogers' innovation-decision process, our study aimed to investigate TCMN-CPs' EBP teaching competence and the related characteristic factors at five stages of knowledge, persuasion, decision, implementation and confirmation.

METHODS

An online survey was conducted by using a modified evidence-based practice teaching competence questionnaire (EBPT-COQ) encompassing attitude, knowledge/skill and practice of EBP teaching in four TCM teaching hospitals in Beijing, China.

RESULTS

A total of 654 TCMN-CPs were included, with a response rate of 91.47 %. Most TCMN-CPs were in knowledge stage (339, 51.83 %), followed by the persuasion stage (166, 25.38 %), decision stage (123, 18.81 %), implementation stage (23, 3.52 %) and confirmation stage (3, 0.46 %). The total and dimension scores of EBPT-COQ increased as the diffusion stage developing, the confirmation stage was the highest (5.48 ± 0.80). Twenty-three items' mean scores were higher than 4 points (95.83 %), except for "Research skills" (3.58 ± 1.38). The related characteristic factors were 1) age (Z = -4.177), working experience (H = 11.087), clinical teaching experience (H = 12.602), management position (Z = 2.565), research experience (Z = -2.867) and EBP training (Z = 3.146) at Knowledge stage; 2) research experience (ZPersuasion = -2.617; ZDecision = -3.510), EBP training (ZPersuasion = 2.528; ZDecision = 3.433) at Persuasion and Decision stage (all P<0.05). And the first three stages TCMN-CPs' EBPT-COQ scores were positively correlated with TCMN-CPs' attitude toward clinical teaching (r = 0.244-0.331, P<0.001).

CONCLUSIONS

Most of the TCMN-CPs' EBP teaching status are in the first three diffusion stages. Though their attitude, knowledge/skills and practice to EBP teaching competence have gradually improved with the deepening of the diffusion stage, much efforts should be made to keep progressing. TCMN-CPs' qualifications of EBP teaching could include rich clinical work and teaching experience, enjoying teaching. Nursing managers, with higher EBP teaching competence, might play a crucial role in promoting the diffusion of EBP teaching. All TCMN-CPs showed an inadequacy of research skills of EBP teaching. Therefore, it is warranted to explore the minimum research skill requirements for EBP teaching and to establish academic-practice partnerships.

Knowledge, attitude and use of evidence based practice (EBP) among registered nurse-midwives practicing in central hospitals in Malawi: a cross-sectional survey

BACKGROUND

Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi.

METHODS

The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.9%). The study used a paper version questionnaire to collect the data. The data were analysed using both descriptive and inferential statistics in the Statistical Product and Service Solutions version 23. Descriptive statistics were calculated to summarise overall knowledge levels, attitudes, and use of nurse-midwives as percentages based on their scores on the assessment scale (1 to 7 Likert scale) in the EBP questionnaire. Non-parametric Mann-Whitney and Kruskal-Wallis tests were carried out to compare evidence-based practice scores based on demographics. Pearson's correlation (r) and stepwise regression analysis were further performed to analyse the relationship between the knowledge, attitude and use of nurse-midwives on the overall EBP of nurse-midwives.

RESULTS

The average scores (mean±SD) of evidence-based practice amongst nurse-midwives were 78.7 ± 19.6 for attitude, 70.6 ± 15.1 for knowledge levels, 57.8 ± 23 for use, and 68.9 ± 14.2 for the overall EBP. Higher educational qualification was associated with higher scores in knowledge levels (P = 0.02). Research experience was associated with higher scores in nursing use (P = 0.005), and higher overall evidence-based practice were associated with both research experience (P = 0.035) and educational qualification (P = 0.004). Nurse-midwives attitude was affected by clinical experience (P = 0.006) and the hospital where nurse-midwives worked (P = 0.016). There was no significant difference in the EBP scores of nurse-midwives based on gender and/or their administrative roles in their respective central hospitals.

CONCLUSION

It is important to develop the knowledge or skills of nurse midwives in order to enhance evidence-based practice amongst nurse-midwives in Malawian hospitals. The results can be used by nurse managers, nurse educators, policy makers at the Ministry of Health and Nurses and Midwives Council of Malawi to enhance implementation of EBP.

