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Evaluating and Teaching EBP in ADN Programs: A Mixed-Methods Study

This study aims to explore the competence of ADN nurse educators in evidence-based practice (EBP) concepts, specifically in evaluating nursing texts and literature for teaching. The study will assess educators' confidence, knowledge, and understanding of EBP, as well as their integration of EBP guidelines and competency standards. The results will help advance EBP education in ADN programs.

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Evaluating and Teaching EBP in ADN Programs: A Mixed-Methods Study

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  1. Evidence-based Nursing Education: How do Nurse Educators Evaluate and Teach Evidence-Based Practice in ADN programs? Rebecca BoyerCollege of Education/Capstone College of Nursing EdD Comprehensive Examination2019

  2. Introduction • Issues: Evidence-based practice (EBP) competency, no clear Associate Degree Nursing (ADN) frameworks for literacy, formal education, >40 yrs, confidence • Problem: Alabama Community College System (ACCS) ADN educators may lack confidence and understanding to competently evaluate evidence-based skills presented in course texts or literature. • Proposal: Mixed Method Study-appraise/describe nurse educators’ (NE) confidence, EBP teaching concepts, knowledge, and correspondence to training • Purpose: To explore ACCS ADN NE competence in EBP concepts by describing understanding in evaluating use of nursing texts and literature for teaching. • Goal: Further study to support knowledge and understanding of EBP for teaching

  3. ROL: Gaps in Knowledge • Confidence in EBP knowledge and skills • Primary sources of information(Bayea & Slattery, 2006) • Meta-analysis (2005-2015) EBP competence (Laibhen-Parks, 2014) • Theory, research, & practice using PICOT acronym-population, interventions, comparison, outcome, time (Melnyk, Fineout-Overholt, et al, 2017; Penz & Bassendowski, 2006) • Nursing schools in Sydney, Australia use scenario-based competency tool: measures national competency requirements • EBP 5-Step Model: Ask, Acquire, Appraise, Apply, and Assess • 10 Competency Standards direct practice (Leung, Trevena, & Waters, 2016) • University of Finland advanced competencies

  4. Literature / EBP Guidelines • Do educators integrate EBP guidelines or competency standards evaluating literature? • Advancing Research and Clinical Practice (ARCC) Model: PICOT • Australian national competencies use EBP 5-Step Model • National League of Nursing (NLN) Discipline Inquiry (DCI) Model • American Association of Colleges of Nursing (AACN) standards • Framework for Information Literacy for Higher Education delphi • Walter & Avant 8-Step approach to competency • Academic Center for Evidence-Based Practice (ACE) Star Model • Quality and Safe Education in Nursing (QSEN) competencies • Cochrane Collaboration systematic reviews (Fritz, 2018; ACRL 2016; Leung, Trevena, Waters, 2016; Peterson et al, 2014, Porter, 2010; Mackey & Bassendowski, 2016)

  5. EBT Theory (Boyer, 2019) 1 Carper’s Fundamental Patterns of Knowing (Porter, 2010) (center) informs the Star Model’s first stage of Knowledge Discovery ACE STAR Model of Knowledge Transformation (Stevens, 2004) organizes EBP processes to illustrate 5 major stages 2 5 • Knowledge: • Empirical • Personal Ethical • Esthetic Awareness 4 3

  6. Hypothesis Statement • The level and type of advanced nursing degree or additional training in EBP correspond to the ADN nurse educator’s preparation to teach EBP in nursing.

  7. Qualitative Research Questions • What are the experiences of Associate Degree program nurse educators utilizing EBP in meeting nurse educator core competencies in curriculum? • What specific training in EBP or educational theory assist the nurse educator with teaching EBP? • What specific experiences with EBP assist the nurse educator with teaching EBP? 2. How do Associate Degree program nurse educators critically appraise nursing text for accurate EBP in nursing literature? A. Do Associate Degree nurse educators’ in the ACCS have the skills to evaluate EBP in the nursing textbooks and literature ?

