Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review

Effect of a workplace-based learning program on clerkship students' behaviors and attitudes toward evidence-based medicine practice

In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program's effect on the students' attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students' clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the 'within six months' group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.

Midwifery and nursing honours programs in Australia and New Zealand: A scoping review of contemporary challenges and opportunities

PROBLEM

Contemporary resources that identify the challenges and experiences of Midwifery and Nursing honours students and providers within Australia and New Zealand are lacking.

BACKGROUND

The establishment and development of accredited, tertiary education for Midwifery and Nursing has enhanced professionalism and opportunity. However, the progression from registration pathway programs to Higher Degrees by Research remain limited.

AIM

To undertake a scoping review of Australian and New Zealand honours programs and synthesise student and provider perspectives.

METHODS

A scoping review was undertaken. Publicly available grey literature and relevant database searched. English language, peer-reviewed publications were identified from the past 10-years.

FINDINGS

Within Australia, 16 universities, and 2 in New Zealand, offer a Midwifery and/or Nursing honours program. Within Australia, the majority of programs were offered in both Midwifery and Nursing streams, however only Nursing in New Zealand. Four studies met inclusion criteria and described strengths and challenges of the current offerings.

DISCUSSION

Challenges included: logistical issues related to low/decreasing enrolments and resource. Students identified burdens associated with student driven research and balancing the multiple demands of clinical roles. Opportunities were seen in terms of providers professional interactions between academic and clinical sites. Students viewed honours programs as an opportunity to actively partake in research and determine their commitment to further research training including Doctor of Philosophy (PhD).

CONCLUSION

Progressing the professional status of both Midwifery and Nursing is based on discrete professional research and evidence. Honours programs provide a research focused degree to prepare nurses and midwives, but challenges are present.

Readiness for clinical practice: Self-perceived confidence of final year dental students in Turkey - A multi-institutional study

Introduction

The primary aim of undergraduate dental education is to prepare dental students for independent dental practice and to enable them to provide safe and effective dental care. This study aimed to investigate the self-perceived preparedness of senior dental undergraduate students in Turkey.

Methods

Purposive sampling was used to recruit final-year dental students from 10 dental institutions offering undergraduate dental programs in Turkey. Student preparedness was assessed using a previously validated dental preparedness assessment scale based on 50 items encompassing core clinical skills, cognitive attributes, and behavioral skills. The research instrument was then translated into Turkish. The R statistical environment for Windows was used for the data analysis.

Results

Responses were provided by 272 students (156 women and 116 men; 57% and 43%, respectively) across 10 different universities. The mean score of the participants was 75.68 with slightly higher scores for men compared to women (77.35 vs. 74.46 respectively). However, independent t-tests showed that the scores did not differ significantly between women and men.

Conclusions

This study evaluated the self-perceived preparedness for dental practice of final-year students from 10 universities in Turkey. Although the results showed several areas of weakness, the scores of self-perceived preparedness of Turkish students were comparable to those reported in Europe and Asia. These findings can be used to inform future curriculum development to support students in consolidating their learning in perceived areas of weakness.

Inverted Classroom Teaching of Physiology in Basic Medical Education: Bibliometric Visual Analysis

Background

Over the last decade, there has been growing interest in inverted classroom teaching (ICT) and its various forms within the education sector. Physiology is a core course that bridges basic and clinical medicine, and ICT in physiology has been sporadically practiced to different extents globally. However, students' and teachers' responses and feedback to ICT in physiology are diverse, and the effectiveness of a modified ICT model integrated into regular teaching practice in physiology courses is difficult to assess objectively and quantitatively.

Objective

This study aimed to explore the current status and development direction of ICT in physiology in basic medical education using bibliometric visual analysis of the related literature.

Methods

A bibliometric analysis of the ICT-related literature in physiology published between 2000 and 2023 was performed using CiteSpace, a bibliometric visualization tool, based on the Web of Science database. Moreover, an in-depth review was performed to summarize the application of ICT in physiology courses worldwide, along with identification of research hot spots and development trends.

Results

A total of 42 studies were included for this bibliometric analysis, with the year 2013 marking the commencement of the field. University staff and doctors working at affiliated hospitals represent the core authors of this field, with several research teams forming cooperative relationships and developing research networks. The development of ICT in physiology could be divided into several stages: the introduction stage (2013-2014), extensive practice stage (2015-2019), and modification and growth stage (2020-2023). Gopalan C is the author with the highest citation count of 5 cited publications and has published 14 relevant papers since 2016, with a significant surge from 2019 to 2022. Author collaboration is generally limited in this field, and most academic work has been conducted in independent teams, with minimal cross-team communication. Authors from the United States published the highest number of papers related to ICT in physiology (18 in total, accounting for over 43% of the total papers), and their intermediary centrality was 0.24, indicating strong connections both within the country and internationally. Chinese authors ranked second, publishing 8 papers in the field, although their intermediary centrality was only 0.02, suggesting limited international influence and lower overall research quality. The topics of ICT in physiology research have been multifaceted, covering active learning, autonomous learning, student performance, teaching effect, blended teaching, and others.

Conclusions

This bibliometric analysis and literature review provides a comprehensive overview of the history, development process, and future direction of the field of ICT in physiology. These findings can help to strengthen academic exchange and cooperation internationally, while promoting the diversification and effectiveness of ICT in physiology through building academic communities to jointly train emerging medical talents.

Scientific approach, attitudes, and perspectives on research among Swedish physiotherapy students-a cross-sectional study

BACKGROUND

Scientific evidence is important to evidence-based practice. Hence, the application of evidence-based practice requires relevant skills and an understanding of science, which therefore need to be learned and trained during the undergraduate program in physiotherapy. The aim of this study was to investigate attitudes, perceived competence, and conditions for a scientific approach among physiotherapy students in Sweden, and to compare attitudes and perceived competence between students in different program years.

METHODS

Physiotherapy students from six universities (n = 1499) were invited to respond to a digital survey. The survey contained questions regarding attitudes toward science, perceived competence in research interpretations and open comments regarding requirements for a strengthened scientific approach during education. Comparisons between education years were performed with ANOVA/Kruskal‒Wallis test (scale outcomes) and logistic regression (binary outcomes).

RESULTS

A total of 466 students responded to the survey. In total, 57% (n = 266) of the students had a high interest in science. No significant difference in interest in science was found between students in the three program years, but 75% (n = 347) reported increased interest during the program. A perceived high ability to understand the structure and performance of scientific studies was reported by 31% (n = 144), to evaluate the methodology by 16% (n = 72) and to interpret statistical results from scientific studies by 12% (n = 55). The lowest perceived competence was reported among students in their second year (p < 0.05). A majority of the students (88%; n = 410) reported a perceived personal need for strengthened conditions for a scientific approach, with suggested prerequisites during education via increased theoretical and applied understanding of the research.

CONCLUSION

Even though this study does not fully cover physiotherapy students at all undergraduate programmes in Sweden, the results support that a scientific approach and training should be strengthened during education to enable physiotherapists to understand and interpret science and to fully apply an evidence-based approach in upcoming clinical practice. Both theoretical and applied knowledge and understanding are needed.

GridlockED as an Intervention for Nurses (GAAIN) Study

BACKGROUND

GridlockED (The Game Crafter, LLC) is a serious game that was developed to teach challenges that face nursing and medical professionals in the emergency department (ED). However, few studies have explored nurses' perceptions of the utility, fidelity, acceptability, and applicability of the serious game modality. This study examined how ED nurses view GridlockED as a continuing education platform.

