Achievements and challenges in baccalaureate student nurses' preparation for evidence-based nursing practice: A mixed methods study

The effect of simulation-based learning on nursing students' clinical decision-making skills: Systematic review and meta-analysis

BACKGROUND

Simulation-based education methods improve nursing students' clinical decision-making skills. It allows students to experience situations they may not encounter in a real clinical environment.

OBJECTIVES

The aim of this systematic review was to better understand the effectiveness of simulation-based education on clinical decision-making skills in undergraduate nursing students.

DESIGN

Meta-analysis of randomized controlled trials and quasi-experimental studies.

DATA SOURCES

The review included fourteen studies obtained by scanning the PubMed, EBSCO (Medline, CINAHL), OVID, Web of Science, and Cochrane databases.

REVIEW METHODS

Three authors independently screened the literature, extracted data, and assessed the quality of the included studies. The methodological quality of the studies was assessed with the Critical Appraisal Checklists for experimental and quasi-experimental studies developed by the Joanna Briggs Institute. Standardized mean difference with 95 % confidence interval was used to facilitate direct comparisons between studies. All statistical tests were performed with Review Manager 5.4 software.

RESULTS

In this study, 1614 records were reached as a result of the first screening. After examining the titles and removing duplicate articles and other articles that did not meet the research criteria according to the abstracts, 48 articles were included in the full-text analysis. Three researchers read the studies (n = 48) eligible for evaluation, and 14 (n = 14) studies suitable for full-text review met all of the listed inclusion criteria and were included in the meta-analysis.

CONCLUSION

The analysis revealed that simulation-based educational practices appeared to improve undergraduate nursing students' clinical decision-making skills.

Evidence-based practice attitudes, knowledge and skills of nursing students and nurses, a systematic review and meta-analysis

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.

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

Objective

The EKAN is a reliable and validated tool for objectively measuring the evidence-based practice (EBP) knowledge of nurses. Thus, we set out to translate and culturally modify the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN), and then evaluate its validity and reliability among Chinese practicing nurses.

Methods

This cross-sectional study consisted of two phases. The first phase involved translating the EKAN into Chinese (EKAN-Chinese), using a process of forward translation, back translation, review, cultural adjustment as well as a pilot study. The second phase aimed to assess the psychometric properties of the EKAN-Chinese and establish a baseline measure of EBP knowledge among 120 nurses from a large general hospital in Beijing, China. Data were collected from August to November 2022 and analyzed with Rasch software. This study was reported using the cross-sectional STROBE checklist.

Results

The newly translated, EKAN-Chinese was pilot-tested after slight modification of four items without altering the intended meaning. The outfit unweighted mean square was 1.03 (SD = -0.13), the infit weighted mean square was 1.00 (-0.17), and the mean difficulty index ranged from -3.43 to 2.85 according to validity indices. The results of the reliability indices revealed low person reliability (0.49), high item reliability (0.96), moderate person separation index (0.99), and sufficient item separation index (4.71). The mean EKAN-Chinese sum score was 9.8 (max score = 20, SD = 2.9).

Conclusion

The newly translated EKAN-Chinese showed sufficient psychometric evidence to support use in practicing Chinese nurses. The EKAN-Chinese can be used by nurse leaders in China as a potential screening tool to 1) objectively identify nurses who need educational training in evidence-based nursing practice, and 2) gauge the effectiveness of education and training programs to improve EBP knowledge and ultimately, evidence-based care.

Impact of a teaching strategy to promote evidence-based practice on nursing students' knowledge and confidence in simulated clinical intervention choices

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.

The Effectiveness of a Critical Appraisal Skills Workshop 6 Months After Nurses' Participation

Background The aim of this study was to explore whether nursing staff retained knowledge, self-confidence, and attitudes 6 months after participating in a critical appraisal skills workshop. Method A retrospective matched case-control study was conducted to ascertain the effects of this training on the ability to appraise literature. Results Mean scores on the critical appraisal knowledge test, self-confidence, and attitudes were significantly higher in the case group compared to the control group (p < .001, p < .05, and p = .031, respectively). Conclusion Six months after the workshop, critical appraisal knowledge, self-confidence, and attitudes remained improved among the nursing staff who participated. This indicates that the workshop was effective for learning and can be used for clinical training. [J Contin Educ Nurs. 2022;53(8):372-378.].