Predictors of evidence-based practice competency among Tunisian nursing students

BACKGROUND

Evidence-based practice (EBP) is an important competency of undergraduate nursing students which should be cultivated before graduation by increasing future healthcare providers' knowledge, skills and attitudes towards EBP. This study aimed to describe nursing students' competencies (attitudes, knowledge, skills) in Evidence-based practice (EBP) and to determine factors predicting EBP competency.

METHODS

A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse (Tunisia) among 365 nursing students. Data were collected using the validated Evidence Based Practice Competencies Questionnaire (EBP-COQ). Multiple linear regression was performed to determine factors predicting EBP competencies.

RESULTS

The overall score of EBP-COQ questionnaire was 3.26 ± 0.53 out of 5. The attitude, skills and knowledge subscales received 4.04 ± 0.41; 3.05 ± 0.77 and 2.70 ± 0.74 as mean scores respectively. Multiple linear regression analysis (table 4) revealed that significant related factors were academic level (β = 0.271, p = 0.001), English-language reading skills (β = 0.435, p < 0.001), facing staff resistance in implementing a new evidence-based procedure (β = - 0.081, p = 0.035) difficulties in obtaining full-text papers (β = - 0.127, p < 0.001) and training in methodology (β = 0.232, p < 0.001) and also in statistics (β = 0.205, p < 0.001).

CONCLUSIONS

These results help to understand students' attitudes, knowledge and skills in EBP and can be therefore a starting point to develop effective strategies for EBP curricula.

Evidence-based practice profiles of nurses: a transcultural study†

Objective

To compare (i) the evidence-based practice (EBP) profiles and (ii) socio-demographic characteristics of nurses in 4 selected low-middle income countries (LMICs).

Methods

A cross-sectional survey was conducted among 677 nurses from 4 hospitals in 4 countries (Afghanistan, Ghana, Iran, and Uganda).

Results

The findings revealed that there are significant differences between the 3 EBP subscales (that is, practice/use, attitude, and knowledge/skill) across the 4 countries (P < 0.05). No significant EBP differences were identified across age groups and gender in the subscales of practice, knowledge, and attitude. Practice and knowledge subscales were significantly associated with working schedules (that is, part-time and full-time) (P < 0.05). Analyses also revealed significant differences between attitude and knowledge subscales and working experience (P < 0.05).

Conclusions

Nurses in the 4 countries have moderate practice, attitude, and knowledge/skills of EBP. Nurses in LMICs require continuous professional development programs and support to enhance their practice and knowledge regarding EBP in clinical settings.

Evidence-based healthcare competence of social and healthcare educators: A systematic review of mixed methods

BACKGROUND

Social and healthcare operating environments are constantly evolving, so educators have major responsibility for ensuring that Evidence-Based Healthcare is included in the education of future healthcare professionals and applied in their practice. A holistic understanding and implementation of evidence-based healthcare competence is critical to the delivery of appropriate, relevant, and effective healthcare.

AIM

To identify and describe social and healthcare educators' EBHC competence according to the five main components of the JBI model and associated factors to it.

METHODS

A mixed-methods systematic review was conducted, with inclusion and exclusion criteria identified according to PICo and PEO inclusion criteria for qualitative and quantitative studies, respectively. Five databases-the CINAHL (EBSCO), PubMed, Scopus, Medic and ProQuest databases- were searched in June 2020. In total, 12 original studies (qualitative and quantitative) were included for quality appraisal, data extraction and narrative synthesis.

RESULTS

Key competence areas addressed in the selected studies were integrated into the four components of the JBI model of EBHC (evidence generation, synthesis, transfer, and implementation, and focus on its ultimate goal: global health). In the majority of chosen studies', it was found that educators had a positive attitude towards EBHC and wanted to stay up-to-date in the areas of global health and collaboration. Educators demonstrated their abilities to locate, appraise, and interpret the best current relevant evidence. They knew how to integrate EBHC into their teaching and had strong communication skills in evidence transfer. Their EBHC competence was strongest in the educational context and educators could transfer evidence when teaching but were not able to translate it into how to implement EBHC in clinical care. In addition to higher academic education and work experience, organizational support and continuous education reportedly play essential roles in development of educators' EBHC competence.