METHOD

This single-center observational study explored how nurses engage with and respond to Grid-lockED. The convenience sample included participants recruited from a local continuing nursing education day. Participants completed a presurvey, engaged in a full game play session with the GridlockED game for approximately 45 minutes, and immediately completed a post-game play survey.

RESULTS

Of the 48 participants (11 male, 37 female; 44 of 48 were RNs), most (91%) agreed that the workflow reflected in the game was equivalent to the flow in a typical ED. Almost all (96%) found the cases in the game reflective of real ED patients, and most (92%) found the game a useful educational tool to prepare new nurses to transition into the ED environment.

CONCLUSION

The GridlockED game shows potential as a serious game to support nursing education, particularly for new ED nurse orientation and transition to ED practice. [J Contin Educ Nurs. 2024;55(5):231-238.].

Planning, implementation and revision of the longitudinal scientific curriculum at the Medical School Brandenburg

Objectives

The aim of this paper is to present the development of a longitudinal curriculum for medical students that is rooted in the particularity of the medical sciences and that aims to build and strengthen medical students' scientific skills and use thereof in clinical practice.

Methods

The curriculum development was initiated based on students' feedback on the initial curriculum. To improve and expand the curriculum appropriately, a needs assessment, a literature review to define science specific to the medical sciences and practice, and an analysis of national and international curricula were performed. The curriculum development followed the PDCA cycle (Plan-Do-Check-Act).

Results

The curriculum extends across the entire medical study programme from semesters 1 to 10. It consists of the seminar series on basic conduct and the epistemological groundings of science, scientific methods in medical research and health sciences, statistics and the scientific internship. Up to the sixth semester, the focus is on the acquisition of skills and abilities to work on and carry out a concrete research project; starting in semester seven, the critical evaluation and application of research results in everyday clinical practice are introduced. The curriculum is taught by epidemiologists, anthropologists, statisticians and public health scholars. Starting in semester seven, seminars are generally taught together with clinicians as tandem teaching. The curriculum is regularly assessed and adjusted.

Conclusions

The Brandenburg Scientific Curriculum can be seen as a model of a longitudinal curriculum to teach scientific thinking and acting. One that is at the same time highly integrated in the medical curriculum overall. A central coordination point seems to be necessary to coordinate the teaching content and to ensure that teachers are interconnected. Furthermore, a complex curriculum in scientific methodology requires a set of teachers from a range of disciplinary backgrounds. To ensure equally high-quality education, the variability of research projects and faculty must be taken into account by establishing generally applicable evaluation criteria and fostering faculty development, and providing all students supporting courses throughout the research project.

Using evidence to identify teaching strategies to improve student competencies

BACKGROUND

Organizational assessment revealed opportunities to develop a critical mass of faculty educated about EBP and integrate competencies into practice. The faculty orientation online program did not include information about the EBP process, teaching strategies, or student competencies.

PURPOSE

The purpose of this EBP project was to investigate the best teaching strategies that foster student competencies.

IMPLEMENTATION PLAN

Based on the evidence, an online EBP module was developed including the best teaching strategies for instruction of EBP, the student competencies that must be mastered and teaching barriers that must be overcome. The results and implementation plan were presented to leaders and faculty Online Council for feedback, approval, and buy-in.

OUTCOMES

Twenty-five faculty completed the EBP online module over 1 year providing examples for teaching strategies that related EBP to clinical practice, teaching methods that engaged students and examples of assignments that promoted student competency.

IMPLICATIONS FOR PRACTICE

Using evidence to develop an EBP module for faculty orientation to online teaching provided a cost-effective way to develop a critical mass of faculty educated in EBP teaching strategies and methods that foster student competencies.

Validation of an instrument to measure knowledge, attitudes and skills towards Evidence-Based Practice in nursing students in Colombia

BACKGOUND

Evidence-Based Practice (EBP) is crucial for the nursing profession, as it helps professionals make informed clinical decisions based on the best available evidence. Most EBP competency assessment tools focus on specific technical knowledge or skill components, and most have been tested on medical students. The Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) is an instrument that assesses the competence in EBP in nursing students. The objective of the article was to evaluate the psychometric properties of the EBP-COQ-E instrument in final year nursing students in Colombia.

DESIGN

A validation study was conducted using a cross-sectional design.

METHODS

The population included nursing students from 19 programs in Colombia, who were selected during the years 2020 and 2021 based on their university enrollment in the last year of training in nursing programs with current qualified registration by the Ministry of Education and who had attended the least one subject related to research. The data were collected through a virtual platform and the researchers consolidated it into a general database. The EBP-COQ-E instrument consists of 25 items grouped into three factors: attitude towards EBP, skills for EBP and knowledge about EBP. The items were answered on a Likert-type scale from 1 to 5. An exploratory factor analysis was performed and an internal consistency analysis of the instrument.

RESULTS

A total of 1021 final year students from 19 university nursing programs participated, with a mean age of 23 years and where 83% identified themselves as female. The results showed good internal consistency and construct validity for the instrument, with a Cronbach's alpha of 0.89. In the exploratory factor analysis, 3 factors were found that explained 51% of the variance of the data. Together these three factors had statistically significant positive correlations.

CONCLUSION

The study contributes to the validation of the Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) which is a valid and reliable tool to assess knowledge, attitudes and skills in EBP in nursing students in the Colombian context. Training in EBP is crucial to guarantee the quality of performance of future professionals in care practice and the EBP-COQ-E can be useful and applicable where it is necessary to evaluate this competence in training processes.

Effectiveness of educational strategies to teach evidence-based dentistry to undergraduate dental students: a systematic review

OBJECTIVES

Evidence-based dentistry (EBD) training has been widely promoted in dental schools around the world and policymakers ask for suitable strategies to teach EBD within undergraduate dental education. The present study aims to evaluate the effectiveness of these strategies on dental students' knowledge, attitude, and skills.

METHODS

PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, and Eric databases were searched using search terms obtained from Medical Subject Headings (MeSH) terms and free text method without time restrictions, up to November 2022. The identified articles were screened based on titles and abstracts for inclusion criteria. Subsequently, relevant articles underwent data extraction. Finally, the risk of bias was assessed through Joanna Briggs Institute critical appraisal checklists.

RESULTS

Twelve of 439 studies were included: nine quasi-experimental studies, two cross-sectional, and one randomized controlled trial study. Regarding the overlap among categories, six studies assessed knowledge, seven assessed attitude, and eight focused on skills or performance in EBD. Due to the heterogeneity of the interventions and results of included studies, a meta-analysis was not performed. EBD was mostly taught in small group collaborations. Interventions included lectures, workshops, seminars, small group sessions, journal clubs, online sessions, or a combination of them in various frequencies and duration.

CONCLUSIONS

EBD implementation into dental curricula is improving through strategies including designing continuing and frequent dental education courses, establishing collaborative student research groups, utilizing online tools for EBD education, and dividing EBD courses into shorter modules. The systematic review protocol was registered in PROSPERO (ID: CRD42022350238).

