Capability Beliefs Regarding Evidence-Based Practice are Associated with Application of EBP and Research Use: Validation of a New Measure

Instruments measuring evidence-based practice behavior, attitudes, and self-efficacy among healthcare professionals: a systematic review of measurement properties

BACKGROUND

Evidence-based practice (EBP) is well known to most healthcare professionals. Implementing EBP in clinical practice is a complex process that can be challenging and slow. Lack of EBP knowledge, skills, attitudes, self-efficacy, and behavior can be essential barriers that should be measured using valid and reliable instruments for the population in question. Results from previous systematic reviews show that information regarding high-quality instruments that measure EBP attitudes, behavior, and self-efficacy in various healthcare disciplines need to be improved. This systematic review aimed to summarize the measurement properties of existing instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy.

METHODS

We included studies that reported measurement properties of instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy. Medline, Embase, PsycINFO, HaPI, AMED via Ovid, and Cinahl via Ebscohost were searched in October 2020. The search was updated in December 2022. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, reliability, and measurement error. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were conducted in accordance with the COSMIN methodology for systematic reviews.

RESULTS

Thirty-four instruments that measure healthcare professionals' EBP attitudes, behaviors or self-efficacy were identified. Seventeen of the 34 were validated in two or more healthcare disciplines. Nurses were most frequently represented (n = 53). Despite the varying quality of instrument development and content validity studies, most instruments received sufficient ( +) ratings on content validity, with the quality of evidence graded as "very low" in most cases. Structural validity and internal consistency were the measurement properties most often assessed, and reliability and measurement error were most rarely assessed. The quality assessment results and overall rating of these measurement properties varied, but the quality of evidence was generally graded higher for these properties than for content validity.

CONCLUSIONS

Based on the summarized results, the constructs, and the population of interest, several instruments can be recommended for use in various healthcare disciplines. However, future studies should strive to use qualitative methods to further develop existing EBP instruments and involve the target population.

TRIAL REGISTRATION

This review is registered in PROSPERO. CRD42020196009. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020196009.

Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review

INTRODUCTION

Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the "EBP status quo" is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany.

METHODS

The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria.

RESULTS

Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed "sufficient" evidence for content validity, three questionnaires showed "sufficient" evidence for reliability, two questionnaires showed "sufficient" evidence for structural validity as well as internal consistency, and nine questionnaires showed "sufficient" evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested.

DISCUSSION

Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with "sufficient" content validity and, in addition, "sufficient" reliability or "sufficient" internal consistency.

CONCLUSION

Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.

Senior nursing students' reflections on deviations from guideline adherence regarding venous blood specimen collection practice: A qualitative study

BACKGROUND

Venous blood specimen collection is a common procedure within healthcare and both diagnoses as well as treatment evaluation, are often based on results from these analyses. However, studies among both students and staff have demonstrated suboptimal adherence to venous blood specimen collection practice guidelines which in turn might jeopardize patient safety.

OBJECTIVES

This study aimed to describe final semester nursing students' experiences of deviations from venous blood specimen collection practice guidelines during clinical training.

METHODS

This study adopted a qualitative design. Twentysix final (6th) semester nursing students were recruited through purposive sampling at a Swedish university. Data were collected through semi-structured, face-to-face, focus group interviews in September 2015. The transcribed interviews were analyzed using qualitative content analysis.

RESULTS

The students' experiences generated two categories; 1) Striving to blend in (subcategories Feeling uncomfortable and Adapting to the prevailing practice culture) and 2) Diminished confidence (subcategories Being confused due to inconsistency and Being uncertain about guideline usefulness) forming the overall theme Being a copycat.

CONCLUSION

The research concludes that nursing students adapt to the prevailing practice culture encountered during clinical training, often at the expense of guidelines adherence. Since the students are being assessed during clinical training, the eagerness to belong to the team and be well-liked might be stronger than the ambition to follow guidelines. As a consequence, nursing students in clinical training might become copycats by aligning themselves with the prevailing practice culture which in turn might jeopardize adherence with VBSC guideline practice and thereby patient safety. With the ambition to support nursing students' learning in clinical training, facilitators of learning to comprise both students and supervisors need to be further addressed.

TWEETABLE ABSTRACT

Nursing students adapt to the prevailing venous blood sample collection practice culture and become copycats.

