Evidence-Based Practice Competence in Nursing Students: An Exploratory Study With Important Implications for Educators

Translation, Cultural Adaptation, and Validation of the Arabic Version of the Student Evidence-Based Practice Questionnaire (S-EBPQ)"

BACKGROUND

Evidence-based practice (EBP) lowers costs, guarantees staying current with new technology and abilities, and enables the provision of high-quality care. Evidence-based practice (EBP) considered the foundation for safe patient care.

AIM

is to validate and carry out the linguistic-cultural adaptation of the S-EBPQ for the Arabic language.

DESIGN

A methodological study design was used.

METHOD

There were two primary stages: translation and validation. Three experts reviewed the contents during the translation and validation in order to ensure their relevancy. 15 nursing students conducted face validation to confirm the produced items' clarity and understandability. Reliability assessment was achieved by conducting a pilot study on 72 nursing students. Ethical approval was taken. For statistical analysis, SPSS software was used. The internal reliability of the questionnaire was evaluated using Cronbach's Alpha. The Pearson Correlation was used to test the relationship between the student's score on the questionnaire and their age and gender.

RESULTS

The Scale-Content Validity Index was 0.90; Cronbach's Alpha value was 0.963. Students in face validation phase confirmed that wording, clarity, and understandable language of the items were achieved. The Mean of students total score was 80.2 (SD = 21.5). Pearson test revealed that there was a weak positive correlation between students' scores and age R = 0.320 (p = 0.001). Also, it demonstrated that there was no correlation between the students' scores and the gender R =-0,028 (p = 0.817).

CONCLUSION

The Arabic version of the S-EBPQ generally had a solid structure and it demonstrated high validity and reliability. The questionnaire could be used in future studies.

Bottlenecks to Learning Evidence-Based Practice: Recommendations for Nursing Faculty

BACKGROUND

Evidence-based practice (EBP) competency is an expected outcome of baccalaureate education; however, research indicates nursing graduates enter practice with competency gaps.

PURPOSE

The purpose of this study was to explore the challenges accelerated baccalaureate students experience when learning the steps of EBP.

METHODS

A qualitative, descriptive design was used to identify bottlenecks to student learning.

RESULTS

Learning the steps of EBP in an accelerated format was challenging for students. Data analysis revealed 3 types of bottlenecks that stalled learning: cognitive, procedural, and emotional.

CONCLUSIONS

Faculty build EBP competency by making explicit the steps that help students progress. Scaffolded learning, collaborative partnerships, and reflective practices are recommended to support student learning in accelerated formats.

Defining evidence-based nursing practice: An interpretative phenomenological study

BACKGROUND

Evidence-based nursing practice (EBNP) has been regarded core competencies in nursing practice and education. Defining evidence-based nursing practice and translating evidence into nursing practice by nursing students who are green to clinical practice in their education journey remain unclear.

AIM

To explore how pre-registered nursing students define and characterize evidence-based nursing practice as they participate in their clinical practicum.

DESIGN

This study used an interpretive phenomenological qualitative study design.

SETTINGS AND PARTICIPANTS

Twenty nursing students were interviewed for their clinical practicum experience from four universities, one nursing college and one hospital-based nursing school in Hong Kong.

METHODS

Data was generated through semi-structured in-depth interview and analyzed following interpretative phenomenological analysis guidelines, using a cyclical coding process.

RESULTS

Four themes emerged regarding nursing students' definition of EBNP, highlighting that EBNP is 'identifying a reliable learning source', by which they can 'rationalize their nursing practice', and enabling them to 'establish care standard through critical thinking', and eventual 'fostering their professionalism' to improve health outcomes and reduce potential harms.

CONCLUSION

Nursing students defined and characterized evidence-based nursing practice as core competencies in accompany their practicum that enables them to learn and grow professionally with a universal desire to be qualified, cope with doubt, and improve patient outcome. They recognized the challenges in identifying evidence and emphasized conservative approach to validate the evidence to avoid patient harm. Students expressed doubt towards their instructors EBNP when observing procedures untaught at school, which requires the curriculum model to foster students' skills in applying and appraising evidence and instructors' capacity to rationalize and role model EBNP.