CONCLUSION

Measures are needed to maintain and improve social and health educators' EBHC competence and develop robust methods to reliably assess it.

Evidence-Based Practice Beliefs, Implementation, and Organizational Culture and Readiness for EBP Among Nurses, Midwives, Educators, and Students in the Republic of Ireland

BACKGROUND

Evidence-based practice (EBP) is an approach to health care that combines best available evidence, healthcare professionals' expertise, and patient preferences, yielding benefits for patients, healthcare professionals, and organizations. However, globally, EBP implementation remains inconsistent among nurses. Exploring this in an Irish context will establish a national baseline from which progress can be made on system-wide integration of EBP in nurse and midwife (i.e., clinician) practice, nursing/midwifery education, and the Irish healthcare system.

AIM

To establish clinician, educator, and student's EBP beliefs, knowledge, and implementation, and the organizational culture of the clinical and educational settings within the Republic of Ireland.

METHODS

Using a descriptive study design, a national survey with demographic questions, uniquely focused EBP scales, and an open-ended question were administered to clinicians, nursing/midwifery educators, and students. Ethical review was obtained. Descriptive and inferential statistics were used to analyze the quantitative data.

RESULTS

Clinicians, educators, and students reported positive beliefs about EBP (M = 59.98, SD 8.68; M = 87.72, SD = 10.91; M = 55.18, SD = 10.29, respectively). Beliefs regarding their ability to implement EBP were lower overall. EBP implementation was low across all groups (clinicians: M = 12.85, SD = 14; educators: M = 31.09, SD = 16.54; students: M = 16.59, SD = 12.11). Clinicians, educators, and students reported varying perceptions of organizational support and readiness for EBP (M = 74.07, SD = 19.65; M = 86.43, SD = 15.01; M = 93.21, SD = 16.21, respectively). Across all measures, higher scores indicated higher beliefs, implementation, and organizational culture and readiness for EBP.

LINKING EVIDENCE TO ACTION

Clinicians have a unique opportunity to facilitate system-wide integration of EBP. Furthermore, given the variable EBP knowledge, beliefs, and implementation, opportunities to enhance these attributes abound, particularly when supported by their organizations. This study established a contemporary baseline in Ireland from which to engage the identified strengths, challenges, and opportunities required to craft an organizational culture and environment that supports and advances an EBP approach to nursing and midwifery practice and education.

Building evidence-based practice competencies among rehabilitation students: a qualitative exploration of faculty and preceptors' perspectives

Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. We gathered data from seven focus groups and an individual interview with a sample of 24 faculty and 15 preceptors, i.e., clinical supervisors. Data collected were subjected to inductive thematic content analysis. We identified three overarching themes and corresponding strategies. First, "Recognizing EBP as a multifaceted concept" denoted participants' lack of consensus regarding the meaning and scope of EBP, and their awareness of such discrepancies. Second, "Complexity of EBP is at the core of teaching practices and experiences" referred to participants' perception of EBP as a complex process involving high-level cognitive skills, which influenced their teaching practices and challenged students and themselves. Third, "Connections and divides between research and practice" represented the limited and delicate connection between faculty and preceptors, the factors either bridging or maintaining the gap between them, and the impacts of such connections and divides on teaching. Improving collaboration between faculty and preceptors constitutes an essential first step towards more effective EBP training programs in rehabilitation that could be facilitated through online communities of practice or integrated knowledge translation research projects.

Nursing educators' and undergraduate nursing students' beliefs and perceptions on evidence-based practice, evidence implementation, organizational readiness and culture: An exploratory cross-sectional study

AIMS

To describe the undergraduate nursing students' and nursing educators' evidence-based practice beliefs, their extent of evidence-based practice implementation and their perspectives regarding organizational culture for evidence-based practice. To identify any relationship between the mentioned variables.

BACKGROUND

The integration of evidence-based practice in nursing curricula is crucial to educate nursing students to incorporate evidence-based practice in their future clinical practice. Therefore, to promote its integration within nursing education, it is important to deeply understand how prepared academic institutions are for teaching about and supporting evidence-based practice integration.

DESIGN

Cross-sectional study.

METHODS

Nursing educators and undergraduate nursing students from nine Portuguese nursing schools were invited to participate in this study through an electronic survey comprising socio-demographic questions and the scales.

