Developing information literacy: a key to evidence-based nursing

Evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior toward the application of evidence into practice: A comprehensive systematic review of UG student

BACKGROUND

To produce graduates with strong knowledge and skills in the application of evidence into healthcare practice, it is imperative that all undergraduate health and social care students are taught, in an efficient manner, the processes involved in applying evidence into practice. The two main concepts that are linked to the application of evidence into practice are "evidence-based practice" and "evidence-informed practice." Globally, evidence-based practice is regarded as the gold standard for the provision of safe and effective healthcare. Despite the extensive awareness of evidence-based practice, healthcare practitioners continue to encounter difficulties in its implementation. This has generated an ongoing international debate as to whether evidence-based practice should be replaced with evidence-informed practice, and which of the two concepts better facilitate the effective and consistent application of evidence into healthcare practice.

OBJECTIVES

The primary objective of this systematic review was to evaluate and synthesize literature on the effectiveness of evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior of undergraduate health and social care students toward the application of evidence into practice. Specifically, we planned to answer the following research questions: (1) Is there a difference (i.e., difference in content, outcome) between evidence-informed practice and evidence-based practice educational interventions? (2) Does participating in evidence-informed practice educational interventions relative to evidence-based practice educational interventions facilitate the application of evidence into practice (as measured by, e.g., self-reports on effective application of evidence into practice)? (3) Do both evidence-informed practice and evidence-based practice educational interventions targeted at undergraduate health and social care students influence patient outcomes (as measured by, e.g., reduced morbidity and mortality, absence of nosocomial infections)? (4) What factors affect the impact of evidence-informed practice and evidence-based practice educational interventions (as measured by, e.g., course content, mode of delivery, multifaceted interventions, standalone intervention)?

SEARCH METHODS

We utilized a number of search strategies to identify published and unpublished studies: (1) Electronic databases: we searched Academic Search Complete, Academic search premier, AMED, Australian education index, British education index, Campbell systematic reviews, Canada bibliographic database (CBCA Education), CINAHL, Cochrane Library, Database of Abstracts of Reviews on Effectiveness, Dissertation Abstracts International, Education Abstracts, Education complete, Education full text: Wilson, ERIC, Evidence-based program database, JBI database of systematic reviews, Medline, PsycInfo, Pubmed, SciELO (Scientific Electronic Library Online), and Scopus; (2) A web search using search engines such as Google and Google scholar; (3) Grey literature search: we searched OpenGrey (System for Information on Grey Literature in Europe), System for information on Grey Literature, the Society for Research on Educational Effectiveness, and Virginia Henderson Global Nursing e-Repository; (4) Hand searching of journal articles; and (5) Tracking bibliographies of previously retrieved studies. The searches were conducted in June 2019.

SELECTION CRITERIA

We planned to include both quantitative (including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies) and qualitative primary studies (including, case series, individual case reports, and descriptive cross-sectional studies, focus groups, and interviews, ethnography, phenomenology, and grounded theory), that evaluate and compare the effectiveness of any formal evidence-informed practice educational intervention to evidence-based practice educational intervention. The primary outcomes were evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, and behavior. We planned to include, as participants, undergraduate pre-registration health and social care students from any geographical area.

DATA COLLECTION AND ANALYSIS

Two authors independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full-text of selected articles. Discrepancies were resolved through discussion or consultation with a third author. We found no article eligible for inclusion in this review.

MAIN RESULTS

No studies were found which were eligible for inclusion in this review. We evaluated and excluded 46 full-text articles. This is because none of the 46 studies had evaluated and compared the effectiveness of evidence-informed practice educational interventions with evidence-based practice educational interventions. Out of the 46 articles, 45 had evaluated solely, the effectiveness of evidence-based practice educational interventions and 1 article was on evidence-informed practice educational intervention. Hence, these articles were excluded as they did not meet the inclusion criteria.

AUTHORS' CONCLUSIONS

There is an urgent need for primary studies evaluating the relative effectiveness of evidence-informed practice and evidence-based practice educational interventions targeted at improving undergraduate healthcare students' competencies regarding the application of evidence into practice. Such studies should be informed by current literature on the concepts (i.e., evidence-informed practice and evidence-based practice) to identify the differences, similarities, as well as appropriate content of the educational interventions. In this way, the actual effect of each of the concepts could be determined and their effectiveness compared.

