To provide a framework for the teaching and dissemination of evidence based practice in a baccalaureate nursing program.
Methods:
Baccalaureate nursing curriculum lacks clear methodology for teaching evidence based practice (EBP) (Malik, McKenna, & Griffiths, 2015). The integration of EBP into the curriculum is vital to prepare nursing graduates to become providers of evidence based care (Serfass & Wonder, 2018). Nursing scholars have identified that the process of learning EBP promotes critical thinking in nursing students (Cui, Li, Geng, Zhang, & Jin, 2018). The Saint Mary’s College Department of Nursing Science was cited recently by the Indiana State Board of Nursing for excellence in teaching EBP. Our progressive, innovative evidence based curriculum spans four semesters and is multifaceted, incorporating knowledge, skills, and attitudes related to EBP (Graves, O’Neal, Roussel, & Polancich, 2018; Zimmerman, 2017).
Didactic classroom presentations by faculty members and librarians develop knowledge of the structure and concepts of EBP beginning in the fall of the junior year. Unique to our program is the use of a detailed rubric which guides students through the process of developing a group EBP project. Faculty raise compelling nursing practice questions during class and clinical to engage students in the process of inquiry. Students develop team skills working in groups of three or four members to formulate a clinical practice question in a PICO (patient/population, intervention, comparison, outcome) format. A research librarian assists the development of academic database search skills to locate current, relevant research articles on the PICO statement of interest (Dhakal, 2018; Swanberg et al., 2016). Once a body of studies is retrieved, students develop knowledge and skill to critically appraise the evidence and determine the level of evidence ranking using the Melnyk, Gallagher-Ford, and Fineout-Overholt (2017) pyramid. Group members summarize findings, formulate recommendations, and provide implications for nursing practice during a peer EBP presentation day.
Results:
Development of professional attitudes is facilitated through the use of assessment tools. Evidence suggests that team based projects prepare students to function in collaborative healthcare teams (Hannay, 2014). Students evaluate their individual group contributions, team effectiveness, and peer presentations using a set of specially designed assessment tools for their EBP project.
Students further develop professional skills and attitudes through the dissemination of their EBP group projects. Student teams were encouraged to submit abstracts of their EBP topics for possible poster or podium presentations at the annual Saint Mary’s College research symposium. Dissemination also occurs through an education-practice partnership (Coyne, Kennedy, Self, & Bullock, 2017). Student groups are invited to present their EBP projects for nurses and nurse residents at a regional acute care facility each academic semester. Presentations have contributed directly to practice changes. For example, modification of neutropenic diet teaching materials and the use of soap and water hand hygiene when caring for patients with clostridium difficile infection were implemented with agency staff collaboration.
Conclusion:
Integration of EBP across the curriculum builds knowledge, skills, and attitudes. Nursing graduates consistently verbalize confidence and competence in their knowledge of EBP based on this curriculum design.