RESULTS

Sixty-eight nursing educators replied to the survey. Most were female, have PhD and have evidence-based practice training. They showed mean scores of 88.92 ± 8.18 for evidence-based practice beliefs, 40.20 ± 18.93 for evidence-based practice implementation and 80.59 ± 17.52 for evidence-based practice organizational culture and readiness. Concerning nursing educator sample, there were moderate and statistically significant relationship between: evidence-based practice beliefs and implementation; and evidence-based practice beliefs and organizational culture and readiness for school-wide integration of evidence-based practice. Between evidence-based practice implementation and organizational culture and readiness for school-wide integration of evidence-based practice, there was a small relationship. One hundred and sixty-seven undergraduate nursing students answered the survey. Mostly, they were female and were in third or fourth year of their nursing degree. Similarly, to educators, students showed mean scores of 58.69 ± 6.92 for evidence-based practice beliefs, 32.37 ± 16.97 for evidence-based practice implementation and 84.20 ± 23.48 for evidence-based practice organizational culture and readiness. Regarding undergraduate nursing student sample, there were moderate and statistically significant relationship between the different variables.

CONCLUSIONS

Both nursing educators and undergraduate nursing students had strong evidence-based practice beliefs, but low levels of evidence-based practice implementation. In nursing educators' and undergraduate nursing students' perspectives, there were opportunities in their schools for the development of an evidence-based practice culture. Based on results, support for development and testing of interventions, specifically tailored for promoting evidence-based practice implementation in nursing educational contexts, is recommended.

Assessing Evidence-Based Practice Knowledge: An Innovative Approach by a Nursing Research Council

OBJECTIVE

The aim of this study was to describe the structure and processes implemented by nursing research councils to conduct a nurse-led research study at an urban community teaching hospital.

BACKGROUND

We assessed nurses' knowledge, skills, and attitudes toward evidence-based practice (EBP) to inform development plans.

METHODS

This is an institutional review board-approved single-site cross-sectional anonymous online survey (Evidence-Based Practice Questionnaire [EBPQ]) emailed to 850 participants. Data were analyzed using SPSS v25 (Armonk, New York).

RESULTS

Initial response rate was 11%. Deployment of new strategies achieved an overall response rate of 57.5%. EBPQ subscale scores were highest for "attitude," followed by "knowledge/skills," and "practice." Lowest-scoring items included critical appraisal of literature, converting information needs into a question, time for new evidence, information technology, and research skills.

CONCLUSIONS

Our EBPQ scores were consistent with prior findings. Our strategies provide a framework for other institutions in similar stages of implementing EBP and nurse-led research initiatives.

Clinical learning environment of nursing and midwifery students in Ghana

Background

Data on student experience of the clinical learning environment in Ghana are scarce. We therefore aimed to assess students’ evaluation of the clinical learning environment and the factors that influence their learning experience.

Methods

This was a cross-sectional survey of 225 undergraduate nursing and midwifery students. We used the Clinical Learning Environment and Supervision + Nurse Teacher (CLES +T) evaluation scale to assess students’ experience of their clinical placement. The association between student demographic characteristics and clinical placement experience was determined using t-test or ANOVA.

Results

Most of the sampled students were Nurses (67%) and in the third year of training (81%). More students received supervision from a nurse (57%) during clinical placement and team supervision (67%) was the most common during clinical placement. Nursing students were more likely to rate their clinical experience better than midwifery students (p=0.002). Students who had increased contact with private supervisors were also more likely to rate their experience higher (p=0.002). Clinical experience was also rated higher by students who received successful supervision compared to those who had unsuccessful or team supervision (p=0.001).

Conclusion

Team supervision is high in health facilities where students undertake clinical placement in Ghana. Frequent contact with private supervisor and successful supervision are associated with better rating of clinical experience among Ghanaian undergraduate nursing and midwifery students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-020-00533-8.

Senior Nursing Students' Perceptions of Their Readiness for Practice Prior to Final Year Internship: Part 2-A Qualitative Perspective

INTRODUCTION

Preparing nursing students for their role as future registered nurses is an essential and complex endeavor. It is a responsibility that is shared between academic and clinical health care organizations. Arguably, the prevailing economic climate places additional pressures on the fiscal and manpower aspects of health care management. Maintaining a quality practice learning environment for students against this backdrop has become increasingly challenging. Indeed, students themselves have raised these concerns. The authors sought to explore these concerns further with the students, and this article will present the qualitative findings of a study exploring final-year students' perceptions of their readiness for practice in a school of nursing in the Republic of Ireland.