Effet d’un club de lecture sur le sentiment d’efficacité personnelle, les attentes et les intentions d’étudiantes en sciences infirmières à l’égard de l’utilisation des résultats probants

INTRODUCTION

Nursing associations require that nurses develop the skills to integrate evidence into practice to support the quality of care.

CONTEXT

Lack of self-confidence in the operational steps of evidence-based practice was identified as a barrier to integrating evidence into nursing practice.

OBJECTIVE

To assess the effect of a journal club (JC) on nursing students' self-efficacy (SE), expectations, and intentions to use evidence.

METHOD

Quasi-experimental, longitudinal approach with a non-randomized comparison group.

RESULTS

The development of SE toward the use of evidence-based practices favored students who participated in the JC (n=48) compared to students who received a conventional educational modality (CEM) (n=50). However, there was no significant group x time interaction effect on expectations or intentions.

DISCUSSION

The significant positive changes beyond the CEM may be explained by the fact that the JC incorporated modes of influence on SE.

CONCLUSION

The positive effect associated with the JC on SE is difficult to sustain without continued practice. It is important to maintain high outcome expectations within nursing training.

Evidence-Based Practices and Use among Employees and Students at an Austrian Medical University

Developed in the pre-internet era in the early 1980s, empirical medical practice, i.e., evidence-based practice (EBP) has become crucial in critical thinking and statistical reasoning at the point-of-care. As little evidence is available so far on how EBP is perceived in the Austrian academic context, we conducted a cross-sectional online survey among a nonrandom purposive sample of employees and students at the Medical University Vienna, Austria (total n = 1247, 59.8% females). The German questionnaire assessed both EBP capability beliefs and EBP use, with the respective indices both yielding good internal consistency. We conducted subgroup comparisons between employees (n = 638) and students (n = 609). In line with Bandura's self-efficacy theory, we found a correlation between EBP capability beliefs and EBP use, with higher scores reported in the employee group. The results indicated that the participants did not strictly follow the sequential EBP steps as grounded in the item-response theory. Since its emergence, EBP has struggled to overcome the dominating traditional way of conducting medicine, which is also known as eminence-based medicine, where ad hoc decisions are based upon expert opinions, and nowadays frequently supplemented by quick online searches. Medical staff and supervisors of medical students should be aware of the existing overlaps and synergies of these potentially equivalent factors in clinical care. There is a need for intensifying the public and scientific debate on how to deal with the divergence between EBP theory and EBP practice.

Registered Nurses' Evidence-Based Practice Revisited: A Longitudinal Study in Mid-Career

BACKGROUND

To improve patient outcomes and patient safety and to reduce costs in health care, the implementation of evidence-based practice (EBP) is crucial.

AIMS

To examine the use of the EBP process in Swedish health care. Specifically, to examine whether professional career development (years of experience, years in current position, specialist education, care setting) is associated with RNs' practice of EBP activities and changes in the extent of practicing the EBP process between early and mid-career.

METHODS

In this observational longitudinal study, the extent of EBP activities was investigated in three national cohorts of 2,474 RNs. Nurses rated their own EBP levels 11-15 and three years after graduation. Six items measured the respondents' extent of practicing the EBP process. Comparisons of EBP levels between subgroups were tested using unpaired t-tests or one-way ANOVAs.

RESULTS

On average, RNs used the EBP process occasionally every half year. RNs with specialist education reported a higher extent of EBP activities as did RNs who worked in outpatient and home care settings. There was a significant increase in the extent of EBP activities 11 to 13 years after graduation compared to three years after graduation.

LINKING EVIDENCE TO ACTION

The findings raise some central questions for practice: How well equipped are RNs to practice the EBP process? What is needed to facilitate EBP in clinical settings? Building on the findings of this study, managers in clinical practice need to develop supportive organizational structures that facilitate EBP. This study suggests that mid-career RNs increased the extent of practicing the EBP process over time compared to previous reported practice in their first years as RNs. However, the level of EBP activities was low to moderate, and this modest increase took 11 to 13 years to achieve. To enhance the practice of EBP in nursing care, educational and organizational factors need to be considered.

Capability beliefs and the intention to adopt evidence-based practices in the future among nursing students: An international study

BACKGROUND

Capability beliefs and the intention to adopt EBP in future nursing practice have been identified as strong antecedents of subsequent utilization of EBP. Despite this, a multicountry comparison may yield interesting findings that can be useful in designing empirically based and culturally tailored strategies to facilitate and enhance students' capability beliefs as well as their intentions to integrate evidence into nursing practice.

