Evidence-Based Nursing Education: Myth or Reality?

Effects of Arts-Based Pedagogy on Competence Development in Nursing: A Critical Systematic Review

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students' changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.

The Need for Occupational Therapy Evidence-Based Education

Knowledge of evidence-based-education principles is essential for occupational therapy academics and fieldwork supervisors to ensure the teaching and learning methods and strategies being used are informed, targeted, cost effective, contemporary, and worthwhile. This paper defines evidence-based-education is and how it can be applied in the context of occupational therapy student academic and fieldwork education. The factors that impact occupational therapy evidence-based education in the university sector are introduced which have the potential to ensure that students obtain a quality, meaningful, value-for-money, and high impact education in both academic and fieldwork environments. It is recommended that university faculty and fieldwork supervisors use, create, support, and disseminate evidence-based-education related findings with continued debate and investigation are recommended.

Evidence-based practice profiles of nurses: a transcultural study†

Objective

To compare (i) the evidence-based practice (EBP) profiles and (ii) socio-demographic characteristics of nurses in 4 selected low-middle income countries (LMICs).

Methods

A cross-sectional survey was conducted among 677 nurses from 4 hospitals in 4 countries (Afghanistan, Ghana, Iran, and Uganda).

Results

The findings revealed that there are significant differences between the 3 EBP subscales (that is, practice/use, attitude, and knowledge/skill) across the 4 countries (P < 0.05). No significant EBP differences were identified across age groups and gender in the subscales of practice, knowledge, and attitude. Practice and knowledge subscales were significantly associated with working schedules (that is, part-time and full-time) (P < 0.05). Analyses also revealed significant differences between attitude and knowledge subscales and working experience (P < 0.05).

Conclusions

Nurses in the 4 countries have moderate practice, attitude, and knowledge/skills of EBP. Nurses in LMICs require continuous professional development programs and support to enhance their practice and knowledge regarding EBP in clinical settings.

Undergraduate nursing student knowledge and attitudes of healthcare consumers with problematic alcohol and other drug use: A scoping review

Problematic alcohol and other drug use has a significant societal, personal, and financial burden. Nurses are key in responding to problematic alcohol and other drug use; however, research indicates many nurses hold negative attitudes towards people with substance and alcohol use disorders. Further, little content exists in most undergraduate degrees to address stigma held by new nurses. The objective of this scoping review, structured using Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8 (1), 19-32, 2005) framework, is to examine studies that either explore or attempt to improve the knowledge and attitudes of undergraduate nurses caring for people who use alcohol and other drugs. Our initial search located 610 articles, and after screening, 14 articles were appraised using the Mixed Methods Appraisal Tool (MMAT) and included in this review. Most of the papers appraised were small, localized studies using evaluation methods considered low quality, but showed promising results in addressing stigma and confidence in providing care to people who use alcohol and other drugs. This review indicates that a consistent direction for improving knowledge and attitudes among undergraduate nursing students working with people who use alcohol and other drugs is urgently needed. Further studies of interventions, tested with more rigorous evaluation methodologies, are required to extend existing work in this area.

The characteristics of effective technology-enabled dementia education for health and social care practitioners: protocol for a mixed studies systematic review

BACKGROUND

The global prevalence of people living with dementia is expected to increase exponentially and yet evidence suggests gaps in dementia-specific knowledge amongst practitioners. Evidence-based learning approaches can support educators and learners who are transitioning into new educational paradigms resulting from technological advances. Technology-enabled learning is increasingly being used in health care education and may be a feasible approach to dementia education.

METHODS

This protocol aims to describe the methodological and analytical approaches for undertaking a systematic review of the current evidence based on technology-enabled approaches to dementia education for health and social care practitioners. The design and methodology were informed by guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.

DISCUSSION

The evidence generated from a systematic review of the current evidence is intended to inform the design and implementation of technology-enabled dementia education programmes and to advance the current academic literature at a time of unprecedented demographic and technological transition.

TRIAL REGISTRATION

PROSPERO, CRD42018115378.