METHODS

Two open-ended questions were included on a quantitative survey, which sought to ascertain students' self-reported level of readiness for oral medication administration. A convenience sample of 24 final-year students undertaking a 4-year BSc (honors) in general nursing program was involved. Content analysis was employed to explore and elicit the key components of participants' written responses to the open-ended questions.

RESULTS

Participants highlighted the constraints that they have witnessed in some practice areas, the consequent impact on the availability of particular learning opportunities, and their level of preparedness for practice. Three key areas of concern emerged including medication management, patient caseload management, and communication. A recurring issue centered on the delegation of the more fundamental nursing tasks to students by qualified nurses, to the detriment of students' experience of the more complex aspects of holistic patient care. This proved quite exasperating for these participants.

CONCLUSION

This study demonstrates that final-year undergraduate nursing students in a school in the Republic of Ireland are concerned about their readiness for practice. Specific areas of concern for students relate to their capacity to develop competence for registered practice. These findings provide both a timely reminder and opportunity for those charged with the responsibility of preparing nurses for registration, in both clinical and academic settings, to raise awareness of factors that can impact on the student experience and learning in practice. They highlight the importance of a collaborative approach to addressing the issues that emerged, if competence and patient safety are to be safeguarded and maintained in the future.

Pain relief during wound care for patients with a deep open wound in an orthopedic trauma department: a best practice implementation project

OBJECTIVES

The aim of this project was to implement best practice in pain relief during wound care for patients with deep open wounds in the orthopedic trauma department of a tertiary teaching hospital in China.

INTRODUCTION

Patients with deep open wounds often suffer from severe pain during wound care. Inadequate pain relief for these patients calls for evidence-based changes to close the gap between current and best practice.

METHODS

The current quality improvement project was carried out over six months using the JBI Practical Application of Clinical Evidence System (JBI PACES). A baseline and two follow-up audits of wound pain management practice were conducted to identify practice gaps and post implementation compliance in pain management in wound care. The sample comprised 20 patients and two dressing nurses. The Getting Research into Practice tool identified barriers to and strategies for improvement in practice. The patients' pain experiences were measured following the implementation of changes.

RESULTS

The baseline audit identified poor compliance with best practice. Following implementation of the recommended changes, some significant improvements in practice were made by the dressing nurses; however, these were inadequately maintained at the second post implementation audit. Patients' pain scores improved following the nurses' practice changes (t = 2.272, P > 0.05).

CONCLUSION

The implementation of best practice in pain relief during wound care for patients with deep open wounds has led to significant improvement in nurses' performance in the orthopedic trauma department. The most challenging barriers involved interdisciplinary collaborations and organizational structure.

Knowledge, Attitude and Implementation of Evidence-Based Practice among Physiotherapists Working in the Kingdom of Saudi Arabia: A Cross-Sectional Survey

The current study aimed to investigate knowledge, attitudes, and implementation of evidence-based practice among physiotherapists working in Saudi Arabia. A sample of physiotherapists working in various outpatient settings in Saudi Arabia participated in this survey. Sixty-four therapists (30 females, 34 males) completed a 28-item survey questionnaire. Approximately half of the participants indicated that evidence-based practice was useful and important for clinical practice. About 60% of the participants reported that they have adopted the evidence-based practice on a regular basis. Participants who had a membership in a physiotherapy organization and had advanced degrees showed more positive attitudes (t = −2.31, p = 0.02 and t = −2.15, p = 0.04, respectively) and greater levels of knowledge (t = −2.32, p = 0.02 and t = −3.86, p = 0.001, respectively) regarding evidence-based practice terminology. Furthermore, place of training (trained overseas) was associated with a positive attitude towards literature findings (t = 2.26, p = 0.03). The results of this study demonstrated that participants reported that evidence-based practice had not been extensively implemented, despite positive attitudes regarding its implementation among physiotherapists practicing in Saudi Arabia.