Exploring academic and clinical nurses' perspectives on evidence-based nursing course for undergraduates from perspectives of academic-practice partnerships: a qualitative study

AIM

To explore nurses' perceptions of evidence-based nursing courses for undergraduates through academic-practice partnerships.

DESIGN

A deductive thematic analysis based on the practice-academic logic model.

METHODS

Fifteen academic and clinical nurses were interviewed between November and December 2023, either online or through face-to-face meetings. Each interview lasted 20-30 min. The interview outline was constructed based on the practice-academic partnership logic model, which was followed during the process of recorded, analyzed, and checked.

RESULTS

Themes identified include inputs (e.g., stakeholder commitment), activities (e.g., communication), outputs (e.g., nursing projects), and outcomes (e.g., improved competence). These themes highlight the various aspects and outcomes of academic-practice partnerships in evidence-based nursing courses.

CONCLUSION

Effective academic-practice partnerships are crucial for developing evidence-based nursing courses, leading to positive educational and professional outcomes.

IMPACT

Nurses' perceptions provide valuable guidelines for developing effective evidence-based nursing courses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public users participated in this study.

What is needed for nurses to work with evidence-based practice? A qualitative study

BACKGROUND

Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promote EBP in nursing practice and improve related education, more insight into nurses' needs is necessary to overcome existing EBP barriers.

OBJECTIVE

To identify the current needs to work with EBP principles among hospital and community care nurses and student nurses.

DESIGN

A qualitative, exploratory approach with focus group discussions.

METHODS

Data was collected between February and December 2020 through 5 focus group discussions with 25 nurses and student nurses from a hospital, a community care organisation, and nursing education schools (bachelor and vocational). Data were analysed using reflexive thematic analysis, and the main themes were synchronised to the seven domains from the Tailored Implementation for Chronic Diseases (TICD) checklist.

RESULTS

Nurses and student nurses experience EBP as complex and require more EBP knowledge and reliable, ready-to-use evidence. They wanted to be facilitated in access to evidence, the opportunity to share insights with colleagues and more time to work on EBP. The fulfilment of these needs serves to enhance motivation to engage with evidence-based practice (EBP), facilitate personal development, and empower nurses and student nurses to take more leadership in working according to EBP principles and improve healthcare delivery.

CONCLUSION

Nurses experience difficulties applying EBP principles and need support with their implementation. Nurses' and student nurses' needs include obtaining more EBP knowledge and access to tailored and ready-to-use information. They also indicated the need for role models, autonomy, incentives, dedicated time, and incorporation of EBP in daily work practice.

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.

Nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings: A qualitative systematic literature review

AIMS AND OBJECTIVES

To identify and synthesise nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings.

BACKGROUND

Modifiable lifestyle risk behaviours contribute to an increased prevalence of chronic diseases worldwide. Lifestyle counselling is part of nurses' role which enables them to make a significant contribution to patients' long-term health in various healthcare contexts, but requires particular competence.

DESIGN

Qualitative systematic literature review and meta-aggregation.

METHOD

The review was guided by Joanna Briggs Institute's methodology for conducting synthesis of qualitative studies. PRISMA-checklist guided the review process. Relevant original studies were search from databases (CINAHL, PubMed, Scopus, Medic and Psych Articles, Ebscho Open Dissertations and Web of Science). After researcher consensus was reached and quality of the studies evaluated, 20 studies were subjected to meta-aggregation.

RESULTS

From 20 studies meeting the inclusion criteria, 75 findings were extracted and categorised into 13 groups based on their meaning, resulting in the identification of 5 synthesised findings for competence description: Supporting healthy lifestyle adherence, creating interactive and patient-centred counselling situations, acquiring competence through clinical experience and continuous self-improvement, collaborating with other professionals and patients, planning lifestyle counselling and managing work across various stages of the patient's disease care path.