Knowledge and Attitudes about Pain Management among Canadian Nursing Students

BACKGROUND

Poorly managed pain is a problem that affects individuals, entire health care systems, and societies worldwide. Nurses are involved in pain management, yet little is known about the knowledge and attitudes of nursing students.

AIMS

The aim of this study was to examine preregistration nursing students' knowledge and attitudes about the assessment and management of pain.

DESIGN

This was a cross-sectional, descriptive survey.

SETTINGS

Four education sites from two post-secondary institutions in Ontario, Canada.

PARTICIPANTS/SUBJECTS

A convenience sample of 336 final year Bachelor of Science in Nursing and practical nursing students.

METHODS

Participants were recruited in the classroom setting to complete the Knowledge and Attitudes Survey Regarding Pain. A score of eighty percent is considered a pass.

RESULTS

Ninety percent of students who were in class on the day of the survey agreed to participate (n = 336/373). Fifteen (4.5%) participants passed the Knowledge and Attitudes Survey Regarding Pain, and the mean score was 66.7% (standard deviation 9.1). English as primary language, institution attended, and prior experience caring for someone with pain were independently associated with higher scores (p < .05). Students were found to have major gaps in knowledge and attitudes related to understanding the risk of respiratory depression after opioid therapy, calculating medication dosages, administrating medication, and understanding pharmacology.

CONCLUSIONS

The majority of nursing students in this sample did not have adequate knowledge and positive attitudes about pain assessment and management.

Effects of an evidence-based practice education program using multifaceted interventions: a quasi-experimental study with undergraduate nursing students

BACKGROUND

Although Evidence-Based Practice (EBP) should be introduced early on in nursing education to develop students' independence and self-learning ability, there are few such courses for undergraduate nursing students in Korea. This study examined the effects of the EBP education program for undergraduate nursing students (EBP-EPUNS) on nursing students' knowledge, skills, attitudes, competencies, and future use of EBP.

METHODS

A quasi-experimental study design with pre-test, intervention, and post-test was used. The participants were 44 nursing students (experimental: 22, control: 22). A 20-h long EBP-EPUNS consisting of 5-step EBP components was provided through 8 sessions spread across 4 weeks.

RESULTS

An independent t-test and a repeated-measures ANOVA showed that the experimental group had statistically significant higher post-test scores on EBP knowledge (p < 0.001), skills (p < 0.001), attitudes (p < 0.001), competencies (p < 0.001), future use of EBP (p = 0.001), and critical thinking (p < 0.001), compared to the control group.

CONCLUSION

The EBP education program was effective in improving the knowledge, skills, attitudes, competencies, and future use of EBP among nursing students. Hence, we recommend the EBP education program as a general education course for undergraduate nursing students to promote needed proficiency in EBP.

Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study

PURPOSE/OBJECTIVES

To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
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DESIGN

Exploratory, mixed-methods study employing a questionnaire approach.
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SETTING

14 regional cancer centers (RCCs) in Ontario, Canada.
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SAMPLE

Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
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METHODS

Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
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MAIN RESEARCH VARIABLES

Attitudes toward and self-reported use of standardized symptom screening and ESAS.
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FINDINGS

More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
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CONCLUSIONS

Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
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IMPLICATIONS FOR NURSING

Oncology nurses are integral to providing high-quality person-centered care. Using standardized approaches that enable patients to self-report symptoms and understanding barriers and enablers to optimal use of patient-reported outcome tools can improve the quality of patient care.

Can Nursing Students Practice What Is Preached? Factors Impacting Graduating Nurses' Abilities and Achievement to Apply Evidence-Based Practices

BACKGROUND

In order to meet national Australian nursing registration requisites, nurses need to meet competency requirements for evidence-based practices (EBPs).

AIMS

A hypothetical model was formulated to explore factors that influenced Australian nursing students' ability and achievement to understand and employ EBPs related to health care provision.

METHODS

A nonexperimental, descriptive survey method was used to identify self-reported EBP efficacy estimates of 375 completing undergraduate nursing students. Factors influencing participants' self-rated EBP abilities were validated by Rasch analysis and then modeled using the partial least squares analysis (PLS Path) program.

