Integrating Evidence-Based Practice as a Way of Thinking in an Undergraduate Curriculum

The role of the nurse has transformed dramatically over the past decade to include the way nurses are educated (Benner, Sutphen, Leonard, & Day, 2010; IOM, 2011). Nurse educators have responded to this transformation in a variety of ways. One such methodology is to include the incorporation of competencies that equip nursing students with the knowledge, skills, and attitudes important for quality and safety within the current healthcare environment (QSEN, 2012). When nurse educators integrate competencies into a curricular framework, they are not necessarily a set of tasks to accomplish, but rather a guide to help master a particular domain. Melnyk, Gallagher-Ford, Long, and Fineout-Overholt (2014) established a set of researched based evidence-based practice (EBP) competencies for nurses, which may be integrated within an undergraduate program. These competencies provide a way to measure the particular outcomes for student nurses in relation to incorporating evidence-based practice. These competencies provide a more specific way to measure this important part of decision making.

For years, nurse educators have been challenged with how to teach research utilization, rather than EBP. Students often struggle with understanding research and how to apply research to nursing practice. This lack of understanding can be further extended with identifying the relevance of how evidence informs decision making processes and they do not see it as their role to be the purveyors of knowledge (Aglen, 2016). Paramount to understanding how to incorporate evidence-based practice includes the knowledge of information literacy (Aglen, 2016; Brettle & Raynor, 2013). The focus should help the student learn application of knowledge through being able to synthesize when information is needed, where to find it, and how to apply it to a situation. The change in a student’s cognitive maturity is something that develops over time as the student gains knowledge and understanding of EBP (Aglen, 2016). Important to the epistemological concepts of understanding includes the pedagogical aspects of teaching and learning which addresses the synthesis of knowledge for nursing students. EBP may be fully embraced as a way of thinking about every clinical decision if it is integrated within every course throughout an undergraduate nursing curriculum. The integration of EBP into a curriculum includes the importance of information literacy as a part of the pedagogical process of reframing thinking. Paramount to teaching and learning includes the constructivism theory relating to how knowledge is socially constructed. Students learn how to incorporate EBP into their own clinical judgement through practicing activities which create a socially constructed environment, enhancing learned experiences.

The time has come to examine the traditional ways of thinking about research utilization and move towards a contemporary approach of applying evidence-based practice to every aspect of teaching thus enhancing how EBP may be incorporated with patient care. When EBP is integrated throughout an undergraduate nursing curricula, it can be considered a way of thinking and ‘being’, rather than merely something else to ‘do’. The process of integrating EBP includes organizational change as faculty gain a understanding of EBP; paramount to curricular assimilation. Nurse educators often lack the knowledge and skills themselves in relation to both understanding EBP and how to incorporate innovative teaching strategies to help students learn how to apply the knowledge (Aglen, 2016; Malik, McKenna, & Griffiths, 2017; Orta et al., 2016). Barriers to integrating EBP in a nursing curriculum can include knowledge, skills, and attitudes related to EBP in both didactic and clinical settings (Fiset, Graham, & Davies, 2017). The pedagogical strategies for integrating EBP should include approaches that enable the student to become the co-creator of knowledge when addressing clinical problems (Fiset et al., 2017); thus, creating a synthesis of understanding, rather than merely just knowledge recall. This can be accomplished by increasing student engagement through active learning strategies which include narrative pedagogy, project-based learning, case studies, and journal clubs.

This presentation will provide a contemporary pedagogical perspective to faculty development to include theoretical concepts, research surrounding the integration of EBP and identifying how those strategies may enhance student understanding of EBP. Important to integration of EBP includes the recognition of how each program is unique and varies in strategies for incorporation of the competencies. This presentation will include testimonials from students in reaction to the integration of the EBP competencies. A discussion about how faculty enact pedagogical changes within their undergraduate nursing programs to incorporate the EBP competencies for RN’s. This presentation will address those challenges experienced to integration and how research informs overcoming those challenges. The discussion will ensure how to incorporate EBP, pedagogical strategies, and site-specific program needs when incorporating the EBP competencies.