How do nurse academics value and engage with evidence-based practice across Australia: Findings from a grounded theory study

BackgroundIntegrating evidence-based practice (EBP) into undergraduate education and preparing future nurses to embrace EBP in clinical practice becomes paramount in today's complex and evolving healthcare environment. The role that EBP plays in the practical lives of nursing students will depend on the degree to which it is promoted by academics, how it is incorporated into courses and its application to clinical setting. Hence, nursing academics play a crucial role in influencing its integration into curricula. Drawn from a larger doctoral study, this paper presents findings discussing how nurse academics value and engage with EBP.MethodsGrounded theory was employed to explore processes used by nursing academics while incorporating EBP into teaching and learning practices. Twenty-three academics across Australian universities were interviewed. Nine were also observed while teaching undergraduate students. Data were collected from semi-structured interviews and non-participant observation. In keeping with the tenets of grounded theory, data collection and analysis continued until theoretical saturation was reached. In total, four categories emerged. This paper focuses on the category conceptualised as Valuing and Engaging with EBP.ResultsHow nursing academics valued and engaged with EBP was closely associated with meanings they constructed around understanding it, attitudes and commitment to implementation while teaching and working clinically. Different opinions also existed in regard to what actually constituted EBP. However, they engaged with and valued EBP by keeping themselves up-to-date, being involved in research activities, using evidence in teaching, therefore leading by example. Participants identified a number of barriers influencing their engagement with EBP including heavy workloads, limited time, lack of commitment within their schools, lack of confidence with teaching EBP, and complexity of EBP application. Faculty clinical practice, committed academics, workload management and continuing education were highlighted as facilitators.ConclusionA number of barriers prevented academics from fully engaging with EBP at academic or practice levels. Academic institutions and practice settings need to employ strategic planning to overcome such barriers.     

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

AimTo examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students.BackgroundThe competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students.DesignA quasi-experimental study.MethodsBased on Astin’s Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor’s program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students’ EBP competence, learning experience and satisfaction and score of team-based research protocol assignment.ResultsCompared with conventional teaching, the innovative teaching characterized by EBP improved students’ EBP competence in terms of attitudes and skills and enhanced student’s comprehensive ability in nursing research. Students’ learning experience and satisfaction were similarly favorable between the two groups.ConclusionsFor undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.     

The effect of evidence-based practice perception,information literacy self-efficacy,and academic motivation on nursing students' future implementation of evidence-based practice

BackgroundEvidence-based practice (EBP) in nursing is an important tool for promoting quality care and improving patient outcomes. Global evidence suggests that the rate of EBP implementation among nurses and nursing students is low. The effects of EBP perception, information literacy self-efficacy, and academic motivation on nursing students' future implementation of EBP have not been fully explored.PurposeTo examine the effect of EBP perception, information literacy self-efficacy, and academic motivation on future implementation of EBP among pre-registration nursing students.MethodA cross-sectional study used a self-administered structured questionnaire and analyzed data from 148 pre-registration nursing students at a university in central Israel. A hierarchical forced steps regression analysis was conducted to predict future implementation of EBP.ResultsInformation literacy self-efficacy, EBP perception, and intrinsic academic motivation to experience stimulation, may predict EBP future implementation. The model explained 46.3% of the variance.ConclusionThe results indicate the importance of information literacy skills and positive attitudes to EBP, as well as of intrinsic academic motivation, for enhancing future implementation of EBP among nursing students.     

The Ottawa model for nursing curriculum renewal: An integrative review

BackgroundHigh-quality and relevant nursing education is needed to ensure graduates meet entry to practice competencies. Despite the important role of curricula in the development of nurses and the nursing profession, there does not appear to be a consistent or widely accepted approach to nursing curriculum renewal.ObjectiveTo identify and synthesize existing curriculum renewal/redesign practices, create an aggregated logic model depicting an evidence-informed process for nursing curriculum renewal, and stimulate dialogue about how to keep nursing curricula relevant in an ever-changing healthcare context.DesignAn integrative review, modeled on the Joanna Briggs Methodology of Systematic Reviews, of the available published articles, including empirical research and discussion articles.Data sourcesWe searched for quantitative, qualitative, and non-research literature (English and French) on full nursing programs or curriculum revisions for pre-licensure nursing students enrolled in an undergraduate or associate degree program. Databases included CINAHL, Nursing and Allied Health, and Medline from January 2010 to January 2017. We then did a hand search for articles from January 2017 to April 2019.SynthesisExtracted data were synthesized into an aggregated logic model based on Yin's method of cross-case analysis. Data included information about the internal context, the external context, drivers, the preparatory phase, the active phase, outcomes, and evaluation methods of the described curriculum renewal process.ResultsTwenty articles were included, which were published between 2010 and 2018. The resulting logic model, The Ottawa Model for Nursing Curriculum Renewal, includes information on the context, process and outcomes of the renewal process, and how and when to evaluate curricula.ConclusionThis synthesis aids in defining the process of curriculum renewal for undergraduate nursing education. It stimulates systems level thinking and reveals gaps, such as the need for further research into curriculum evaluation. The Ottawa Model for Nursing Curriculum Renewal is a usable template to aid educators undertaking their own process of curriculum renewal.     