The Undermined ACGME Subcompetency: A Roadmap for Radiology Residency Programs to Foster Residents-as-Educators

Radiology Residency programs in the United States use a set of six core competencies as laid out by the Accreditation Council for Graduate Medical Education (ACGME) to evaluate the foundational skills of every resident. Despite the fact that educational skills are included under the heading of Practice-Based Learning and Improvement in the ACGME guidelines for radiology residents, it is often underappreciated and undervalued, when compared with medical knowledge or patient care. In this paper, the authors lay out the important role of residents-as-educators and how it can be inculcated as part of formal training during residency. They enunciate five pillars for academic programs to build and maintain the pedagogical skills of their radiology residents: Training, Practicing, Providing Feedback, Mentoring, and Changing the Culture. The authors believe that implementing this will holistically benefit radiology residents as well as radiology in building future educators. The authors also delineate the challenges that programs currently face in implementation and ways to overcome them.

A Psychometric Study of the Student Evidence-Based Practice Scale S-EBPQ-Arabic Version for Use among Undergraduate Nursing Students

Background

Previous studies have demonstrated the significance of evidence-based practice in improving patient care and outcomes. Therefore, integrating evidence-based practice into the health professions' education curriculum has become a pedagogical priority. However, there is a lack of reliable and valid scales to measure students' evidence-based practice usage, attitudes, knowledge, and skills in Arab countries.

Aim

This study aims to examine the adapted Student Evidence-Based Practice Scale Questionnaire (S-EBPQ) validity at logical statistical level and reliability for use among students in Arabic context.

Methods

This cross-sectional study included 233 undergraduate nursing students from a university in Saudi Arabia, who were recruited after translating and pilot testing the S-EBPQ. Three distinctive types of validity including conceptual, content, and face validity were assessed to determine the quality of the questionnaire items logically. Exploratory factor analyses were performed to examine the tool's structural validity. Additionally, internal consistency was assessed to evaluate reliability. Findings. All items were considered relevant to Arab culture, and no changes were made to any items. The content validity indices for all items were above 0.80 as this was considered an acceptable value. The exploratory factor analysis identified the same four factors (practice, attitude, retrieving and reviewing evidence, and sharing and applying evidence-based practice). All KMO values for the individual items ≥0.876 were also well above the acceptable 0.6 limit. The four-factor structure explained a total variance of 64%, with factor load score λ ≥ 0.455. The total and subscale S-EBPQ scores showed evidence of reliability, with Cronbach's alpha ≥0.8.

Conclusions

This study demonstrated the reliability and validity of the Arabic S-EBPQ version. The study has the potential to advance Arab countries' understanding of evidence-based practice. S-EBPQ is a validated tool that can be used to assess nursing students' knowledge of EBP practices. Since educators need to continually evaluate instructional and curricular design in order to meet contemporary nursing needs, this scale can enhance the educational process and enhance students' competencies.

Evidence-based practice in undergraduate physiotherapy programs in Brazil: A cross-sectional document analysis study

BACKGROUND AND PURPOSE

Physiotherapists worldwide are encouraged to integrate evidence-based practice (EBP) to provide safer and effective services. However, for professionals to consolidate this practice, the contact with EBP must begin at the university. In this study, we aimed to map and analyze the distribution of EBP courses and their characteristics in undergraduate physiotherapy programs in Brazil.

METHODS

This web-based document analysis study analyzed the current curricula of undergraduate physiotherapy programs in Brazil according to their availability on university sites. The identification of curricular components and analysis of EBP course syllabi used evidence-based descriptive terms. A descriptive analysis was used to verify the frequency and the regional distribution of EBP courses.

RESULTS

Of 1033 accredited programs in Brazil, 809 curricula were analyzed. Only 9.4% (76/809) of the analyzed curricula presented EBP courses; the mean duration of courses was 44.3 (SD 13.5) hours. Southeast region had the greatest number of undergraduate programs (46.5%, 376/809), and the north region had a proportionally greater number of EBP courses (24%, 12/50). In addition, 15.6% (10/64) and 8.9% (66/739) of the curricula of public and private institutions, respectively, provided EBP content. Critical appraisal was the most mentioned step among 15 undergraduate programs with complete EBP syllabi.

DISCUSSION

Most undergraduate physiotherapy programs in Brazil did not offer an EBP course. Also, an unbalanced emphasis on the critical appraisal step was observed. The lack of EBP content and skills in the curricula of Brazilian undergraduate physiotherapy programs may negatively influence the training, decision-making, and clinical practice of physiotherapists. A re-evaluating of the current undergraduate programs and curricula for EBP-based education is needed.

Artificial intelligence education: An evidence-based medicine approach for consumers, translators, and developers

Current and future healthcare professionals are generally not trained to cope with the proliferation of artificial intelligence (AI) technology in healthcare. To design a curriculum that caters to variable baseline knowledge and skills, clinicians may be conceptualized as "consumers", "translators", or "developers". The changes required of medical education because of AI innovation are linked to those brought about by evidence-based medicine (EBM). We outline a core curriculum for AI education of future consumers, translators, and developers, emphasizing the links between AI and EBM, with suggestions for how teaching may be integrated into existing curricula. We consider the key barriers to implementation of AI in the medical curriculum: time, resources, variable interest, and knowledge retention. By improving AI literacy rates and fostering a translator- and developer-enriched workforce, innovation may be accelerated for the benefit of patients and practitioners.

Undergraduate research implementation in physiotherapy: a hands-on and real experience of a randomised controlled trial

BACKGROUND

Evidence-based practice (EBP) is the gold standard approach in physiotherapy, and it is essential that students are aware that it is the appropriate way to provide the patient with the best possible treatment. Undergraduate research (UR) can positively influence learning outcomes and research competencies related to EBP compared to traditional methods of higher education. The aim of this study was to evaluate the effect of implementing a research-based activity (i.e., active participation in a randomised controlled trial [RCT]) in the UR programme on the learning and acquisition of research methodology-related competencies by first-year physiotherapy students.

METHODS

Students in the first academic year of the Bachelor´s Degree in Physiotherapy of University of Deusto (Donostia-San Sebastian, Spain) who were enrolled in the subject 'Introduction to Research Methodology' were invited to take part in a real RCT which consisted of three groups: intervention, placebo, and control group. While the RCT was carried out, researchers and/or participants roles were combined among students during the semester. At the end, a questionnaire that included open and closed questions was used to evaluate the effectiveness of the UR strategies used in students´ acquisition of theoretical knowledge, research competencies, self-efficacy of RCT skills and procedures. Lecturers also completed the questionnaire to evaluate their experience.

RESULTS

From the 114 students enrolled in the subject, 102 participated in the RCT and 110 answered the final questionnaire. Regarding the development of research competencies, UR had a positive or very positive impact on critical thinking (67% and 18%, respectively) and in the assessment of methodological quality (66% and 23%, respectively). Furthermore, most students reported that the implementation of the RCT facilitated their knowledge of placebo, detection of bias, development of critical thinking and a better understanding of methodological issues in research. Lecturers reported an additional burden that was difficult to reconcile with daily duties.

CONCLUSION

The novel UR program provided students with a new opportunity to improve their knowledge of RCT procedures, thus making the learning process more meaningful. Therefore, ways of teaching and learning focused on improving research and inquiry attitudes should be considered and integrated into the health care curriculum, especially in physiotherapy programs, to ensure the transfer of EBP for the provision of the best care.

TRIAL REGISTRATION

Australian New Zealand Clinical Registry: ACTRN12622000263796p (14/02/2022).