Supporting the development of information literacy skills and knowledge in undergraduate nursing students: An integrative review

BACKGROUND

Undergraduate nursing students have the opportunity to develop information literacy skills while at university so they can work effectively in an increasingly information-intensive clinical environment. This can be achieved through learning how to effectively search for required information, critically evaluate it, apply and reference it. Librarians working in academic libraries can assist with this essential skill development through library instruction, delivery and support.

OBJECTIVES

The aim of this integrative review was to undertake an analysis of the peer-reviewed research in the context of library instruction programs delivered in undergraduate nursing courses. A synthesis of the key themes was also undertaken.

METHODS

This paper takes the form of an integrative review. Four library databases were systematically searched for research articles investigating 'library instruction' within 'undergraduate nursing' courses. The search strategy was based on synonyms for these two concepts.

RESULTS

A total of 26 articles based on 25 studies were identified for review. Research was undertaken in a number of different countries with the most being in the United States of America (8). Total participants were 2820 nursing students. Sixteen of the studies were a quantitative approach, three were qualitative and six were mixed methods. A range of data collection methods were used that included surveys, interviews, focus groups and an observational study. One study was a randomised controlled trial and one used a mixed methods final year thesis analysis. The year level of participants varied with most being in the first year of their course (12 studies). Six studies were a mix of year levels. The four key inter-related themes identified were: collaboration, course-integration, linking to assessments, and confidence.

CONCLUSION

There is evidence to suggest a positive relationship between library instruction and information literacy skill development. Sustained training and support across year levels provides the opportunity for positive student outcomes.

The Impact of Library Tutorials on the Information Literacy Skills of Occupational Therapy and Physical Therapy Students in an Evidence-Based Practice Course: A Rubric Assessment

This study measures how online library instructional tutorials implemented into an evidence-based practice course have impacted the information literacy skills of occupational and physical therapy graduate students. Through a rubric assessment of final course papers, this study compares differences in students' search strategies and cited sources pre- and post-implementation of the tutorials. The population includes 180 randomly selected graduate students from before and after the library tutorials were introduced into the course curriculum. Results indicate a statistically significant increase in components of students' searching skills and ability to find higher levels of evidence after completing the library tutorials.

Developing occupational therapy students' information and historical literacy competencies: an interprofessional collaborative project

OBJECTIVE

The study examined the efficacy of an interprofessional information and historical literacy project implemented by an occupational therapy educator and a librarian.

METHODS

A graduate course was revised to include information and historical literacy objectives and instruction. A course-specific questionnaire administered on the first and last day of class, assignment grades, and course evaluations provided measures of project outcomes for six years. Differences between questionnaire pre- and post-test means were determined using t-tests. Course evaluation comments were analyzed to obtain qualitative perceptions.

RESULTS

A significant difference (p<0.0001) was found between pre-test (M=3.93, SD=0.48) and post-test (M=4.67, SD=0.30) scores of total information and historical literacy competence across all years (n=242). Responses to individual items also differed significantly (p<0.0001). Student ratings (n=189) from the course evaluation historical literacy objectives were high (M=4.6 on a 5-point scale). Assignment quality and grades improved, and course evaluation comments reflected student satisfaction.

CONCLUSIONS

The findings supported the hypothesis that students' self-reported information and historical literacy competencies would increase after project participation. Acquired skills were evident in students' assignments. Research to determine if these capabilities were used post-graduation is needed. Because this was a course-specific project, findings are not generalizable; however, the instructional methods developed for this project can serve as a model for effective interprofessional collaboration. The broadening of information literacy instruction to include discipline-specific historical literacy provides a unique opportunity for health sciences librarians and educators. Developing students' historical literacy in their chosen fields can help them understand their profession's present status and be informed participants in shaping its future.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students

BACKGROUND

The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP.

OBJECTIVES

This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles.

DESIGN

A longitudinal panel study.

SETTINGS AND PARTICIPANTS

A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014.

METHODS

Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence.

RESULTS

Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory.

CONCLUSIONS

Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice.

Changes in nursing students' perceptions of research and evidence-based practice after completing a research course

BACKGROUND

Nurses need a sound education in research and evidence-based practice (EBP) to provide patients with optimal care, but current teaching methods could be more effective.

OBJECTIVES

To evaluate the changes in nursing students 1) perceptions of research and EBP, 2) confidence in research and EBP, and 3) interest in research participation after completing a course in research and EBP.

DESIGN

A pre-post assessment design was utilized to compare changes in students.

SETTINGS

This project was conducted at a small, private liberal arts institution with Bachelor of Science (BSN) students.

PARTICIPANTS

Two cohorts of third-year BSN students (Year 1 N=55, Year 2 N=54) who were taking a required, semester-long Nursing Research and EBP course.

