Framework for Integrating Evidence-Based Practice in an Undergraduate Curriculum

Friday, 20 July 2018: 3:10 PM

Amy Suzanne Jauch, MSN, RN, CNE
College of Nursing, The Ohio State University, Columbus, OH, USA

The highly complex healthcare environment is increasingly requiring the use of evidence-based practice (EBP) to translate the use of evidence into clinical practice (Malik, McKenna, & Griffiths, 2016). To prepare student for practice it is essential to incorporate EBP into undergraduate nursing education. Integrating EBP into undergraduate nursing curricula includes the use of the language of EBP, EBP process, and evidence-based decision making (EBDM) (Melnyk, Gallagher-Ford, & Fineout-Overholt, 2017). Confusion between research, research utilization, quality improvement, and EBP can impede the purposeful incorporation of EBP throughout an undergraduate nursing curriculum. The use of a framework allows nurse educators the structure needed to be focused and deliberate for the integration of EBP in curricula.

Research on the integration of EBP in undergraduate nursing programs generally has a focus on self-reporting of knowledge, skills, attitude and frequency of use (Reid, Briggs, Carlisle, Scott, & Lewis, 2017; Scurlock-Evans, Upton, Rouse, & Upton, 2017) or the impact of a single course or assignment on the acquisition of EBP knowledge, skills, and attitudes in nursing students (André, Aune, & Brænd, 2016; Dawley, Bloch, Suplee, McKeever, & Scherzer, 2011; Ruzafa-Martínez, López-Iborra, Armero Barranco, & Ramos-Morcillo, 2016). Little to no research exists concerning the integration of EBP, using a framework, into an undergraduate nursing curriculum. The framework being presented consists of elements that have been validated though research.

The creation of a framework for EBP integration into undergraduate nursing curricula, must address the steps of EBP and associated competencies. Melnyk, et al. (2017) introduced the first set of EBP competencies for registered nurses that had been validated through research. Although, Leung, Trevena, & Waters (2016) acknowledge the usefulness of the 13-researched based EBP competencies developed by Melnyk et al., concerns were discussed of the remaining ambiguity in measurement of skill acquisition for the steps of EBP, even with the competencies. This presentation will provide a framework for integrating EBP in undergraduate nursing programs, utilizing the seven steps of EBP (Melnyk & Fineout-Overholt, 2015), the research validated EBP competencies (Melnyk et al., 2017) and active learning techniques with correlating evaluation strategies.

The first 13 EBP competencies apply to all registered nurses (Melnyk et al., 2017) and serve as a tool for undergraduate nurse educators integration and evaluation of EBP throughout their curriculum. The EBP competencies provide a common language and outcomes for all faulty, decreasing the confusion between research and EBP (Melnyk et al., 2017). Furthermore, the competencies address some of the existing standards set forth by regulatory, professional, and accrediting organizations (Melnyk et al., 2017). Incorporation of the EBP competencies cannot be done without acknowledging and understanding the seven steps of EBP. The seven steps of EBP provide a tangible source for students to understand the EBP process. EBP steps include cultivating a spirit of inquiry, asking a burning clinical question in PICOT format, searching and collecting the most relevant best evidence, critically appraising the evidence, integrating the best evidence with one’s clinical expertise and patient preferences and values, evaluating outcomes of the change based on the evidence, and dissemination of the outcomes (Melnyk & Fineout-Overholt, 2015). The expectation for level of knowledge and skill acquisition, regarding the EBP process, needs to be evaluated based on the level of education (Melnyk et al. 2017). For an undergraduate program, mastering evaluation and dissemination of outcomes may be unrealistic but a novice understanding of evaluation and dissemination should be expected.

The integration of the EBP is site-specific, meaning how it is framed within a curriculum is based on the faculty and program specific needs. Faculty guide the incorporation of the EBP competencies in each course and create evaluation measures of the competencies throughout the curriculum. This presentation will provide examples of how to correlate the steps of EBP with Melnyk et al. (2017) EBP competencies for nurses, creating the framework. A discussion of how the framework can be adapted for use in associate degree, diploma, baccalaureate, and baccalaureate completion programs based on the faculty and program’s needs will be provided. The incorporation of EBP into an undergraduate nursing curriculum should be consistent with a “way of thinking”, not an additive topic. Finally, the presentation will provide practical active learning strategies for EBP and associated evaluation methods. The active learning activities will provide students the opportunity to practice EBDM and demonstrate competence for each of the EBP competencies.