Evaluating the impact of an arts-based multimedia knowledge translation assignment on undergraduate nursing students

BACKGROUND

Despite the expectation that nurses utilize research to provide excellent patient care, students often fail to recognize the value of learning about evidence-informed practice. Experiential, creative pedagogical approaches are needed to engage undergraduate nursing students in evidence-informed practice. In two undergraduate courses, we implemented an innovative assignment in which students created an arts-based multimedia knowledge translation presentation to communicate systematic review findings to patients.

OBJECTIVE

To evaluate how the assignment affected nursing students' satisfaction, learning, and anticipated behaviour changes regarding evidence-informed practice and to assess what factors influenced their evaluation of the assignment.

DESIGN AND METHODS

Kirkpatrick's Evaluation Model and Groff's Theory of Whole-Mindedness informed our study, incorporating an observational cross-sectional survey design. We recruited a convenience sample of nursing students (N = 242) from two baccalaureate programs. We collected data with an online survey comprised of closed- and open-ended questions. Quantitative data were analyzed with descriptive statistics, univariate analysis, and general linear models, and qualitative data with content analysis.

RESULTS

Most students were satisfied (68%) and reported learning (77%) and benefits for their future practice (75%). Age, enjoyment of and experience with the arts, type of motivation, and valuing evidence-informed practice were significant predictors (p < 0.01) and the model predicted 59% of the variance in positive student perceptions of the assignment. Students reported experiencing relational and engaged learning, translating research findings creatively and clearly, understanding complex research concepts through experiential learning, and having frustrations and pragmatic concerns.

CONCLUSION

Creative approaches that contextualize research findings hold potential to deepen students' understanding of evidence-informed practice. This study identified key factors that influenced students' evaluation and experience of the assignment. These results provide valuable insights to inform effective implementation of arts-based assignments in nursing education.

Evidence-Based Practice Curriculum Development for Undergraduate Nursing Students: The Preliminary Results of an Action Research Study in Taiwan

BACKGROUND

Equipping undergraduate nursing students with sufficient competence in evidence-based practice (EBP) is essential to meeting future practice needs. Integrating necessary EBP knowledge and skills systematically into the formal curriculum allows students to obtain better learning experience and outcomes. However, in Taiwan, a systematic nursing curriculum that integrates EBP concepts across the 4-year nursing baccalaureate program has not yet been developed. Moreover, engaging students in the clinical application of evidence remains a key challenge facing nursing education.

PURPOSE

This study aimed to construct an EBP undergraduate nursing curriculum and develop clinical scenarios that support EBP teaching.

METHODS

Three cycles of action research, incorporating both focus group interviews and questionnaire surveys, were applied to construct and evaluate the appropriateness and feasibility of the EBP nursing curriculum and relevant teaching strategies.

RESULTS

An EBP nursing curriculum was constructed that integrates the three levels of learning objectives and corresponding learning outcomes, teaching content, and learning activities. Scenario activities were developed to familiarize students with the EBP process and to maximize their learning with regard to the clinical application of evidence. Next, a preliminary evaluation showed the appropriateness and feasibility of the developed curriculum, which was shown to foster the EBP competency of students and increase their confidence and positive attitudes toward EBP.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

A systematic EBP bachelor nursing curriculum with effective pedagogical strategies was developed. The associated process and the elicited information may offer a valuable reference for other nursing schools.

Obstacles in employing evidence-based practice by nurses in their clinical settings: a descriptive study

Objective

The challenge of employing evidence-based practice (EBP) is multifarious and varied. Nursing interventions supported by research evidence have been exposed to progress positive patient outcomes, while its implementation is faced with various obstacles. This study aimed to identify obstacles in employing EBP by nurses in their clinical settings.

Methods

This descriptive design study was conducted at Benha University Hospital with a convenient sample of 154 nurses. Two tools were utilized: (I) sociodemographic data sheet, which included sociodemographic characteristics of the participants, and (II) interview scale, which contained two parts: (1) obstacles scale, which contained obstacles that impede nurses from the utilization of EBP, and (2) questions to rank the three greatest obstacles in employing EBP by nurses.