METHODS

Students' perceptions of and confidence in research and EBP were assessed pre- and post-semester using the Confidence in Research and EBP survey, which contained 7 demographic items, 9 Research Perceptions items, and 19 Confidence in Research items (5-point Likert scale; 1=Not at all confident, 5=Extremely confident). Two years of data were collected and analyzed in SPSS v.24.0. Wilcoxon signed-ranks tests and Mann-Whitney-U tests were utilized to examine the data.

RESULTS

Students had significant improvements in perceptions of and confidence in research and EBP (p<0.05). They were more likely to agree to plan to use EBP in the future (p=0.007), yet there were no significant improvements on students' plans to perform research or plans to participate in research in the future.

CONCLUSIONS

A Research and EBP course is an effective way to improve student perceptions of and confidence in research and EBP, increasing the likelihood of applying these skills to future nursing practice.

Evidence-based Medicine versus the Conventional Approach to Journal Club Sessions: Which One Is More Successful in Teaching Critical Appraisal Skills?

This study aimed to compare evidence-based medicine (EBM) vs. conventional approaches to journal club sessions in teaching critical appraisal skills in reading papers by emergency medicine residents. This double cut off discontinuation regression quasi-experimental study was conducted among emergency medicine residents. EBM vs. the conventional approach were applied to teach critical appraisal skills for half of the residents as an experimental group and another half as a control group respectively. Both groups participated in one hour monthly journal club sessions for six months. Before and after the study, all participants were examined by two tests: the Fresno Test (FT) [to evaluate their knowledge about EBM] and the Critical Appraisal Skills Test (CAST) [to evaluate their competency with critical appraisal skills]. The allocation of the participants into the experimental or control groups was according to their CAST scores before the study. 50 emergency medicine residents participated. After the study, the scores of both groups in the FT and CAST significantly improved (p<0.01), and the promotion of scores of the FT and CAST in the experimental group were more than that of the conventional group (p<0.0001). The current study indicated that an evidence-based medicine approach in journal club sessions was comparatively more advantageous compared to the conventional approach in teaching critical appraisal skills for reading papers among the residents of emergency medicine.

Developing an “experience framework” for an evidence-based information literacy educational intervention

Purpose

– The purpose of this paper is to describe how an “experience framework” for an evidence-based information literacy educational intervention can be formulated.

Design/methodology/approach

– The experience framework is developed by applying the qualitative methodology phenomenography to the analysis of the variation in the experience of a phenomenon by a target group, making specific use of one of its data analysis methods, that pioneered by Gerlese Akerlind. A phenomenographic study’s descriptions of the limited but related experiences of the phenomenon, and the detail of context and complexity in experience achieved through the Akerlind data analysis technique, are essential to a framework’s structure and educationally valuable richness of detail.

Findings

– The “experience framework”, an example of which is set out in this paper, is formed from a detailed range of contexts, forms and levels of complexity of experience of a phenomenon, such as information literacy, in a group or profession. Groupings of aspects of that experience are used to formulate, through the application of variation theory, an education theory developed from previous phenomenographic research, learning contexts and aims which can form the focus of educational activities.

Originality/value

– The framework can be used to form the basis of an evidence-based educational intervention to enrich the experience of any concept within LIS that Information professionals work to develop in their users.

Strategy of health information seeking among physicians, medical residents, and students after introducing digital library and information technology in teaching hospitals of Iran

OBJECTIVES

It is important for physicians, medical students and health care organizations of developing countries to use reliable clinical information in order to deliver the best practice. Therefore, health sector of Iran endeavored to encourage physicians and medical students to integrate research findings into practice since 2005. Several educational interventions in the areas of information technology and databases were performed. Digital library was introduced in the teaching hospitals. The purpose of this study was to investigate whether these interventions increased the use of evidence-based health information resources among physicians, medical residents and students.

METHODS

This descriptive study involved 315 physicians, assistants and medical students in affiliated hospitals of Semnan University of medical sciences in 2013.

RESULTS

A total 52.9% of physicians and 79.5% of medical residents and students always used patient data. 81.3% of physicians and 67.1% of medical residents and students reported using their own experiences, 26.5% of physicians and 16.9% of medical residents and students always used databases such as PubMed and MEDLINE for patient care.

CONCLUSION

Our results revealed that in spite of providing educational and technical infrastructures for accomplishment of research utilization in medical education, the study subjects often identified and used what they regarded as reliable and relevant information from sources that do not truly represent the best evidence that is available.

