Effectiveness of Evidence‐Based Practice (EBP) Education on Emergency Nurses’ EBP Attitudes, Knowledge, Self‐Efficacy, Skills, and Behavior: A Randomized Controlled Trial

Abstract

Background Emergency care clinicians are expected to use the latest research evidence in practice. However, emergency nurses do not always consistently implement evidence‐based practice (EBP). An educational intervention on EBP was implemented to promote emergency nurses’ use of EBP, and the effectiveness of it was evaluated. Aims This study aimed to evaluate the effectiveness of an EBP educational intervention on emergency nurses’ EBP attitudes, knowledge, self‐efficacy, skills, and behavior. The study also examined learners’ satisfaction with the EBP educational intervention. Methods A randomized controlled trial with parallel groups with evaluations before the education, immediately after it, and 6 and 12 months after the education was conducted at four emergency departments in two university hospitals. The experimental group (N = 40) received EBP education while the control group (N = 40) completed self‐directed EBP education. The primary outcomes were emergency nurses’ EBP attitudes, knowledge, self‐efficacy, skills, and behavior, while the secondary outcome was satisfaction with the EBP education. Results Thirty‐five participants of an experimental and 29 participants of a control group completed the study. There were no statistically significant (p < .05) improvements and differences between groups in EBP attitude, self‐efficacy, or behavior immediately after the EBP education. At the 6‐month measurement point, the experimental group showed significantly better EBP attitudes, behavior, knowledge, and self‐efficacy than the control group. At the 12‐month measurement point, the improvements began to decrease. The groups also differed significantly in terms of participant satisfaction with how the teacher encouraged learners to ask clinical questions. Linking Evidence to Action The EBP educational intervention implemented in this study had a positive effect on emergency nurses’ EBP attitudes, knowledge, self‐efficacy, skills, and behavior. The effects of the education appeared the best 6 months after the education. After this point, the results began to decrease and approached baseline levels. EBP educational interventions designed for emergency nurses should apply various teaching strategies to improve their EBP attitude, knowledge, self‐efficacy, skills, behavior, and satisfaction with the education.

Effectiveness of Digital Flipped Learning Evidence-Based Practice on Nurses’ Knowledge, Attitude, and Practice: A Quasi-Experimental Trial

“…Compared to past studies, for the primary outcome, the scores of the immediate post-test of knowledge, attitude, skills, and self-efficacy were higher than those of the pre-test [ 14 , 16 ], while the knowledge and self-efficacy of the experimental group were significantly higher than those of the control group [ 16 ]; however, for the scores one month later, there was no difference between the two groups in knowledge and self-efficacy [ 16 ]. In terms of the learning effect between the groups, the difference of knowledge in the experimental group was higher than that of the control group [ 17 ]. To observe the effect of persistent learning, at the 6-month measurement point, the experimental group showed significantly better EBP knowledge, attitudes, behavior, and self-efficacy than the control group; at the 12-month measurement point, the improvements began to decrease [ 17 ].…”

“…In terms of the learning effect between the groups, the difference of knowledge in the experimental group was higher than that of the control group [ 17 ]. To observe the effect of persistent learning, at the 6-month measurement point, the experimental group showed significantly better EBP knowledge, attitudes, behavior, and self-efficacy than the control group; at the 12-month measurement point, the improvements began to decrease [ 17 ]. Our study results were similar to those findings.…”

“…In this study, both groups had a good response in learning satisfaction under the intervention of educational strategies. For the secondary outcome, past studies showed that the satisfaction score of participants for the flipped education teaching style provided by the educators was better than that of the control group [ 17 ]. Similar to the results of this study, the participants had good satisfaction with the learning of the EBP 5As, which was also better than that of the control group.…”

“…Therefore, promoters of clinical EBP education need to be creative in planning and designing courses and incentives and overcome obstacles by using flipped classrooms instead of traditional courses [ 7 , 13 ]. In the past, some studies have also used various flipped learning models to evaluate the effect of nurses on EBP [ 14 , 15 , 16 , 17 ]. The measurement target includes knowledge, attitude, skills, behavior, self-efficacy, and learner’s satisfaction.…”

“…The measurement target includes knowledge, attitude, skills, behavior, self-efficacy, and learner’s satisfaction. There is usually a significant improvement in the evaluation score after the interventional educational strategy [ 14 , 16 , 17 ]. However, there are still shortcomings in various study designs, such as being limited to a single-group measurement, only descriptive questionnaires being used without interventional educational measures, a lack of persistent learning assessments, the participants being limited to a single work unit, or, in the self-learning link of flipped learning, a lack of online interaction with participants and the integration of the curriculum, so that the study may ignore passive participants [ 14 , 15 , 16 , 17 ].…”