Evidence based practice among healthcare providers: a cross-sectional study

PURPOSE

Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016.

DESIGN/METHODOLOGY/APPROACH

This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers' attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software.

FINDINGS

A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue.

PRACTICAL IMPLICATIONS

Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles.

ORIGINALITY/VALUE

The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers' knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.

Knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students: A survey at three universities in Colombia, Chile and Spain

Teaching nursing students about the model of evidence-based practice is a challenge for university faculty. The aim of this study was to measure knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students, as well as associated factors. The study involved a cross-sectional design using a survey of all students enrolled in a Bachelor of Nursing programme (1st to 4th year) in three nursing faculties of universities in Chile, Colombia and Spain. The Spanish version of the Evidence-Based Competence Questionnaire was used to measure knowledge, skills, attitudes and overall competency. In total, 875 students completed the questionnaire. The overall score of competency in evidence-based practice was similar in all three universities (range 1-5) (3.63 in Chile, 3.58 in Colombia and 3.68 in Spain). The score of self-rated attitudes was strongly correlated with the overall competency measured. More hours of training in research methods and reading nursing journals articles in the last month were the factors associated with higher scores in evidence-based practice competency. The undergraduate nursing students at the three universities surveyed obtained a high score in overall competency in evidence-based practice. No differences were found among them, despite the different approaches used in educational programmes.

Health professions faculty beliefs, confidence, use, and perceptions of organizational culture and readiness for EBP: A cross-sectional, descriptive survey

BACKGROUND

Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP.

OBJECTIVES

The purpose of this study was to describe; 1) health profession faculty beliefs about and confidence in their ability to teach and implement EBP, 2) use of EBP for education, 3) organizational culture and readiness for EBP; and to determine whether relationships exist among these variables.

DESIGN

This study used a cross-sectional, descriptive survey design.

SETTING AND PARTICIPANTS

College of Nursing (CON) and College of Health Professions (CHP) faculty from a university located in the Northeast, United States. Faculty were defined as anyone teaching a course for the CON or CHP during the fall of 2016.

METHODS

Faculty were invited to complete an electronic survey measuring EBP beliefs, EBP use, and EBP organizational culture and readiness. The survey was comprised of three tools developed specifically for health professions educators in 2010 by Fineout-Overholt & Melnyk.

RESULTS

Sixty-nine faculty returned usable surveys (25.5% response rate). Mean EBP beliefs score was 89.49 (SD = 10.94) indicating respondents had a firm belief in and confidence in their ability to implement and teach EBP. Mean EBP use was 32.02 (SD = 20.59) indicating that respondents taught and implemented EBP between 1 and 3 times in the last 8-weeks. Mean EBP culture and readiness score was 90.20 (SD = 15.23) indicating essential movement toward a sustainable culture of college-wide integration of EBP. Mean scores for beliefs/confidence were higher for full-time clinical faculty compared to other groups [F_{(2, 55)} = 0.075, p = 0.928; ηp² = 0.003)]. Adjunct faculty reported higher EBP behaviors expected by health profession educators in the last 8-weeks compared to other groups [F_{(2, 55)} = 0.251, p = 0.779; ηp². =0.009)]. Adjunct faculty had the highest mean scores on OCRSIEP-E followed by full-time clinical faculty. These group differences in OCRSIEP-E were statistically significant [F_{(2, 49)} = 7.92, p = 0.001; ηp² = 0.244)]. OCRSIEP-E was significantly different between full-time tenure/tenure track faculty (M = 78.0, SD = 12.58) and full-time clinical faculty (M = 91.37, SD = 14.79, p = 0.027) and between full-time tenure/tenure track faculty and adjunct faculty (M = 97.19, SD = 12.39, p = 0.001).

CONCLUSIONS

Faculty adoption of EBP as a foundational pillar of teaching is essential. Research is needed to define the scope of the problem internationally. Organizations need to set standards for faculty teaching in the health professions to be EBP proficient. Programs preparing faculty to teach in nursing and other health professions must include educator EBP competencies.

Egyptian and Jordanian nurse educators' perception of barriers preventing the implementation of evidence-based practice: A cross-sectional study

BACKGROUND

Studies discussing nurse educators' attitudes, knowledge/skills, practicing of evidence-based practice (EBP) and barriers encountered towards implementation is somewhat limited.