Self-reported eHealth literacy among undergraduate nursing students in South Korea: a pilot study

BACKGROUND

With the Internet being the preferred primary source for information seekers, 9 out of 10 Internet users report that they have looked online for health information in South Korea. Nurses as well as nursing students need to be knowledgeable about online health information resources and able to evaluate relevant information online in order to assist patients and patients' families' access.

STUDY OBJECTIVE

The purpose of the study was to assess eHealth literacy among undergraduate nursing students in South Korea. The specific aims were to: 1) identify the self-reported eHealth literacy levels, and 2) determine differences in levels of eHealth literacy between pre-nursing and nursing students.

METHODS

This study used a descriptive comparison design. One hundred and seventy-six undergraduate nursing students in South Korea participated. Participants were asked to complete the eHealth Literacy Scale. Collected data were analyzed using a descriptive statistical method and t-tests.

RESULTS

Participants responded that the Internet is a useful or very useful tool in helping them make health-related decisions. Furthermore, participants felt that it is important to be able to access health resources on the Internet. The majority of the participants either agreed or strongly agreed that they felt comfortable using the Internet with awareness of what information is available and of their skill to find information. Only a few respondents agreed or strongly agreed that they had the ability to differentiate between a high quality and a low quality health resource on the Internet. Students enrolled in nursing scored higher means in all eHealth literacy items than students enrolled in pre-nursing. Six out of ten eHealth literacy items showed significant differences between two groups.

CONCLUSION

Findings from this study provide fundamental data for education administrators and educators to begin supporting students with appropriate education programs to enhance their eHealth literacy.

Comparison of effects of training programs for final year nursing students in Turkey: differences in self-efficacy with regard to information literacy

BACKGROUND

Information literate person are aware of where and how they can obtain the information they need. Little is known about student nurses information literacy skills in different education programs.

OBJECTIVES

To find out how final year nursing students rated their own abilities to acquire new information.

DESIGN AND PARTICIPANTS

This study used comparative and descriptive cross-sectional surveys. Participants were final year students in two different programs, in two different universities in Turkey.

METHODS

The study sample consisted of final year nursing students who received training in Classic Learning (N: 61) and Problem-Based Learning (N: 96). As an evaluation instrument for the perceptions of the students their own information literacy, a scale consisting of 28 questions with 7 Likert ratings for each was used (min: 28, max: 196).

RESULTS

The return rates of the surveys were 96.7% in the school with classic training and 81.2% in the school with PBL. It was found that the average scores of the students were high, with a mean of 137±29 in the school where the classic training program was carried out, and 163±21 in the school where the training was PBL. A statistically significant difference was found by comparing the average scores of the two independent groups (t : -6.0; p<0.05).

CONCLUSIONS

Students in both of the training programs rated themselves as high. However, PBL training had a stronger influence on the development of their self-perceptions regarding information literacy. We conclude that training programs should be reviewed, and new methods should be developed based on these concepts.

Six ways of experiencing information literacy in nursing: the findings of a phenomenographic study

BACKGROUND

Information literacy plays a vital role in evidence-based practice in nursing. However there is currently little evidence to show how being information literate is actually experienced by nurses and therefore information literacy educational interventions are not genuinely evidence-based. Are they promoting the appropriate knowledge and skills to help nurses find and use the research evidence they need?

OBJECTIVES

To investigate how being information literate is experienced by nurses. To use the insights obtained to develop a description of the parameters of information literacy in nursing, including those of its role and value in evidence-based practice.

DESIGN

Phenomenography.

PARTICIPANTS

41 UK nurses of varying experience, specialism and background.

METHODS

Open-ended interviews.

RESULTS

7 contexts in which information literacy is experienced, were mapped out and 6 representative ways of being an information literate nurse, in increasing levels of depth and sophistication, were described.

CONCLUSIONS

These findings may form the basis of future evidence-based information literacy education programmes.

A systematic review of how studies describe educational interventions for evidence-based practice: stage 1 of the development of a reporting guideline

BACKGROUND

The aim of this systematic review was to identify which information is included when reporting educational interventions used to facilitate foundational skills and knowledge of evidence-based practice (EBP) training for health professionals. This systematic review comprised the first stage in the three stage development process for a reporting guideline for educational interventions for EBP.

