Evidence-Based Practice Fellowship Immersion: Transforming Staff Nurse's Professional Practice

Background: Evidence-based practice (EBP) fellowship programs have been shown to decrease barriers to EBP and promote professional growth. Nurses at one organization described their EBP fellowship program as “life-changing”, prompting nursing leaders and educators to examine what intrinsic changes might have occurred as a result of participation in the program.

Purpose: The purpose of this qualitative study was to explore the professional and personal changes that occurred in staff nurses during and following a 1-year EBP fellowship program

Materials & Methods: Focus groups were conducted with staff nurses in an academic medical center who completed the fellowship program from 2007 to 2011. Six questions with predetermined probes were asked during the focus group. Focus Groups were audiotaped and transcribed for content analysis using Atlas TI. Three focus groups were conducted before saturation was reached. A total of 12 nurses participated.

Results: Five themes were identified from the data: support, resources, knowledge, confidence/self-actualization, and empowerment. Within each focus group, there were multiple examples of changes that occurred in these nurses in terms of their confidence in their ability to seek evidence, apply it to their practice, and make a change based upon it. The sense that “I can make a practice change” reflects the sense of empowerment these nurses described.

Discussion: The participants in the focus groups described a transformation in their professional and personal development as a result of the fellowship program. The themes that emerged were consistent with Kanter’s definitions of the elements of structural empowerment. Each nurse gained knowledge, confidence, and the firmly-rooted sense that he/she can make a real difference in patient care through practice change.

Conclusion: We observed differences in staff nurses’ commitment to nursing and an enthusiasm for research that was not evident prior to the fellowship program. Our data suggest that a 1-year program on research and EBP may provide all of the essential elements needed for structural empowerment. Ultimately, this sense of empowerment will lead to better patient outcomes.