AIMS AND OBJECTIVES

This report sought to compare capability beliefs and intentions to adopt EBP in the future among student nurses from four countries-specifically, Oman, India, Nigeria, and Saudi Arabia-and to identify specific variables that predict the intention to adopt EBP.

METHODS

This study employed a descriptive, cross-sectional, comparative research design to gather data from a convenience sample of 1387 nursing students from four countries using self-report questionnaires that captured their EBP capability beliefs and their intention to adopt EBP in clinical practice upon graduation. This study adhered to STROBE guideline for cross-sectional studies.

RESULTS

Overall, nursing students reported a high intent to adopt EBP in their future nursing practice; however, the exact rate varied according to the country of origin. Students' gender, student track, education, country of origin, access to the internet, and capability beliefs were seen as important in explaining the likelihood of future implementation of evidence in clinical nursing practice. Capability beliefs among students were moderate, with large differences observed between countries.

CONCLUSIONS

Although the surveyed nursing students reported moderate capability beliefs, their intention to adopt and integrate EBP in their future nursing practice was relatively high.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study highlight the critical role of nurse educators and nurse administrators in fostering EBP capability beliefs and future intentions to adopt among students through curricular review, implementation of evidence-based strategies, and the promotion of EBP culture within the clinical learning sites.

A Confirmatory Factor Analysis of the Student Evidence-Based Practice Questionnaire (S-EBPQ) in an Australian sample

BACKGROUND

It is crucial that nursing students develop skills and confidence in using Evidence-Based Practice principles early in their education. This should be assessed with valid tools however, to date, few measures have been developed and applied to the student population.

OBJECTIVE

To examine the structural validity of the Student Evidence-Based Practice Questionnaire (S-EBPQ), with an Australian online nursing student cohort.

DESIGN

A cross-sectional study for constructing validity.

PARTICIPANTS AND METHOD

Three hundred and forty-five undergraduate nursing students from an Australian regional university were recruited across two semesters. Confirmatory Factor Analysis was used to examine the structural validity.

RESULTS

Confirmatory Factor Analysis was applied which resulted in a good fitting model, based on a revised 20-item tool.

CONCLUSIONS

The S-EBPQ tool remains a psychometrically robust measure of evidence-based practice use, attitudes, and knowledge and skills and can be applied in an online Australian student context. The findings of this study provided further evidence of the reliability and four factor structure of the S-EBPQ. Opportunities for further refinement of the tool may result in improvements in structural validity.

Capability beliefs on, and use of evidence-based practice among four health professional and student groups in geriatric care: A cross sectional study

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months' employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students' high EBP capability beliefs might inspire staff in this matter.

Effects of Education Programs on Evidence-Based Practice Implementation for Clinical Nurses

This study was conducted to identify the effectiveness of an education program for evidence-based practice (EBP) implementation of clinical nursing. EBP knowledge/skill, attitude, and belief; information search ability; and EBP implementation were significantly higher in the experimental group than in the control group. Furthermore, the effect on implementation was maintained at week 4 and week 8, indicating that the education program practically promotes the EBP implementation of nurses. Results confirm that the education program for EBP implementation is critical and the continuous education program is an essential part of EBP implementation. Also, to promote EBP implementation and disseminate it to nursing organizations, an immediate concern should be the cultivation of mentors for EBP and fortification of the belief and ability regarding EBP implementation. J Contin Educ Nurs. 2016;47(8):363-371.

Factors associated with nursing students' adherence to venous blood collection practice guidelines - A cross sectional study

Venous blood specimen collection is a common procedure that nursing students perform during pre-registration courses, and training for such collections takes place on campus as well as at clinical placements. However, levels of adherence to practice guidelines are still suboptimal among both nursing students and healthcare staff. We aimed to explore nursing students' adherence to the Swedish national venous blood specimen collection practice guidelines regarding patient identification and test request management and how this adherence is related to clinical experience, capability beliefs, research use, and the perceived social climate in clinical contexts. A survey with a cross-sectional design was conducted among 305 nursing students at a medium-sized university in Sweden. Descriptive statistics and logistic regression were used for data analysis. The survey showed that 82% of the students adhered to patient identification guideline practices and 80% to test request management practices. Factors associated with correct patient identification procedures were semester and frequency of research use. Factors associated with correct test request management were previous healthcare work experience, semester, and capability beliefs regarding academic abilities and evidence-based practice. We conclude that there is a need to develop educational tools to train students in research use and evidence-based practice in order to enhance guideline practice adherence and improve patient safety.

