Evidence-based practice is primarily the most essential standard of care outlined for healthcare professionals. Schools of nursing competent enough in their curriculum provision are expected to produce nurse graduates who are ready to practice on evidence-based care to patients, families as well as communities. Generally, evidence-based training is an expectation in nursing curricula aiming at imparting positive attitudes on students. This paper seeks to analyze the article written by Thiel and Ko (2017) titled “Baccalaureate nursing students’ attitudes toward evidence-based practice: A longitudinal study.
Study Purpose
Essentially, the study outlined in the article aimed at presenting an approach towards the assessment evidence-based practice among students from the beginning of the program to the end of the program in an accredited school of nursing in the Midwest United States in a pre-licensure BSN program (Thiel & Ko, 2017). The research further aimed at answering the question as to what the attitudes of students are regarding the evidence-based practice. The concept of attitudes in this study was defined as being the individual skills, knowledge, and beliefs they assume with regard to evidence-based practice.
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Study Design
This research study assumed a descriptive longitudinal survey which was directed towards the assessment of the attitudes of students towards evidence-based practice over time. The study used a single cohort which was used in the first survey in the year 2014 with follow-ups through to the year 2017 (Thiel & Ko, 2017).
Sample Characteristics
The survey had a population of six hundred students. The initial research had a population of seventy-five freshman nursing students with sixty-three participating in the first survey (Thiel & Ko, 2017). The same students were followed up in 2017. Later in the research, seventy students at the senior level were invited to participate but only fifty-eight students participated in the follow-up survey. Data collection was done from the eligible students at the end of each class period. The selection of participants in this research study was based on purposive sampling. Eligibility was based on three categories. The first category included full time or part-time students at the University. The second category had students at the freshman level who were enrolled in the BSN pre-licensure program during the fall of 2014. The third category had students at the senior level who were also enrolled in the BSN pre-licensure program during the winter of 2017.
Institutional Review Board Approval
The study outlined various ethical considerations which aimed at protecting the privacies of the participants as well as regulating the study itself. The survey included a cover which outlined alongside itself an explanation of the voluntary nature of the survey. In the cover letter, it was included the purposes and the anonymous nature of the responses therein. It was explained to the students that the participation in the survey or lack of it would not impact their grades. Institutional review board approval was given to the study at the Midwest University where the study was conducted. The implied consent of respondents’ participation was given to the respondents after they had completed the survey.
Instruments used in the Study
The first survey outlined three demographics which are gender, age, and program of study and one evidence-based practice characteristic such as the familiarity with the evidence-based practice term. Additionally, the fourteen item Nurses’ Attitudes towards Evidence-Based Practice Scale tool was used. The follow-up survey also outlined the same features as the first survey but with two evidence-based characteristics. The Nurses’ Attitudes towards Evidence-Based Practice Scale tool was also used in the follow-up survey measuring attitudes and comprising of two domains such as behaviors and beliefs towards evidence-based practice. Participants in the survey were allowed to rate their disagreement or agreement levels with each item outlined on a five-point Likert rating scale. The result of this could bring a summative score ranging between fourteen and seventy points. The higher the scores, the more positive the attitudes towards evidence-based practice.
How the Data was Analyzed
Statistical Package for Social Scientists was used to complete the statistical data entry as well as analysis. The percentage of respondents completing the survey was also known as the return rate was calculated. Further, the computation of all the study variables was done by the researchers to include the descriptive statistics. In turn frequencies and percentages for nominal and ordinal data levels were generated including means and standard deviations for the interval level data. Nurses’ Attitudes towards Evidence-Based Practice Scale tool was also used in the determination of the attitudes of students towards evidence-based practice.
Study Results
About fifty percent of the freshman participants indicated their familiarity with the term evidence-based practice with another seventeen percent reporting being very familiar with the term (Thiel & Ko, 2017). Only one freshman respondent indicated unfamiliarity with the term evidence-based practice. Senior level participants were given revised items due to the fact that throughout the program, familiarity with the term evidence-based practice increased thus a need to make the survey more elaborate. In the freshman first attitudinal survey, descriptive statistics outlined neutral or uncertain scores while senior follow up survey indicated a decrease in uncertain or neutral selection.
Implications for Nursing Practice
Evidence-based practice is becoming an issue of concern in the contemporary world. In actual sense, the healthcare system needs to be restructured towards an evidence-based practice because this will ensure quality delivery. Nurse graduates for that matter should be able to outline positive attitudes towards evidence-based practice. This longitudinal study critically assessed and outlined the benefits of the evidence-based practice. The study also revealed that attitudes of students towards evidence-based practice increased over time.
It should be understood that universally, patients always look forward to receiving the most effective care based on the available evidence. In this manner, evidence-based practice becomes important because it outlines the most effective care which is available. Evidence-based practice, in essence, aims at promoting an attitude of inquiry in students and health care professionals in general. The question which evidence-based practice seeks to answer in health care professionals in why are they doing what they are doing? Further, they get to ask if there are any pieces of evidence which can act as a guide for them to outline their responsibilities in a more effective way (Melnyk & Fineout-Overholt, 2011). Health care professionals are mandated with the responsibility of providing professional service and in addition ensuring that their practice is informed by the best available evidence. Evidence-based practice further ensures that health resources which are finite in nature are wisely utilized and making sure that evidence is considered in making decisions concerning funding of health services.
Personal Critique
The longitudinal study was successful in outlining attitudes of student nurses with regard to evidence-based practice. However, the study ought to have assumed a consecutive sampling technique to come up with a more representative sample. Additionally, the application of purposive sampling had some bias concerns which in essence would not reflect the true nature of the results of the study. This is coupled with validity issues because the research was self-administered. An additional psychometric analysis was required in this study because the Nurses’ Attitudes towards Evidence-Based Practice Scale tool have significant limitations when used with student nurses. However, the research study outlined the importance of evidence-based practice and that positive attitude towards the same is an expectation throughout the healthcare and nursing programs (Youngblut, & Brooten, 2001). Additionally, the evidence-based practice should be noted as a core competency which health care professionals should be able to display at any point in time. Further research is however required to expand the evaluation as well as assessment strategies for nurses’ attitudes towards evidence-based practice and its application.
References
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice . Lippincott Williams & Wilkins.
Thiel, L.M. & Ko, A. (2017). Baccalaureate nursing students’ attitudes toward evidence-based practice: A longitudinal study. Journal of Nursing Practice Applications & Reviews of Research, 7(2), 22-28.
Youngblut, J. M., & Brooten, D. (2001). Evidence-based nursing practice: why is it important?. AACN Advanced Critical Care , 12 (4), 468-476.
