Effectiveness of an Evidence-Based Practice Training Program on School Nurses' Knowledge, Attitudes, and Skills

Friday, 28 July 2017

Pei-Lin Hsieh, PhD, RN
School of Nursing, Chang Gung University of Science and Technology, Chang Gung Memorial Hospital, Keelung, Tao-Yuan, Taiwan
Sue-Hsien Chen, PhD
Department of Nursing, and Chang Gung Memorial Hospital at Keelung, Chang-Gung Memorial Hospital at Keelung,Taiwan, Keelung, Taiwan


When school nurses embrace evidence-based practice (EBP), higher-quality care is provided to students, their families, and the larger community. However, there is little or no research on the adoption and implementation of EBP among school nurses in Taiwan, many of whom have limited experience using and lack the necessary skills to confidently implement EBP. The purpose of this study, therefore, was to evaluate the effectiveness of a multifaceted EBP training program on the knowledge, attitudes, and skills.


Four hundred and fifty-six school nurses recruited. The program comprised 9 hours of face-to-face lectures, 10 hours of online teaching, and outreach support for 3 months. Support involved email, online interaction and telephone contact. Knowledge, attitudes, and skills were assessed using a questionnaire, administered at baseline, post-training program, and 3 months follow-up, with the effectiveness of the training program being analyzed using a repeated-measures ANOVA.


The age of the participants ranged from 31 to 66-years-old, with a mean age of 41.95 years, and the mean length of time employed as a school nurse was 8.4 years; the majority had a bachelor’s degree (73.3%), with 41.3% coming from medium-sized schools. The results revealed significant gains in knowledge at the post-training program stage (p<.001), which was maintained at follow-up. Although there was no statistically significant difference between pre-test and post-test attitudes, the scores at follow-up were significantly higher than at post-test (p<.001). The improvement in skills between post-test and follow-up was small and non-significant.


In summary, targeted education and outreach support led to a marked improvement in evidence-based practice knowledge and attitudes, but only minor changes in skills. Therefore, health educators should focus on skill development and helping school nurses to establish new routines around evidence-based practice. Finally, this study can be used as a basis to developing a comprehensive strategy for building evidence-based practice competencies through proper training for school nurses.