RESULTS

Graduating nursing students' ability to understand and apply EBPs for clinical improvement can be directly and indirectly predicted by eight variables including their understanding in the analysis, critique and synthesis of clinically based nursing research, their ability to communicate research to others and whether they had actually witnessed other staff delivering EBP.

LINKING EVIDENCE TO ACTION

Forty-one percent of the variance in the nursing students' self-rated EBP efficacy scores is able to be accounted for by this model. Previous exposure to EBP studies facilitates participants' confidence with EBP, particularly with concurrent clinical EBP experiences.

Status and Trends in Swedish Dissertations in the Area of Cardiovascular Nursing

In Europe, cardiovascular nursing (CVN) is a young branch of nursing science. The explicit knowledge contained in CVN dissertations has, so far, not been studied in Europe, and this is especially true in the case of Sweden. Accordingly, the aim of this literature study was to describe the status of and compare trends in Swedish dissertations in the area of CVN in terms of organisational structure, approach, research strategy, social orientation and socio-demographic aspects. The literature search resulted in 29 dissertations and a 26-item questionnaire that illuminated the problem areas. Most dissertations were produced in the universities of Göteborg, Halmstad and Linköping; a minority had a nurse as main supervisor; rehabilitation was the most common CVN approach; very few of the dissertations had an experimental design; and the majority was hospital-based. The main trends were (A) an increase in dissertations that were written during the last 6 years, (B) an increased number of nurses as main supervisors as well as publication in nursing journals, (C) an increase in hospital care settings while a decrease in community settings, and finally, (D) an increased number of dissertations addressing the issues of tertiary prevention as well as focusing on patients and next-of-kin as target groups. An important implication is to stimulate nurse-led interventions at all preventative levels in order to maintain or improve the cardiac health of both healthy and sick individuals, but also in order to visualize CVN and distinguish it from cardiology.

Current state of evidence-based practice education for undergraduate nursing students in Taiwan: A questionnaire study

BACKGROUND

Evidence-based practice (EBP) has been emphasized as the core competency of undergraduate nursing students and must be cultivated before graduation. However, there is limited information of EBP education for undergraduate nursing students in Taiwan.

OBJECTIVES

The purpose of this study was to investigate the current state of EBP education for undergraduate nursing students in Taiwan.

DESIGN

A self-developed questionnaire, validated by experienced educators, was designed to explore curriculum design, teaching resources, qualification of teachers, and barriers regarding EBP education.

PARTICIPANTS

A total of 21 nursing schools and colleges participated. The chair of each recommended a faculty member involved in teaching EBP as the school's representative to fill out the questionnaire.

RESULTS

Among the 21 nursing schools and colleges, 18 (85.7%) had implemented EBP education in the curriculum. Among these schools, 22.2% conducted an independent EBP course, 50% incorporated EBP concepts into other courses, and the remainder offered both kinds of EBP courses. Multiple strategies were incorporated to teach the EBP. Less than 35% of the schools had designed or adopted standardized teaching materials and evaluated students' learning outcomes. Although 55.6% of the schools reimbursed faculty for participation in EBP training, 39% of their faculty members who taught EBP did not receive any EBP training. Shortage of qualified faculty and limited opportunity to involve students in evidence-based applications were reported as major obstacles to teaching EBP.

CONCLUSIONS

EBP education has already gained the attention of nursing schools in Taiwan. However, lack of comprehensive EBP training among teachers and the difficulty of teaching clinical application of EBP require special consideration. In order to promote EBP education in undergraduate nursing curriculums, we suggest that nursing schools reinforce and support faculty to participate in formal EBP training. Also needed is a systematic curriculum design with multiple teaching strategies and links with clinical practicum.

Evidence-Based Teaching Practice in Nursing Education: Faculty Perspectives and Practices

PURPOSE

This national online study was conducted to describe nursing faculty perspectives and practices about evidence-based teaching practice (EBTP).

