Factors Influencing Undergraduate Students' Intention to Use Evidence-Based Practice (EBP) After Graduation

Sunday, 30 July 2017: 3:50 PM

Mary-Anne Ramis, PhD, MPhil, BN
Evidence in Practice Unit, Mater Health, Brisbane, Australia
Anne M. Chang, PhD
School of Nursing, Queensland University of Technology, Brisbane, Australia, Brisbane, Australia
Lisa Nissen, PhD, BPharm
School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia

Purpose: EBP education has historically been aimed at teaching EBP knowledge and skills to health professionals to effect a change in clinical behaviour (Young, Rohwer, Volmink, & Clarke, 2014), however, professional registration criteria in nursing and across many health disciplines now requires undergraduate students to be competent and capable of incorporating EBP into their clinical practice upon graduation (Bloom, Olinzock, Radjenovic, & Trice, 2013; Melnyk, 2013; Tilson et al., 2011). Despite this mandate, little research has been undertaken to identify factors which are influential toward student’s uptake of EBP in their respective clinical environments. Using Bandura’s self-efficacy construct (Bandura, 2012) as a framework, this research aimed to develop and test a model of factors influencing undergraduate health student’s intention to use EBP following graduation.

Methods:  Variables for inclusion in the model were determined from the theory, current literature and a systematic review of modeling studies predicting student intention to use EBP following graduation. A protocol for the systematic review was registered on the PROSPERO International Prospective Register of Systematic reviews (ID number: CRD42015029263). For the second stage of the research, data were collected via online survey from second year nursing and paramedicine students using validated measurement scales for each variable, to fit the hypothesised model. Structural equation modelling using path analysis methods were used to identify relationships between the dependant and outcome variables.

Results: Variables of student EBP self-efficacy, sources of EBP self-efficacy, EBP beliefs, EBP outcome expectancy and EBP use were found to be correlated to the outcome variable of intention to use EBP and subsequently were included in the model. Data from the first episode of data collection were entered into the modelling software however, the initial model was a poor fit for the data. After modification according to the parameters as suggested from the initial analysis report, the model was tested again using Maximum Likelihood analysis. The model fit indices (Blunch, 2012) for the modified model indicated a good fit (χ2 =9.04, df= 6, p =0.171; GFI = 0.982;AGFI = 0.936; Standardized RMR = 0.0451; RMSEA 0.046), identifying undergraduate health student’s intention to use EBP as being directly influenced by EBP beliefs, with the overall model identifying 25 % of variance of intention to use EBP.

Conclusion: Positive attitudes and beliefs that EBP is relevant and beneficial impact significantly on student’s intention to use EBP, which has particular relevance to EBP educators. A high correlation between EBP expected outcomes and EBP self-efficacy was identified suggesting students do expect improved outcomes for the steps of the EBP process, however, this did not directly influence their intention to use EBP. Further research will be conducted to validate the model with a separate cohort of undergraduate students as well as further analysis of factors’ influencing health undergraduate’s current use of EBP.

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