Teaching evidence-based practice to physiotherapy students in Italy: a cross sectional study

BACKGROUND

Evidence-based practice (EBP) is being rapidly adopted by the Italian physiotherapy community, although a knowledge gap persists at clinical level with consequent lack of integration of EBP into ground roots practice. Teaching of EBP during the Bachelor of Science (BSc) undergraduate course in physiotherapy likely has a vital role to play in the spread of knowledge, providing a grounding in the fundamental concepts of EBP. The aim of the present study was to investigate the prevalence of EBP educational content in Italian BSc courses in physiotherapy.

METHODS

This is a cross-sectional study during which characteristics of EBP teaching in BSc degree courses of physiotherapy in Italy were collected from institutional websites during the period May to September 2021 with an update in August 2022. We used the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for our manuscript.

RESULTS

Forty-two physiotherapy BSc degree programs were retrieved, accounting for all the BSc delivered in the 2021-2022 academic year. Fourteen of these (33.3%) did not report EBP content. Northern universities provided EBP content in 16 out of 18 (88%) degree courses. Central Italian universities provided EBP content in 6 out of 9 (66.6%) degree courses. Southern universities delivered EBP content in 3 out of 9 (33.3%) degree courses. The universities of Sicily and Sardinia provided EBP content in 2 out of 5 (40%) degree courses. The degree courses taught in public universities were more likely to contain EBP material (25 out of 37, 67.4%), compared to those taught within the private system (3 out of 5, 60%).

CONCLUSIONS

The prevalence of EBP content within physiotherapy BSc degree programs in Italy can be considered suboptimal, with both regional differences and according to the system (public vs private). The results of this study could be used as a stimulus for increasing investment in the teaching of EBP in Italian physiotherapy degree courses, thereby improving educational standards.

The role of nursing leadership in promoting evidence-based nursing practice

Although the undermining of the nursing profession, time constraints, and the lack of inclusive teaching of evidence-based nursing (EBN) in the nursing school's curriculum have long been identified as being some of the main barriers to the adoption of evidence-based practice (EBP) by nurses, the specific role of nurse leaders in directly influencing and supporting evidence-based nursing is not well demonstrated. This opinion piece discusses potential factors that influence the implementation of EBP into clinical routine practice, as well as how nursing leadership styles can contribute to its promotion in contemporary healthcare settings.

Improving the Evidence-Based Practice Skills of Entry-Level Physiotherapy Students through Educational Interventions: A Scoping Review of Literature

Evidence-based practice (EBP) is an essential approach in healthcare, attracting growing interest among both practitioners and researchers. This scoping review aims to (1) systematically investigate the effectiveness of pedagogical methods used to facilitate learning of the EBP approach, and (2) explore the perceptions, experiences, and issues related to these learning methods. The overarching purpose is to identify the state of the art in pedagogical methods, instruments, influences, and barriers in teaching and learning EBP within entry-level physiotherapy education programs. This scoping review was conducted following PRISMA guidelines, with PubMed and Eric databases being searched for peer-reviewed original research articles using a combination of keywords. Excluding non-pertinent articles from the initial 465 identified, 12 were eligible for final inclusion (5 quantitative, 3 qualitative, and 4 mixed-methodology studies). A range of pedagogical methods and instruments for teaching EBP in physiotherapy education were detected, all of which having the capability to positively affect physiotherapy outcomes. Findings from this study support the significant influence that EBP exerts on the improving of the quality of teaching, together with the necessities that the involvement of EBP in physiotherapy education programs provide. Several barriers were identified, which should be taken into consideration when designing population-specific EBP strategies tailored to these particular needs.

Online training to improve evidence-based leadership competencies among nurse leaders in Finland and China: study protocols for two randomised feasibility trials

INTRODUCTION

This study protocol describes two randomised feasibility trials that will evaluate the feasibility and preliminary effectiveness of an online training course to improve evidence-based leadership competences among nurse leaders working in hospitals in Finland and China.

METHODS AND ANALYSIS

Two randomised, parallel-group studies will be conducted separately: one in Finland (n=140) and one in China (n=160). Nurse leaders who fulfil the eligibility criteria will be randomly allocated (1:1) to participate in either the online evidence-based leadership training or conventional online training (reading material only). The primary outcomes will be acceptance of the online course (logging into the platform) and adherence in the online course (returned course tasks and drop-out rate of the participants). The secondary outcomes will be acceptance of the study regarding recruitment, feasibility of the eligibility criteria and outcome measures and potential effectiveness of the online course on leadership skills, evidence-based knowledge, attitudes, practice, self-efficacy, self-esteem and intention to leave. In addition, the feedback will be asked after the course.

ETHICS AND DISSEMINATION

Two separate trials have received ethical clearance from local ethics committees (12/2022 in Finland, E2021167 in China). Permission to conduct the study will be granted by hospital authorities. All participants will provide electronic informed consent before baseline data are collected. The trial results will be published locally, nationally and internationally in professional and peer-reviewed journals, and shared at national and international meetings and conferences.

TRIAL REGISTRATION NUMBERS

NCT05244512; NCT05244499.

Knowledge in Motion: A Comprehensive Review of Evidence-Based Human Kinetics

This comprehensive review examines critical aspects of evidence-based human kinetics, focusing on bridging the gap between scientific evidence and practical implementation. To bridge this gap, the development of tailored education and training programs is essential, providing practitioners with the expertise and skills to effectively apply evidence-based programs and interventions. The effectiveness of these programs in improving physical fitness across all age groups has been widely demonstrated. In addition, integrating artificial intelligence and the principles of slow science into evidence-based practice promises to identify gaps in knowledge and stimulate further research in human kinetics. The purpose of this review is to provide researchers and practitioners with comprehensive information on the application of scientific principles in human kinetics. By highlighting the importance of evidence-based practice, this review is intended to promote the adoption of effective interventions to optimize physical health and enhance performance.

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

AIM

To examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students.

BACKGROUND

The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students.

DESIGN

A quasi-experimental study.

METHODS

Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students' EBP competence, learning experience and satisfaction and score of team-based research protocol assignment.

RESULTS

Compared with conventional teaching, the innovative teaching characterized by EBP improved students' EBP competence in terms of attitudes and skills and enhanced student's comprehensive ability in nursing research. Students' learning experience and satisfaction were similarly favorable between the two groups.

CONCLUSIONS

For undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.

Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research

BACKGROUND

Point-of-care medical information systems (POCMIS) can provide an efficient and effective means of strengthening health systems globally through their encouragement of continued medical education. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this research provides suggestions for improved implementation of POCMIS in low- and middle-income countries informed by an intervention implemented across public and military hospitals in Lima, Peru.

METHODS

Analysis is based on qualitative interviews conducted with 12 Peruvian surgeons across eight public hospitals and one military hospital who received an intervention that provided free access to UpToDate and introduced Google Translate. The post-intervention interviews were transcribed, translated, and analyzed for themes overlapping with CFIR constructs to expose barriers to implementation and suggestions for improved implementation of future interventions.

RESULTS

Barriers included a lack of seniority buy-in and engaged leadership, an overabundance of personal preferences for multiple POCMIS, and a culture of assumption that inhibited open communication regarding access to and use of POCMIS. Suggestions for improved implementation focused on the adaptation of the intervention. Namely, surgeons discussed regionally-specific adaptations as well as adaptations specific to their surgical specialty including visual, rather than written, representation of the information available via POCMIS.