CONCLUSION

The review provides an evidence base that can be used to support nurses' competence in lifestyle counselling when working with adult patients in healthcare settings. Lifestyle counselling competence is a complex and rather abstract phenomenon. The review identified, analysed and synthesised the evidence derived from nurses' experience which shows that lifestyle counselling competence is a multidimensional entity which relates to many other competencies within nurses' work.

IMPLICATIONS FOR THE PROFESSION

Recognising the competencies of nurses in lifestyle counselling for adult patients can stimulate nurses' motivation. The acquisition of these competencies can have a positive impact on patients' lives and their health.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

IMPACT

The research may enhance nurses' competence in lifestyle counselling, leading to improved health outcomes, better adherence to recommendations and overall well-being. It may also drive the development of interventions, improving healthcare delivery in lifestyle counselling.

REPORTING METHOD

The review was undertaken and reported using the PRISMA guidelines.

PROTOCOL REGISTRATION

Blinded for the review.

Nursing Students' Beliefs and Willingness to Implement Evidence-Based Nursing Practice at Umm Al-Qura University: A Descriptive Cross-Sectional Study

Background It is essential to provide evidence-based practice (EBP) courses for undergraduate nursing students. For this reason, students' beliefs and intentions to implement EBP should be measured to ensure that EBP courses are effective. Aim The aim of this study is to evaluate Saudi nursing students' EBP beliefs (EBPB) and implementation before they enroll in an EBP course. Methods A descriptive cross-sectional study was conducted. Two scales were used: the EBPB scale and the EBP implementation (EBPI) scale. The questionnaire was available for completion a single time before the second-year nursing students were introduced to the EBP course. Results The study revealed that the mean age for students is 20 ± 0.83. Nearly two-thirds (61.54%) of students are female. It can be noted that 71.5% have not attended any EBP programs. Additionally, 65.38% of students understand the concept of EBP, and 68.46% are willing to apply EBP nursing care. Therefore, there is a positive correlation between the EBPB scale variable and the EBPI scale. Conclusion This study highlights the positive attitude of undergraduate nursing students toward EBP. Nursing education programs must place more emphasis on integrating EBP curricula into their teaching strategies, with a focus on developing students' knowledge, skills, and values in EBP.

Frontline nurse leaders' competences in evidence-based healthcare: A scoping review

AIM

To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences.

DESIGN

A scoping review.

DATA SOURCES

The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched.

REVIEW METHOD

The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data.

RESULTS

A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC.

CONCLUSION

There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods.

Competency scale of quality and safety for greenhand nurses: instrument development and psychometric test

BACKGROUND

Guaranteeing nursing service safety and quality is a prioritized issue in the healthcare setting worldwide. However, there still lacks a valid scale to measure the quality and safety competencies of newly graduated nurses globally.

METHODS

This scale was developed in two phases. In Phase One, a literature review and three-round e-Delphi were conducted to generate the initial item pool; while in Phase Two, five experts tested the content validity of the scale. The construct validity was evaluated using confirmatory factor analysis (CFA), and the data were collected among 1,221 newly graduated nursing students between May, 2017 and August, 2017. Finally, the internal consistency reliability and test-retest reliability were tested.

RESULTS

The final version's Competency Scale of Quality and Safety (CSQS) was confirmed by the CFA involving 64 items in six dimensions, including patient-center care, safety, evidence-based practice, collaboration and teamwork, continuous quality improvement, and informatics. The results of data showed that the data supported the modified model of CSQS (Standardized Root Mean Square Residual = 0.03, p = 0.053, Adjusted Goodness of Normed Fit Index = 1.00, Root Mean Square Error of Approximation = 0.007, Fit Index = 0.95, Goodness of Fit Index = 0.97, χ2/df = 1.06), and the standardized factor loadings of items were from 0.59 to 0.74 (p < 0.05). The internal consistency reliability of the total scale was 0.98, and the test-retest reliability was 0.89.

CONCLUSIONS

CSQS was a valid and reliable instrument to measure the safety and quality abilities of greenhand nurses, and could be fully utilized by nursing students, greenhand nurses, nursing educators, as well as hospital nursing managers.