OBJECTIVE

The study aimed to identify the attitudes, perceived knowledge/skills, and implementation of evidence-based as perceived by nurse educators, in Egyptian and Jordanian universities, and to assess factors preventing them from adopting it in nursing program.

DESIGN/SETTING/RESPONDENTS/METHODS

A cross-sectional design was conducted including two groups from Egypt and Jordan. Two questionnaires: (i) The Evidence-Based Practice Questionnaire (EBPQ) and (ii) The Developing Evidence-Based Practice Questionnaire (DEBPQ) and a demographic data sheet were used. Data were analyzed using SPSS version 20 and descriptive and inferential statistics tabulated.

RESULTS

Majority of the respondents (85.5%) were females, <40 years old (62.1%), and from medical-surgical nursing departments (49.2%). The mean score of EBPQ was 4.96 ± standard deviation 0.91. Frequency of practicing EBP and attitudes toward EBP scores were similar between nurse educators in both countries (p > 0.05). However, the Jordanian staff had a remarkably higher perceived knowledge/skills of EBP than their Egyptian counterparts (Mean Rank = 79.98 & 57.63 respectively, at p = 0.004). There was a statistically significant positive, moderate correlation between attitudes, knowledge/skills and frequency of practicing EBP among nurse educators in both countries. The highest correlation observed for attitudes and frequency of practicing EBP was among Jordanian staff (r = 0.707, p < 0.000). Egyptian nurse educators had significantly higher perceived barriers to finding and reviewing evidence than their Jordanian counterparts (p = 0.000). However, both groups had similar perceived barriers related to changing practice and support from colleagues.

CONCLUSIONS

Egyptian and Jordanian nurse educators, equally, hold positive attitudes toward adopting EBP. However, they encounter many barriers to implement it.

Endeavoring to Contextualize Curricula Within an EBP Framework: A Grounded Theory Study

Adopting evidence-based practice (EBP) principles in undergraduate education can facilitate nursing students' appreciation of EBP. Using grounded theory method, this study aimed to explore processes used by nurse academics while integrating EBP concepts in undergraduate nursing curricula across Australian universities. Twenty-three nurse academics were interviewed and nine were observed during teaching of undergraduate students. In addition, 20 unit/subject guides were analyzed using grounded theory approach of data analysis. The theory " On a path to success: Endeavoring to contextualize curricula within an EBP framework" reflects academics' endeavors toward linking EBP concepts to practice, aiming to contextualize curricula in a manner that engages students within an EBP framework. However, academics' journeys were influenced by several contextual factors which require strategies to accomplish their endeavors. In conclusion, initiatives to minimize barriers, faculty development, and provision of resources across educational and clinical settings are fundamental to achieving undergraduate curricula underpinned by EBP concepts.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students

BACKGROUND

The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP.

OBJECTIVES

This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles.

DESIGN

A longitudinal panel study.

SETTINGS AND PARTICIPANTS

A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014.

METHODS

Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence.

RESULTS

Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory.

CONCLUSIONS

Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice.

Early predictors of study success in a Dutch advanced nurse practitioner education program: A retrospective cohort study

BACKGROUND

Study delay and attrition are major concerns in higher education. They cost time and effort, and threaten the availability of higher qualified professionals. Knowing early what factors contribute to delay and attrition may help prevent this.

OBJECTIVE

The aim of this study was to examine whether student characteristics, including a literature study report grade as a proxy of cognitive abilities, predicted study success in a dual advanced nurse practitioner education program.

METHODS

Retrospective cohort study, including all 214 students who between September 2009 and September 2015 started the two-year program at the HAN University of Applied Sciences in Nijmegen, the Netherlands. Study success was defined as having completed the program within the envisaged period. Variables examined included: age, gender, previous education (bachelor's degree or in-service training in nursing), work setting (general health, mental health, public health, or nursing home care), and literature study report grade (from 1 to 10). A hierarchical logistic regression analysis was performed.

RESULTS

Most students were female (80%), had a bachelor's degree in nursing (67%), and were employed in a general healthcare setting (58%). Mean age was 40.5years (SD 9.4). One hundred thirty-seven students (64%) had study success. Being employed in a general healthcare setting (p≤0.004) and a higher literature study report grade (p=0.001) were associated with a higher study success rate.

