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      Educational Interventions for Teaching Evidence-Based Practice to Undergraduate Nursing Students: A Scoping Review

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          Abstract

          Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours, EBP beliefs, use, practice, level of evidence, critical thinking and future use of EBP were mentioned and assessed in different studies. Conclusions: EBP training can improve nursing students’ capacity in healthcare provision. Teaching EBP competencies along undergraduate nursing curricula should be a high priority at nursing programmes. The use of innovative approaches seems to be more effective than traditional ways. Education of EBP increases its future use and critical thinking and EBP programs improve self-efficacy and the level of evidence utilization.

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          Development of an evidence-based practice questionnaire for nurses.

          The aim of this paper is to report the development and validation of a self-report measure of knowledge, practice and attitudes towards evidence-based practice (EBP). Evidence-based practice has become increasingly important in health care since the mid-1990s as it provides a framework for clinical problem-solving. However, to date no means exist to quantify the extent to which barriers, such as lack of time in the working day, lack of appropriate skills and negative attitudes, may prevent greater uptake of EBP. Questionnaire development was based on established psychometric methods. Principal component factor analysis was used to uncover the underlying dimensions of the scale. Internal consistency of the scale was assessed by Cronbach's alpha. Finally, construct validity was assessed via convergent and discriminant validity. The final questionnaire comprised three distinct scales (EBP, attitudes towards EBP and knowledge of EBP), which had robust validity and internal reliability. This tool can be used to measure the implementation of EBP.
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            The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators.

            This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.
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              The development and validation of a knowledge, attitude and behaviour questionnaire to assess undergraduate evidence-based practice teaching and learning.

              Most evidence-based practice (EBP) educational assessment tools evaluated to date have focused on specific knowledge components or technical skills. Other important potential barriers to the adoption of EBP, such as attitudinal, perceptual and behavioural factors, have yet to be studied, especially in the undergraduate setting. Therefore, we developed and validated a knowledge, attitude and behaviour questionnaire designed to evaluate EBP teaching and learning in an undergraduate medical curriculum. We derived the questionnaire from a comprehensive literature review, informed by international and local experts and a Year 5 student focus group. We determined its factor structure and refined and validated the questionnaire according to the responses of a cohort of Year 5 and a combined group of Years 2 and 3 students using principal components factor analysis with varimax rotation. Factor reliability was computed using Cronbach's alpha coefficient. We assessed construct validity by correlating the factors with other measures of EBP activity and examined responsiveness through paired t-test of the pre/post factor mean scores. A 43-item questionnaire was developed. Four factors were identified from both student groups. The overall questionnaire as well as each factor had high construct validity (Cronbach's alpha > 0.7 for each scale). No significant correlations were found between the 4 factors, confirming their orthogonality. Positive correlations, however, resulted between factor mean scores and other EBP activities. The responsiveness of the questionnaire was satisfactory. A reliable knowledge, attitude and behaviour measure of EBP teaching and learning appropriate for undergraduate medical education has been developed and validated.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                31 August 2020
                September 2020
                : 17
                : 17
                : 6351
                Affiliations
                [1 ]Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71414 Crete, Greece; athina.patelarou@ 123456gmail.com (A.E.P.); epatelarou@ 123456hmu.gr (E.P.)
                [2 ]Clinic of Social and Family Medicine, School of Medicine, University of Crete, 70013 Crete, Greece
                [3 ]Department of Health Care, Faculty of Public Health, University of Vlora, 9401 Vlora, Albania
                [4 ]Faculty of Nursing, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain; maruzafa@ 123456um.es (M.R.-M.); ajramos@ 123456um.es (A.J.R.-M.)
                [5 ]Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic; jakub.dolezel@ 123456osu.cz (J.D.); darja.jarosova@ 123456osu.cz (D.J.)
                [6 ]Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; joanna.gotlib@ 123456wum.edu.pl (J.G.); mariusz.panczyk@ 123456wum.edu.pl (M.P.)
                [7 ]Angela Boškin Faculty of Health Care, Spodnji Plavž 3, 4270 Jesenice, Slovenija; bskelasavic@ 123456fzab.si (B.S.-S.); msmodis@ 123456fzab.si (M.S.)
                [8 ]Degree Course in Nursing, University of Modena and Reggio Emilia, Seat of Reggio Emilia, 42123 Reggio Emilia, Italy; sfinotto@ 123456unimore.it (S.F.); daniela.mecugni@ 123456unimore.it (D.M.)
                Author notes
                [* ]Correspondence: mechili@ 123456univlora.edu.al
                [†]

                European Nursing Centre for Learning Evidence—Based Practice (ENCLEBP), 30100 Murcia, Spain.

                Author information
                https://orcid.org/0000-0002-0300-0650
                https://orcid.org/0000-0002-4072-296X
                https://orcid.org/0000-0003-3335-5150
                https://orcid.org/0000-0002-1028-5383
                https://orcid.org/0000-0002-3490-3326
                https://orcid.org/0000-0003-3372-602X
                https://orcid.org/0000-0002-3032-3076
                https://orcid.org/0000-0002-0442-050X
                https://orcid.org/0000-0003-1830-2114
                Article
                ijerph-17-06351
                10.3390/ijerph17176351
                7503534
                32878256
                145c075c-c08b-49bf-95cc-b35c01bfcf90
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 July 2020
                : 18 August 2020
                Categories
                Review

                Public health
                evidence-based practice,evidence-based nursing,undergraduate students,nursing students,nursing education,teaching ebp

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