Assessing evidence-based practice competencies of undergraduate nursing students using a developed multi-criteria decision-analysis model

AIM

The developed multi-criteria decision analysis model was used to identify the inter-influence relationships and key factors affecting the EBP competencies of UNSs, to assess the EBP competencies of UNSs and based on these results, to formulate an improvement strategy to enhance the EBP competencies of UNSs.

BACKGROUND

EBP is considered a core competency in international nursing practice. However, few studies have developed EBP evaluation models and applied them to assessing and improving the EBP competencies of UNSs.

DESIGN

This is a quantitative study with multi-criteria decision-analysis model.

METHODS

Firstly, the questionnaire was designed based on the characteristics of the DEMATEL and VIKOR-AS methods, which was completed by 17 nursing experts from a case hospital in Zhejiang Province, China. Subsequently, the DEMATEL method was used to analyze the inter-influence relationships among various criteria to determine their respective weights. Finally, the VIKOR method is utilized to integrate multiple criteria and their relative weights to assign comprehensive scores to each UNSs.

RESULTS

The use of the DEMATEL method reveals that "Knowledge (C1)", "Mastering the basic scientific research methods during the study of the undergraduate courses (C11)", "Being able to consult clinical experts appropriately when encountering problems in clinical practice (C23)" and "Understanding the importance of reading journals related to the nursing profession regularly (C34)" were critical influencing factors. "Skill (C2)," "Being able to explain the essential roles of the best research evidence in determining clinical practice (C15)," "Being able to apply the collected research evidence to the individual case in nursing care (C25)" and "Paying attention to using the evidence-based nursing practice concept to determine the best clinical practice (C35)" were the most influential factors. According to the VIKOR method, the performance of the UNSs in the case hospitals in terms of EBP competencies from highest to lowest was Student C, Student B and Student A. However, all of these students suffered from deficiencies at the knowledge level.

CONCLUSIONS

The application of the DEMATEL and VIKOR methods provides a systematic and comprehensive approach to the assessment of EBP competencies of UNSs. The lack of EBP competencies of UNSs in case hospitals is mainly reflected in knowledge level. To improve UNSs' EBP competencies, medical schools and hospital educators should propose short- and long-term strategies to improve knowledge.

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.

An example of evaluation of tuning nursing competences in the licensure exam: An observational study

Introduction The licensure exam in nursing has always focused on the curricula used in universities. 'Tuning' was the first project that sought to harmonize training purposes regarding competences and learning outcomes in Europe. The Tuning educational structures have been offered in various disciplines, including nursing with the development of the Tuning Nursing Project. The study describes which of 47 Tuning Nursing Competences were evaluated during the licensure exam in nursing degree courses, and what types of trials were used for their assessment. Methods A multicentric observational study was conducted in 4 universities in Italy. Data were collected in academic years 2017-2019, using two grids: one for cognitive and one for psychomotor tests. Results The Tuning competences were requested 7522 times. The most frequently demanded were those associated with domain number two, "Nursing practice and clinical decision making". The level of performance most required in cognitive tests was the autonomy of judgement, and both tests concerned the fields of non-communicable diseases and the hospitalized adult patient. Conclusions The competences most often assessed coincided with those deemed core for the first cycle of studies at the European level. Unfortunately, it has been detected a high degree of discrepancy in the types of tests used in different schools.

Using mixed-methods in evidence-based nursing: a scoping review guided by a socio-ecological perspective

Background

Increased pressure for evidence-based practice in nursing necessitates that researchers use effective approaches. Mixed-methods research (MMR) has potential to improve the knowledge and implementation of evidence-based nursing (EBN) by generating outcome-based and contextually-focused evidence.

Aims

To identify methodological trends in how MMR is used in EBN research.

Methods

Searches were completed in PubMed, CINAHL, and Google Scholar using the terms "nursing", "mixed-methods", and "evidence-based". Seventy-two articles using MMR to address EBN and published 2000-2021 were reviewed across content themes and methodological domains of the Socio-Ecological Framework for MMR.