METHODS

The review question was 'What information has been reported when describing educational interventions targeting foundational evidence-based practice knowledge and skills?'MEDLINE, Academic Search Premier, ERIC, CINAHL, Scopus, Embase, Informit health, Cochrane Library and Web of Science databases were searched from inception until October - December 2011. Randomised and non-randomised controlled trials reporting original data on educational interventions specific to developing foundational knowledge and skills of evidence-based practice were included.Studies were not appraised for methodological bias, however, reporting frequency and item commonality were compared between a random selection of studies included in the systematic review and a random selection of studies excluded as they were not controlled trials. Twenty-five data items were extracted by two independent reviewers (consistency > 90%).

RESULTS

Sixty-one studies met the inclusion criteria (n = 29 randomised, n = 32 non-randomised). The most consistently reported items were the learner's stage of training, professional discipline and the evaluation methods used (100%). The least consistently reported items were the instructor(s) previous teaching experience (n = 8, 13%), and student effort outside face to face contact (n = 1, 2%).

CONCLUSION

This systematic review demonstrates inconsistencies in describing educational interventions for EBP in randomised and non-randomised trials. To enable educational interventions to be replicable and comparable, improvements in the reporting for educational interventions for EBP are required. In the absence of a specific reporting guideline, there are a range of items which are reported with variable frequency. Identifying the important items for describing educational interventions for facilitating foundational knowledge and skills in EBP remains to be determined. The findings of this systematic review will be used to inform the next stage in the development of a reporting guideline for educational interventions for EBP.

Sources of knowledge used by intensive care nurses in Norway: an exploratory study

This study explored the sources of knowledge that intensive care nurses used in their daily nursing practice. It used a qualitative design based on four focus group interviews with 20 intensive care nurses, from four intensive care units in Norway. Data were analysed using systematic text condensation. The following condensed meaning units were identified: research, theoretical knowledge, experiential knowledge, work place culture, clinical expertise and patient participation. This study illustrates the complexity and variety of the knowledge bases of intensive care nurses. Despite some variation in nurses' familiarity with research literature, nursing interventions found by research to be useful were given priority, and research affected daily practice through changes in guidelines and procedures.

Nurses' information appraisal within the clinical setting

Limited discussion in nursing literature exists regarding how nurses appraise information. In the absence of information appraisal skills, nurses cannot safely and effectively apply evidence in practice. The research study used an interpretive description design to define and describe the process of information appraisal in the clinical setting. This study represented a sample of 44 RNs employed at a medical center in the Southeastern US. Based on the descriptions offered by participants, information appraisal contains three dimensions: gathering, analysis, and application. In addition, nurses perform information appraisal by way of an unspoken algorithm, incorporating two major decision points: first situational urgency, then familiarity with information sources. In most cases, the trusted resource served as a proxy for evaluating the information that was provided by the resource. Findings suggest that information appraisal is described in a number of ways by nurses, resulting in an unclear definition for the process. Understanding the perceptions of this sample has given insight into how nurses describe and perform information evaluation. Knowledge gained from this study may be used by nurse educators in the academic and clinical setting as they work to deliver relevant information that facilitates providing the highest-quality care.

Developing health information literacy: a needs analysis from the perspective of preprofessional health students

OBJECTIVE

The research identified the skills, if any, that health preprofessional students wished to develop after receiving feedback on skill gaps as well as any strategies they intended to use to address these gaps.

METHODS

A qualitative approach was used to elicit students' reflections on building health information literacy skills. First, the students took the Research Readiness Self-Assessment instrument, which measured their health information literacy, and then they received individually tailored feedback about their scores and skill gaps. Second, students completed a post-assessment survey asking how they intended to close identified gaps in their skills on these. Three trained coders analyzed qualitative comments by 181 students and grouped them into themes relating to "what skills to improve" and "how to improve them."

RESULTS

Students intended to develop library skills (64% of respondents), Internet skills (63%), and information evaluation skills (63%). Most students reported that they would use library staff members' assistance (55%), but even more respondents (82%) planned to learn the skills by practicing on their own. Getting help from librarians was a much more popular learning strategy than getting assistance from peers (20%) or professors (17%).

CONCLUSIONS

The study highlighted the importance of providing health preprofessional students with resources to improve skills on their own, remote access to library staff members, and instruction on the complexity of building health literacy skills, while also building relationships among students, librarians, and faculty.

Developing information literacy skills in pre-registration nurses: an experimental study of teaching methods

AIM

To compare the effectiveness of an online information literacy tutorial with a face-to-face session for teaching information literacy skills to nurses.

DESIGN

Randomised control trial.

PARTICIPANTS

Seventy-seven first year undergraduate pre-registration diploma nursing students.

