Assisting Undergraduate Nursing Students To Learn Evidence-based Practice During Clinical Practicum

Objective To explore appropriate learning strategies to equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP) during their clinical practicum.Methods During the first stage, the perceived EBP basic knowledge, attitude and behavior levels of all the nursing students practicing in the same hospital were investigated through a self-designed questionnaire and possible influencing factors were analyzed as well. In the second stage, a total of 80 undergraduate nursing students were recruited and divided into 15 groups to learn the basic knowledge of Evidence-Based Nursing (EBN) at first through a self-directed learning (SDL) approach with the help of a package of learning materials. Clinical preceptors and peer students played roles of facilitators and internet and library resources were utilized. Then students in the same group cooperate together for the purpose of learning how to critically evaluate research evidence with a research report evaluation guideline and literature appraisal examples as reference. They also made a presentation and had an in-depth discussion of their research evaluation report by means of workshop. The outcomes were evaluated through questionnaires to compare EBP competencies before and after the learning process and satisfaction and feedback were surveyed as well.Results1. The theoretical score range of EBP related knowledge, attitude and belief, and behavior were 8-24, 14-42, 8-24 and the mean scores clinical nursing students achieved were 10.85,34.34,10.84 respectively.2. Multivariate analysis showed that educational background was the influencing factors of evidence-based knowledge level as well as attitude and belief of nursing students. The undergraduate nursing students had the highest level of EBN related knowledge and attitude. Previous experience of EBN training was a positive factor of the level of evidence-based knowledge and behavior at this stage, while previous experience of evidence-based practice was a positive influencing factor of current EBN related knowledge.3. Statistically significant differences in the mean scores of EBP knowledge, attitude and belief, and behavior (t=-11.64, t=-4.24, t=-8.95, P<0.001) levels were found after students participated in the learning program.4. A total of 72 participants (97.3%) showed some or complete satisfaction with the learning strategies and statistical difference (χ2=4.5709, P<0.05) and more satisfaction with workshop were shown in addition. More than 90% of the participants found improvement in analytical and problem-solving ability, independent learning ability, cooperative and communication ability, evidence-based conception and scientific research ability, among which the proportions for obvious improvement were 31.1%, 45.9%, 44.6%, 27.0% and 24.3% respectively.5. More than half of the students (n=43, 58.1%) thought learn EBP in clinical practice as the best way to learn, while the primary barrier during learning process was a lack of literature retrieval and evaluation skills (n=37, 50%).Conclusions1. Although nursing students have positive attitudes and confidence about EBP, there remains a substantial gap in knowledge and practice level.2. The undergraduate nursing students are the most appropriate people for EBP training. The evidence-based learning plan should be based on their competencies and we need provide more opportunities for their EBP training. Meanwhile, through continuous learning of EBN knowledge and implementing evidence-based practice they can gradually base nursing care on evidence in clinical work.3. This study provides evidence that a learning program through the SDL and workshop strategies can effectively equip undergraduate nursing students with beginning competencies in EBP. Meanwhile, their independent learning abilities, cooperative and communicative skills were improved as well. 4. It is implicated the learning program may be extended to assist students gain an insight into the essence and hierarchy of evidence for EBP and more opportunities should be provided for clinical utilization of evidence in the future through strengthening and improving the evidence-based qualities and competencies of clinical preceptors.