Evidence-based practice educational intervention studies: a systematic review of what is taught and how it is measured

Abstract

BackgroundDespite the established interest in evidence-based practice (EBP) as a core competence for clinicians, evidence for how best to teach and evaluate EBP remains weak. We sought to systematically assess coverage of the five EBP steps, review the outcome domains measured, and assess the properties of the instruments used in studies evaluating EBP educational interventions.MethodsWe conducted a systematic review of controlled studies (i.e. studies with a separate control group) which had investigated the effect of EBP educational interventions. We used citation analysis technique and tracked the forward and backward citations of the index articles (i.e. the systematic reviews and primary studies included in an overview of the effect of EBP teaching) using Web of Science until May 2017. We extracted information on intervention content (grouped into the five EBP steps), and the outcome domains assessed. We also searched the literature for published reliability and validity data of the EBP instruments used.ResultsOf 1831 records identified, 302 full-text articles were screened, and 85 included. Of these, 46 (54%) studies were randomised trials, 51 (60%) included postgraduate level participants, and 63 (75%) taught medical professionals. EBP Step 3 (critical appraisal) was the most frequently taught step (63 studies; 74%). Only 10 (12%) of the studies taught content which addressed all five EBP steps. Of the 85 studies, 52 (61%) evaluated EBP skills, 39 (46%) knowledge, 35 (41%) attitudes, 19 (22%) behaviours, 15 (18%) self-efficacy, and 7 (8%) measured reactions to EBP teaching delivery. Of the 24 instruments used in the included studies, 6 were high-quality (achieved ≥3 types of established validity evidence) and these were used in 14 (29%) of the 52 studies that measured EBP skills; 14 (41%) of the 39 studies that measured EBP knowledge; and 8 (26%) of the 35 studies that measured EBP attitude.ConclusionsMost EBP educational interventions which have been evaluated in controlled studies focus on teaching only some of the EBP steps (predominantly critically appraisal of evidence) and did not use high-quality instruments to measure outcomes. Educational packages and instruments which address all EBP steps are needed to improve EBP teaching.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1284-1) contains supplementary material, which is available to authorized users.

Factors Influencing Undergraduate Students’ Intention to Use Evidence‐Based Practice After Graduation: Development and Validation of a Theory‐Based Prediction Model

“…However, students require time to practice and master skills such as question formulation and searching and appraising literature, as these skills form a basis for clinical and critical enquiry (Aglen, ). Many EBP programs focus only on the first three steps of the EBP process (Albarqouni et al., ), yet opportunities for observing and participating in EBP implementation and evaluation are also essential. With reports of decreasing EBP confidence over the first 5 years of clinical practice across health disciplines (Forsman et al., ; Klaic et al., ), mastery opportunities incorporated throughout curriculum rather than as a single EBP course or module could be considered as one strategy to sustain EBP behaviors.…”

“…In response to recommendations for improved patient safety, undergraduate curriculum across disciplines incorporates teaching about evidence‐based practice (EBP; Albarqouni, Hoffmann, & Glasziou, ; Young, Rohwer, Volmink, & Clarke, ). However, strategies for supporting EBP capability in students to meet EBP professional requirements are less clear.…”

Teaching scientific principles in undergraduate medical education – a scoping review on international examples

“…Reporting strategies of the educational interventions differed substantially. Some studies report precisely, describe the educational intervention and present evaluation data including pre-and postmeasures of student knowledge and student attitude (32,34,38,41). Others characterize the intervention briefly and present post-course evaluation data of student satisfaction (35,(48)(49)(50) or report on the educational intervention without any kind of evaluation (25,28,51).…”

“…Methods of assessment can range from self-report to performance assessment, activity monitoring up to patient-oriented outcomes (7). A variety of instruments to measure students skills in, knowledge of and attitudes towards EbM exist (38). These instruments should be used to reflect the success of educational interventions on scientific principles.…”

Evidence-based practice work file - A learning strategy for occupational therapy students during clinical placements: a descriptive cross-sectional study

“…Questions remain about optimal EBP teaching strategies throughout the occupational therapy curriculum (5,11). There is a need for educational strategies addressing all EBP steps to improve EBP teaching (14), including applying EBP teaching to real world environments (9).…”