INTERVENTION

Online in-house information literacy tutorial

COMPARISON

One hour face-to-face session, covering the same material as the intervention, delivered by the nursing subject librarian.

METHODS

Search histories were scored using a validated checklist covering keyword selection, boolean operators, truncation and synonyms. Skills retention was measured at 1 month using the same checklist. Inferential statistics were used to compare search skills within and between groups pre and post-session.

RESULTS

The searching skills of first year pre-registration nursing students improve following information literacy sessions (p<0.001), and remain unchanged 1 month later, regardless of teaching method. The two methods produce a comparable improvement (p=0.263). There is no improvement or degradation of skills 1 month post-session for either method (p=0.216).

CONCLUSION

Nurses Information literacy skills improve after both face-to-face and online instruction. There is no skills degradation at 1 month post-intervention for either method.

Promoting information literacy through collaborative service learning in an undergraduate research course

Information literacy is an important foundation for evidence-based nursing practice. Librarians, the experts in information literacy, are important collaborators in the process of teaching nursing students information literacy skills. In this article we describe a service learning project, offered in a third year nursing research course, designed to teach information literacy and to enhance students' appreciation of the role of evidence in nursing practice. Students worked in groups, and under the guidance of a nursing instructor and librarian, to answer a question posed by practice-based partners. Through the project students learned essential skills of refining a question, identifying systematic search strategies, gleaning essential information from a study and using a bibliographic management tool. Evaluation of the project indicated that although the project was challenging and labour intensive students felt they learned important skills for their future practice. Several recommendations for further enhancing the collaboration are made.

Evidence-based practice and related information literacy skills of nurses in Singapore: an exploratory case study

Increased demand for medical or healthcare services has meant that nurses are to take on a more proactive and independent role intending to patients, providing basic treatment and deciding relevant clinical practice. This, in turn, translates into the need for nurses to be able to translate research and evidence into their practice more efficiently and effectively. Hence, competencies in looking for, evaluating, synthesizing and applying documented information or evidence-based practice becomes crucial. This article presents a quantitative study that involved more than 300 nurses from a large government hospital in Singapore. A self-reporting questionnaire was developed to collect data pertaining to evidence-based practice and activities, including those that demonstrate information literacy competencies. Results seem to suggest that the nurses preferred to use print and human information sources compared to electronic information sources; were not proactive in looking up research or evidence-based information and, instead, preferred such information to be fed to them; and that they perceived they lacked the ability to evaluate research papers or effectively search electronic information related to nursing or evidence-based practice. It was also found that more than 80% of the nurses have not had any training related to evidence-based practice.

Utilizing grounded theory to explore the information-seeking behavior of senior nursing students

BACKGROUND

The ability to find and retrieve information efficiently is an important skill for undergraduate nursing students. Yet a number of studies reveal that nursing students are not confident in their library searching skills and encounter barriers to retrieving relevant information for assignments.

OBJECTIVES

This grounded theory study examined strategies used by students to locate information for class assignments and identified barriers to their success.

METHODS

Purposive sampling was used to recruit eleven students, who were asked to record their searching processes while completing a class assignment, and semi-structured, open-ended, audiotaped interviews took place to discuss the students' journals and solicit additional data. Methods of information seeking, strategies used to find information, and barriers to searching were identified.

RESULTS

Students' main concern was frustration caused by the challenge of choosing appropriate words or phrases to query databases. The central theme that united all categories and explained most of the variation among the data was "discovering vocabulary."

CONCLUSIONS

Teaching strategies to identify possible words and phrases to use when querying information sources should be emphasized more in the information literacy training of undergraduate nursing students.

Integrating evidence-based practice and information literacy skills in teaching physical and occupational therapy students

BACKGROUND

To ensure that physical and occupational therapy graduates develop evidence-based practice (EBP) competencies, their academic training must promote EBP skills, such as posing a clinical question and retrieving relevant literature, and the information literacy skills needed to practice these EBP skills.

OBJECTIVE

This article describes the collaborative process and outcome of integrating EBP and information literacy early in a professional physical therapy and occupational therapy programme.

METHODS

The liaison librarian and a faculty member designed an instructional activity that included a lecture, workshop and assignment that integrated EBP skills and information literacy skills in the first year of the programme. The assignment was designed to assess students' ability to conduct a search independently.

RESULTS

The lecture and workshop were successful in their objectives, as 101 of the 104 students received at least 8 out of 10 points on the search assignment.

