Barbara Krainovich-Miller EdD, APRN-BC

Judith Haber, PhD, APRN-BC, FAAN

The master’s prepared nurse, whether Nurse Practitioner, Clinical Nurse Specialist, Nurse-midwife, Nurse Anesthetist, educator, administrator or informatics specialist, is expected to be a competent active consumer of the “best-available evidence” that informs clinical decision making rather than simply a passive consumer of the traditional research process that is perceived by many nurses as irrelevant (Sackett et al., 2000). Producing master’s level nurses with such EBP expertise requires that they critically appraise the best available evidence. It is imperative to teach graduate level research from an EBP rather than the traditional “conduct of research” perspective in order to create realistic linkages between the best available research evidence and its applicability to practice. The TREAD© Evidence Based Practice Model refers to Teaching EBP components of a Research course Early, Adventurously and Differently. The TREAD model requires in-depth discussions of the essential EBP concepts (e.g., hierarchy of levels of evidence) rather than the components of the research process. Emphasis is on: a) teaching the use of multiple electronic data bases by a reference librarian, to obtain level one evidence, if possible; b) letting students conduct electronic searches in class for this purpose; c) the role modeling critical appraisal of evidence, in particular, level one evidence (systematic review, meta-analyses, and evidence-based practice guidelines) using gold-standard tools such as CASP and AGREE; d) evidence debates, PICO projects, one page EBP gem “critical appraisals”, and simulated EBP clinical grand rounds. Repetition, repetition and more repetition of the EBP concept of critical appraisal with instructor feedback enables students to develop the sophisticated EBP skills needed for advanced EBP nursing practice.