BACKGROUND

Professional standards for nurse educator practice stress the importance of EBTP; however, the use of evidence by faculty in curriculum design, evaluation and educational measurement, and program development has not been reported.

METHOD

Nurse administrators of accredited nursing programs in the United States (N = 1,586) were emailed information about the study, including the research consent form and anonymous survey link, and invited to forward information to nursing faculty.

RESULTS

Respondents (551 faculty and nurse administrators) described the importance of EBTP in nursing education, used multiple sources of evidence in their faculty responsibilities, and identified factors that influence their ability to use EBTP.

CONCLUSION

EBTP in nursing education requires sustained institutional, administrative, and collegial support to promote faculty effectiveness and student learning.

The evidence-based practice profiles of academic and clinical staff involved in pre-registration nursing students' education: a cross sectional survey of US and UK staff

BACKGROUND

Competency in evidence-based practice (EBP) is a requirement for graduate nurses. Despite a growing body of research exploring the EBP profiles of students, little research has explored the EBP profiles of nurse educators.

OBJECTIVES

To explore: the differences/similarities in the EBP profiles of US and UK clinical and academic faculty; the barriers nurse educators experience when teaching EBP; the impact of postgraduate education on EBP profile and; what nurse educators perceive "success" in implementing and teaching EBP to be.

DESIGN

A cross-sectional online survey design was employed.

SETTINGS

Two Universities delivering undergraduate nursing education in the US and UK, in partnership with large hospital systems, small community hospitals, community settings, and independent sector health organisations.

PARTICIPANTS

Eighty-one nurse educators working in academic and clinical contexts in the US and UK (US academic=12, US clinical=17, UK academic=9, UK clinical=43) were recruited opportunistically.

METHODS

Participants were emailed a weblink to an online survey, comprising demographic questions, the Evidence-Based Practice Questionnaire and open-ended questions about EBP barriers, facilitators and successes.

RESULTS

Quantitative results indicated that academic faculty scored significantly higher on knowledge and skills of EBP, than clinical faculty, but revealed no other significant differences on EBP use or attitudes, or between US and UK professionals. Participants with postgraduate training scored significantly higher on EBP knowledge/skills, but not EBP attitudes or use. Qualitative findings identified key themes relating to EBP barriers and facilitators, including: Evidence-, organisational-, and teaching-related issues. Perceptions of successes in EBP were also described.

CONCLUSIONS

Nurse educators working in the UK and US face similar EBP barriers to teaching and implementation, but view it positively and use it frequently. Clinical staff may require extra support to maintain their EBP knowledge and skills in comparison to staff working in academic contexts.

Fear and Loathing: Undergraduate Nursing Students’ Experiences of a Mandatory Course in Applied Statistics

This article describes the results of a qualitative research study evaluating nursing students’ experiences of a mandatory course in applied statistics, and the perceived effectiveness of teaching methods implemented during the course. Fifteen nursing students in the third year of a four-year baccalaureate program in nursing participated in focus groups before and after taking the mandatory course in statistics. The interviews were transcribed and analyzed using content analysis to reveal four major themes: (i) “one of those courses you throw out?,” (ii) “numbers and terrifying equations,” (iii) “first aid for statistics casualties,” and (iv) “re-thinking curriculum.” Overall, the data revealed that although nursing students initially enter statistics courses with considerable skepticism, fear, and anxiety, there are a number of concrete actions statistics instructors can take to reduce student fear and increase the perceived relevance of courses in statistics.

Evidence-based reflective teaching practice: a preceptorship course example

AIM

This preceptorship course case study employed an evidence-based reflective teaching practice perspective based on a nursing process framework to develop, implement, and evaluate assignment efficacy directly related to course objectives.

BACKGROUND

Journaling and article analysis had been used to assess development of role socialization, critical thinking, and self-reflective practice. These activities were found to be ineffective; new assignments were needed to address essential issues and allow for evaluation of assignment efficacy.

METHOD

Based upon contextual constructivism, four assignments were developed focused on learning goals, nursing skills, assumptions/biases, and role socialization.Assignment efficacy was evaluated via anonymous exploratory surveys.