Psychometric Testing of the Health Care Evidence-Based Practice Assessment Tool

BACKGROUND AND PURPOSE

Evidence-based practice (EBP) is essential to optimal health care outcomes. Interventions to improve use of evidence depend on accurate assessments from reliable, valid, and user-friendly tools. This study reports psychometric analyses from a modified version of a widely used EBP questionnaire, the information literacy for nursing practice (ILNP).

METHODS

After content validity assessments by nurse researchers, a convenience sample of 2,439 nurses completed the revised 23-item questionnaire. We examined internal consistency and used factor analyses to assess the factor structure.

RESULTS

A modified 4-factor model demonstrated adequate fit to the data. Cronbach's alpha was .80-.92 for the subscales.

CONCLUSIONS

The shortened ILNP (renamed Healthcare EBP Assessment Tool or HEAT) demonstrated adequate content validity, construct validity, and reliability.

Evaluating factors associated with implementing evidence-based practice in nursing

RATIONALE, AIMS AND OBJECTIVES

Evidence-based practice (EBP) has emerged as an innovation for quality improvement in health care. Nurses have important role in implementing EBP but they face many challenges in this context. Evaluation of factors influencing implementation of EBP seems necessary. The aims of this study were to examine nurses' attitude towards EBP, their self-efficacy and training needs, as well as supporting factors and barriers for implementing EBP.

METHODS

A cross-sectional study was conducted on 182 nurses from four teaching hospitals in Kerman, Iran. Data were collected using a questionnaire consisting of two main sections; a section to collect socio-demographic information of participants and a section collecting information on five topics (staff's attitude, self-efficacy skills of EBP, supporting factors, barriers and training needs for implementing EBP).

RESULTS

The majority (87.4%) of the nurses had not attended any formal training on EBP and 60% of them were not familiar with the concept of EBP. Nurses' attitude towards EBP was unfavourable (2.57 ± 0.99) and their self-efficacy skills of EBP were poor (2.93 ± 1.06). The most important supporting factor was mentoring by nurses who have adequate EBP experience (3.65 ± 1.17) and the biggest barrier was difficulty judging the quality of research papers and reports (2.46 ± 0.95). There was a moderate demand for training in all areas of EBP (3.62 ± 1.12).

CONCLUSIONS

Nursing care needs to move towards quality improvement using EBP. It is necessary to equip nurses with knowledge and skills required for EBP. Managers should design an appropriate strategic plan by considering supporting factors and barriers for integrating EBP into clinical setting.

The state of readiness for evidence-based practice among nurses: An integrative review

OBJECTIVES

To review factors related to nurses' individual readiness for evidence-based practice and to determine the current state of nurses' evidence-based practice competencies.

DESIGN

An integrative review study.

DATA SOURCES

Thirty-seven (37) primary research studies on nurses' readiness for evidence-based practice, of which 30 were descriptive cross-sectional surveys, 5 were pretest-posttest studies, and one study each was an experimental pilot study and a descriptive qualitative study. Included studies were published from the beginning of 2004 through end of January 2015.

REVIEW METHODS

The integrative review study used thematic synthesis, in which the quantitative studies were analyzed deductively and the qualitative studies inductively. Outcomes related to nurses' readiness for evidence-based practice were grouped according to the four main themes that emerged from the thematic synthesis: (1) nurses' familiarity with evidence-based practice (EBP); (2) nurses' attitudes toward and beliefs about evidence-based practice; (3) nurses' evidence-based practice knowledge and skills; and (4) nurses' use of research in practice. Methodological quality of the included studies was evaluated with Joanna Briggs Institute critical appraisal tools.

RESULTS

Although nurses were familiar with, had positive attitudes toward, and believed in the value of EBP in improving care quality and patient outcomes, they perceived their own evidence-based practice knowledge and skills insufficient for employing evidence-based practice, and did not use best evidence in practice. The vast majority (81%) of included studies were descriptive cross-sectional surveys, 84% used a non-probability sampling method, sample sizes were small, and response rates low. Most included studies were of modest quality.

CONCLUSIONS

More robust, theoretically-based and psychometrically sound nursing research studies are needed to test and evaluate the effectiveness of interventions designed to advance nurses' evidence-based practice competencies, especially teaching them how to integrate evidence-based practice into clinical decision-making. All efforts should be focused on systematically using knowledge transformation strategies shown to be effective in rigorous studies, to translate best evidence into practice-friendly, readily usable forms that are easily accessible to nurses to integrate into their clinical practice.