Results

Mixed-methods research has been used to study how EBN strategies are perceived, developed and assessed, and implemented or evaluated. A few studies provided an MMR definition reflecting the methods perspective, and the dominant MMR rationale was gaining a comprehensive understanding of the issue. The leading design was concurrent, and half of studies intersected MMR with evaluation, action/participatory, and/or case-study approaches. Research quality was primarily assessed using criteria specific to quantitative and qualitative approaches.

Conclusions

Mixed-methods research has great potential to enhance EBN research by generating more clinically useful findings and helping nurses understand how to identify and implement the best available research evidence in practice.

How nursing stakeholders in the Republic of Ireland define evidence-based practice and why it matters

BACKGROUND

Evidence-based practice (EBP) has garnered increasing exposure in professional healthcare discourse over three decades. While the term is used frequently, its interpretation varies widely. An accurate, shared understanding of what EBP means is essential to the achievement of EBP implementation in clinical practice. As part of a national study in the Republic of Ireland, nurses, midwives, educators, and students shared their personal understanding of what EBP was to them.

AIM

To establish nurses', midwives', educators', and students' knowledge and understanding of the concept of EBP in the Republic of Ireland.

METHODS

In a national study exploring EBP beliefs, implementation, and organizational readiness for EBP among nurses, midwives, educators, and students, an open-ended question invited participants to explain what EBP is, in their own words. Content analysis was used to interpret participants' responses.

RESULTS

Five themes emerged from the data from the single open-ended question: (1) varying definitions of EBP, (2) best practice, (3) nurses' and midwives' role in EBP, (4) knowledge, and (5) barriers and facilitators of EBP. The dominant finding centered on the substantial conflation of EBP with research utilization and other concepts such as quality improvement.

LINKING EVIDENCE TO ACTION

Poor knowledge and understanding of EBP is a fundamental challenge to EBP implementation. Conflation of EBP with research utilization and other healthcare concepts is not uncommon among nurses and midwives globally and has persisted for some time. This has the potential to hinder the advancement of EBP in nursing and midwifery and, therefore, measures to enhance EBP knowledge and promote EBP implementation are key. Professional regulating bodies, educators, and clinical and educational organizations all have a role to play. The findings from this aspect of this national study offer a realistic, context-specific starting point for tailored educational interventions for clinicians, educators, and students and identify professional and organizational strategies that promote EBP as the expectation and "the way things are done here."

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.

Access, Utilization, and Implementation of Research Among Rehabilitation Nurses

Purpose

This study aimed to understand rehabilitation nurses’ perceptions of research information, related barriers, and avenues for future research, specifically in those caring for individuals with burn injury, spinal cord injury, or traumatic brain injury.

Design

Qualitative semistructured interviews were conducted.

Methods

Eighteen interviews were conducted. A thematic network approach identified codes and developed basic, organizing, and global themes.

Results

Researchers identified factors that facilitated research uptake, determined organizational structures that support research culture, and described nurse engagement with literature.

Conclusions

Although participants desired to engage with the research literature, they identified barriers including time constraints, heavy workloads, and lack of access. To facilitate research uptake, research must be easily accessible, be easily digestible, and include clinical practice recommendations. Research must expand its scope to address issues relevant to the rehabilitation population.

Clinical Relevance

Our findings may be used to drive improvements in research competence, facilitate knowledge translation, and support evidence-based practice among rehabilitation nurses.

