Impact of the learning context on undergraduate healthcare students’ Evidence-Based Practice confidence and attitudes

Authors

  • Kylie Ann Murphy Charles Sturt University
  • Yann Guisard Charles Sturt University
  • Michael Curtin Charles Sturt University
  • Catherine Jane Thomas Charles Sturt University
  • Ruth Elizabeth Crawford Charles Sturt University
  • Jessica Biles Charles Sturt University

Abstract

Evidence-based practice (EBP) is a complex process of enquiry and reasoning undertaken by practitioners to ensure defensible healthcare decisions are made. This study investigated the impact of different learning contexts on undergraduate healthcare students’ EBP confidence and attitudes. Within a broader project, 231 third- and fourth-year students in 20 undergraduate healthcare degrees in one Australian university completed an online survey. Students were asked to indicate: the context(s) in which they could remember learning EBP skills (in a research-focused subject, in a non-research-focused subject, and/or during workplace learning); their frequency of exposure to research articles in different learning contexts in the past year; and their levels of EBP confidence and other attitudinal target variables. There was no association between learning EBP skills in a research subject and any target variable. Learning EBP skills in a non-research (e.g., clinically focused) subject or during workplace learning was associated with higher levels of EBP confidence (p < 0.05) and pro-EBP attitudes. In addition, there was a positive relationship between exposure to research articles and EBP confidence, found to be strongest when exposure to the research occurred in the context of practice-based learning (r = 0.42, p < 0.001). The findings show that the curricular context in which EBP skills are taught impacts on students’ EBP confidence and attitudes. Teaching EBP skills in research-focused subjects may be necessary, but it is insufficient for maximising confidence and attitudes conducive to EBP. These findings are relevant to curriculum designers and educators seeking to enhance the effectiveness of undergraduate EBP education.

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Author Biographies

Kylie Ann Murphy, Charles Sturt University

Dr Kylie Murphy is a Health Research lecturer and Honours Coordinator in the School of Community Health at CSU. She leads a program of research on EBP education.

Yann Guisard, Charles Sturt University

Dr Yann Guisard is a Course Director with the Faculty of Science at CSU. His responsibilities include curriculum design and evaluation and reporting on course outcomes to accreditation bodies.

Michael Curtin, Charles Sturt University

Associate Professor Michael Curtin is Head of the School of Community Health at CSU.

Catherine Jane Thomas, Charles Sturt University

Associate Professor Cate Thomas is the Associate Dean Academic in the Faculty of Science at Charles Sturt University. Cate is a Social Worker by profession and has a diverse history in health, human services, leadership and management.

Ruth Elizabeth Crawford, Charles Sturt University

Ruth Crawford is a Lecturer in Nutrition & Dietetics in the School of Exercise Science, Sport and Health at CSU. Ruth is an Accredited Practising Dietitian with 25 years experience.

Jessica Biles, Charles Sturt University

Dr Jess Biles is Associate Head of the School of Nursing Midwifery and Indigenous Health at CSU.

References

Ajjawi, R & Higgs, J 2008, 'Learning to reason: A journey of professional socialisation', Advances in Health Sciences Education : Theory and Practice, vol. 13, no. 2, p. 133. doi: 10.1007/s10459-006-9032-4

Barnsley, L, Lyon, PM, Ralston, SJ, Hibbert, EJ, Cunningham, I, Gordon, FC & Field, MJ 2004, 'Clinical skills in junior medical officers: A comparison of self-reported confidence and observed competence', Medical Education, vol. 38, no. 4, pp. 358-67. doi: 10.1046/j.1365-2923.2004.01773.x

Bennett, S, Hoffmann, T & Arkins, M 2011, 'A multi‐professional evidence‐based practice course improved allied health students' confidence and knowledge', Journal of Evaluation in Clinical Practice, vol. 17, no. 4, pp. 635-9. doi: 10.1111/j.1365-2753.2010.01602.x

Curtin, M, & Jaramazovic, E 2001, 'Occupational therapists' views and perceptions of evidence-based practice', British Journal of Occupational Therapy, vol. 64, no. 5, pp. 214-22. doi.org/10.1177/030802260106400502

