Theory-based strategies for teaching evidence-based practice to undergraduate health students: a systematic review

Abstract

Background Undergraduate students across health professions are required to be capable users of evidence in their clinical practice after graduation. Gaining the essential knowledge and clinical behaviors for evidence-based practice can be enhanced by theory-based strategies. Limited evidence exists on the effect of underpinning undergraduate EBP curricula with a theoretical framework to support EBP competence. A systematic review was conducted to determine the effectiveness of EBP teaching strategies for undergraduate students, with specific focus on efficacy of theory-based strategies. Methods This review critically appraised and synthesized evidence on the effectiveness of EBP theory-based teaching strategies specifically for undergraduate health students on long or short-term change in multiple outcomes, including but not limited to, EBP knowledge and attitudes. PubMed, CINAHL, Scopus, ProQuest Health, ERIC, The Campbell Collaboration, PsycINFO were searched for published studies and The New York Academy of Medicine, ProQuest Dissertations and Mednar were searched for unpublished studies. Two independent reviewers assessed studies using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Results Twenty-eight studies reporting EBP teaching strategies were initially selected for review with methodological quality ranging from low to high. Studies varied in course duration, timing of delivery, population and course content. Only five included papers reported alignment with, and detail of, one or more theoretical frameworks. Theories reported included Social Cognitive Theory (one study), Roger’s Diffusion of Innovation Theory (two studies) and Cognitive Apprenticeship Theory (one study). Cognitive Flexibility Theory and Cognitive Load Theory were discussed in two separate papers by the same authors. All but one study measured EBP knowledge. Mixed results were reported on EBP knowledge, attitudes and skills across the five studies. Conclusions EBP programs for undergraduate health students require consideration of multiple domains, including clinical behaviors, attitudes and cognitive learning processes; Interventions grounded in theory were found to have a small but positive effect on EBP attitudes. The most effective theory for developing and supporting EBP capability is not able to be determined by this review therefore additional rigorous research is required. Electronic supplementary material The online version of this article (10.1186/s12909-019-1698-4) contains supplementary material, which is available to authorized users.

Educational Interventions for Teaching Evidence-Based Practice to Undergraduate Nursing Students: A Scoping Review

“…Embedding EBP in undergraduate nursing programs has been strongly recommended [ 18 ]. Earlier systematic reviews have been focused on the effectiveness of EBP teaching strategies for undergraduate health students [ 19 , 20 , 21 , 22 ], while other reviews focused on nursing students have exclusively focused on the effectiveness of EBP teaching methods to promote students’ critical thinking [ 23 ], without quantifying the effect of the strategies [ 12 , 13 ] or being oriented to qualitative studies [ 15 ].…”

Core Evidence‐Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements

“…The set of competencies and learning outcomes was adapted and developed to respond to the specific learning needs of the European nursing discipline, as it was necessary to design new strategies for teaching EBP (Aglen, 2016). The organization of EBP into affective, cognitive, and skills domains, as suggested by Ramis et al (2019), may serve as guidance for developing and harmonizing the content of teaching and teaching principles and strategies that may improve EBP competencies in nurses.…”

Evidence-Based Educational Practices for Public Health: How We Teach Matters

“…For the purposes of this article, we have included evidence-based practices both directly in public health and in other academic disciplines and made note of each field. Best practices in teaching based on evidence in public health include a variety of active and collaborative learning (Cardarelli et al, 2019) approaches such as flipped classroom, peer-to-peer instruction, learning communities, team-based learning, problem-based learning, educational technologies, practice-based learning, community-engaged learning, case studies, and interprofessional collaboration, among others (Cheung & Slavin, 2012;Clemson University, n.d.;Greece et al, 2018;Kleinbaum, 2019;Mackenzie et al, 2019;Ramis et al, 2019;Scott, 2015). Active learning, for example, has been shown to raise student scores.…”