  8. Methodology • Exploratory sequential mixed-method study; 4 X 3-way ANOVA, a priori estimate N=15, 90% confidence; pragmatic approachto explore EBT methods and find themes using the Colaizzi method • Compare influence of levels, specialties, and type of nursing education • Explore confidence questioning textbook contradictions vs assuming one text is based on best available evidence • Describe assignments using nursing texts and literature • Analyze potential deficits in EBP competence/Identify EBTS themes using CAQDAS NVivo(Maxwell, p 115, 2013)

  9. Measures • Survey: 4-point Likert scale followed by narrative interviews • 1stQuantitative: demographics using closed-ended questions determine whether level and type of advanced nursing degree or additional training corresponds to understanding/utilization EBT • Survey Tool https://fuld.nursing.osu.edu/ebp-competencies • 2ndQualitative: open-ended questions, explore confidence in questioning validity of EBP in texts or assume texts are based on best available evidence (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014)

  10. Data Collection Procedures: Start to Finish • Email/receive survey data (4-6 wks) • Analyze demographics: 4 X 3-way ANOVA, education levels, EBP training; belief in effectiveness; use of EBT • Explore and describe narrative assessments to collect EBP understanding and EBT strategies by reflecting on past records or case-based learning • Analyze understanding of EBT and examine understanding of nursing texts and literature for EBP to teach nursing (6-8 wks) • Identify major themes from narrative open-ended questions using the Colaizzimethod • Concurrent triangulation and final analysis-check similarities and differences in preparation of ADN faculty in ACCS who examine EBT (4-6 wks)

  11. Significance • Identify relationships and correlations between conceptual/theoretical frameworks in discovery of knowledge of EBP, research questions, and hypothesis • Key Variables: Level and type of degree or training correlates directly to nurse educator’s understanding and utilization EBT • Determine significance of educational, experiential background to understanding of EBP in nursing texts • Identify EBP knowledge gaps and areas for further discussion and research

  12. References • Beyea, S. C. & Slattery, M. J. (2006). What is evidence based practice? Evidence-based Practice in Nursing. Marblehead, MA: HCPro, Inc. • Leung, K., Trevena, L., Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39 189-196. Retrieved from http://dx.doi.org/10.10.1016/j.nedt.2016.01.0260260-6917 • Penz, K. L. & Bassendowski, S. L. (2006). Evidence-based nursing in clinical practice: Implications for nurse educators. The Journal of Continuing Education in Nursing, 37(6) 255-269. • Maxwell , J. A., (2013). Qualitative research design: An interactive approach. (3rd ed.) Los Angeles: Sage Publications. • Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). The seven steps of evidence-based practice. American Journal of Nursing, 110(1) 51-53. • Porter, S. (2010). Fundamental patterns of knowing in nursing: The challenge of Evidence-Based Practice. Advances in Nursing Science, 33(1) 3-14. • Saunders, H. & Vehvilainen-Julkunen, K. (2016). The state of readiness for evidence-based practice among nurses: An integrative review. International Journal of Nursing Studies, 56 128-140. doi.org/10.1016/j.nurstu.2015.10.0180020-7489 • Spector, N. (2013). Evidenced-based nursing regulation: A challenge for regulators. Journal of Nursing Regulation, 1(1) 30-36.

  13. References • Spector, N. (2006). Systematic review of studies of nursing education outcomes: An evolving review. National Council of State Boards of Nursing. Retrieved from http://ncsbn.org/3937.htm • Stevens, K. R. (2004). ACE Star Model of EBP: Knowledge Transformation. Academic Center for Evidence-based Practice. The University of Texas Health Science Center at San Antonio. Retrieved from www.acestar.uthscsa.edu • Sullivan, D. T., (2016). An introduction to curriculum development. In Billings, D. M. & Halstead, J. A. Teaching in nursing: A guide for faculty. (5th ed.) St. Louis, MO: Elsevier. • Peterson, M. H., Donnelly, B., Hill, K., Miley, H., Riggs, L., et al (2014). Choosing the best evidence to guide clinical practice: Application of AACN levels of evidence. Critical Care Nurse, 34(2) 58-68. Retrieved from doi: http://dx.doi.org/10.4037/ccn2014411 • Porter, S. (2010). Fundamental patterns of knowing in nursing: The challenge of Evidence-Based Practice. Advances in Nursing Science, 33(1) 3-14. • Saunders, H. & Vehvilainen-Julkunen, K. (2016). The state of readiness for evidence-based practice among nurses: An integrative review. International Journal of Nursing Studies, 56 128-140. doi.org/10.1016/j.nurstu.2015.10.0180020-7489 • Stevens, K. R. (2004). ACE Star Model of EBP: Knowledge Transformation. Academic Center for Evidence-based Practice. The University of Texas Health Science Center at San Antonio. Retrieved from www.acestar.uthscsa.edu • Sullivan, D. T., (2016). An introduction to curriculum development. In Billings, D. M. & Halstead, J. A. Teaching in nursing: A guide for faculty. (5th ed.) St. Louis, MO: Elsevier. • https://fuld.nursing.osu.edu/ebp-competencies

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