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

Competency gap among graduating nursing students: what they have achieved and what is expected of them

BACKGROUND

Nurses' professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices.

METHODS

In a descriptive-comparative study, students' perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests.

RESULTS

The results of the study showed that the highest scores for students' acquired competencies and nursing faculties' expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups' mean scores was significant in all 5 core-competencies and 17 sub-core competencies (P < .001). Evidence-based nursing care was the highest mean difference (mean diff = 1) and the professional nursing process with the lowest mean difference (mean diff = 0.70).

CONCLUSION

The results of the study highlight concerns about the gap between expected and achieved competencies in Iran. Further research is recommended to identify the reasons for the gap between the two and to plan how to reduce it. This will require greater collaboration between healthcare institutions and nursing schools.

Ramifications of the COVID-19 Pandemic on Nursing Students' Transition to Practice

As the COVID-19 pandemic altered the course of nursing education worldwide, it disrupted efforts to transition nursing students to professional practice. The investigators examined clinical nursing faculty members' assessment of senior students' practice strengths and challenges compared to graduates of prior years. Findings demonstrated COVID-19's wide-ranging impacts on nursing students' transition to practice and offered suggestions about the implications for nursing professional development practitioners.

Effective Strategies for Teaching Evidence-Based Practice in Undergraduate Nursing Programs

BACKGROUND

Literature shows that nursing program graduates cannot apply skills related to evidence-based practice (EBP) on graduation. However, the influence of EBP on quality and safety in nursing is well documented and shows that innovative strategies for teaching the content need to be explored.

PROBLEM

Teaching EBP in nursing programs is challenging due to students' attitudes and lack of engagement. These challenges are compounded when the program is accelerated or an undergraduate completion program.

APPROACH

A literature search was conducted to identify best practices for improving the quality of EBP courses. The findings, along with the application of EBP 7 steps, were identified and implemented in the course redesign.

CONCLUSIONS

A structured and sequential approach to learning core skills related to EBP may be an effective method of improving course quality and application of EBP skills upon graduation.

Determinant factors associated with the use of evidence-based dietetics practice among registered dietitian nutritionists

AIMS

There is a lack of research assessing perceived and actual evidence-based dietetics practice knowledge among registered dietitian nutritionists. This cross-sectional research examined the association between determinant factors (i.e., education attainment) and objective knowledge (i.e., quiz items) of evidence-based dietetics practices. Other determinant factors associated with perceived knowledge and skill, attitudes, behaviours and outcomes related to evidence-based dietetics practice were also assessed. Perceived knowledge items were compared to objective knowledge items to evaluate the accuracy of self-assessed evidence-based dietetics practice knowledge among dietitians in the United States.

METHODS

A modified and adapted evidence-based practice survey was emailed to registered dietitian nutritionists in the United States via the Commission on Dietetic Registration database between November and December 2020. Analysis of variance assessed the relationship between highest degree held and actual knowledge of evidence-based dietetics practices. Multiple linear regression and ordinal logistic regression determined participant-level characteristics associated with survey subscales and survey items, respectively. Pearson's correlation coefficient evaluated the relationship between subjective and objective items.

RESULTS

Four hundred and eighty-two dietitians completed the survey. Each increase in degree type was associated with an increase in objective knowledge score (all comparisons p < 0.001). Other determinants included recency of degree completion and peer-reviewed publications. Moderate positive associations (r = 0.35, p < 0.001) were found between subjective and objective measures.

CONCLUSION

Graduate-level education, recency of degree completion and peer-reviewed publications were supportive of evidence-based dietetics practice-related outcomes. Future research should evaluate the efficacy of training, particularly among those further from their highest completed degree.

Clinical judgment and decision-making of the Undergraduate Nursing students

Abstract Clinical judgment and decision-making are essential competencies in nursing, emerging as expanding learning areas of nursing education. Aiming to characterize the types of clinical judgment and decision-making adopted by nursing students in clinical education, we designed a qualitative, exploratory and descriptive study, with data collection obtained through documental analysis of nursing student’s reflective journals, in clinical education settings. Data analysis was performed according to Bardin using the webQDA software. Thirty-four students participated in the study, while attending the Clinical Learning Curricular Unit: Caring for Clients with Increased Vulnerability and Families in Transition, producing a total of 40 reflective journals. Of the 248 identified registration units, we highlight the evaluation decision-making with 45 registration units and the intervention decision-making, with 55 registration units. It is concluded that student´s reflections in the context of clinical teaching, are mainly about the assessment of the care situation and the decision-making related to the action. This study is intended to guide the learning of these competencies in nursing education.

Clinical judgment and decision-making of the Undergraduate Nursing students

Clinical judgment and decision-making are essential competencies in nursing, emerging as expanding learning areas of nursing education. Aiming to characterize the types of clinical judgment and decision-making adopted by nursing students in clinical education, we designed a qualitative, exploratory and descriptive study, with data collection obtained through documental analysis of nursing student's reflective journals, in clinical education settings. Data analysis was performed according to Bardin using the webQDA software. Thirty-four students participated in the study, while attending the Clinical Learning Curricular Unit: Caring for Clients with Increased Vulnerability and Families in Transition, producing a total of 40 reflective journals. Of the 248 identified registration units, we highlight the evaluation decision-making with 45 registration units and the intervention decision-making, with 55 registration units. It is concluded that student´s reflections in the context of clinical teaching, are mainly about the assessment of the care situation and the decision-making related to the action. This study is intended to guide the learning of these competencies in nursing education.

Integrating EBP into an undergraduate research methodology course using the Star Model of Knowledge Transformation: A mixed-method study

BACKGROUND

Evidence-based practice (EBP) competence is essential for healthcare professionals. Before undergraduate nursing students become research producers, they should first be competent research consumers.

OBJECTIVE

To assess the level of students' readiness for EBP and explore their learning experiences after a modified research methodology course integrated with an EBP model.

DESIGN

A mixed-method study using a one-group posttest-only design was utilized.

PARTICIPANTS AND SETTING

Participants were 146 third-year students of a nursing school in South Korea.

METHODS

A 15-week research methodology course was modified based on the Star Model of Knowledge Transformation. The course consisted of lectures, group discussions, group reports, and student presentations. EBP readiness was measured using a Korean version of the EBP Readiness Inventory, and the students' reflective logs were analyzed.

RESULTS

Most students reported that EBP education was necessary. The average scores of students' EBP self-efficacy and knowledge were 4.36 out of 6 and 7.65 out of 15, respectively. Of the students, 73% rated their own EBP knowledge at a beginner level. Analysis of the reflective logs revealed that students regarded evidence appraisal as the most critical content (26.3%), additional learning was necessary (21.1%), and evidence-based practice was perceived as difficult (49.4%).

CONCLUSION

Through the integrated research methodology course, nursing students gained EBP self-efficacy while recognizing its importance. However, acquiring sufficient knowledge in a single course was difficult, and the students remarked on the difficulty of the course. Therefore, integrating EBP concepts and applications in core nursing courses should be considered, and various innovative learning strategies are required to improve students' knowledge and competencies.