RESULTS

Student reports identified that assignments met learning outcomes. Methods for improvement in instructional practice were identified and revisions made.

CONCLUSION

Participation in evidence-based reflective teaching practice can enhance reflective practice in students through appropriate assignment development, advancing the discipline of nursing education.

Evidence for teaching: what are faculty using?

The benefit of engaging in evidence-based teaching practice (EBTP) is to identify and implement best practices in nursing education. Unfortunately, nursing education has made little forward movement in identifying the evidence upon which faculty base their teaching practices. A national online survey of 295 nurse educators from 86 programs revealed the evidence they use in their teaching practices as well as the facilitators and barriers to EBTP. The majority of participants indicated they used quantitative and qualitative research (94 percent) but also considered written course evaluations, conference information, class feedback, and student comments as evidence. Participants identified personal beliefs as the most frequent facilitator to EBTP with 25 percent indicating their institution as a barrier. As EBTP offers a guide to establishing best practices in nursing education, building a science of nursing education is the responsibility of all nurse educators.

A critique of the undergraduate nursing preceptorship model

The preceptorship model is a cornerstone of clinical undergraduate nursing education in Canadian nursing programs. Their extensive use means that nursing programs depend heavily on the availability and willingness of Registered Nurses to take on the preceptor role. However, both the health service and education industries are faced with challenges that seem to undermine the effectiveness of the preceptorship clinical model. Indeed, the unstable nature of the clinical setting as a learning environment in conjunction with faculty shortages and inadequate preparation for preceptors and supervising faculty calls us to question if the preceptorship model is able to meet student learning needs and program outcomes. In a critical analysis of preceptorship, we offer a deconstruction of the model to advance clinical nursing education discourse.

Constructivism applied to psychiatric-mental health nursing: an alternative to supplement traditional clinical education

With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma.

Can one learn to think critically? - a philosophical exploration

Within nursing, critical thinking is a required skill that educators strive to foster in their students' development for use in complex healthcare settings. Hence the numerous studies published measuring critical thinking as a terminal outcome of education. However, an important comparison between different philosophical underpinnings such as person, truth and the nature of nursing, and how one defines and utilizes critical thinking in practice, has been absent from discussions about critical thinking and learning. When one views critical thinking with varying philosophical lenses, important questions are raised and discussion is expanded. These questions illuminate different perspectives of critical thinking and attempt to explore whether critical thinking can be learned in nursing. The implications of taking a single philosophical viewpoint and a pluralistic approach to understanding critical thinking and learning are explored.

Examining the impact of high and medium fidelity simulation experiences on nursing students' knowledge acquisition

AIM

This paper describes a study that measured and compared knowledge acquisition in nursing students exposed to medium or high fidelity human patient simulation manikins.

BACKGROUND

In Australia and internationally the use of simulated learning environments has escalated. Simulation requires a significant investment of time and money and in a period of economic rationalisation this investment must be justified. Assessment of knowledge acquisition with multiple choice questions is the most common approach used to determine the effectiveness of simulation experiences.

METHOD

This study was conducted in an Australian school of nursing; 84 third year nursing students participated. A quasi-experimental design was used to evaluate the effect of the level of manikin fidelity on knowledge acquisition. Data were collected at three points in time: prior to the simulation, immediately following and two weeks later.

RESULTS

Differences in mean scores between the control (medium fidelity) and experimental (high fidelity) groups for Tests 1, 2 and 3 were calculated using independent t tests and were not statistically significant. Analysis of covariance (ANCOVA) was conducted to determine whether changes in knowledge scores occurred over time and, while an improvement in scores was observed, it was not statistically significant.

CONCLUSION

The results of this study raise questions about the value of investing in expensive simulation modalities when the increased costs associated with high fidelity manikins may not be justified by a concomitant increase learning outcomes. This study also suggests that multiple choice questions may not be the most appropriate measure of simulation effectiveness.

