Evidence-Based Practice Competencies among Nutrition Professionals and Students: A Systematic Review.

BACKGROUND: Evidence-based practice (EBP) promotes shared decision-making between clinicians and patients. OBJECTIVE: The aim was to determine EBP competencies among nutrition professionals and students reported in the literature. METHODS: We conducted a systematic review by searching Medline, Embase, CINAHL, ERIC, CENTRAL, ProQuest Dissertations and Theses Global, BIOSIS Citation Index, and clinicaltrials.gov up to March 2023. Eligible primary studies had to assess one of the 6 predefined EBP competencies: formulating clinical questions; searching literature for best evidence; assessing studies for methodological quality; effect size; certainty of evidence for effects; and determining the applicability of study results considering patient values and preferences. Two reviewers independently screened articles and extracted data, and results were summarized for each EBP competency. RESULTS: We identified 12 eligible cross-sectional survey studies, comprising 1065 participants, primarily registered dietitians, across 6 countries, with the majority assessed in the United States (n = 470). The reporting quality of the survey studies was poor overall, with 43% of items not reported. Only 1 study (8%) explicitly used an objective questionnaire to assess EBP competencies. In general, the 6 competencies were incompletely defined or reported (e.g., it was unclear what applicability and critical appraisal referred to and what study designs were appraised by the participants). Two core competencies, interpreting effect size and certainty of evidence for effects, were not assessed. CONCLUSIONS: The overall quality of study reports was poor, and the questionnaires were predominantly self-perceived, as opposed to objective assessments. No studies reported on competencies in interpreting effect size or certainty of evidence, competencies essential for optimizing clinical nutrition decision-making. Future surveys should objectively assess core EBP competencies using sensible, specific questionnaires. Furthermore, EBP competencies need to be standardized across dietetic programs to minimize heterogeneity in the training, understanding, evaluation, and application among dietetics practitioners. This study was registered at PROSPERO as CRD42022311916.

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.

A Comparison of Evidence-Based Practice Training With and Without Postimmersion Follow-up.

OBJECTIVE: The aim of this study was to determine best practice for evidence-based practice (EBP) education that leads to implementation. BACKGROUND: Current methods of teaching EBP do not reliably translate to implementation. METHODS: Participants in an EBP immersion were compared with participants in EBP immersion plus a follow-up EBP course. RESULTS: The EBP immersion group implemented 18% of their initiatives. The EBP immersion plus the follow-up EBP course implemented 35% of their initiatives, and an additional 22% were in the process of implementation. CONCLUSION: Evidence-based practice education may not be sufficient in promoting EBP implementation. Additional ongoing support may be needed to bring EBP initiatives through implementation.

Interventions, methods and outcome measures used in teaching evidence-based practice to healthcare students: an overview of systematic reviews.

BACKGROUND: To fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student's development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare need a systematic overview of evidence-based teaching and learning interventions. The purpose of this overview of systematic reviews was to summarize and synthesize the current evidence from systematic reviews on educational interventions being used by educators to teach evidence-based practice to professional bachelor-degree healthcare students and to identify the evidence-based practice-related learning outcomes used. METHODS: An overview of systematic reviews. Four databases (PubMed/Medline, CINAHL, ERIC and the Cochrane library) were searched from May 2013 to January 25th, 2024. Additional sources were checked for unpublished or ongoing systematic reviews. Eligibility criteria included systematic reviews of studies among undergraduate nursing, physiotherapist, occupational therapist, midwife, nutrition and health, and biomedical laboratory science students, evaluating educational interventions aimed at teaching evidence-based practice in classroom or clinical practice setting, or a combination. Two authors independently performed initial eligibility screening of title/abstracts. Four authors independently performed full-text screening and assessed the quality of selected systematic reviews using standardized instruments. Data was extracted and synthesized using a narrative approach. RESULTS: A total of 524 references were retrieved, and 6 systematic reviews (with a total of 39 primary studies) were included. Overlap between the systematic reviews was minimal. All the systematic reviews were of low methodological quality. Synthesis and analysis revealed a variety of teaching modalities and approaches. The outcomes were to some extent assessed in accordance with the Sicily group`s categories; "skills", "attitude" and "knowledge". Whereas "behaviors", "reaction to educational experience", "self-efficacy" and "benefits for the patient" were rarely used. CONCLUSIONS: Teaching evidence-based practice is widely used in undergraduate healthcare students and a variety of interventions are used and recognized. Not all categories of outcomes suggested by the Sicily group are used to evaluate outcomes of evidence-based practice teaching. There is a need for studies measuring the effect on outcomes in all the Sicily group categories, to enhance sustainability and transition of evidence-based practice competencies to the context of healthcare practice.