CONCLUSIONS

Results indicate necessary adaptations for implementing interventions including POCMIS in LMICs, mimicking much of the implementation science literature on intervention adaptation. In addition to explicit suggestions provided by surgeons, we also suggest actionable steps to adapt to barriers identified in our data. Rapid assessment procedures (RAP) are one established methodological technique useful for assessing organization culture prior to implementation, allowing for necessary cultural adaptations. Dynamic adaption process (DAP) is another useful and established method that breaks implementation into four phases allowing for adaptations based on the initial assessment of the intervention site.

CE: How to Write an Effective Résumé

ABSTRACT

In today's health care job market, nursing students are aggressively recruited for jobs even before graduation. Employers want to see accurate, informative résumés that efficiently and honestly convey an applicant's education and skills and how they match up with the employer's needs. Although résumés remain essential tools for job seekers, in recent years requirements have changed: nursing students and new graduate nurses need to develop an employer-focused résumé geared toward a specific job. This article can assist these nurses in developing résumés that accommodate these latest trends.

Evidence-Based Medicine Course in Combination With Journal Clubs to Promote Evidence-Based Surgery

Introduction To provide high-quality surgical care, surgeons must critically appraise medical literature to adapt their clinical practice whenever convincing evidence emerges. This will promote evidence-based surgery (EBS). Over the last decade, we have organized monthly journal clubs (JCs) and more extensive quarterly EBS courses for surgical residents and PhD students, supervised by surgical staff. We evaluated the participation, satisfaction, and knowledge gained by this EBS program, to make the program future-proof and aid other educators. Materials and methods An anonymous digital survey was distributed via email among residents, PhD students, and surgeons of the Amsterdam University Medical Centers' (UMC) surgical department in April 2022. The survey included general questions on EBS education, specific course-oriented questions for the residents and PhD students, and questions about supervision for surgeons. Results The survey was completed by 47 respondents from the surgery department of the Amsterdam UMC University Hospital, of whom 63.8% (n=30) were residents or PhD students and 36.2% (n=17) were surgeons. During one year of the combined EBS course and JCs, the EBS course was attended by 40.0% (n=12) of PhD students and was rated with a mean score of 7.6/10. JCs were attended by 86.6% (n=26) of residents or PhD students and received a mean score of 7.4/10. Reported strengths of the JCs were their easy accessibility and the acquisition of critical appraisal skills and scientific knowledge. A reported point of improvement was to focus more deeply on specific epidemiological topics per meeting. Of the surgeons, 64.7% (n=11) had supervised at least one JC and gave a mean score of 8.5/10. The main reasons to supervise JCs were the distribution of knowledge (45.5%), scientific discussion (36.3%), and contact with PhD students (18.1%). Conclusion Our EBS educational program, including JCs and EBS courses, was well appreciated by residents, PhD students, and staff. This format is advocated for other centers aiming to better implement EBS in surgical practice.

The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students

Introduction

Evidence-based medicine (EBM) refers to medical practice that uses current best evidence to inform decision-making. This requires several skills including (1) creating an answerable question, (2) searching literature, (3) critically appraising evidence, and (4) applying results. Journal clubs are known to be effective in improving searching and critical appraisal skills in graduate medical education. In pre-clerkship medical education, journal clubs are used less often, and students often do not have the opportunity to engage in all of the steps above.

Methods

We developed a journal club for pre-clerkship students and measured its effectiveness using a pre-test, post-test design. Students attended 5 journal club sessions run by rotating student leaders and facilitated by faculty. Student groups developed searchable questions from clinical cases, searched the literature, located and critically appraised an article, and applied results to the case. We measured EBM skills and confidence using two validated questionnaires.

Results

Twenty-nine students (MS-1 and MS-2) completed the study. EBM confidence significantly improved at post-test with greatest improvements in the MS-1 student cohort. Confidence in developing a searchable question from a patient case significantly improved in both cohorts. There were no changes measured on the Test of EBM Knowledge and Skills.

Discussion

Participation in a faculty-mentored, student-led journal club improved confidence across all domains of EBM, primarily in MS-1 students. Journal clubs are positively received by pre-clerkship medical students and provide effective mechanisms to teach and promote all steps of EBM in pre-clerkship curricula.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01779-y.

Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment

BACKGROUND

Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence.

STUDY DESIGN

This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes.

RESULTS

Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency.

CONCLUSIONS

Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems.

How Well Prepared Are Dental Students and New Graduates in Pakistan-A Cross-Sectional National Study

The transition of an undergraduate dental student to an actual practicing dentist is a crucial phase and ensuring the preparedness of graduates for the complexity and demands of contemporary dental practice is a challenging task. This study aimed to evaluate the self-perceived preparedness of undergraduate dental students and house officers in the dental colleges of Pakistan. A cross-sectional national study was planned to collect information from dental students and new graduates in Pakistan. The pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS) was used. A purposive sampling technique was utilized to recruit house officers and undergraduate dental students from 27 dental schools in Pakistan. The data analysis was carried out using the R statistical environment for Windows (R Core Team, 2015). A total of 862 responses with 642 females and 219 males were analyzed in the study. Overall, the clinical skills score was 30.56 ± 9.08 and the score for soft skills was 30.54 ± 10.6. The mean age of the participants was 23.42 ± 1.28. Deficiencies were reported in various soft skills and clinical skills attributes. The results highlighted the strengths and weaknesses of dental students and new graduates in Pakistani dental institutions. The findings may be used to further develop and strengthen the teaching and training of dental students in Pakistan.

Self-perceived competences in evidence-based practice of clinical-teaching nurses versus clinical nurses

AIM

To compare the evidence-based practice (EBP) self-perceived competences of clinical teacher nurses (CTN) versus clinical nurses (CN) to detect areas for improvement in practical training.

METHOD

A cross-sectional study by means of a self-assessment questionnaire sent to nurses of two public hospitals of Castilla y León was performed, between February to May 2020. Variables included competences in evidence based practice (EBP) - attitude, knowledge, skills and use-, sociodemographic, job, academic, teaching relations and training in investigation methodology and/or EBP. A validated questionnaire EBP-COQ prof© of 35 questions with answers type Likert (1, very disagree-5, very agree) was used. Data analysis (descriptive and bivariate) was performed by means SPSS v.24 program.

RESULTS

171 questionnaires were answered by nurses. CN 52%, CTN 48%. There were no significant differences between both groups regarding sociodemographic variables. Mean age was 43.6 ± 9.9 and 42.9 ± 8.5 for CN and CTN, respectively. Total sample showed a mean EBP competency score of 3.54 ± 1.00 (attitudes: 4.40 ± 0.60; knowledge: 3.08 ± 0.94; skills: 3.57 ± 0.66; utilization: 3.36 ± 0.75). The CTN group obtained higher mean scores in knowledge dimension, compared with CN (P = .02) and with total sample (P = .02). There were no significant differences in other dimensions.

CONCLUSION

CTN showed better self-perceived competences scores only in the knowledge dimension compared with CN. Taking in account the level of responsibility they support in their daily practice, it would be advisable to design management strategies in order to improve attitudes, skills and utilize EBP, acting as professional role models for students and peer mentors.

Methods of teaching evidence-based practice: a systematic review

BACKGROUND

To identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency.

METHODS

Electronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool.

RESULTS

Twenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention.

CONCLUSION

Current evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.

E-Learning Material of Evidence-Based Medicine for Laypersons

BACKGROUND

There is a need for evidence-based medicine (EBM) education for laypersons. However, there are few materials or opportunities to learn EBM for Japanese laypersons.

OBJECTIVE

The aim of this study was to develop and test the usability of e-learning material on EBM for health-conscious laypersons in Japan.