Primary health care content in Australian undergraduate nursing curricula

The importance of primary health care PHC is receiving increasing attention. The demand for skilled workers is due to an increased emphasis on community-based care but until recent times pre-registration preparation for nurses, including clinical placements, have focussed on acute care specialties.AimTo systematically review, measure and describe the PHC content in the undergraduate nursing curriculum in Australian schools of nursing over time.MethodsA cross-sectional study of all Australian universities offering undergraduate (pre-registration) baccalaureate degrees was undertaken in February 2017. Curriculum artifacts were retrieved from university websites. A terminology matrix guided retrieval of PHC content.FindingsAll 29 universities offering pre-registration undergraduate nursing degrees in Australia were included in this study. While most universities cite PHC principals as core values underpinning their undergraduate curriculum, only 12 (<2%) of the 694 subject titles had obvious or manifest “primary health care” content and these were mainly offered in 1st and 3rd year. Subject outlines tended to demonstrate more explicit content than subject titles.DiscussionThis study confirms ambiguity in PHC interpretation and nomenclature, and opportunities for undergraduate preparation for nursing roles in the home setting is limited. Prospective undergraduate nurses seeking careers in PHC might be deterred by a lack of manifest PHC content in the public domain, which may or may not accurately represent the actual content provided.ConclusionThe predominance of acute episodic care in both curricula and clinical experiences potentially diminishes the importance of PHC. This study offers some direction for education providers and policymakers wishing to attract and prepare next generation nurses for roles in PHC.     

The inclusion of cognitive behavioural therapeutic components in the undergraduate nursing curriculum. A systematic integrative review of the evidence

BackgroundDespite the increasing evidence base for the use of cognitive behavioural interventions in nursing, the extent to which therapeutic interventions and their components are included in the undergraduate curriculum in Australia remains unclear.ObjectivesTo explore if and how cognitive behavioural components are being taught to undergraduate nursing students to deliver outcome benefits to students and patients.DesignAn integrative literature review reporting links between CBT components and methods taught in pre-registration nurse education.Findings and conclusionBased on an analysis of current literature, it is suggested that evidence-based cognitive behavioural components are being taught to undergraduate nursing students. The study reports that teaching cognitive behavioural components can bring clinical benefits to positive patient outcome, to student wellbeing and study performance. However, the teaching of cognitive behavioural conceptual models as a therapeutic skill was found to be limited. Recommendations to incorporate a simple, evidence based cognitive behavioural conceptual tool, highlights how nurse educators can address the requirement to teach from the current evidence base.     

Enhancing utility and understanding of evidence based practice through undergraduate nurse education

Background

The concept of evidence-based practice is globally relevant in current healthcare climates. However, students and teachers struggle with integrating evidence based practice effectively into a curriculum. This has implications for nurse education and in particular the way in which research is presented and delivered to students.A new undergraduate Evidence Based Practice module (Evidence Based Nursing 1) was developed in a large University within the United Kingdom. It commenced in October 2014 running in year one of a 3 year undergraduate nursing programme. This study sought to formally evaluate attitudes and beliefs, knowledge level and utilization of evidence based practice though using two validated questionnaires: Evidence Based Practice Beliefs Scale© and Evidence Based Practice Implementation Scale©.

Method

This was a pilot study using quantitative pre and post-test design. Anonymised data was collected from Year 1 undergraduate student nurses in the September 2014 intake (n = 311) at two time points. Time 1: pre-module in September 2014; and Time 2: post –module in August 2015. All data was collected via Survey Monkey.

