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Danguolė Šakalytė Valdonė Indrašienė

Abstract

Evidence-based practice (EBP) in nursing is one of the ways for professional practice to be based on reliable and valid evidence, on which clinical decisions that are acceptable not only to nursing staff but also to the patient can be formulated. After completing the first level of higher education in nursing programs, students often lack the knowledge and skills to apply EBP in their professional activities. It is therefore essential that EBP training be fully integrated into nursing training curricula to properly train future nursing specialists. The education of future nurses must be geared towards EBP education strategies that integrate both the principles of the profession and substantiated scientific evidence, improving the quality of patient care and creating an appropriate educational space for the student (Martins, Baptista, Coutinho, Fernandes, & Fernandes, 2018). However, there is a lack of clearly defined information on how this training space needs to be designed and adapted for effectual EBP training. Many researchers emphasize that higher education institutions in different countries support the teaching of EBP in nursing education. Nevertheless, higher education institutions do not include it entirely in their study programs due to the higher costs of organizing the study process or due to the lack of skills and knowledge of teachers on how to organize EBP training when choosing teaching/learning strategies. According to Melnyk and Fineout-Overholt (2011), teaching/learning strategies must be understandable and easy for all those involved in the learning process, and the integration of EBP must be a natural part of academic culture. The object of this research is the application of teaching/ learning strategies and methods to nursing students in teaching evidence-based practices. The aim of this research is to analyze the application of teaching/learning strategies and methods to nursing students in teaching evidence-based practices.
The methods of this research included a literature review, which was planned and written according to the PRISMA requirements. From February to April 2021, a targeted literature search was performed in the EBSCO, PubMed, and ScienceDirect databases. The following keywords were used for this search: evidence-based practice and nursing; education of evidence-based practice; nursing education; and other similar terms with the full-text restriction applied. Criteria for inclusion and exclusion of publications were formulated to ensure the validity of the review of the scientific literature. All scientific publications that met the selection criteria were included in the analysis, and those that did not meet the established criteria were rejected and not included in the literature review. Articles were selected for analysis according to the following selection criteria: articles published in a reviewed scientific journal; full-text articles available in English; articles published from 2010 to 2021; and articles in which the EBP teaching/learning strategies and teaching methods were analyzed.
The process of the collection and analysis of data involved the four-stage Grove, Burns, and Gray (2012) method: skimming, comprehension, analysis, and synthesis of sources. The quick review of the articles included reading titles, summaries, and keywords, whereas the critical review was aimed at assessing and understanding their content. The analysis included a breakdown of articles by problematic questions in the research, namely: what EBP teaching/learning strategies are applied in the study process, and what teaching methods are used to teach EBP. Data on the authors, year of publication, research strategy, applied teaching/learning strategy or teaching methods, and conclusions were selected and included in the analysis table. During the synthesis of the articles, the content of the collected information was analyzed, taking into account the theoretical perspective of this research and in order to answer its set goal. The data obtained during the analysis were interpreted according to the ideas of Melnyk and Fineout-Overholt’s (2011) evidence-based theory of nursing practice.
The results of the research involved 985 sources. Duplicate articles and articles that did not match search criteria were rejected after reviewing these sources; as such, 20 out of 152 articles were included in this review. These included both direct and mixed educational interventions. The organization of EBP training involved a single educational form – a seminar, conference, lecture, or e-learning – and a multifaceted form of education using a combination of teaching methods, such as: lectures, practical work, and discussions; lectures, teamwork, and observation, etc. The duration of training lasted from a few hours per semester to training during all study time over three or four years. The research included a five-step EBP training model: asking a question, finding information or evidence to answer a question, critically evaluating information or evidence, integrating evaluated evidence through personal clinical experience and patient preferences, and evaluating results obtained. EBP training is organized using interactive teaching/learning, “flipped classroom,” and “traditional classroom” methods.
The analysis of scientific articles on the application of teaching/learning strategies and methods to nursing students in teaching EBP revealed that authors try to group and classify the various teaching/learning strategies and teaching methods used in the study process. When teaching EBP nursing students, it is generally recommended to use a combination of constructive teaching/learning and collaborative learning strategies. Also, traditional teaching methods such as lectures, seminars, discussions, small group and team learning, case studies, and individual learning should be used. However, in nursing bachelor study programs a higher priority should be given to the application of an interactive teaching/ learning strategy in the study process, which includes: applying the five-step teaching model to the EBP and applying a multi-faceted form of teaching; and combinations of teaching methods such as traditional or reverse classes, interactive lectures, small group work, journal clubs, reading quizzes, presentations by nursing practitioners, and creative workshops based on simulation and clinical scenarios. Teachers should take on the role of facilitators to properly implement EBP training and to involve librarians and practical mentors more actively in the study process. Little has been written about the use of technologies in the teaching/learning of EBP; therefore, it would be expedient to perform a more detailed analysis of the effectiveness of the application of technology in the study process in training future nurses on EBP.

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Section
Education Science