Results

The greatest EBP obstacle ranked by nurses was the organizational limitations (90.9%), followed by research quality (86.9%) and research accessibility (51.0%), while individual characteristics (35.9%) were ranked as the least obstacle. There was a significant statistical correlation between organizational limitations, research quality as well accessibility-related obstacles and nurses’ age, level of education, as well their years of work experience (P<0.05).

Conclusions

Findings of this study showed series of obstacles in employing EBP by nurses in their clinical settings, stressing the call for expansion of nurses’ capabilities related to EBP utilization in patients’ care.

Evidence-based nursing education for undergraduate students: A preliminary experimental study

With increasing needs for evidence-based practice, the well-designed EBP education is necessary to enhance the critical thinking and decision-making skills of nursing undergraduates. This study is to evaluate the effectiveness of an evidence-based practice education program with blended learning on undergraduate nursing students. In this preliminary experimental study, 45 senior nursing undergraduates were recruited from a university in Seoul, Korea. Self-selection was used to create two groups: an intervention group and a control group consisting of 21 and 24 students, respectively. The intensive 30-hours evidence-based practice education program was provided to the intervention group. Evidence-based practice knowledge, self-efficacy, and evidence utilization were evaluated as outcome variables at baseline and two months after the intervention. There were no significant differences between the intervention and control groups on the background characteristics and outcome variables (p > .05). There were significant increases in evidence-based practice knowledge (Z = -5.28), self-efficacy (t = -6.42), resource utilization (Z = -2.60), and databases utilization (t = -2.98) in the intervention group, when compared with the control group (p < .01). Further studies are recommended to develop the evidence-based practice train-the-trainer program for nursing educators and to maximize the effectiveness of utilizing blended learning in evidence-based practice education.

"The more you did, the more it made sense": Problem-based learning to improve early evidence-based practice in an undergraduate physiotherapy professional programme

BACKGROUND AND PURPOSE

Evidence-based practice (EBP), which integrates clinical reasoning skills, research evidence, and patient preference, has become standard in curricula for health care professional programs. Students however perceive EBP as difficult and often irrelevant to clinical practice.

METHODS

A problem-based learning (PBL) approach is trialled in an early stage module where EBP knowledge and skills are stated learning outcomes. Prior to this, the content-based approach to EBP teaching and learning received negative student feedback. The impact of delivering EBP through PBL is evaluated by comparing 5 standard Likert feedback scales and open-ended question responses relating to the EBP instruction in the module before and after a PBL approach was implemented. The impact of a PBL approach on EBP profiles is further examined under domains (relevance, sympathy, terminology, practice, and confidence) of the validated Evidence-based Practice Profile Questionnaire.

RESULTS

All mean Likert scores relating to subject understanding, relevance of assessments, achievement of learning outcomes, teaching, and overall module satisfaction improved when the PBL approach was compared with the lecture-based format (p < 0.05). Student comment post-PBL continued to identify EBP as a difficult concept, but now comments on the teaching and assessment approach were mainly positive, addressing the collaborative nature of PBL, identifying EBP, communication and team-working skills acquired, praising the real life, practical application of EBP taken, and commenting on improvement in EBP self-efficacy. Within group change in the Evidence-based Practice Profile Questionnaire following a PBL approach identified significant improvement in EBP domains of terminology (mean change 3.38; p < 0.001); practice (mean change 16.5; p < 0.001), and confidence (mean change 10.1; p = 0.008). Conceptual links, based on constructivist underpinnings of PBL and EBP, are developed in the paper.

CONCLUSIONS

Using mixed methods evaluation, PBL is effective at promoting early EBP. Students identified with the interactive, collaborative, and experiential nature of PBL to EBP instruction.