METHODS

This study was conducted in two steps. First, content elements for the material were identified using purposive evaluation and a prototype of the e-learning material was developed. Following this, usability testing of the material was conducted. A questionnaire survey and qualitative semi-structured focus group interviews were conducted with health-conscious laypersons. Subsequently, the material was refined and finalized.

KEY RESULTS

A total of 217 descriptions related to EBM were extracted from 12 materials and were integrated into 56 major elements. Each element was rated from the viewpoint of usefulness for laypersons and reviewed by four expert panelists, and finally 18 elements were confirmed, most of which were critical appraisal skills related to critical health literacy. For the usability testing after constructing the material, 25 laypersons participated, and 19 (76%) felt very/rather much interest in the contents of the material in the questionnaire. The results of five focus group interviews showed that the effectiveness of the e-learning material was influenced by the story and characters, and whether the contents of the material were consistent with interviewees' daily interests.

CONCLUSIONS

The e-learning material on EBM was found to be of interest to health-conscious laypersons and appeared to be useful in participants' daily lives. This study successfully developed novel e-learning material on the essential components of EBM for laypersons in Japan. [HLRP: Health Literacy Research and Practice. 2022;6(4):e290-e299.] Plain Language Summary: This study developed and tested the usability of e-learning material to encourage health-conscious laypersons in Japan to learn the fundamentals of evidence-based medicine. Most of the contents of the material are related to critical health literacy. The usability testing showed that the material was of interest to non-health professionals and useful for dealing with health information in their daily lives.

Evidence-Based Practice in Medical Education: Mapping a Research and Critical Analysis Program Against the Sicily Statement

This paper describes how evidence-based practice (EBP) is taught through an integrated curriculum across a 4-year graduate MD program. Mapping of the curriculum to the domains of the Sicily Statement of EBP was an effective approach to evaluate integration of EBP into a graduate medical education program. The longitudinal integration of EBP engages students in multiple opportunities to learn, understand, and apply these concepts. The EBP program incorporates both traditional and innovative teaching approaches and can easily be adapted for other professional courses. This whole-course approach is graduating a new generation of doctors with a sound understanding of EBP.

Relationship between research self-efficacy and evidence-based practice in the medical students

BACKGROUND

Due to the rapid advancement of medical knowledge, promotion in research is necessary to have the best clinical practice. Research Self-efficacy (RSE) is the researcher's confidence in their ability to conduct a specific study. The Evidence-Based Practice (EBP) represents how to improve the quality of care and treatment of patients. RSE and EBP are the cornerstones of successful research and then efficacious medical practice. This study aims to evaluate RSE and acceptance of EBP and their correlation among medical students.

MATERIALS AND MEHODS

This is a cross-sectional study designed on 600 clinical students at the medical school of Shiraz, using a census method in 2020. Students were invited to fill out the standardized Phillips and Russell's questionnaires about RSE (4 domains, 33 questions) and Rubin and Parrish's questionnaire of EBP (10 questions). The gathered data were analyzed through the SPSS at α = 0.05 using descriptive statistics, t-test, Chi-square, and multiple linear regressions.

RESULTS

There was a positive correlation between EBP and RSE score (P < 0.05). The results of linear regression test showed that all variables had a significant effect on our response variables and their effect were significant (P < 0.05). The highest mean score in RSE was shown in the subscale of writing skills (52.54). The lowest score was observed in the subscale of quantitative (student's subjective assessment of their ability to work with statistically related data and formulas) as well as computer skills (35.61).

CONCLUSIONS

Students who participated in a research project, workshop, or Master of Public Health program got a higher RSE and EBP. Due to the positive correlation between RSE and EBP, we conclude that trained physicians who can research independently and use research evidence can find the best treatment approach for patients. These finding support the importance of integrating research education in medical curriculum to increase RSE and finally improvement of EBP among medical students.

Research-based education in undergraduate occupational therapy and physiotherapy education programmes: a scoping review

BACKGROUND

In a research-based learning environment, students learn how to become critical thinkers and lifelong learners, and to generate discipline-enriching knowledge. Research training is important for all healthcare professionals and the integration of research in education can be one approach to improve evidence-based practice among future professionals. The purpose of this scoping review was to identify studies reporting on research-based education in undergraduate occupational therapy and physiotherapy curricula to document the current state of knowledge and to map factors that reflect and support the implementation of research-based education in undergraduate occupational therapy and physiotherapy programmes.

METHODS

A scoping review was used to systematically select and summarize existing literature. The search was conducted using a combination of keywords and MeSH terms in the following databases: EBSCO (Academic Search Elite, CINAHL, ERIC), MEDLINE, Embase, Education Source and grey literature. A thematic analysis identified strategies used to implement and promote research-based education in occupational therapy and physiotherapy bachelor programmes.

RESULTS

The database search identified 3068 records. 75 were eligible for full-text assessment and 27 studies were included. The studies were published between 1999 and 2021 and were conducted in Norway, Canada, South Africa, Australia, the United Kingdom, the United States, New Zealand, Ireland, Taiwan, Italy, and Iran. The study designs were mainly quantitative and qualitative, and studies included primarily occupational therapy and physiotherapy students. We identified the following four strategies: 'student engagement in research', 'curriculum improvement regarding EBP', 'EBP teaching' and 'journal club', where 'EBP teaching' was most frequently identified.

CONCLUSIONS

Findings from this scoping review suggest that ensuring students' competence in research methods is necessary for students to be able to read and understand research articles, which are important as foundational skills in undergraduate research training. Journal clubs can be a foundation for student engagement with research literature, and students' basic research skills may be facilitated through their involvement in research projects and by conducting systematic reviews. Further, cooperation with clinical practice is important, and the awareness of research-based education should be increased among both faculty members and students.

Effect of flipped classroom approach in the teaching of a hematology course

The flipped classroom is a teaching strategy used to enhance the engagement of students in the learning process. Replacing didactic lectures with active learning strategies through flipped classroom sessions fosters independence and the opportunity for students to engage in different passive learning styles. Although many studies of the flipped classroom approach have been conducted with medical students, few have focused on the effect of flipped classroom sessions on students in other medical professional fields. The aim of this study was to assess the effect of the flipped classroom approach on the performance of medical laboratory science students in a hematology course and their perception of the flipped classroom as an active learning strategy. In addition, students' perceptions regarding the flipped classroom as an active learning strategy were assessed. Of two cohorts in hematology courses, cohort 2 attended flipped classroom sessions, whereas cohort 1 underwent traditional class sessions. Students' learning outcomes, achievements and performance on examinations in hematology courses were assessed. In addition, a satisfaction survey was distributed to the students to evaluate their perception of the flipped classroom as a student-centred learning strategy. Students in cohort 2 performed significantly better in the knowledge and cognitive domains than did those in cohort 1 (p < 0.001). Cohort 2 students completed the course successfully with an average grade of 81%, and few students received low grades; in comparison, cohort 1 students completed the course with an average grade of 73%, and 7 students received a grade of F. Of students in cohort 2, 83% believed that the flipped classroom provided a better understanding of the subject matter and appropriate knowledge and skills. The results indicate the effectiveness of flipped classrooms as an active learning style in enabling students to obtain desirable knowledge and improve their academic performance. Moreover, students zrecognized that the flipped classroom as an active learning style was more beneficial than the traditional teaching approach.