CONCLUSION

In advanced nurse practitioner education, study success rate seems associated with the student's cognitive abilities and work field. It might be worthwhile to identify students 'at risk of failure' before the start of the program and offer them extra support.

Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China

Objective. This study was to describe RNs' attitude, knowledge, and practice on evidence-based practice (EBP) in traditional Chinese nursing field and to estimate the related sociodemographic and professional factors. Methods. A multiple institutional cross-sectional survey design with self-reported EBP Questionnaire (EBPQ) and self-designed questionnaires were used. Results. The average scores of the total EBPQ were with a mean of 4.24 (SD = 0.79). The score of attitude was the highest one, followed by the knowledge score, and the lowest one is practice. RNs with longer experience reported stronger EBP knowledge (H = 6.64, P < 0.05). And RNs under higher working pressure reported less positive attitudes (ρ = 0.17, P < 0.001), whereas RNs holding negative professional attitude reported lower scores (Spearman's ρ: 0.12 to 0.15, P < 0.001). Significant statistics were found between RNs with research experience and without in attitude (t = −2.40, P < 0.05) and knowledge (t = −2.43, P < 0.05). Conclusions. Respondents generally viewed EBP positively and their attitudes towards EBP tended to be more positive than knowledge and practice of EBP. Data also showed that longer working experience, having administrative position, research experience, lighter working load, and better professional attitude might facilitate EBP.

How do nurse academics value and engage with evidence-based practice across Australia: Findings from a grounded theory study

BACKGROUND

Integrating evidence-based practice (EBP) into undergraduate education and preparing future nurses to embrace EBP in clinical practice becomes paramount in today's complex and evolving healthcare environment. The role that EBP plays in the practical lives of nursing students will depend on the degree to which it is promoted by academics, how it is incorporated into courses and its application to clinical setting. Hence, nursing academics play a crucial role in influencing its integration into curricula. Drawn from a larger doctoral study, this paper presents findings discussing how nurse academics value and engage with EBP.

METHODS

Grounded theory was employed to explore processes used by nursing academics while incorporating EBP into teaching and learning practices. Twenty-three academics across Australian universities were interviewed. Nine were also observed while teaching undergraduate students. Data were collected from semi-structured interviews and non-participant observation. In keeping with the tenets of grounded theory, data collection and analysis continued until theoretical saturation was reached. In total, four categories emerged. This paper focuses on the category conceptualised as Valuing and Engaging with EBP.

RESULTS

How nursing academics valued and engaged with EBP was closely associated with meanings they constructed around understanding it, attitudes and commitment to implementation while teaching and working clinically. Different opinions also existed in regard to what actually constituted EBP. However, they engaged with and valued EBP by keeping themselves up-to-date, being involved in research activities, using evidence in teaching, therefore leading by example. Participants identified a number of barriers influencing their engagement with EBP including heavy workloads, limited time, lack of commitment within their schools, lack of confidence with teaching EBP, and complexity of EBP application. Faculty clinical practice, committed academics, workload management and continuing education were highlighted as facilitators.

CONCLUSION

A number of barriers prevented academics from fully engaging with EBP at academic or practice levels. Academic institutions and practice settings need to employ strategic planning to overcome such barriers.

'An exploration of the health beliefs of Chinese nurses' and nurse academics' health beliefs: A Q-methodology study'

Q-methodology was used to investigate the health beliefs of Chinese clinical nurses and nurse academics. Twenty-eight participants from one hospital and nursing school in China were involved. The four stages of this study included: (i) concourse development from literature review, Internet searches, and key informant interviews; (ii) A pilot study to develop the Q-sample from the concourse; (iii) participants sorted the Q-sample statements along a continuum of preference (Q-sorting); and (iv) PQ data analysis using principal component analysis and varimax rotation. Five viewpoints were revealed: (i) factor 1--health management and the importance of evidence; (ii) factor 2--challenging local cultural belief, and Eastern and Western influences; (iii) factor 3--commonsense; (iv) factor 4--health and clinical practice; and (v) factor 5--health and nursing education. This study presents a need for nurses and nurse academics to think critically, examine their long-held health beliefs, and promote the use of evidence-based practice.