Assessment of Evidence-Based Practice (EBP) among physiotherapists in Cameroon: a cross-sectional survey.

BACKGROUND: Evidence-Based Practice (EBP) is reported to ease effective and adequate decision making for all works of life including health professionals. Investigating the level of implementation of EBP among physiotherapists helps to identify barriers and propose solutions for its extensive implementation. Despite available data on EBP elsewhere, it remains limited or non-existent in Cameroon. This study was designed to establish the current state of EBP among physiotherapists in Cameroon, by assessing knowledge, practice, and barriers to its implementation. METHODS: A cross-sectional survey was conducted online among French- and English-speaking physiotherapists in Cameroon over a period of six months from April to July 2023, using the EBP2 questionnaire. This enabled us to collect socio-demographic data from participants and information on their knowledge, understanding and practice of EBP and possible barriers to EBP according to 5 domains (Confidence, Relevance, Terminology, Practice, Compatibility) scored out of 100. Data were analysed using IBM SPSS 25.0 software and Pearson correlations (95% CI) and significance (p < 0.05). RESULTS: A total of 110 physiotherapists practising in the 10 regions of Cameroon participated in the study. The majority were male (54.5%), the median age was 34 years (age range 20 to 50), the median year of graduation was 2019 (range 2004 to max 2022) with 72.7% never having knowledge or training in EBP. Participants scored below 50/100 for 3 domains (confidence, relevance, and compatibility) showing poor general knowledge and understanding of EBP, although they generally had a positive attitude towards EBP. The use of EBP in practice was low (26.3/100 SD. 6.5), despite that they appeared to have a good understanding of research terminology (55.4 SD. 17.2). Level of study of participants did not appear to significantly influence domain scores (P > 0.05). The main barriers to practice were lack of time (75.1%), workload (66%), cost of access to information resources like databases for seek informations about recent support protocols (60%), ease of access to computers (49%), and lack of resources or skills (49%). CONCLUSION: Physiotherapists in Cameroon have a poor knowledge of EBP and a low level of practice of EBP, despite an overall positive attitude towards it. These results could inform stakeholders of higher education on the need to improve training of physiotherapy students in the domain of EBP in Physiotherapy. Also, it will help in raising the level of scientific research and promoting the implementation of EBP in Cameroon.

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.

Suggestions from Experience and AI Tools to Teach Evidence Based Practice to Nurses.

Hospital librarians receive invites to teach thinking and searching in an evidence-based way and critical appraisal of the literature to nurses. With these invitations, the hospital librarians play a central role in establishing an evidence-based culture in the hospital and contribute to the nursing staff feeling competent and confident in fulfilling evidence-based competencies. This author just prepared a 17-minute online talk as part of an international nursing webinar on "searching nursing literature in an evidence-based way." Using this experience, remembering other teaching and presentation experiences, and some "help" from AI tools, this experienced hospital librarian suggests decision points for colleagues to create a meaningful, practical information session for nurses and introduce to some AI tools along the way.

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.

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).

Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study.

BACKGROUND: Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation. METHODS: One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman's test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis. RESULTS: There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0). CONCLUSIONS: EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

Evidence-Based Practice Knowledge Retention Among Nurse Practitioner Students.

ABSTRACT: The mastery of clinical scholarship and analytic methods for evidence-based practice (EBP) is a published essential for nurse practitioner (NP) education; however, retention of EBP-related knowledge during NP education remains unknown. We assessed EBP knowledge during a first-semester research course and again during the last semester using an item response model. We found that changes depended on the exam item, with performance dropping on a third of the items. Our findings suggest a need to integrate EBP concepts across curricula (e.g., feedback loops in courses other than the research course) to retain these essential skills.

Care, lead, and inspire: Infusing innovation into nursing research and evidence-based practice course.