Association Between Critical Thinking and Academic Performance in Dental Hygiene Students

Critical thinking is a key element of complex problem-solving that facilitates health professionals' clinical practice and professional behavior. Despite the importance of critical thinking, the measurement of critical thinking skills and its associations with academic performance remains a challenge. The aim of this study was to determine the associations between critical thinking and academic performance among undergraduate dental hygiene students. All 63 third- and fourth-year baccalaureate degree dental hygiene students (Class of 2018 and Class of 2017, respectively) in The Ohio State University Dental Hygiene Program were invited to participate in this quantitative, cross-sectional research study. Critical thinking was measured with the California Critical Thinking Disposition Inventory (CCTDI) and the Health Sciences Reasoning Test with Numeracy (HSRT-N). A total of 45 students completed the two tests, for an overall response rate of 71.4%. For the Class of 2018, the response rate was 90.6% (n=29), and for the Class of 2017, the response rate was 51.6% (n=16). The results showed the CCTDI and HSRT-N scores were higher for the Class of 2017 than the Class of 2018, suggesting that critical thinking skills were being developed across the course of the curriculum. The CCTDI was not significantly correlated with or a predictor of academic performance. The HSRT-N was more correlated with clinical performance than was the CCTDI, and HSRT-N components were found to be predictors of clinical performance. Continued attention is needed in the development and measurement of critical thinking skills to improve the academic and clinical performance of undergraduate dental hygiene students.

Establishing the competences of clinical reasoning for nursing students in Taiwan: From the nurse educators' perspectives

BACKGROUND

Clinical reasoning is an essential core competence for nurses. Maintaining quality of care and safety of patients results from cultivation of student's clinical reasoning competency. However, the concept of clinical reasoning in nursing students is complex and its meaning and process needs further clarification.

OBJECTIVES

The objectives were to explore the meaning of clinical reasoning competency in Taiwanese nursing students and to operationalize the concept in order to structure a framework illustrating the process of clinical reasoning.

SETTING AND PARTICIPANTS

Thirteen seasoned nursing experts who had more than ten years of experience in nursing education or clinical practice participated in the interviews. The interviews were conducted in settings that the participants perceived as convenient, quiet and free of disturbance.

METHODS

Semi-structured interviews were conducted. The interviews were audio-recorded and field notes were taken. The data were analyzed using Waltz et al.'s (2010) method of content analysis.

RESULTS

The data revealed four domains and 11 competency indicators. The four domains include: awareness of clinical cues, confirmation of clinical problems, determination and implementation of actions, and evaluation and self-reflection. Each domain comprises of 2-4 indicators of clinical reasoning competency. In addition, this study established a framework for cultivation of clinical reasoning competency in nursing students.

CONCLUSION

The indicators of clinical reasoning competency in nursing students are interwoven, interactive and interdependent to form a dynamic process. The findings of this study may facilitate evaluation of nursing students' clinical reasoning competency and development of instruments to assess clinical reasoning in nursing students.

Transforming Nursing Education: Fostering Student Development towards Self-Authorship

Nurse educators share a common goal: To foster student development in ways that fully prepare graduates for the challenges of contemporary practice. As patient acuity continues to escalate the responsibilities of the nurse and the nurse educator have become daunting. Contemporary practice requires a self-authored perspective that allows the nurse to appraise knowledge, weigh evidence, make autonomous decisions, and question authorities when warranted. Nurse leaders have called for transformation in nursing education through the application of evidence-based pedagogies that promote complex thinking and professional formation. This article introduces self-authorship theory and constructive-developmental pedagogy as a framework for enacting the pedagogical reform called for by nursing leaders. Drawing on the Carnegie study recommendations for nursing education reform, the article describes three constructive-developmental principles faculty can incorporate into their current practice to foster student development towards self-authorship and describes the implications of constructive-developmental pedagogy for substantive transformation in nursing education.

Undergraduate nursing students' attitudes and use of research and evidence-based practice - an integrative literature review

AIMS AND OBJECTIVES

This integrative review of the literature addresses undergraduate nursing students' attitudes towards and use of research and evidence-based practice, and factors influencing this. Current use of research and evidence within practice, and the influences and perceptions of students in using these tools in the clinical setting are explored.