Social, health care and rehabilitation educators' competence in professional education-Empirical testing of a model

The social and health care educator's role in educating future professionals need to be stronger emphasised and deserves international recognition. The purpose of this study was to develop and test an empirical model of social and health care educators' competence in higher and professional education. The presented research employed a cross-sectional study design. Data were collected using HeSoEduCo-instrument from 28 educational institutions in Finland. The model was empirically tested with confirmatory factor analysis through Structural Equation Modelling that applied the Full Imputation Maximum Likelihood estimator. A total of 422 social and health care educators participated in the study. The empirical model of social and health care educators including eight competence areas: leadership and management, collaboration and societal, evidence-based practice, subject and curriculum, mentoring students in professional competence development, student-centred pedagogy, digital collaborative learning, and cultural and linguistic diversity. All of the connections between concepts of the empirical model were found to be statistically significant. There were strong connections between most of the identified competence concepts; however, two weak connections were found, namely, the link between competence in evidence-based practice and competence in subject and curriculum, along with the link between competence in digital collaborative learning and competence in student-centred pedagogy. The presented empirical model can help stakeholders identify which areas of social and health care educators' curricula should be further developed. The model is also relevant for improving continuous education, allowing educators to assess their competence levels and evaluating educators' performance at the organisational level.

What Should Be Considered in the Evidence-Based Practice Competency-Based Curriculum for Undergraduate Nursing Students? From the Student's Point of View

Background: The nursing curriculum should be systematically developed to improve the evidence-based practice (EBP) competencies of undergraduate nursing students. We attempted to identify the factors important for developing or improving the EBP-integrated nursing curriculum. Methods: This study adopted the qualitative research design using qualitative content analysis. A total of 168 study participants were included in the study. The participants were third-year nursing students at a private university located in southeastern South Korea. An open-ended question was asked: “To improve students’ EBP competencies during theory classes, on-campus practicums, or clinical practicums, what do you think is necessary?” Result(s): The analysis presented thirty themes, which were grouped into 10 sub-categories and further into four categories, and finally into three main categories. The students responded that they needed to form their own attitudes toward EBP. Regarding educator-related needs, students responded that effective teaching and learning methods should be used in classes. The students also suggested that the EBP process should be applied during clinical practicum. Regarding school-related needs, students suggested that EBP education should be applied at the beginning of the curriculum. Furthermore, the students recommended that repeated teaching should be used for EBP, and that EBP education should be connected to the major courses. Conclusions: The development of EBP competencies among undergraduate students is an important factor that can impact the nursing quality and patient safety. Based on the findings of this study, multidimensional efforts are needed to improve the liberal arts education of students and strengthen the educators’ competencies of EBNP and EBTP. Furthermore, schools should strive to assess students’ educational needs regularly and integrate the subsequent EBP-integrated nursing curricula consistent with these needs.

Social, health and rehabilitation sector educators' competence in evidence-based practice: A cross-sectional study

AIM

The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors.

DESIGN

This study was carried out as a descriptive cross-sectional study.

METHODS

Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis.

RESULTS

Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work.

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain

Background: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. Aim: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. Methods: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). Results: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. Conclusions: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.

Effect of the Specific Training Course for Competency in Doing Arterial Blood Gas Sampling in the Intensive Care Unit: Developing a Standardized Learning Curve according to the Procedure's Time and Socioprofessional Predictors

Background

Standardization of clinical practices is an essential part of continuing education of newly registered nurses in the intensive care unit (ICU). The development of educational standards based on evidence can help improve the quality of educational programs and ultimately clinical skills and practices.

Objectives

The objectives of the study were to develop a standardized learning curve of arterial blood gas (ABG) sampling competency, to design a checklist for the assessment of competency, to assess the relative importance of predictors and learning patterns of competency, and to determine how many times it is essential to reach a specific level of ABG sampling competency according to the learning curve.

Design

A quasi-experimental, nonrandomized, single-group trial with time series design. Participants. All newly registered nurses in the ICU of a teaching hospital of Tehran University of Medical Sciences were selected from July 2016 to April 2018. Altogether, 65 nurses participated in the study; however, at the end, only nine nurses had dropped out due to shift displacement.

Methods

At first, the primary checklist was prepared to assess the nurses' ABG sampling practices and it was finalized after three sessions of the expert panel. The checklist had three domains, including presampling, during sampling, and postsampling of ABG competency. Then, 56 nurses practiced ABG sampling step by step under the supervision of three observers who controlled the processes and they filled the checklists. The endpoint was considered reaching a 95 score on the learning curve. The Poisson regression model was used in order to verify the effective factors of ABG sampling competency. The importance of variables in the prediction of practice scores had been calculated in a linear regression of R software by using the relaimpo package.