CONCLUSIONS

The teaching activities developed for the students in this course appear to have achieved the goal of teaching students the EBP research cycle so that they might begin to emulate it. The collaboration between the faculty member and the librarian was integral to the success of this endeavour. Future work will include the evaluation of students' long-term retention of information literacy objectives.

Nursing students' perceptions of their resources toward the development of competencies in nursing informatics

PURPOSE

This article presents the findings of a doctoral study about the internal and external resources required to develop nursing informatics competencies in student nurses.

BACKGROUND

Colleges and universities are responsible for training nursing students, including in the area of nursing informatics. Even though nursing informatics is a specialty recognized by the American Nursing Association (2001), it has received limited attention in Quebec, Canada.

METHOD

A total of 131 college-level nursing students were randomly surveyed with a mail questionnaire designed to describe their perceptions about their internal and external resources in nursing informatics.

RESULTS

Nursing students perceive that their internal and external resources necessary to ensure "knowledge to act" in nursing informatics is moderately high. They said they lacked knowledge about using spreadsheet programs, presentation software, and courseware, about data security, and about how to analyze the quality of a health-related Web site and search electronic scientific databases.

CONCLUSION

These results show that, even if nursing students have access to a computer and the Internet at home and even if they feel competent using informatics in nursing, they still lack important resources for developing competencies in nursing informatics. We recommend that faculties and colleges focus on these elements.

Predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities

Nursing students are strategically positioned to influence adoption of evidence-based practice within the nursing profession. The purpose of this study was to identify the predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities. A cross-sectional survey design was used to study a convenience sample of 436 nursing students (response rate of 63.3%) enrolled at two baccalaureate nursing programs at the beginning of 2007 fall semester in the United States. The surveys included demographic questionnaire and knowledge, attitudes and behaviors questionnaire for evidence-based practice. EBP Knowledge, Attitudes toward EBP and Future Use of EBP subscales demonstrated statistically significant increase in mean scores with advancing academic levels. Confidence in clinical decision-making and clinical preparedness had moderate positive correlation with EBP Use and Future use of EBP. Simultaneous multiple regression analyses indicated that the clinical preparedness and confidence in clinical decision-making were statistically significant predictor variables for EBP use and Future use of EBP. Clinically well-prepared nursing students with high confidence in clinical decision-making are most likely to use evidence-based practice, both in the present and the future.

Literacy and numeracy for pre-registration nursing programmes: 1. An innovative way to widen access to nursing programmes for students without formal qualifications by enabling them to give evidence of their literacy and numeracy skills

The Nursing and Midwifery Council (NMC, 2003) removed standard entry criteria for nursing programmes and asked Higher Education Institutions (HEIs) to consider the literacy and numeracy skills of prospective students. This triggered admissions staff within a Faculty of Health to consider ways of attracting people with the right skills but not the qualifications to prove it. It is important to encourage a wide range of people into nursing to meet the demands of strategic plans and policy, as well as to ensure the nursing profession reflects the diverse client groups it serves. Removing standard entry criteria and the widening participation agenda gave an ideal opportunity to try something new. A course entitled 'Portfolio of Evidence for Entry to Level 1 Study' was developed within the Faculty of Health at Staffordshire University to enable potential nursing students without standard entry qualifications to demonstrate their skills in numeracy and literacy. This paper reports on the background to this course and its success for three student cohorts (over an 18 month period) who have completed their first year of pre-registration nursing. The methodology employed is descriptive, qualitative analysis, comparing portfolio and standard entry students' assignment results.

Leveraging change to integrate library and informatics competencies into a new CTSC curriculum: a program evaluation

This program evaluation reports on the curricular development and integration of library, biomedical informatics, and scholarly communications (LBS) skills into a required informatics course for a new graduate degree program in the University of New Mexico's Clinical and Translational Sciences Center (CTSC). The course built on the opportunity presented by the new degree program to integrate LBS competencies rarely included in most traditional clinical research training programs. This report tracks the experiences and evaluations of two cohorts of graduate students who have completed the course. This article presents lessons learned on curricular integration and offers thoughts for future work.

A case study for teaching information literacy skills

BACKGROUND

The Internet has changed contemporary workplace skills, resulting in a need for proficiency with specific digital, online and web-based technologies within the fields of medicine, dentistry and public health. Although younger students, generally under 30 years of age, may appear inherently comfortable with the use of technology-intensive environments and digital or online search methods, competence in information literacy among these students may be lacking.

METHODS

This project involved the design and assessment of a research-based assignment to help first-year, graduate-level health science students to develop and integrate information literacy skills with clinical relevance.