BACKGROUND: Today's nursing workforce is expected to know how to identify and understand research methods and procedures and apply the most current evidence into daily practice. However, teaching evidence-based practice (EBP) in an undergraduate nursing curriculum poses unique challenges in overcoming students' perception of content relevancy to their educational experience, but also offers opportunities for innovation to facilitate critical thinking and clinical application. AIMS: The aim of this article is to report on how teaching and learning innovation was infused into a research and evidence-based practice course and the effect on students' perceptions of course values and effectiveness. METHODS: We used a Plan-Do-Study-Act approach to introduce innovation in an undergraduate course within a university setting. Final student course evaluations were used to measure outcomes on a 5-point Likert scale (1 = low and 5 = high) on the following dimensions: (1) value of overall educational experience, (2) relevancy of course content, (3) improvement in critical thinking, and (4) level of student-instructor interaction. RESULTS: Overall course evaluation scores improved greatly from 2.69 to 3.90 between Spring 2020 and Fall 2021. This finding remained relatively consistent across subsequent semesters (3.79 [Spring 2022], 3.84 [Fall 2022]). Students also reported appreciation and increased engagement and interest with the material after transitioning from examinations to a project-based assignment that allowed them to walk through the steps of EBP in class. LINKING EVIDENCE TO ACTION: We identified and implemented several innovative strategies to improve student outcomes and increase the relevance of the course content. These innovations can be easily incorporated at other universities to enhance delivery and student engagement in this content that is essential to advancing quality care in nursing and developing future nurse scientists and practice leaders who care, lead, and inspire.

An objective test to measure evidence-based practice knowledge and skill competency of acute care nurses: A psychometric validation study.

BACKGROUND: Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. AIM: The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. METHODS: A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. RESULTS: The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha = 0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. LINKING EVIDENCE TO ACTION: The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.

Seeking to Understand: Qualitative Research on Sustainability of Evidence-Based Practice in Acute Care.

OBJECTIVE: The aim of this study was to describe cultural characteristics, values, and beliefs that influence sustainability of an evidence-based practice (EBP) intervention in the acute care clinical setting. BACKGROUND: There is an urgent need to identify best practices to sustain EBP to gain efficiencies in nursing care delivery and improve patient outcomes. METHODS: A focused ethnographic qualitative study was conducted in a community hospital with nurses that used Screening, Brief Intervention, and Referral to Treatment (SBIRT). RESULTS: Customizing the intervention to the unit culture evolved and was crucial for sustainability. Overlap in responsibilities, time, clinician confidence, and impact to workflow were noted as negative influences. The intervention was primarily viewed as a task to be checked off a list instead of a tool that informs the patient's plan of care. CONCLUSIONS: Assessing clinician experiences, beliefs, and values of an EBP should be incorporated into a strategic sustainability plan. Clinician understanding of how an EBP can advance the patient plan of care could promote ownership of professional practice and sustainment.

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.

Connecting Evidence-Based Practice and Clinical Practice Guidelines With Bachelor of Science in Nursing Students.

ABSTRACT: Research has demonstrated the ability of evidence-based practice (EBP) to enhance quality and reliability of health care, improve health outcomes, and reduce cost and health disparities. Nursing curricula often lack best practices for teaching EBP, as well as actual EBP course content, objectives, and activities, to advance student understanding of EBP. The unfortunate results are nurse graduates who do not value or perceive that they can use EBP. This study implemented an EBP assignment assessing clinical practice guidelines as a means of improving EBP beliefs in senior-level nursing students.

Teaching evidence-based practice: Knowledge to implementation in a BSN program, part 1.

BACKGROUND: Despite increased recognition for the importance of evidence-based practice (EBP), nurses still identify a need for more education and skill-building in the process used to provide evidence-based care. Nurse educators play a vital role in addressing these needs. This article is part 1 of a two-part series. AIMS: To describe an interactive learning process regarding EBP taught over two courses that allow students to not only appraise evidence but also implement evidence on a clinical unit. Part 1 focuses on course one, Evidence-Based Practice, which takes place during junior year. METHODS: In course one, students learn about EBP steps 1-3. Faculty assign students to teams of three to four for an evidence-based project. Project scenarios are written ahead of time by faculty, and student teams are given class time for project completion. After course completion, an anonymous survey was distributed to measure the student perceived achievement for the EBP learning objectives. Students responded to statements using a 5-point Likert scale for level of agreement (1 = strongly disagree to 5 = strongly agree) regarding achieving course objectives. RESULTS: The evidence-based project culminated with a PowerPoint presentation to the class with recommendations for nursing practice based on the best evidence for the scenario they were provided. Eighty students responded to the evaluation survey, and mean scores were 4.0 or higher. This finding indicates that students had a high degree of perceived achievement. LINKING EVIDENCE TO ACTION: Interactive learning in teams promotes discussion and understanding of EBP and mimics real-life EBP implementation. Implementing EBP steps should be tied to clinical scenarios or clinical situations to enhance student learning.

