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

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

AIM/OBJECTIVE

This study aims to carry out a meta-analysis of attitudes, knowledge, and skills level of nursing students and nurses in EBP, providing a reference for optimizing EBP education strategies.

BACKGROUND

At present, no meta-analysis has been performed to quantitatively synthesize the attitudes, knowledge and skill levels of nursing students and nurses toward EBP. This makes it difficult to precisely identify the true level of EBP among nurses, implying that there is no evidence to support the adoption of EBP teaching strategies approaches.

DESIGN

A total of 9 Chinese and English databases including CNKI, Wan fang, VIP, CBM, PubMed, Embase, Web of Science, Cochrane Library and CINAHL were used to search cross-sectional quantitative articles on EBP attitudes, knowledge and skills level of nurses and nursing students. The search time limit was from the inception of the database to September 2023.

METHODS

Two researchers independently screened the literature and extracted the data. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the quality of the included studies. Stata15.0 software was used for statistical analysis to summarize the scores of EBP attitude, knowledge and skills level of nursing students and nurses included in the study.

RESULTS

A total of 25 cross-sectional studies from 13 countries were included, involving 11363 nursing students and nurses. The meta-analysis results revealed that nursing students and nurses lacked evidence-based practical knowledge and skills, with pooled mean scores of 3.06 (95 % CI: 2.72, 3.39), 2.91 (95 % CI: 2.60, 3.22), 4.31 (95 % CI: 4.08, 4.54) and 4.45 (95 % CI: 4.20, 4.70). In contrast, nursing students and nurses revealed a positive attitude towards EBP, with pooled mean scores of 3.57 (95 % CI: 3.28, 3.86) and 5.11 (95 % CI: 4.80, 5.42). Subgroup analysis revealed that senior nursing students and nurses with master's degree or above had higher attitudes, knowledge and skills.

CONCLUSIONS

In summary, nursing students and nurses have a positive attitude towards EBP. However, they seem to lack the necessary knowledge and skills. Therefore, nursing educators should consider this as an opportunity to strengthen the teaching of their evidence-based practical knowledge and skills. This will lay a reference for developing nursing discipline.

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.

Comparison of the traditional and block mode of delivery on undergraduate nursing students' perceived levels of preparedness to use evidence-based practice: a two-group experimental study

OBJECTIVES

To examine how delivery time impacted on undergraduate nursing students' preparedness for evidence-based practice (EBP) by comparing the traditional semester mode and block mode of delivery models.

METHODS

This two-group experimental study compared the traditional semester and block modes of delivery using a self-reported questionnaire. The factor of time was the variable in relation to learning with the block mode delivery being in a compressed timeframe.

RESULTS

From a purposive sample, 219 students participated in the self-reported questionnaire. There were only two significant differences were the block mode of delivery students responded less positively to the statements 'the unit of study prepared them for knowledge and skills for EBP' and 'EBP should be discussed and shared in practice'.

CONCLUSIONS

The transition from the traditional semester mode to the block mode delivery has had minimal impact on undergraduate nursing students' perceptions of EBP and its application to clinical practice.

How Teaching and Internship Influence the Evidence-Based Practice Approach of Nursing Students: A Longitudinal Study

AIM

The study aimed to analyze students' approach to evidence-based practice and evaluate the effect of teaching (based on lessons in statistics, epidemiology, evidence-based nursing, bioengineering, English language) and internship experiences on the attitude of nursing students to evidence-based practice.

METHOD

In 2019,one hundred nineteen second-year nursing students from an Italian university were involved in a pre-post longitudinal study. The Italian version of the Student-Evidence Based Practice Questionnaire was administered to nursing student in four moments of one academic year.

RESULTS

The Student-Evidence Based Practice Questionnaire showed different mean scores based on the four moments of the survey with a significant increase after the experience of planning clinical cases with an online simulation system. In particular, the aptitude subscale does not have significant improvements in the various phases of the study. Conversely, the support of the clinical tutor affects student performance. The didactic module on evidence-based nursing develops the ability to assess the quality of the information found and its sharing. Basic English proficiency is not significantly correlated.

CONCLUSION

To develop evidence-based practice knowledge, aptitude, and skills in nursing students, it is necessary to strengthen the learning opportunities both in classroom lessons and in simulation and internship experiences.