Dawes, M, Summerskill, W, Glasziou, P, Cartabellotta, A, Martin, J, Hopayian, K, Porzsolt, F, Burls, A & Osborne, J 2005, 'Sicily statement on evidence-based practice', BMC Medical Education, vol. 5, no. 1, p. 1. doi: 10.1186/1472-6920-5-1

Del Mar, C, Glasziou, P & Mayer, D 2004, 'Teaching evidence based medicine', BMJ, vol. 329, no. 7473, p. 989. doi: 10.1136/bmj.329.7473.989

Dizon, JMR, Grimmer‐Somers, KA & Kumar, S 2012, 'Current evidence on evidence‐based practice training in allied health: A systematic review of the literature', International Journal of Evidence‐Based Healthcare, vol. 10, no. 4, pp. 347-60. doi: 10.1111/j.1744-1609.2012.00295.x

Glasman, LR & Albarracín, D 2006, 'Forming attitudes that predict future behavior: A meta-analysis of the attitude-behavior relation', Psychological Bulletin, vol. 132, no. 5, pp. 778-822. doi: 10.1037/0033-2909.132.5.778

Graue, M, Bjarkøy, R, Iversen, MM, Haugstvedt, A & Harris, J 2010, 'Integrating evidence‐based practice into the diabetes nurse curriculum in Bergen', European Diabetes Nursing, vol. 7, no. 1, pp. 10-5. doi: 10.1002/edn.148

Grimshaw, J, Eccles, M & Tetroe, J 2004, 'Implementing clinical guidelines: Current evidence and future implications', Journal of Continuing Education in the Health Professions, vol. 24, no. S1, pp. S31-S7. doi: 10.1002/chp.1340240506

Harvey, G & Kitson, A 2015, 'Translating evidence into healthcare policy and practice: Single versus multi-faceted implementation strategies - is there a simple answer to a complex question?(Editorial)', International Journal of Health Policy and Management, vol. 4, no. 3, p. 123. doi: 10.15171/ijhpm.2015.54

Hecht, L, Buhse, S & Meyer, G 2016, 'Effectiveness of training in evidence-based medicine skills for healthcare professionals: A systematic review', BMC Medical Education, vol. 16, no. 1, p. 103. doi: 10.1186/s12909-016-0616-2

Higgs, J & Mcallister, L 2007, 'Being a clinical educator', Advances in Health Sciences Education, vol. 12, no. 2, pp. 187-200. doi: 10.1007/s10459-005-5491-2

Hitch, D & Nicola-Richmond, K 2017, 'Instructional practices for evidence-based practice with pre-registration allied health students: A review of recent research and developments', Advances in Health Sciences Education, vol. 22, no. 4, pp. 1031-45. doi: 10.1007/s10459-016-9702-9

Hoffmann, T, Bennett, S & Del Mar, C 2017, Evidence-Based Practice Across the Health Professions, 3rd edn, Elsevier, Australia.

Khan, KS & Coomarasamy, A 2006, 'A hierarchy of effective teaching and learning to acquire competence in evidenced-based medicine', BMC Medical Education, vol. 6, pp. 59-68. doi: 10.1186/1472-6920-6-59

Malik, G, McKenna, L & Griffiths, D 2017, 'Using pedagogical approaches to influence evidence-based practice integration – processes and recommendations: Findings from a grounded theory study', Journal of Advanced Nursing, vol. 73, no. 4, pp. 883-93. doi: 10.1111/jan.13175

Melnyk, BM, Fineout-Overholt, E, Stillwell, S & Williamson, K 2010, 'Evidence-Based Practice: Step by Step: The Seven Steps of Evidence-Based Practice', American Journal of Nursing, vol. 110, no. 1, p. 3. doi: 10.1097/01.NAJ.0000366056.06605.d2

O’Halloran, P, Porter, SAM & Blackwood, B 2010, 'Evidence based practice and its critics: What is a nurse manager to do?', Journal of Nursing Management, vol. 18, no. 1, pp. 90-5. doi: 10.1111/j.1365-2834.2009.01068.x

