EBP Educational Programme in Nursing Students' EBP Beliefs and Knowledge, and the Extent of Their EBP Implementation

Study Overview
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Brief Summary
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Evidence-based practice (EBP) prevents unsafety/inefficiency and improves healthcare quality. However, EBP implementation and sustainment are challenging for healthcare organizations and providers considering gaps between research and practice. An educational preparation of the future healthcare professionals can minimize these gaps. Thus, it is mandatory that undergraduate curricula in health sciences, namely in nursing, promote an EBP culture so that future health professionals use it into clinical practice. Within the Portuguese context, there is no available scientific literature about the current state of EBP integration in the undergraduate nursing curricula. Thereby, the investigators intend to verify if an EBP educational programme would be successful in improving the undergraduate nursing students' EBP knowledge and beliefs and, and the extent of their EBP implementation This will be tested using a prospective cluster randomized control trial with two-armed parallel group design.

Detailed Description
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Evidence-Based Practice (EBP), also known as Evidence-Informed Practice, could be defined as a clinical decision-making that considers the best available evidence; the context in which the care is delivered; client preference; and the professional judgment of the health professional. It has been recognizing that the adoption, implementation and sustainment of EBP in healthcare organizations are very important to promotes high-value health care, improves the patient experience and health outcomes, and reduces health care costs. In consequence, several organizations acclaim EBP implementation, because this implementation improves the quality of care; reduces the uncertainty, risk and variability; and becomes the decision-making more simplified. Moreover, Dawes et al at the Sicily statement on evidence-based practice highlighted that all health care professionals need to understand the principles of EBP, recognize EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Nevertheless, nowadays EBP is not the standard of care in the world and some studies recognized education as a strategy to promotes the adoption, implementation and sustainment of EBP. In fact, the Committee on the Health Professions Education Summit in 2003 recommended the development of competencies regarding the EBP use in all health professional educational programs. Therefore, it is important that undergraduate nursing curricula are based on EBP principles to educate the future nurses to use EBP into clinical practice. This will, consequently, improve health outcomes, with a positive impact in patients' safety, costs and health systems. Regardless of the above recommendation, the nursing curricula still provide contents related to traditional nursing research and do not integrate the EBP content and process. Therefore, this randomized control trial aims to evaluate the effectiveness of an educational EBP programme in undergraduate nursing students' EBP beliefs and knowledge, and the extent of their EBP implementation. This study will have two arms: experimental group (EBP educational program) and control group (no intervention - education as usual) and it will have the following methodology: Sample: For sample size calculation it was used the software G*Power 3.1.9.2. Power analysis was based on a type I error of 0.05; power of 0.80; effect size f=0.25; and ANOVA: repeated measures between factors determined a total sample size of 92. In a Portuguese nursing school, six optional courses of the 8th semester of the nursing graduation were randomly assigned to experimental (EBP educational programme) or control group (no intervention - education as usual). An independent researcher performed this assignment using random.org. Intervention: The EBP educational programme will be implemented over 17 weeks (12 hours of lessons - expositive method and practice method and 3 sessions of mentorship to small groups of students - 2/3 students - with the duration of 2 hours each). Assessment: All participants will be assessed before (week 0) and after the intervention (week 18) by a blind assessor using the validated instruments to assess undergraduate nursing students' EBP beliefs, the extent of their EBP implementation and their knowledge in EBP. Data analysis: The data will be analyzed using Statistical Package for the Social Sciences (SPSS) to conduct a descriptive and inferential analysis. To minimize the noncompliance impact, the intention to treat analysis - Last observation carried forward will be used.

Official Title
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The Effectiveness of an Evidence Based Practice (EBP) Educational Programme in Undergraduate Nursing Students' EBP Beliefs and Knowledge, and the Extent of Their EBP Implementation: A Cluster Randomized Control Trial

Conditions
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Evidence-Based Nursing

Intervention / Treatment
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* Other: EBP Educational Programme


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Undergraduate nursing students, aged 18 years or older, attending the 8th semester of the degree course in nursing at a nursing school in Portugal Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EBP Educational Programme<br>The educational EBP programme will include 12 hours of classroom lessons regarding EBP more 6 hours of mentorship made to a small groups of students (2 or 3 students per group). | Other: EBP Educational Programme<br>* The educational EBP programme will include 12 hours of classroom lessons regarding EBP more 6 hours of mentorship made to a small groups of students (2 or 3 students per group).<br>|
| No Intervention: Usual Educational Programme<br>Without intervention. The participants in this group will be maintain usual educational programme. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in the participant's Evidence Based Practice knowledge | Outcome measure: Fresno Test of Ramos, Schafer, & Tracz (2003) - adapted to nursing students and Portuguese population | Post-intervention assessment (week 18) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in the participant's Evidence Based Practice beliefs | Outcome measure: Evidence Based Practice beliefs scale of Melnyk, Fineout-Overholt, & Mays (2008) - Portuguese version. Minimum score: 16; maximum score: 80. Higher values represent a better outcome. | Post-intervention assessment (week 18) | 
| Change from Baseline in the participant's Evidence Based Practice implementation | Outcome measure: Evidence Based Practice implementation scale for students of Melnyk, Fineout-Overholt, & Mays (2008) - Portuguese version. Minimum score: 0; maximum score: 72. Higher values represent a better outcome. | Post-intervention assessment (week 18) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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undergraduate nursing students, evidence based practice beliefs, evidence based practice knowledge, evidence based practice implementation, Evidence based practice Education programme