EBP education and skills building for leaders: An RCT to promote EBP infrastructure, process and implementation in a comprehensive cancer center.

BACKGROUND: Implementation of evidence-based practice (EBP) in healthcare remains challenging. The influence of leadership has been recognized. However, few randomized trials have tested effects of an educational and skills building intervention for leaders in clinical settings. AIMS: Test effects of an EBP leadership immersion intervention on EBP attributes over time among two cohorts of leaders at a national comprehensive cancer center. METHODS: A stratified, randomized, wait-list group, controlled design was conducted. Participants received the evidence-based intervention one year apart (2020, n = 36; 2021, n = 30) with EBP knowledge, beliefs, competencies, implementation self-efficacy, implementation behaviors, and organizational readiness measured at pre- and post-intervention, and one- and two-year follow-ups. Participants applied learnings to a specific clinical or organization priority topic. RESULTS: Baseline outcomes variables and demographics did not differ between cohorts except for age and years of experience. Both cohorts demonstrated significant changes in EBP attributes (except organizational readiness) post-intervention. Mixed linear modeling revealed group by time effects at 3-months for all EBP attributes except implementation behaviors and organizational readiness after the first intervention, favoring cohort 2020, with retained effects for EBP beliefs and competencies at one year. Following Cohort 2021 intervention, at 12-weeks post-intervention, implementation behaviors were significantly higher for cohort 2021. LINKING EVIDENCE TO ACTION: An intensive EBP intervention can increase healthcare leaders' EBP knowledge and competencies. Aligning EBP projects with organizational priorities is strategic. Follow-up with participants to retain motivation, knowledge and competencies is essential. Future research must demonstrate effects on clinical outcomes.

Degrees of freedom analysis in educational research and decision-making: leveraging qualitative data to promote excellence in bioinformatics training and education.

Qualitative data are commonly collected in higher, graduate and postgraduate education; however, perhaps especially in the quantitative sciences, utilization of these qualitative data for decision-making can be challenging. A method for the analysis of qualitative data is the degrees of freedom analysis (DoFA), published in 1975. Given its origins in political science and its application in mainly business contexts, the DoFA method is unlikely to be discoverable or used to understand survey or other educational data obtained from teaching, training or evaluation. This article therefore introduces and demonstrates the DoFA with modifications specifically to support educational research and decision-making with examples in bioinformatics. DoFA identifies and aligns theoretical or applied principles with qualitative evidence. The demonstrations include two hypothetical examples, and a case study of the role of scaffolding in an independent project ('capstone') of a graduate course in biostatistics. Included to promote inquiry, inquiry-based learning and the development of research skills, the capstone is often scaffolded (instructor-supported and therefore, formative), although it is intended to be summative. The case analysis addresses the question of whether the scaffolding provided for a capstone assignment affects its utility for formative or summative assessment. The DoFA is also used to evaluate the relative efficacies of other models for scaffolding the capstone project. These examples are intended to both explain this method and to demonstrate how it can be used to make decisions within a curriculum or for bioinformatics training.

Evidence-Based Competency Training Program for Blood Product Administration.

BACKGROUND: Health care in deployed military environments requires robust clinical nursing skills to care for patients with traumatic injuries. Blood product administration is a critical skill in which nurses should be competent. However, in non-deployed environments, blood transfusions are performed less frequently, resulting in skill competency loss. AIMS: Our clinical inquiry focused on maintaining competency for infrequently performed nursing skills, specifically blood product administration. METHODS: A literature review and critical appraisal were executed, followed by an evidence-based practice change. A knowledge test, objective and subjective assessment, and training satisfaction evaluation were performed to measure the practice change outcomes. Both inpatient and outpatient nurses were included. RESULTS: Sixteen articles were identified and appraised. The evidence recommended a blended education approach, that is, lecture plus hands-on practice. Thus, a classroom lecture and simulation scenario were put into practice with an existing computer-based training for blood administration. The nurses met knowledge test standards (≥ 90%) before and after implementation, while skill performance improved by 13% and improved self-competence scores by 7%. Nurses in outpatient settings improved performance scores by 18.4% compared to inpatient nurses, whose scores improved by 9.4%. The simulation scenario completion time decreased by 8.3 minutes post-implementation, and the training program earned a 90% satisfactory rating. LINKING EVIDENCE TO ACTION: A blended education program improves clinical skill performance and enhances confidence in performing critical interventions. Blended education provides a safe learning environment for nurses to be prepared for the management of low-volume patient care emergencies.