Evidence-Based Practice Competency of Registered Nurses in the Greek National Health Service

Nurses' competency toward evidence-based practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of the individual qualifications of nurses on their competence toward EBP. Data from 473 registered nurses working in 10 hospitals in the Greek National Health Service (NHS) were collected between October and December 2020 using a convenience sampling method in a cross-section design. The Greek version of the 35-item (five-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses, focusing on attitudes, skills, and knowledge, as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare the possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants' qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. The p-values < 0.05 were considered statistically significant. The mean age of the 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9 ± 0.6, knowledge 3.7 ± 0.6, skills 3.1 ± 0.8, and utilization 3.4 ± 0.7. A multivariate regression analysis revealed that associates of "Master's degree" (t = 3.039, p = 0.003), "Writing an academic article" (3.409, p = 0.001), "Working in a University clinic" (2.203, p = 0.028), and "Computer Skills" (2.404, p = 0.017) positively affected "Attitudes", "Knowledge", "Skills", and "Utilization", respectively. The research data suggest that nurses working in the Greek NHS were limited in competence regarding EBP in comparison with other European countries. Therefore, vocational, educational, and training programs tailored to EBP enhancement are crucially important. This study was not registered.

The Design and Validation of a Self-Assessment Questionnaire of Critical Appraisal of Medical Literature Skills in Medical Students

INTRODUCTION

Critical appraisal of medical literature is a challenging step of the evidence-based medicine practice. Many assessment questionnaires have been published in the literature, but they have mainly focused on all the evidence-based medicine practice process. The authors aimed to develop and validate a questionnaire assessing the critical appraisal skills of medical students from the same Faculty.

METHODS

The questionnaire was developed by item generation through a review of the literature and an expert committee. The questionnaire was validated in terms of content validity and construct validity. Fitness of data for analysis was checked through Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity. Construct validity was carried out using a principal axis exploratory factor analysis (EFA) with 'varimax' rotation to study the internal structure of the questionnaire and to extract the test major factors. The questionnaire was administrated to a cohort of under and postgraduate medical students (n=84) to evaluate the test reliability and select the best items. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient to evaluate the internal consistency. The correlations between the self-confidence and satisfaction dimension score, the critical thinking dimension score, the learning style dimension score, the Fresno-adapted test scores and the total score were assessed using the Spearman's correlation test.

RESULTS

The questionnaire consisted of 31 items. A factorial analysis grouped the items into 3 dimensions that consisted of the self-confidence and satisfaction dimension, the critical thinking dimension and the learning style dimension. Cronbach's alpha accounted for 0.95, CI95% [0.9-1] for the entire questionnaire. The factor analysis explained 79.51% of the variance. The external validity assessment based on a Spearman's correlation study highlighted a weak correlation between the total scores and the critical thinking dimension and the self-perception and satisfaction dimension.

CONCLUSION

In spite of the limitations of this study, mainly the small number of the students recruited, the questionnaire seems to measure with adequate reliability the competences of under and postgraduate medical students.

Translation and Validation of the Greek Version of the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©)

(1) Background: Evidence-based nursing is the benchmark of the nursing profession. It is widely recognized that evidence enhances knowledge, skills, and competencies in nursing education and thus the quality of patient care. Although several proposals have been introduced to reinforce nurses through education in evidence-based practice (EBP) for clinical practice, there is no validated EBP competence tool to determine how nurses approach evidence-based nursing in healthcare practices in Greece. Therefore, the aim of the present study was to translate and validate the Greek version of the Evidence-Based Practice Competency Questionnaire, Professional version (EBP-COQ Prof©). (2) Methods: A cross-sectional study was conducted in a sample of registered nurses working in the public sector. (3) Results: 414 clinical nurses were recruited in total with a response rate of 75.3% and a mean age of 43 years old. Most of the nursing personnel were females, 354 (85.5%), and there were 60 (14.5%) males. Confirmatory factor analysis (CFA) showed a confirmation of the developer's four-factor design. The estimated association between items on each scale showed a strong relationship. The competence questionnaire showed a high internal consistency between the components of attitude, knowledge, skills, and utilization. (4) Conclusions: The competence questionnaire shows a strong relationship between four the components, highlighting the four factors that should be promoted to improve the use of EBP nursing practices.