Building bridges: an innovative academic-service partnership

Academic and service entities can create sustainable models of collaboration that realign relationships and resources to enhance the critical competencies essential for entry into practice. Our hospital and school collaborated to implement an innovative academic-service partnership model in which the academic and the care delivery enterprises intersected to accomplish goals of mutual interest and enhance and enrich the practice environment. Two existing resources-the staff nurse and faculty-were used to realign the educational process with the realities of nursing practice in an interpretive, contextual, live unfolding clinical environment that was relevant and memorable. The students were better integrated into the clinical operations and showed increased levels of critical thinking, clinical decision-making, and clinical inquiry skills. The model holds promise to improve transition to practice, make better use of existing resources, and foster collaborative relationships among the academic, practice, and regulatory enterprises.

Evidence-based practice: issues, paradigms, and future pathways

Evidence-based practice (EBP) has become a real buzz word, not only in the discipline of nursing, but in all healthcare professions. EBP has been identified as the foundation of accountable, professional nursing practice and it would seem that few could argue with the apparent benefits; however, debate does exist in the literature about whether EBP can realistically be attained. As such, a critical discourse regarding the future of EBP for nursing needs to occur. One of the key questions to be addressed through this discourse is, "what counts as evidence?" A review of the nursing literature on the concept of EBP will be presented in this paper along with a discussion of several of the issues associated with EBP within the discipline of nursing. I will also present some ideas about the implications of the EBP movement in nursing and examine the future pathways for nursing.

Advancing nursing education science: an analysis of the NLN's Grants Program 2008-2010

The National League for Nursing has responded to the increasing need for nursing education research through its grant program. Significant growth in proposals has intensified competition for funds and challenged the Nursing Education Research Advisory Council's review process. The purpose of this article is to explore the NLN's nursing education research proposals from 2008 to 2010 in order to improve performance and provide guidance to future nursing education researchers. Beginning with the 2008 grant cycle, a database was developed to assist in performance improvement. A total of 113 proposals were submitted; of those, 24 were funded for a success rate of greater than 21 percent. Various designs and samples were employed and all geographic regions of the United States were represented. Inter-rater reliability among reviewers remained high and the scientific rigor of proposals steadily increased. Increased funding from other sources is urgently needed to build the science of nursing education.

Predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities

Nursing students are strategically positioned to influence adoption of evidence-based practice within the nursing profession. The purpose of this study was to identify the predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities. A cross-sectional survey design was used to study a convenience sample of 436 nursing students (response rate of 63.3%) enrolled at two baccalaureate nursing programs at the beginning of 2007 fall semester in the United States. The surveys included demographic questionnaire and knowledge, attitudes and behaviors questionnaire for evidence-based practice. EBP Knowledge, Attitudes toward EBP and Future Use of EBP subscales demonstrated statistically significant increase in mean scores with advancing academic levels. Confidence in clinical decision-making and clinical preparedness had moderate positive correlation with EBP Use and Future use of EBP. Simultaneous multiple regression analyses indicated that the clinical preparedness and confidence in clinical decision-making were statistically significant predictor variables for EBP use and Future use of EBP. Clinically well-prepared nursing students with high confidence in clinical decision-making are most likely to use evidence-based practice, both in the present and the future.

Part II. Empowering grassroots evidence-based practice: a curricular model to foster undergraduate student-enabled practice change

This article presents evidence collected over the past 15 years that attests to the success of curricular innovations conducted to foster socially meaningful contact between nursing students and practicing nurses as a means to promote evidence-based practice (EBP). Action research data collected as these pedagogical strategies have evolved suggest that such student-staff partnerships offer promise not only to encourage commitment to EBP among nursing students but also to surmount most of the barriers that prevent the widespread diffusion of EBP among practicing nurses in clinical settings. Based upon our successful experiences with student-staff interactions, we propose a curricular model-the Student-Enabled Practice Change model-that suffuses the undergraduate nursing school curriculum with opportunities for nursing students to form meaningful partnerships with practicing nurses. The Student-Enabled Practice Change Curricular Model relocates the power to drive practice change to the grassroots level of students and practicing nurses.