Results

Results demonstrate that the educational initiative positively impacted on both the beliefs and implementation of evidence based practice. Analysis highlighted statistically significant changes (p < 0.05) in both the Evidence Based Practice Beliefs Scale (7/16 categories) and the Evidence Based Practice Implementation Scale (13 / 18 categories).

Conclusions

The significance of integrating evidence based practice into undergraduate nurse education curriculum cannot be underestimated if evidence based practice and its positive impact of patient care are to be appreciated in healthcare settings internationally.

     

Undergraduate student nurses' knowledge of evidence-based practice: A short online survey

BackgroundVarious approaches and frameworks have been designed and tested to increase the uptake of research findings into practice. One approach is to base healthcare providers' practices on the best available research evidence rather than on expired policy or tradition. For which knowledge of evidence-based practice (EBP) principles is a prerequisite.ObjectiveThe purpose of the current inquiry is to evaluate Jordanian nursing students' knowledge of EBP.DesignThis study was an on-line cross-sectional survey.SettingsWe targeted students in two universities in the north and one in the capital city of Amman.ParticipantsThe target population was Jordanian student nurses, and the sample consisted of 316 from the nursing schools within three government universities.MethodsThe EBP knowledge test was used to collect data from students. It was adapted from the EBP Knowledge, Attitudes, Access & Confidence Evaluation. Ethical approval was obtained from the principal investigator's university before the questionnaire was uploaded on to the free online survey website. The link to the survey was established and shared on Facebook.ResultsJust over half of the participating students were male (51.9%) and the average age was 21.6 years (SD 2.7). The mean total knowledge score as measured by the EBP knowledge test was low at 1.9 (SD 1.4) out of 10.ConclusionsAn evaluation of EBP-related content in nursing schools' curricula is needed in order to design and test the effectiveness of implementing an EBP course in improving knowledge and skills. Critical appraisal and evidence synthesis skills should be honed as they are seen to be very weak, with much room for improvement. Meanwhile, research courses could be the mainstay for a nursing faculty to introduce the EBP approach for undergraduate nurses.     

Introduction of patient electronic medical records (EMR) into undergraduate nursing education: An integrated literature review

BackgroundTo prepare student nurses for clinical practice where patient electronic medical records (EMR) competence is required, nursing undergraduate curricula must provide simulation access to developing this skill set. At this stage, however, the integration of electronic documentation into the Australian undergraduate nursing curriculum has been piecemeal.AimThe aim of this integrated literature review was to identify benefits and challenges for faculty nursing staff and nursing students in relation to the integration, use and evaluation of EMR in an undergraduate nursing program.MethodsA systematic search of relevant peer-reviewed research and project report articles was conducted in the electronic databases. Generic qualitative thematic analysis was then undertaken with themes generated from the data itself.ResultsFifty eight articles were identified, of these 23 were found to meet the inclusion criteria. Three major themes were identified: 1) Advantages of using EMR in academic settings, 2) Identified Challenges and Limitations of EMR programs; and 3) Developing an academic EMR program and implementing EMR education program in stages. All papers acknowledged that EMR will be standard in healthcare and should be viewed as an ‘essential tool’ for inclusion in undergraduate nursing programs.Conclusion and implications for practiceThere is a significant increase of electronic technology in healthcare settings, especially relating to patient documentation. Therefore, teaching the use of EMR in the simulated clinical learning environment for new healthcare providers such as nursing students is essential. The papers reviewed identified an urgent need for higher education nursing programs to support undergraduate nursing students and faculty staff to ensure EMR can be implemented effectively into the undergraduate nursing curriculum.     

Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey

AimTo assess the extent to which Canadian undergraduate baccalaureate nursing programs have incorporated Canadian competencies for Registered Nurses in primary care into their curricula.BackgroundCanadian competencies for Registered Nurses in primary care have several benefits, including their ability to inform primary care education in undergraduate nursing programs and to assist in building a robust primary care nursing workforce.DesignWe conducted a national cross-sectional survey of undergraduate baccalaureate nursing programs (n = 74).MethodsThe survey was conducted between April-May 2022. We used a modified version of the “Community Health Nurses’ Continuing Education Needs Questionnaire”. Respondents indicated their level of agreement on a 6-point Likert scale with 47 statements about the integration of the competencies in their program (1 = strongly disagree; 6 = strongly agree).ResultsThe response rate was 51.4%. The overall mean across the six competency domains was 4.73 (SD 0.30). The mean scores of each domain ranged from 4.23 (SD 1.27) for Quality Assurance, Evaluation and Research to 5.17 (SD 0.95) for Communication.ConclusionsThere are gaps in how these competencies are included in undergraduate education programs and opportunities to strengthen education for this growing workforce in Canada.     