Striving for evidence-based practice innovations through a hybrid model journal club: A pilot study

OBJECTIVE

The purpose of this study was to pilot a "hybrid" style journal club and determine whether measurable effects could be detected over 8-weeks' time on evidence-based practice ability, desire, behaviors, use, and barriers.

BACKGROUND

Journal clubs have been suggested as a method to increase nurses' confidence with using research evidence to guide practice. However, it is yet unknown how nurse educators can best implement effective programs for clinicians with varying schedules, education levels, and research skills.

SETTING AND PARTICIPANTS

Thirty-six participants from one large urban United States hospital (72% registered nurses) were invited to access bi-weekly interdisciplinary journal club activities. Nurse educators created curriculum focused on clinical problem solving that was offered via in-person sessions or a social media site.

METHODS

A pretest-posttest no control group design was used to measure impacts of those engaged in journal club activities. Data were collected using a combination of validated evidence-based practice instruments and program participation records.

FINDINGS

A two-tailed paired t test showed significant increases over 8weeks' time in evidence-based practice use (p=.002) and behaviors (p=.007). Slight preference for in-person sessions was reported, although greater participation was reflected in online activities. Mean satisfaction ratings were high; however, attrition rates suggest that more is needed to maximize clinician engagement.

CONCLUSION

A hybrid method using online and in-person sessions was feasible and adaptive for varying learning styles and work schedules. Positive changes in measurements were detected among journal club participants. Instruments were identified that may be useful for trialing similar programs intended to increase evidence-based practice self-efficacy, use, behaviors, and ability.

Nurse leaders' Attitudes, Self-Efficacy and training Needs for Implementing Evidence-Based Practice: Is It Time for a Change toward Safe Care?

Introduction

Evidence-based practice (EBP) has been recognized as the gold standard for safe and high quality care. Nurse leaders have a strategic position in terms of initiating changes in clinical settings for successfully implementing EBP. Therefore, the factors that influence implementing EBP must be measured.

Aims

To examine nurse leaders' attitudes, self-efficacy, and training needs for implementing evidence-based practice.

Place and Duration of Study

Four teaching hospitals affiliated to Kerman University of Medical Sciences in the southeast of Iran from January to April 2014.

Methods

A cross-sectional study was conducted on 70 nurse leaders from four teaching hospitals. After using a modified forward/backward translation procedure to create a Persian version of “perceptions of nurses of evidence-based practice questionnaire”, data were collected from the participants and analyzed using SPSS (version 20), descriptive statistics, Student's t-test, analysis of variance (ANOVA), and Pearson's correlation.

Results

Most (82.86%) of the participants had not attended any specific training course on the implementation of EBP and 80% had not been involved in any research activities. Nurse leaders' attitudes toward EBP were unfavorable (mean=2.55±0.88), their levels of self-efficacy in EBP skills were weak (mean=2.64±1.31), and their demand for training in all of the EBP areas was moderate (3.89±.97).

Conclusion

Current practice of nurse leaders is not evidence-based, which is worrisome and can result in serious deficiencies in the quality and safety of nursing care. Nurse leaders must attempt to equip themselves with the attitudes and skills required to change in practice using EBP.

Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study

BACKGROUND

Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation.

METHODS

A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models.

RESULTS

Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6-7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7-2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4-2.0).

CONCLUSIONS

To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

Current and future health care professionals attitudes toward and knowledge of statistics: How confidence influences learning

BACKGROUND

Health care professionals require some understanding of statistics to successfully implement evidence based practice. Developing competency in statistical reasoning is necessary for students training in health care administration, research, and clinical care. Recently, the interest in healthcare professional's attitudes toward statistics has increased substantially due to evidence that these attitudes can hinder professionalism developing an understanding of statistical concepts.

METHODS

In this study, we analyzed pre- and post-instruction attitudes towards and knowledge of statistics obtained from health science graduate students, including nurses and nurse practitioners, enrolled in an introductory graduate course in statistics (n = 165).

RESULTS AND CONCLUSIONS

Results show that the students already held generally positive attitudes toward statistics at the beginning of course. However, these attitudes-along with the students' statistical proficiency-improved after 10 weeks of instruction. The results have implications for curriculum design and delivery methods as well as for health professionals' effective use of statistics in critically evaluating and utilizing research in their practices.