Undergraduate Nursing Students’ Experiences of Conducting Clinical Research Projects in Their Bachelor Theses – a Qualitative Study

Introduction

The aim of educational institutions in the field of nursing is to educate nurses with the competences to provide high-quality care to their patients, meaning that students need to learn about evidence-based practice and how to translate the knowledge, skills, competency, beliefs, attitudes, and behaviours into daily practice. The bachelor thesis is the ultimate test for undergraduate nursing students to present what they have learned.

Objective

The aim of this study was to explore undergraduate nursing students’ experiences of conducting clinical projects in their bachelor theses.

Methods

We used qualitative focus-group interviews to gain a deeper understanding of the students’ experiences of conducting clinical projects in their bachelor theses as an approach to learn about evidence-based practice. The analyses focused on meaning according to Brinkmann and Kvale.

Results

Eighteen out of 22 eligible students who had chosen to participate in ongoing clinical research projects and write an academic paper as their bachelor thesis were included in this study. The students were all females and divided into three focus groups. The clinical projects were conducted in a public hospital, a private hospital, nursing homes, or within home-care nursing. The analyses showed that conducting clinical projects in the bachelor thesis provided the students with important knowledge for providing evidence-based care and it. motivated them to want to initiate future clinical projects as nurses., They got valuable hands-on experience for how to conduct research, and made the students aware of the importance of keeping themselves updated on the latest knowledge.

Conclusion

Conducting clinical research projects on a bachelor level provide undergraduate nursing students with important knowledge of how to provide evidence-based nursing care to their patients. Learning how to conduct clinical research projects is also important for motivating future nurses to initiate research aiming to improve clinical nursing practice.

Perceptions of Pharmacy Students on the E-Learning Strategies Adopted during the COVID-19 Pandemic: A Systematic Review

BACKGROUND

E-learning strategies were globally adopted by academies because of the COVID-19 pandemic. The characterization of students' perception of online learning is fundamental to design appropriate models for pharmacy curricula. The study aim was to carry out a systematic review about the perception of pharmacy students on the e-learning strategies adopted during the COVID-19 pandemic.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was followed. PICOS criteria were applied. Five databases were screened: PubMed, Cochrane Library, DOAJ-Directory of Open Access Journals, SciELO-Scientific Electronic Library Online and b-on-Online Library of knowledge (Biblioteca do conhecimento online).

KEYWORDS

"pharmacy and (distant or remote or e-learning or online or zoom or education or training or digital) and (COVID or SARS and (student or undergraduate) and (opinion or satisfaction or perception or attitude)".

RESULTS

23 out of 176 papers were selected (28 duplicated and 125 excluded). Selected papers were classified, as follows: studies exclusively involving pharmacy students (n = 8); studies simultaneously involving pharmacy students and other healthcare students (n = 6); and studies related to the involvement of pharmacy students in specific courses (n = 9).

CONCLUSIONS

In general, the perception of pharmacy students on e-learning strategies adopted during the COVID-19 pandemic was positive. However, an expressive proportion of undergraduates reported negative issues about online education, which seems to support the necessity of optimizing e-learning strategies in the future.

Barriers and facilitators to answering clinical questions in the Americas: a cross-sectional study of surgical trauma care providers

BACKGROUND

We aimed to understand how surgical trauma providers in the Americas acquire answers to clinical questions and what barriers and facilitators they face in efforts to practice according to recommendations for common surgical cases. We hypothesized that increased English proficiency and country income improved providers' acquisition and application of clinical knowledge.

METHODS

A 23-question survey evaluated reported confidence in interpretation of evidence, perceived language fluency, and access to and application of recommendations on sepsis and appendicitis. Electronic surveys were distributed across the Americas to Pan American Trauma Society members.

RESULTS

108 participants from 21 countries completed this survey. 59% had ≥21 years of provider experience. 38% reported their English reading comprehension as less than or equal to "limited working proficiency." 44% endorsed using Google Translate; 35% reported they did not need translation tools to evaluate medical literature. 59% felt uncertainty regarding clinical care at least weekly. 65% reported inability to answer their clinical questions at least once per month. 86% felt confident in their ability to interpret and apply evidence for their practice. To answer clinical questions, participants listed guidelines (76%), full-text peer-reviewed journal articles (61%), and meta-analyses (49%) as their most used resources. 25% answered all five clinical questions correctly, whereas 43% answered three or fewer correctly. 79% felt they had adequate access to resources to answer the five clinical questions. When controlling for individual demographic characteristics, decreased age (p<0.01) and increased country income level (p=0.03) positively impacted correct answers to questions.

DISCUSSION

Uncertainties in clinical care are unavoidable. Language, age, and country income level impacted provider acquisition and application of knowledge relevant to select clinical scenarios. These findings highlight disparities in access and training and add urgency to the movement for improved dissemination and implementation approaches for evidence-based practice in surgery.

LEVEL OF EVIDENCE

IV.

Validation of the Evidence-Based Practice Competence Questionnaire for Nursing Students: A Cross-Sectional Study in Greece

(1) Background: evidence-based nursing has been widely adopted by healthcare facilitators, and it is predicated on the connection between research evidence and clinical practice. The knowledge and implementation of evidence-based practice (EBP) depend on a variety of long-established barriers and attitudes. The purpose of this study was to translate and validate the Greek version of the evidence-based practice competence questionnaire (EBP-COQ) and test it on a sample of Greek undergraduate nursing students. (2) Methods: a cross-sectional analysis was conducted on data obtained between November 2018 and January 2019. A convenience sample of 320 Greek undergraduate nursing students participated in a survey to examine the psychometric properties of the tool. The reliability and validity of the tool was examined. Cronbach’s coefficient alpha was used to determine the scale’s internal consistency reliability. (3) Results: the EBP-COQ was translated and validated. The estimated Cronbach’s alpha was higher than 0.70 for all scales. Of the participants, 22.5% were men and 77.5% were women, while 31% of them were in their final year of nursing education. A total of 61% of the students stated that they had not participated in an EBP seminar in the past. High Spearman’s correlation coefficients were found for “Knowledge in EBP” with “Personal attitude towards EBP” (rs = 0.329, p < 0.001). (4) Conclusions: the Greek version of the EBP-COQ is a valid instrument that can be used in the Greek population. It provides information about attitude, knowledge and skills in the EBP approach.

Integrating evidence-based medicine skills into a medical school curriculum: a quantitative outcomes assessment

OBJECTIVES

This research project aims to determine the potential differential impact of two curricular approaches to teaching evidence-based medicine (EBM) on student performance on an EBM assignment administered during the first year of clerkship. A meaningful result would be any statistically significant difference in scores on the assignment given to measure student performance.

DESIGN

In order to assess and compare student learning under the different curricula, the principal investigator and a team of five faculty members blinded to assignment date and other possibly identifying details used a modified version of the previously validated Fresno rubric to retrospectively grade 3 years' worth of EBM assignments given to students in clerkship rotations 1-3 (n=481) during the Internal Medicine clerkship. Specifically, EBM performance in three separate student cohorts was examined.

SETTING

The study took place at a large Midwestern medical school with nine campuses across the state of Indiana.

PARTICIPANTS

Study participants were 481 students who attended the medical school and completed the Internal Medicine clerkship between 2017 and 2019.

INTERVENTIONS

Prior to the inception of this study, our institution had been teaching EBM within a discrete 2-month time period during medical students' first year. During a large-scale curricular overhaul, the approach to teaching EBM was changed to a more scaffolded, integrated approach with sessions being taught over the course of 2 years. In this study, we assess the differential impact of these two approaches to teaching EBM in the first 2 years of medical school.

