A Study On Evidence-based Nursing Education Needs And Developing Evidence-based Nursing Course

BackgroundEvidence-based Nursing(EBN) has been rapidly developed as a new nursing philosophy and method by inflecting and inspirating Evidence-based Practicing(EBP) at the background of rapidly growing of global healthcare literature and information, as well as increasing demand for "effectiveness and efficiency" of health care service. In order to meet the social need and expectation for high quality health care system in the 21 century,US Health Professional Educational Summit(2002) has proposed four core competencies for medical students.Among these core competencies,practice based on best available evidence is strongly empasized.Although many Nursing colleges/schools developed EBN course,there were variations in the content and teaching plan,and fewer literature has been found to report the teaching content, teaching method and evaluation method in a systematic way,and no paper has been found on evaluating the outcome of EBN teaching and learning.EBN has been transmitted to mainland China during the recent decade,but the practice of EBN is still at the earlier stage,there are some misunderstanding on the concepts of EBP and EBN.Although several continuing educational programs or workshops on EBP and EBN have been provided to clinical nursers in many hospitals, only few nursing schools introduced EBN as a course in undergraduate or postgraduate nursing programs.Thus EBN is far from been fully understood by clinical nurses,and more works need to do for comprehensive education on EBP philosophy and skills to nursing students.Therefore it is essencial to study how to develop a course of EBP in nursing,and to explore the teaching content,teaching method,and teaching outcome evaluation.ObjectiveThere were three stages in this study.(1) In stageⅠ,the aims were to analyze EBN education/training demand of society and nursing disciplines through literature study, to investigate the needs for evidence-based nursing education of clinical nurses with bachelor degree in Shanghai;(2) StageⅡaims to investigate the suggestion for teaching content and method of EBN from faculty members in nursing schools in Shanghai that had graduate nursing programs;(3) In stageⅢ,the objectives were to develop EBN course based on adult education theory and course development technology,and provide EBN course to postgraduate nursing students,and to evaluate teaching and learning outcome of the course. Methods1.A self-rated questionnaire was distributed and administered to a convenient sample of 722 clinical nurses with bachelor degree in Shanghai,so as to investigate perception and knowledge on evidence-based nursing and the barriers of implementing EBN;2.In order to collect the suggestions for EBN teaching content and methods,a self-rated questionnaire was distributed and administered to 52 nursing faculty members in 3 nursing schools in Shanghai that had graduate nursing programs;3.According to the demand of social,nursing disciplines and students,and the suggestions from faculty members in nursing schools,an EBN course has been developed based on adult education theory and course development technology.4.A quasi-experimental design study was implemented on evaluating the teaching and learning outcome of EBN course for postgraduate students in School of Nursing Fudan University.Students in 2007 group(n=22) was assigned to experimental group who attended a 36 school-hour(2-credit) course of EBN,while students in 2006 group(n=26) were in control group who did not attend EBN course.Self-rated questionnaires on EBN knowledge and attitude were administered at baseline and post-course.The competencies on critical appraisal and developing systematic review project were evaluated for experimental group after the completion of EBN course. Feedback on EBN teaching and learning were also collected by questionnaire and semi-structured interview for students in experimental group.SPSS 13.0 were used for data analysis.Result1.The investingation of EBN education needs and suggestions from nursing faculty members on EBN education:(1) Athough the word "EBN" had been widely known by clinical nurses with bachelor degree,it was revealed by this study that clinical nurses with bachelor degree had poor knowledge on the nature of EBN,and even had some misunderstandings on EBP and EBN.(2) Nursing faculty members in nursing schools in Shanghai with graduate programs provided constructive suggestions on how to develop an EBN course, including prescribed pre-courses,teaching environment,content,method,points for stress and difficulties in teaching,and teaching evaluation method.2.The development of EBN course,implementation of EBN teaching,and stress and difficulties in teaching,and teaching evaluation method.2.The development of EBN course,implementation of EBN teaching,and evaluation of teaching and learning outcome.(1) According to the demand of social,nursing disciplines and students,and the suggestions from faculty members in nursing schools,an EBN course has been developed based on adult education theory and course development technology;(2) Students in experimental group had significantly higher score on EBN knowledge than control group(p＜0.001);(3) Students in experimental group had significantly higher scores on critical appraisal at post- course than at pre-course(p＜0.01);(4) There was no statistically difference on EBN attitude score for students in experimental group and control group after EBN course(p＞0.05);(5) The results of course feedback questionnaire and semi-structured interview suggested that students had positive perception on EBN learning,they had established the connection between EBP theory and practice after studying EBN course.Most of the students in experimental group were satisfied with course content,teaching materials and teaching methods.In addition,they proposed constructive suggestions on credit hours and teaching arrangement for further implementing of EBN course.Conclusion1.There is need to develop EBN education program for clinical nurses with bachelor degree,as most clinical nurses with bachelor degree know the word "EBN", but had poor knowledge on the nature of EBN,and even had some misunderstandings on EBP and EBN;2.EBN course should be developed based on adult learning theory and course development technology,the need of clinic nurses and suggestion from nursing faculty members.The content and method of the course should be practical and specific for nurses;3.The knowledge and skill of EBN could be significantly improved by learning a comprehensive EBN course for nurses studied in postgraduate nursing program;4.Further study is needed to explore the effect of EBN course on stuents' attitude to EBN.