Building capacity: getting evidence-based practice into healthcare professional curricula

Fostering a culture of clinical effectiveness in healthcare is crucial to achieving optimum outcomes for patients. Evidence-based practice (EBP) is a cornerstone of clinical effectiveness. An EBP capacity-building project commenced in Ireland in 2016, in collaboration with the Centre of Evidence-Based Medicine in Oxford. A key part of this project, reported here, was the development of a competency framework for education in EBP and clinical effectiveness to ensure responsiveness of education standards and curricula of healthcare professionals in this area.

METHODS

Following a review of national and international reports, professional guidance documents and empirical literature pertaining to clinical effectiveness education (CEE), a preliminary competency framework was developed. Stakeholder consultations were conducted over a 6-month period, which consisted of 13 focus groups (n=45) and included representatives from clinical practice, higher education and professional training sectors, regulator/accrediting bodies, the Department of Health (Ireland) and patient/service user groups.

RESULTS

An overarching interprofessional competency framework for CEE was proposed and included the following domains: EBP, quality improvement processes, implementation strategies and collaborative practice: a total of 16 competencies and 60 indicators.

CONCLUSION

A competency framework for CEE for health and social care professionals is presented. It is intended that this framework will provide guidance to healthcare educators and regulators in the construction and revision of curricula, learning outcomes, teaching and assessment strategies, and graduate/clinician attributes.

First-time mothers: social support and confidence in infant care

AIM

This paper reports a study whose primary aim was to explore the relationship between social support for first-time mothers and their confidence in infant care practices. A secondary aim was to identify their sources of support in the postnatal period.

BACKGROUND

Policy documents emphasize the importance of support for new mothers in the postnatal period in caring for their infants. Nurses/midwives require a working knowledge of how social support influences maternal confidence in infant care practices, specifically during the first 6 weeks postdelivery.

METHODS

A descriptive, correlational design was used. A 28 item questionnaire was designed to measure social support in the specific context of first-time motherhood and confidence in infant care practices. Content validity was sought and the instrument demonstrated reliability using Cronbach's alpha. A convenience sample of 135 first-time mothers was recruited and 74% completed questionnaires at 6 weeks after birth. Data were collected in 2000.

RESULTS

Appraisal support had a statistically significant moderate relationship with confidence in infant care practices (r = 0.4, P < 0.01). Informational support had a weaker but statistically significant relationship (r = 0.2, P < 0.05). Respondents' primary sources of appraisal support were husbands/partners and their own mothers. Public health nurses and mothers were primary sources of informational support.

CONCLUSIONS

First-time mothers' husbands/partners need to become active participants in antenatal and postnatal care. Interdisciplinary educational programmes need to be developed so that public health nurses and midwives work collaboratively in facilitating social support for first-time mothers in caring for their infants. Curricula for public health nurses and midwives need to be evidenced-based with respect to social support.