MAIN OUTCOME MEASURES

We used clerkship-level EBM assignment grades to determine whether there was a difference in performance between those students who experienced the old versus the new instructional model. Clerkship EBM assignments given to the students used identical questions each year in order to have a valid basis for comparison. Additionally, we analysed average student grades across the school on the EBM portion of step 1.

RESULTS

Four hundred and eighty-one assignments were graded. Mean scores were compared for individual questions and cumulative scores using a one-way Welch Analysis of Variance test. Overall, students performed 0.99 of a point better on the assignment from year 1 (Y1), prior to EBM curriculum integration, to year 3 (Y3), subsequent to EBM integration (p≤0.001). Statistically significant improvement was seen on questions measuring students' ability to formulate a clinical question and critically appraise medical evidence. Additionally, on the United States Medical Licensing Examination (USMLE) step 1, we found that student scores on the EBM portion of the examination improved from Y1 to Y3.

CONCLUSIONS

Results of this study suggest that taking a scaffolded, curriculum-integrated approach to EBM instruction during the preclinical years increases, or at the very least does not lessen, student retention of and ability to apply EBM concepts to patient care. Although it is difficult to fully attribute students' retention and application of EBM concepts to the adoption of a curricular model focused on scaffolding and integration, the results of this study show that there are value-added educational effects to teaching EBM in this new format. Overall, this study provides a foundation for new research and practice seeking to improve EBM instruction.

TRIAL REGISTRATION NUMBER

IRB approval (Protocol number 1907054875) was obtained for this study.

Individual and organizational factors associated with evidence-based practice among physical and occupational therapy recent graduates: A cross-sectional national study

BACKGROUND

Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate-level entry education to address graduates' readiness for evidence-based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence-based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence-based activities among graduates of professional OT and PT master's programs.

METHODS

A cross-sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence-based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis.

RESULTS

257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence-based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence-based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12).

CONCLUSIONS

Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence-based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence-based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence-based professionals.

Consensus on evidence-based medicine curriculum contents for healthcare schools in Brazil

OBJECTIVES

Healthcare professionals need to take into account their knowledge, skills and attitudes to develop a focused clinical question, perform an effective search of the literature, critically appraise the evidence, and apply to the clinical context and evaluate the effectiveness of the process. To date, there is a lack of consensus on evidence-based medicine (EBM) curriculum for undergraduate healthcare students in Brazil. The aim of this study was to develop a consensus on EBM curriculum contents for healthcare schools in Brazil considering expert opinion.

DESIGN

Modified three-round Delphi methodology.

SETTING

Online survey.

PARTICIPANTS

The expert panel was composed of 40 healthcare professionals from different specialties. Most of the participants (n=24; 60%) were female with the age between 30 and 44 years. Participants were also experts in the field of epidemiology, biostatistics or public health. The mean experience of experts in teaching EBM was 9.5 years.

MAIN OUTCOME MEASURES

An online questionnaire consisting of 89 items related to EBM was sent to the experts. The experts ranked each item of EBM curriculum considering the importance of each item as omitted, mentioned, explained or practised. The last section of the questionnaire was composed of 'additional content' where the experts evaluated only if an item should be included or not, the form of offering the EBM contents and the total workload (in hours/semester). Open-ended questions were present in each section to give the opportunity to experts to insert suggestions. Items that reached values greater than or equal to 70% of agreement among experts was considered definitive for the curriculum. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the EBM contents were classified according to the degree of consensus as follow: strong (≥70% of agreement), moderate (51%-69% of agreement) and weak (50% of agreement) based on the maximum consensus reached.

RESULTS

Of the 89 initial contents, 32 (35.9%) reached a strong degree of consensus, 23 (25.8%) moderate degree of consensus, two (2.2%) weak degree of consensus and 35 items were not recommended (≤50% of agreement). The workload suggested by experts should be between 61 and 90 hour/semester and an EBM curriculum should be offered with epidemiology and biostatistics as prerequisites. Regarding the importance of each item, 29 (72.5%) should be explained and 25 (27.5%) should be practised with exercises.

CONCLUSIONS

The consensus on an EBM curriculum for Brazilian healthcare schools consists of 54 items. This EBM curriculum also presents the degree of consensus (strong, moderate and weak), the importance of each item (mentioned, explained and practised with exercises). A total workload of between 60 and 90 hours per semester was suggested and the EBM curriculum should be offered with epidemiology and biostatistics as prerequisites, but also EBM contents should be included within other disciplines throughout the entire undergraduate course.

Online supplementation for teaching evidence-based medicine: feasibility of a randomised-controlled trial

BACKGROUND AND OBJECTIVES

As teaching technology advances, medical education is increasingly using digital mediums and exploring instructional models such as the flipped classroom and blended learning courses, where the in-class taught sessions are more groups on content delivered before class. Early evidence suggests lectures and foundational material can be equally provided online, but we have low-quality research to be convinced. We aim to test and develop an online evidence-based teaching resource that seeks to improve the availability and scalability of evidence-based medicine (EBM) learning tools. We evaluate the feasibility of a study design that could test for changes in academic performance in EBM skills using an online supplement.

METHODS

Mixed-methods feasibility study of a randomised controlled trial (RCT) in an undergraduate medical student cohort.

RESULTS

Of a small cohort (n=34), eight participants agreed to randomisation and completed the study. No study participant completed the EBM supplementary course in full. Students report time-management as a significant barrier in participation, and all aspects of the study and communications should be delivered with efficiency a key consideration.

CONCLUSION

Randomising students to an online EBM supplement within a medical school programme presents challenges of recruitment and student motivation, but the study design is potentially feasible.

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.

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

BACKGROUND

Evidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour.

METHODS AND FINDINGS

This is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up.

CONCLUSIONS

Teaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments.

STUDY REGISTRATION

The protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262.

UPDATE OF THE OVERVIEW

Young T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: 10.1371/journal.pone.0086706.

Experiences with using a mobile application for learning evidence-based practice in health and social care education: An interpretive descriptive study

Background

Health and social care students are expected to apply evidence-based practice (EBP). An innovative mobile application, EBPsteps, was developed to support learning EBP.

Aim

The aim of this study was to explore health and social care students’ experiences of learning about EBP using the mobile application EBPsteps during their clinical placements.

Methods

An interpretive description approach guided the exploration of student experiences. Four focus groups were conducted with a convenience sample of students from three undergraduate degree programs: occupational therapy, physical therapy, and social education. The constant comparison method was used to categorize and compare the qualitative data.

Results

Three integrated themes were generated: "triggers for EBP", "barriers to EBP", and "design matters". Information needs, academic requirements, and encouragement from clinical instructors triggered the students to use EBPsteps. Lack of EBP knowledge, lack of academic demand, and lack of emphasis on EBP in clinical placement were barriers to using EBPsteps. Design issues mattered, as use of the app was motivated by design features such as the opportunity to practice EBP in one place and taking notes in a digital notebook. The use of the app was hindered by anticipation that the use of phones during clinical placements would be viewed negatively by others and by specific design features, such as unfamiliar icons.

Conclusions

The students perceived the EBPsteps app as a relevant tool for learning EBP, although they also suggested specific changes to the design of the app. Requirements must be embedded in the curriculum to ensure that the app is used. Our findings bring important information to developing and implementing mobile applications as a teaching method in health and social care educations.