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Teaching / Learning Strategies to Support Evidence-Based Practice Asoc . prof. Vida Staniuliene Klaip eda State College Dean of Faculty of Health Sciences 2013. The aim. To outline Teaching and Learning Strategies to support Evidance- Based practice (EBP).
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Teaching/LearningStrategiesto Support Evidence-BasedPractice Asoc.prof. Vida Staniuliene Klaipeda State College Dean of Faculty of Health Sciences 2013
Theaim • To outlineTeachingandLearningStrategies to supportEvidance-Basedpractice(EBP). • To describe EBP processes and present strategies tointegrate EBP into academic nursingeducation.
One aspect of evidence-based nursing education isthe application of the research process (Emerson & Records,2008). • Thisapproach includes application of the concepts relatedto qualitative and quantitative methods of inquiry tofind and use the best evidence to promote optimalpatient care in clinical practice areas.
Accordingto Ciliska(2005), the process of achieving evidence-basednursing practice involves a series of successive steps:(a) identifying a clinical problem; (b) searching theliterature for reviews and critical appraisals of relevantresearch; (c) creating change(s) in practice that is basedon the specific evidence, including patient needs, andexpertise of the advanced practice nurse; and (d) evaluatingimplementedchangesforeffectiveness.
Evidence-based practice is an expected core competency of all health care cliniciansregardless of discipline. Use of evidence-based practice means integrating thebest research with clinical expertise and patient values to achieve optimal healthoutcomes. Evidence-based practice requires nurses to access and appraise evidencerapidly before integrating it into clinical practice.
Nursesare requiredto adhereto acceptedstandardsofpracticeandprofessionalperformance. Thesestandards mandate the use ofevidence-basedinterventionsandthe integration of research findingsintopractice. • EBP as 1 of 5core competencies that every healthcare clinician should have, regardlessof his or her discipline, to meetthe needs of the 21st-century health care system.
UsingEBP means integrating the bestresearch with clinical expertise andpatient values to achieve optimumcare and participating inlearningand research activities to the extentfeasible. • Nursesmustmastercompetenciesto rapidly access, evaluate, and integrateevidenceintoprofessionalnursingpractice(Table 1).
1. Aska ClinicalQuestion • There are 5 elements of a goodclinical question, whichhelp the studentsclarify the key elements of thequestion. These key elements can thenbe used as search terms to find empiricalevidence in a variety of databases. Table 3 includes examples of PICOTquestionsofincreasingcomplexity.
2. Search for the Best Evidence • A common strategy used by nursingfaculty is to require students tofind empirical evidence that identifiesandsupportsnursinginterventionsimplementedduringclinicalexperiences. • To discussthenursinginterventions, levelsofevidence, and the quality of resources used to gather the information(Table 4).
Importantresourcesforstudentsincludeorientation to libraryservices; introduction tocommonlyusedonlinedatabases, such as PubMed; and strategies foreffectiveliteraturesearches. • Accessingandretrievinginformationto promote EBP is best accomplishedwhenactive, hands-onexperiencesthat encourage studentsforcriticalappraisal.
3. CriticallyAppraisetheEvidence • Criticalappraisalinvolvesassessingandinterpreting evidence by systematicallyconsideringthevalidity (truthfulness) andusefulness (clinicalapplicability) of the evidence to a particularcontext. • OnlineresourcessuchasGoogleandWikipediaprovideinstantinformation, evaluationofsources is important to ensure validityof the information used to guidenursingpractice.
4. IntegratetheEvidenceWithClinicalExpertise, PatientPreference, andValues • Opportunities to reinforceEBP often occur during clinical experiences.Clinicalconferencesprovidestudents with time to discuss situationsin which “real world” practice. • Collaboratingwith clinical managers, nurses, facultystaffandstudents is a good way to discussclinicalexperiences, practice-basedarticles, reports of research studies,and newly published clinical guidelinesina stimulatingenvironment.
5. EvaluatetheOutcomes • In the clinical setting, facultystaff andtutorsshould call students’ attentionto the importance of monitoring,evaluating, andreportingtheoutcome of the students’ interventions. • Didtheinterventionhavethe expected effect? Was the outcomeconsistent with results noted in previousclinical experiences and in theliterature? If not, what may accountfor the discrepancy? What changes,if any, need to be made to achievethe intended results? These questionswill yield important information toshare with the clinical faculty, preceptor,andpeers.
Usingscenariosfromclinical practice, students can learndevelopclinicalquestions; collectinformationfrom a variety of sources, includingclinicalexperiences, encounterswithpatients, andpeer-reviewedjournals, to answer questions; evaluatethe strength and relevance of theevidence; and apply and integratethisinformationwithpreviouslylearnedknowledge.
Lackofvalue for research in practice hasbeen identified as a key barrier toEBP.Integrating the skills necessaryto develop EBP into clinical environmentisanimportantpartindevelopingpositiveattitudestoward EBP. • Skills are neededto access, appraise,and integrate evidence into practiceand it is essential toprofessional nursinginthe 21st century. • Challenges, Implications for Nursing Education and Management – CINEMA givesusanoppurtunity to updateourknowledgeandskills.