Results

According to the results, in order to reach a skill level of 55, 65, 75, 85, and 95, nurses, respectively, would need average ABG practice times of 6, 6, 7, 7, and 7. In the linear regression model, demographic variables predict 47.65 percent of changes related to scores in practices but the extent of prediction of these variables totally decreased till 7 practice times, and in each practice, nurses who had the higher primary skill levels gained 1 to 2 skill scores more than those with low primary skills.

Conclusions

Utilization of the learning curve could be helpful in the standardization of clinical practices in nursing training and optimization of the frequency of skills training, thus improving the training quality in this field. This trial is registered with NCT02830971.

Construction of evaluation indexes of nursing students' quality and safety competencies: A Delphi study in China

BACKGROUND

Providing quality and safe nursing care is considered the cornerstone of the healthcare system globally. However, there are no comprehensive evaluation indicators of nursing students' quality and safety competencies in China.

AIM

To develop the evaluation indicators and achieve experts' consensus on bachelor nursing students' quality and safety competencies at their graduation.

METHODS

Based on the framework of the American Association of Colleges of Nursing's Quality and Safety Education for Nurses, literature review, semi-structured interview, and e-Delphi technique, the evaluation indicators were developed and obtained consensus through the participation of 22 nursing educational experts from August 2016 to May 2017.

RESULTS

The evaluation indicators consisted of six domains, including safety care, patient-center care, collaboration and teamwork, continuous quality improvement, informatics, and evidence-based practice competencies, and 88 indicators. These indicators obtained ≥76% consensus on the experts' judgments.

CONCLUSIONS

The evaluation indicators achieved the consensus on a panel of nursing experts, which were scientific and practicable. It could provide guidance for establishing a nursing curriculum to prepare bachelor nursing students' quality and safety competencies.

Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students

Background

Integrating evidence-based practice (EBP) into the daily practice of healthcare professionals has the potential to improve the practice environment as well as patient outcomes. It is essential for nurses to build their body of knowledge, standardize practice, and improve patient outcomes. This study aims to explore nursing students’ beliefs and implementations of EBP, to examine the differences in students’ beliefs and implementations by prior training of EBP, and to examine the relationship between the same.

Methods

A cross-sectional survey design was used with a convenience sample of 241 nursing students from two public universities. Students were asked to answer the questions in the Evidence-Based Practice Belief and Implementation scales.

Results

This study revealed that the students reported a mean total belief score of 54.32 out of 80 (SD = 13.63). However, they reported a much lower implementation score of 25.34 out of 72 (SD = 12.37). Students who received EBP training reported significantly higher total belief and implementation scores than those who did not. Finally, there was no significant relationship between belief and implementation scores (p > .05).

Conclusion

To advance nursing science, enhance practice for future nurses, and improve patient outcomes, it is critical to teach nursing students not only the value of evidence-based knowledge, but also how to access this knowledge, appraise it, and apply it correctly as needed.

A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: Development, implementation, and preliminary outcomes

Improving outcomes and quality of care through evidence-based practice (EBP) is a priority globally. But most nurses have insufficient competence in EBP. How to conduct Educational interventions to enhance clinical nurses' EBP competencies and critical thinking disposition (CTD) requires more evidence. One hundred eleven clinical nurses from a Chinese four-campus hospital were enrolled in our EBP education program. The Johns Hopkins Nursing Evidence-Based Practice Model was used to develop and guide the educational and practical sessions. Multi-dimensional learning strategies -including online self-learning, on-site lectures, workshops, and social media-facilitated group discussions-were used to facilitate the implementation of the education sessions. After education, nurses embedded evidence into practice. The Chinese versions of the EBP Believe scale (EBPB), EBP Implementation scale (EBPI), and the Simplified Chinese Version of the Critical Thinking Disposition Inventory (CTDI-SCV) were applied to assess the relevant competencies among clinical nurses before and after the education program. Clinical nurses' EBPB, EBPI, and CTDI-SCV scores improved. But only EBPB and EBP skills and attitudes were enhanced with a statistical difference (t = -2.980, -4.141, and -2.695, with all p < 0.01). There was a small positive association between EBPB and CTDI-SCV (r = 0.396, p < 0.01). Fifteen EBP programs were successfully accomplished.

