EBP-SDM Training Program Empowers Nurses' Competency and Performance

The purpose of this study will be to evaluate the effect on competency and performance of EBP and SDM.

1. To evaluate the effect of the 5As-steps EBP training program on competency in nurses-midwives
2. To evaluate the effect of the SDM training program on performance in in nurses-midwives

This is a randomized controlled trial with repeated measures at four time points which are before the start of the intervention (Baseline), classroom teaching (posttest 1), clinical practice (posttest 2), and follow-up (posttest 3). The experimental group will receive the tailored EBP-SDM training program both in classroom and clinical settings.A total of 72 nurses will be recruited from one hospital.

The interventions of this study will integrate classroom activities with practical learning experiences. The investigators previously developed the teaching model of 5As-steps EBP which will be use as framework for the teaching. Teaching activities involve lectures, group and individual consulting, hand-on activities, clinical cases, role play exercises, and debriefing. Previous researchers described the fundamental principles and the 5 steps of EBP and adapted those principles into their 5As-steps EBP model as shown in the following figure. The first step is asking. Nurses-midwives have to establish a well-built clinical question with all the components facilitating performance literature review for relevant database. Step two is acquiring in which nurse-midwives efficiently find the best relevant evidence to answer the question. The third step is appraising meaning that nurse-midwives carefully and systematically examining the trustworthiness of research findings. The fourth step is applying of the appraised evidence to the patients. This step requires integrating the best evidence with clinical expertise and patients' unique values and preference. The final step assessing the outcomes. At this step, nurse-midwives evaluate effectiveness and efficacy of the performance and change in practice. With conscientious application of these 5 steps, each time the cycle completes a turn, patient care and clinical practice is improved.

The Ottawa Decision Support Framework will be use as framework for the teaching. As shown in the following figure, Ottawa Decision Support Framework summarizes three elements in SDM, which are decisional needs, decision outcomes, and decision support . This framework integrates viewpoints from social psychology, economics and social support, and applies to all individuals taking part in decision making including the patients, family members and healthcare providers.

Instruments is listed as following:

(1)Health Sciences-Evidence Based Practice (HS-EBP);(2)9-item Shared Decision-Making Questionnaire (SDM-Q-9 and SDM-Q-Nr);(3)OPTION5;(4)Four Habits Coding Scheme (4HSC);(5)Brief Decision Support Analysis (DSAT-10);(6)Demographic Questionnaire;(7)SURE Test.

Eligibility Criteria:
Inclusion Criteria:

* Work more than 3 months
* Registered Nursing in Taiwan

Exclusion Criteria:

* Not providing care in clinical.
* On-job and received the school education.
* Received the training program of EBP.