Paper
Wednesday, 19 July 2006
This presentation is part of : Education Initiatives to Support Evidence-Based Nursing
Integrating an Evidence-Based Approach in Advanced Practice Education in Nursing
Helene Ezer, PhD, RN1, Kelley Kilpatrick, MSc(A), RN1, and Lorie Kloda, MLIS, BA2. (1) School of Nursing, McGill University, Montreal, QC, Canada, (2) Life Sciences Library, McGill University, Montreal, QC, Canada
Learning Objective #1: Understand the course strategies used to develop graduate students’ ability to evaluate and relate levels of evidence to clinical practice.
Learning Objective #2: Understand the benefits and difficulties involved in implementing an evidence-based clinical reasoning course in advanced practice nursing.
A graduate level clinical reasoning course was developed to help students understand levels of evidence available to guide nursing practice and to assist them in integrating the knowledge available into nursing plans of action in common health/illness problems. The course had two components 1) seminar discussions related to identified clinical problems based on available evidence (DiCenso, Guyatt, and Ciliska, 2005) and 2) the analysis of simulated clinical cases. Students leading the seminars were required to identify, critically examine and present the evidence related to one recurring clinical issue (e.g. chronic pain). They were to identify gaps in current knowledge and facilitate the large group discussion about the evidence available to support the nursing interventions in specific clinical cases. Students were also expected to meet with clinicians in advanced practice roles  to discuss simulated clinical cases in six areas - cardiac, respiratory, renal, neurological, musculo-skeletal and cancer care. Students worked in small groups, rotating through all cases and tutors. They submitted a concept map that documented the knowledge required for nursing interventions and were responsible to provide the rationale for their interventions to their tutors.  The course teaching strategies included: librarian guidance on finding evidence to support decision-making, instruction on concept mapping, small-group work, case discussions with clinical tutors and individual discussions with the course co-ordinator. Numerous issues arose in the implementation of the course including difficulty moving from linear to circular thinking in the development of the concept maps; differences in the ability to link theoretical knowledge to clinical practice; the need for ongoing communication between tutors and course coordinator; and issues related to evaluation.   

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)