RESULTS

One cohort of dental students (n = 78) was evaluated for this project and the results demonstrate that although all students were able to provide the correct response from the content-specific, or technology-independent, portion of the assignment, more than half (54%) were unable to demonstrate competence with a web-based, technology-dependent section of this assignment. No correlation was found between any demographic variable measured (gender, age, or race).

CONCLUSION

More evidence is emerging that demonstrates the need for developing curricula that integrates new knowledge and current evidence-based practices and technologies, traditionally isolated from graduate and health-care curricula, that can enhance biomedical and clinical training for students. This study provides evidence, critical for the evaluation of new practices, which can promote and facilitate the integration of information literacy into the curriculum.

Nursing students and Internet health information

This study investigates use of the internet by nursing students to access health information and their evaluation practices in relation to this information. The research method was a retrospective descriptive postal survey. A questionnaire was sent to all undergraduate students enrolled in a Bachelor of Nursing programme at a New Zealand university in 2005. The response rate was 50% or 174 responses. Findings from the study included marked variations in respondents ability to successfully search for and evaluate relevant internet health and nursing information. Few respondents assessed patients use of the internet to gather health information or assisted patients with evaluation. As searching, evaluating and sharing online information is a core element of nursing practice, formal education to develop competency in the ability of all nursing students to retrieve and assess internet health information is essential. The integration of these skills into nursing practice is a vital step in developing new approaches to working with knowledgeable consumers of internet health information.

Integration of nursing education, practice, and research through community partnerships: a case study

Models demonstrating an evidence-based approach to the integration of nursing education, research, and practice are needed to ensure excellence in the nursing profession. Using a theoretical framework of community-engaged scholarship, this article describes a program developed by the Medical University of South Carolina's College of Nursing linking advanced practice, service learning, and applied clinical research for nurse-midwifery faculty and students, while meeting the perinatal healthcare needs of a group of underserved women. Principles of community-based partnerships and integration of scholarship and research in a clinical discipline provide a pragmatic structure to describe and facilitate replication of the program.

Beyond evidence-based nursing: tools for practice

AIM

This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions.

BACKGROUND

As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach.

EVALUATION

This article summarizes nursing's simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making.

KEY ISSUE

I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale.

CONCLUSION

Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more.

IMPLICATIONS FOR NURSING MANAGEMENT

This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions.

Connecting practice to evidence using laptop computers in the classroom

Evidenced-based practice is no longer a "frill" but a necessity, demanded by an evolving healthcare system and the needs of practice, professional nursing bodies, and American consumers who want safe, quality care. Although its importance has been touted by the profession, incorporating evidence into practice is not a skill for which nurses at point of care are ready. Preparation for evidence-based practice must begin in basic educational programs. Yet, the process of using evidence to guide practice is complex especially for undergraduate students who are only beginning to ask questions let alone answer them. Nursing schools have responded to the professional call to evidence-based practice with the use of a variety of teaching approaches. This article presents a unique approach, not previously described, involving the use of laptops in an undergraduate nursing research course to equip students for evidence-based practice, giving students hands-on experience with the process and introducing students to online resources. Student feedback and educator reflections highlight the value of the technology in expediting student learning and comfort with evidence-based practice.

A curricular approach to improve the information literacy and academic writing skills of part-time post-registration nursing students in Hong Kong

In today's environment of rapidly changing health care and information technology, nurses require a broad range of skills. One of the key skills required of all health professionals in this environment is information literacy. For registered nurses returning to a university setting to study for their baccalaureate degree, becoming information literate is one of many challenges they face. Also key to students' ability to use and communicate information in an appropriate and effective manner is their writing skills. This article describes a curricular intervention designed to develop and strengthen post-registration nurses' information literacy and academic writing competencies. An introductory information management module was developed and provided to three successive cohorts of students (n=159). Students were predominantly female (85.4%) with a mean age of 34.2 years (SD=6.8). Prior to commencing the program, students reported low information literacy and writing skills, especially in accessing and searching electronic databases and using referencing formats. The post-test evaluation of skills showed substantial and statistically significant increases in all assessed competencies. This intervention demonstrated that with structured but flexible learning activities early in the curriculum, post-registration nursing students can quickly become information literate.

Teaching and assessing the database searching skills of student nurses

Critical appraisal and application of the evidence to practice cannot proceed without first finding the evidence. To teach evidence-based practice database searching skills to students, a nurse educator partnered with a librarian to design, conduct, and assess instruction. The authors describe the creation, administration, and findings from the assessments and the implications for instruction.