BACKGROUND

Evidence-based practice is an increasingly critical aspect of quality health care delivery, with nurses requiring skills in sourcing relevant information to guide the care they provide. Yet, barriers to engaging in evidence-based practice remain. To increase nurses' use of evidence-based practice within healthcare settings, the concepts and skills required must be introduced early in their career. To date, however, there is little evidence to show if and how this inclusion makes a difference.

DESIGN

Integrative literature review.

METHODS

ProQuest, Summon, Science Direct, Ovid, CIAP, Google scholar and SAGE databases were searched, and Snowball search strategies used. One hundred and eighty-one articles were reviewed. Articles were then discarded for irrelevance. Nine articles discussed student attitudes and utilisation of research and evidence-based practice.

RESULTS

Factors surrounding the attitudes and use of research and evidence-based practice were identified, and included the students' capability beliefs, the students' attitudes, and the attitudes and support capabilities of wards/preceptors.

CONCLUSIONS

Undergraduate nursing students are generally positive toward using research for evidence-based practice, but experience a lack of support and opportunity. These students face cultural and attitudinal disadvantage, and lack confidence to practice independently. Further research and collaboration between educational facilities and clinical settings may improve utilisation.

RELEVANCE TO CLINICAL PRACTICE

This paper adds further discussion to the topic from the perspective of and including influences surrounding undergraduate students and new graduate nurses.

Pedagogical strategies to teach bachelor students evidence-based practice: A systematic review

AIM

The aim of this study is to review international scientific articles about pedagogical strategies to teach nursing students at bachelor degree evidence-based practice (EBP).

METHOD

A literature review including peer reviewed, original, empirical articles describing pedagogical interventions aimed at teaching bachelor's degree nursing students EBP in the period 2004-2014. Theories of discretion, knowledge transfer and cognitive maturity development are used as analytical perspectives.

RESULTS

The main challenge teaching evidence based practice is that the students fail to see how research findings contribute to nursing practice. The pedagogical strategies described are student active learning methods to teach the students information literacy and research topics. Information literacy is mainly taught according to the stages of EBP. These stages focus on how to elaborate evidence from research findings for implementation into nursing practice. The articles reviewed mainly use qualitative, descriptive designs and formative evaluations of the pedagogical interventions.

CONCLUSION

Although a considerable effort in teaching information literacy and research topics, nursing students still struggle to see the relevance evidence for nursing practice. Before being introduced to information literacy and research topics, students need insight into knowledge transfer and their own epistemic assumptions. Knowledge transfer related to clinical problems should be the learning situations prioritized when teaching EBP at bachelor level. Theoretical perspectives of cognitive maturity development, knowledge transfer and discretion in professional practice give alternative ways of designing pedagogical strategies for EBP. More research is needed to develop and test pedagogical strategies for EBP in light of these theories.

Reverse Engineering: Strategy to Teach Evidence-Based Practice to Online RN-to-BSN Students

This article describes an innovative approach to introducing RN-to-BSN students to nursing research and evidence-based practice (EBP). Reverse engineering updates an existing EBP project to better emphasize the role of research and evidence to practicing RNs enrolled in an RN-to-BSN program. Reverse engineering of a nursing practice guideline offers a method for teaching an appreciation of research and supporting nursing practice with best evidence.

Learning to think like a nurse: the development of clinical judgment in nursing students

The purpose of this project was to examine the clinical judgment and reasoning skills of nursing students in high-fidelity simulation. Two levels of students (N = 104), novices and those who are slightly more advanced, participated in individual videotaped simulations. Afterward, interviews were conducted to explore what the student was thinking and feeling during simulation. Five themes emerged from the interviews: thinking like a nurse, assessment, looking for answers, communication, and magical or reflective thinking. There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience. Tanner's model of clinical judgment in nursing is used to understand the findings of the study.