Patterson-Silver Wolf, DA, Dulmis, CN & Maguin, E 2012, 'Empirically Supported Treatments Impact on Organizational Culture and Climate', Research on Social Work Practice, vol. 22, no. 6, pp. 665-71. doi: 10.1177/1049731512448934

Rodger, S, Fitzgerald, C, Davila, W, Millar, F & Allison, H 2011, 'What makes a quality occupational therapy practice placement? Students' and practice educators' perspectives', Australian Occupational Therapy Journal, vol. 58, no. 3, p. 195. doi: 10.1111/j.1440-1630.2010.00903.x

Rousseau, DM & Gunia, BC 2016, 'Evidence-Based Practice: The Psychology of EBP Implementation', Annu Rev Psychol, vol. 67, pp. 667-92. doi: 10.1146/annurev-psych-122414-033336

Ruzafa-Martínez, M, López-Iborra, L, Barranco, DA & Ramos-Morcillo, AJ 2016, 'Effectiveness of an evidence-based practice (EBP) course on the EBP competence of undergraduate nursing students: A quasi-experimental study', Nurse Education Today, vol. 38, pp. 82-7. doi: 10.1016/j.nedt.2015.12.012

Saunders, H & Vehviläinen-Julkunen, K 2016, 'The state of readiness for evidence-based practice among nurses: An integrative review', International Journal of Nursing Studies, vol. 56, pp. 128-40. doi: 10.1016/j.ijnurstu.2015.10.018

Swinkels, A, Albarran, JW, Means, RI, Mitchell, T & Stewart, MC 2002, 'Evidence-based practice in health and social care: Where are we now?', Journal of Interprofessional Care, vol. 16, no. 4, pp. 335-47. doi: 10.1080/1356182021000008265

Thomas, A, Saroyan, A & Dauphinee, WD 2011, 'Evidence-Based Practice: A Review of Theoretical Assumptions and Effectiveness of Teaching and Assessment Interventions in Health Professions', Advances in Health Sciences Education, vol. 16, no. 2, pp. 253-76. doi: 10.1007/s10459-010-9251-6

Towns, E & Ashby, S 2014, 'The influence of practice educators on occupational therapy students’ understanding of the practical applications of theoretical knowledge: A phenomenological study into student experiences of practice education', Australian Occupational Therapy Journal, vol. 61, no. 5, pp. 344-52. doi: 10.1111/1440-1630.12134

Villanueva, EV, Burrows, EA, Fennessy, PA, Rajendran, M & Anderson, JN 2001, 'Improving question formulation for use in evidence appraisal in a tertiary care setting: A randomised controlled trial [ISRCTN66375463]', BMC Medical Informatics and Decision Making, vol. 1, no. 1, pp. 4-9. doi.org/10.1186/1472-6947-1-4

Westwater-Wood, S, Hendrick, P & Diver, C 2014, 'Can ‘Evidence Based Practice’ be Taught in a way that is Meaningful to the Student for Practice?', Health and Social Care Education, vol. 3, no. 1, pp. 44-5. doi: 10.11120/hsce.2013.00037

Wong, G, Greenhalgh, T, Westhorp, G & Pawson, R 2012, 'Realist methods in medical education research: What are they and what can they contribute?', Medical Education, vol. 46, no. 1, pp. 89-96. doi: 10.1111/j.1365-2923.2011.04045.x

Zwolsman, SE, van Dijk, N, te Pas, E & Wieringa-de Waard, M 2013, 'Barriers to the use of evidence-based medicine: Knowledge and skills, attitude, and external factors', Perspectives on Medical Education, vol. 2, no. 1, pp. 4-13. doi: 10.1007/s40037-013-0039-2

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Published

2018-05-04

How to Cite

Murphy, K. A., Guisard, Y., Curtin, M., Thomas, C. J., Crawford, R. E., & Biles, J. (2018). Impact of the learning context on undergraduate healthcare students’ Evidence-Based Practice confidence and attitudes. ealth ducation in ractice: ournal of esearch for rofessional earning, 1(1). etrieved from https://openjournals.library.sydney.edu.au/HEP/article/view/12509

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