An embedded EBP project: Effect on student nurses’ practice,attitude, and knowledge

IntroductionEvidence-based practice (EBP) uses theory-derived and research-backed information to assist healthcare providers in making optimal decisions in patient care. Integration of EBP occurs throughout nursing curricula. The expectation is that once a licensed registered nurse, these types of practices will be incorporated into daily care. However, oftentimes nurses do not adhere to best practices. The purpose of this project was to gain an understanding on the impact of an embedded EBP project in an undergraduate nursing research course.MethodThe Student EBP Questionnaire (S-EBPQ©) was administered to a sample of 56 nursing students using a pre-/postquestionnaire design.ResultsTotal mean score in the pre-/postquestionnaire phase of the study was 4.49 ± 0.83 and 5.40± 0.70. In the area of frequency of use, the mean score in the pre-/postquestionnaire phase was 0.56 ± 0.16 and 0.73 ± 015. The mean score for attitude for the pre-/postquestionnaire phase was 0.59 ± 0.08 and 0.85 ± 0.14. For level of retrieving/reviewing evidence the mean score for the pre-/postquestionnaire phase was 0.58 ± 0.16 and 0.75 ± 0.12. For the level of sharing and applying EBP the mean score for the pre-/postquestionnaire phase was 0.64 ± 0.15 and 0.78 ± 0.13.DiscussionStudent participation in EBP using an EBP project was shown to be an effective tool to engage students and improve practice, attitude, and knowledge related to EBP.     

Current assessment of patient safety education

The purpose of this literature review was to examine current evidence on how student nurses and nursing faculty members perceived the integration of patient safety education in preregistration/undergraduate nursing training. Databases searched from January 2000 to April 2011 included CINAHL, PsycINFO, British Nursing Index, PubMed, AMED, Academic Science, Midline, Cochrane Library Database, Web of Knowledge, Ovid Nursing Database, Wiley Online Library and Science Direct. In total, 77 articles were initially found, although only 15 were included in the author's review. Of these, 5 papers were research-based articles that examined aspects of patient safety education in undergraduate/pre-registration nursing training, and 9 papers were literature review and discussion based, which provided insight into the experience, assessment, evaluation or implementation of patient safety education curriculum in nursing education. The author's literature review highlights the continuing lack of research on patient safety education in undergraduate/preregistration nursing training and, in particular, outlines areas in nursing education which need to be addressed to develop patient-safety-friendly nursing curricula.     

Exploring ethics in practice: creating moral community in healthcare one place at a time

Examining everyday ethical situations in clinical practice is a vital but often overlooked activity for nursing leaders and practitioners, as well as most other healthcare professionals. In this paper, we share how a series of practitioner-led Ethics in Practice sessions (EIPs), which originated within a busy urban teaching hospital, were adapted and translated, first into home care and more recently, into an EIP session for public health nurses. The success of EIP sessions rests with their focus on issues that are selected by practitioners. The aims of EIPs are to foster ethical leadership within communities of practice, create safe places to share concerns, use relevant research evidence and other literature to support informed discussion, and generate stories that deepen our understanding of the ethical situations we encounter in our work. We hope our experience inspires nursing leaders, nursing colleagues and fellow healthcare professionals to consider using the EIP approach to build moral community and the idea of moral imagination with their clinical colleagues, one place at a time.     

Nursing informatics in undergraduate nursing education in Australia before COVID-19: A scoping review

BackgroundTechnology can support transformational outcomes of high quality and evidenced-based care and education. Embedding nursing informatics into the undergraduate nursing curriculum enhances nursing students’ digital health literacy, whilst preparing them to use health information systems and technological innovations to support their learning both at university and in the clinical environment.AimThis scoping review aimed to provide an overview of the published literature on how nursing informatics was embedded and integrated into the undergraduate nursing curriculum in Australia before coronavirus disease (COVID-19).MethodologyA scoping review approach guided this study using the Levac, Colquhoun, and O'Brien framework, and the following databases were searched: CINAHL Plus, EMCARE, MEDLINE Ovid, Scopus, ERIC ProQuest, and Web of Science. A total of 26 articles were included: Five quantitative studies, eight qualitative studies and 13 mixed-methods studies.FindingsFew studies focused on the concept of nursing informatics itself, and only two studies described the process of developing curricula that contain nursing informatics competencies and their implementation: the educational scaffolding and modular development approach and a Community of Inquiry Framework (COI). Most studies centred on nursing informatics tools to facilitate teaching and learning in classrooms and skills laboratories. The reported pedagogical strategies were online learning, blended learning, and technology-enabled simulations. Hindrances to nursing informatics being integrated into undergraduate curricula were disparities of the informatics content, a lack of guidelines and/or frameworks, and poor digital literacy.ConclusionThis study provided a baseline perspective of how nursing informatics was embedded and integrated into nursing education in Australia before COVID-19. Overwhelmingly, the focus of research to date was found to be mainly on the utilisation of technological tools to support learning and teaching.     

Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review

To prepare new graduates with the knowledge, skills, and attitudes to engage in effective interprofessional collaboration (IPC) in practice, healthcare professional programmes need to ensure their curriculum provides opportunities for interprofessional education (IPE) and IPC. To strengthen IPE within an undergraduate curriculum and meet the professional requirements set out by regulatory bodies to prepare new graduate nurses to achieve IPC competencies, a curriculum initiative was developed to expand IPE across the four years of the Baccalaureate of Science in Nursing (BSN) programme. The purpose of this scoping review was to identify published teaching-learning activities in undergraduate nursing programmes to inform the development and integration of IPE curricula. The literature included was identified by searching the following electronic databases: EMBASE and EBSCO (CINAHL, Medline, Education Research Complete, ERIC). The search was limited to articles with abstracts published between 2008 and 2016 in the English language. All ten studies that met inclusion criteria reported students’ perceived interprofessional education as valuable in facilitating their achievement of IPC competencies. Interprofessional education is an approach for preparing nursing students with knowledge, skills, and attitudes to achieve IPC competencies and therefore, urgently needs to become more prevalent in nursing curricula. Educators can use a variety of IPE teaching-learning activities to support students’ achievement of IPC competencies in order to prepare new practitioners to engage in effective IPC in a variety of healthcare milieus. Nurse educators are encouraged to intentionally integrate learning opportunities into current and future undergraduate nursing education to prepare collaborative ready graduate nurses.     

Nursing students learning transfer from classroom to clinical practice: An integrative review

AimThe aim of this integrative review was to examine the theoretical, qualitative, quantitative and mixed-methods literature focused on how nursing students transfer learning from theory courses into clinical practice.BackgroundAs nursing curriculum aligns with the growing body of nursing knowledge, nursing students continue to develop their knowledge base and skill sets to prepare for future nursing practice. The bulk of this preparation involves developing connections between classroom/lab knowledge and further demonstrating those connections in clinical practice. However, the extant state of evidence on undergraduate nursing students’ learning transfer has not yet been synthesized.DesignThis integrative review was conducted using the Whittemore and Knafl framework.Review methodsEight databases were searched in June 2022: MEDLINE, APA PsycInfo, EMBASE, Web of Science, CINAHL, ERIC, Academic Search Complete and Education Research Complete. Literature was included if it focused on undergraduate nursing students who have participated in at least one clinical practicum and reported on learning transfer in clinical settings. Only English-language, peer-reviewed literature was included. Two researchers independently assessed the eligibility of articles at the title-and-abstract level and at the full-text level, followed by an assessment of methodological quality. The Joanna Briggs Institute’s critical appraisal checklists were used to assess theoretical papers and literature reviews and the mixed-methods appraisal tool (MMAT) was used to appraise all studies. Reference lists of included articles were searched for additional relevant literature. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.ResultsTwenty-eight articles met our inclusion criteria and were included in this review, including 20 qualitative studies, one quantitative study, three mixed-methods studies, three theoretical articles and one integrative review. The results of this review highlighted that numerous facilitators and barriers influence nursing students’ ability to transfer learning within clinical learning environments. Facilitators included having knowledgeable and supportive educators and nursing staff, using strategies to promote connections, fostering reflection and aligning theory and practice. Barriers included unclear connections between course content, incongruencies between classroom and practice, lack of nurse role models, lack of real-world applicability and unsupportive nurse educators.ConclusionsThe information generated from this integrative review provides evidence about barriers that can be mitigated and facilitators that can be leveraged to facilitate undergraduate nursing students’ learning transfer into clinical practice. The findings also highlighted gaps in evidence surrounding the need to understand how nursing students transfer learning from classroom settings to clinical practice settings.