Evidence‐Based Practice Article Reviews Using CASP Tools: A Method for Teaching EBP

This column shares the best evidence-based strategies and innovative ideas on how to fa-cilitate the learning of EBP principles and processes by clinicians as well as nursing andinterprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787Excellent evidenced-based practice (EBP) is based on nurses’ability to critically appraise information and determine the rel-evance and usefulness of that information for practice (Porter&O’Halloran,2012).Knowinghowtodoacriticalevidencere-viewisimportanttothesuccessofimplementinganyevidence-based innovation (Ryan, Coughlan, & Cronin, 2007). Consid-ering the importance of critical appraisal skills, faculty whoare teaching research or EBP undergraduate nursing coursesneed to use teaching strategies that will promote students’ de-velopment of superior skills in analyzing research evidence.Research suggests that learning about EBP occurs best whenintegrated into multiple areas of the nursing students’ educa-tionratherthanonlyduringaresearchorEBPcourse(Christie,Hamill, & Power, 2012). There are many ways to foster stu-dents’criticalappraisalskills(Winters&Echeverri,2012).Oneway to improve students’ abilities in this area is through per-forming research appraisals and submitting the work as for-malpapers(MelnykandFineout-Overholt,2011).Suchassign-ments do give students the opportunity to critically appraiseevidence.There is, however, a substantial time commitment for stu-dents to write article reviews and for faculty members to pro-vide quality feedback. In addition, individual student criti-cal appraisal assignments often do not help students engagein collaborative learning or feel supported within the class-room. Such independent learning may decrease motivationandachievement(Zumbrunn,McKim,Buhs,&Hawley,2014).One strategy that addresses these issues is a group approachto quantitative and qualitative article critical appraisals. Thisstrategy helps foster learning about EBP and team collabora-tion at the same time. The strategy may be used in a variety ofundergraduate nursing courses and should not be limited toonly a research or EBP course.Using this approach, the faculty teaching clinical courseschoose either a quantitative or qualitative research article re-lated to the course content. Students receive a link to the PDFversion of the article that will be reviewed. In addition, facultymembers provide students with a critical appraisal tool, theCritical Appraisal Skills Programme tool, also known as CASPtool,asaguideforcriticalappraisalofthearticle.Thestudents’responsibilityistoreadandcriticallyappraisetheselectedarti-cle and plan on presenting their critical appraisal during classusing the form provided.Although there are many critical appraisal tools that maybe used as guides, the CASP tools are succinct and effectivelycover the areas needed for critical appraisal of evidence. Spe-ciﬁc CASP checklists have been developed for reviews of ran-domized controlled trials, systematic reviews, qualitative, casecontrol,diagnostic,cohort,economicdesigns,andclinicalpre-diction rule. Each is free to download and use under the “Cre-ative Commons License” according to the CASP UK website(2013).Questions on the Qualitative CASP Checklist, for example,focus on three broad areas: Are the results of the review valid,whataretheresults,andwilltheresultshelplocally?Toanswerthese three general questions, 10 subcategories of analysis areincluded on the qualitative checklist. These comprise assess-mentsrelatedtotheaimoftheresearch,suitablemethodology,recruitment ﬁtting, the data collection being appropriate andadequate,therelationshipbetweenresearcherandparticipantswell considered, the work ethical, ﬁndings clear, and the valueoftheresearch.Responsesforeachofthe10subcategoriescanbe “yes,” “can’t tell,” or “no.”During a class session, undergraduate students are orga-nized into small groups and assigned to review the same ar-ticle using the CASP tool. Depending on the length of the