Evidence-Based Practice Competence in Nursing Students Preparing to Transition to Practice

BACKGROUND

Opportunities to embed and evaluate evidence-based practice (EBP) competency in the clinical setting across nursing curricula are not well described in the literature.

AIMS

This research aims to describe how clinical learning environments influence senior nursing students' integration of EBP competencies in their practice and perceptions of EBP competence development in a traditional baccalaureate nursing program.

METHODS

A sequential, mixed-methods design was used with senior students upon completion of their last two clinical experiences in the nursing program. Students completed the EBP Work Environment Scale (Pryse, McDaniel, & Schafer, 2014) and semi-structured interviews.

FINDINGS

Students appraised EBP Work Environments positively during preceptor-led experiences as opposed to instructor-led, group clinical experiences. Students described the evolution of emerging EBP competence throughout their nursing education and emphasized the importance of coursework in intentionally developing EBP competence.

LINKING EVIDENCE TO ACTION

Assessment of clinical experiences and models that contribute to EBP competence is needed. Participants in this study emphasized the importance of coursework that builds on EBP competencies, and the tremendous value of nurse preceptors that encouraged growth in their ability to engage with EBP in clinical practice.

Evidence-Based Practice Competency and Related Factors Among Nurses Working in Public Hospitals

This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses’ demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses’ age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.

Evidence-Based, Ethical Decision-Making: Using Simulation to Teach the Application of Evidence and Ethics in Practice

BACKGROUND

Evidence-based practice and ethics should not be taught as isolated concepts. Instead, it is imperative to prepare students with the knowledge needed to practice ethical, evidence-based decision-making in health care.

PURPOSE

The purpose of this project was to describe how a mock hospital ethics committee meeting impacted students' learning about the use of evidence to support ethical decision-making in health care.

METHOD

A mock hospital ethics committee was convened for 121 students from schools of nursing, social work, law, and medicine.

RESULTS

Thematic content analysis showed a positive impact on nursing students' learning of ethics, group dynamics, discipline-specific responsibilities, and EBP.

LINKING EVIDENCE TO ACTION

This interprofessional education experience showed students how evidence and ethics can be used to guide and support practice priorities, responsibilities, and decisions on resource utilization and treatment to enable optimal outcomes for patients and organizations.

Educational Interventions for Teaching Evidence-Based Practice to Undergraduate Nursing Students: A Scoping Review

Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours, EBP beliefs, use, practice, level of evidence, critical thinking and future use of EBP were mentioned and assessed in different studies. Conclusions: EBP training can improve nursing students’ capacity in healthcare provision. Teaching EBP competencies along undergraduate nursing curricula should be a high priority at nursing programmes. The use of innovative approaches seems to be more effective than traditional ways. Education of EBP increases its future use and critical thinking and EBP programs improve self-efficacy and the level of evidence utilization.

Development and validation of the Chinese version of the evidence-based practice profile questionnaire (EBP2Q)

BACKGROUND

Evidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP²Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China.

METHODS

Based on established guidelines for the development of questionnaires, the English EBP²Q was translated and cross-culturally adapted. The Chinese version of the EBP²Q (EBP²Q-C) was validated using a sample of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated.

RESULTS

The content validity index demonstrated good content validity (≥0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis (χ²/df = 2.001; RMSEA = 0.065; SRMR = 0.077; and CFI = 0.884). The Spearman's rank correlation analysis of the EBP²Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses' highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach's α and the Cronbach's α for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability.

CONCLUSIONS

Except for the convergent validity of the Sympathy domain, the EBP²Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.