Measures of evidence-informed decision-making competence attributes: a psychometric systematic review

Abstract

Background: The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing. Methods: The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings. Results: A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6-25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach's alphas ranging from 0.45-0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.

Development and content validation of a measure to assess evidence-informed decision-making competence in public health nursing

“…With respect to validity based on content for our measure, item level content validity indices (CVI) were computed [ 38 ]. Among existing literature, in a systematic review of 35 EIDM measures [ 17 ], CVIs were used to confirm validity based on content for only four measures: the Quick VIK (Values, Implementation, Knowledge) survey [ 44 ]; the Knowledge and Skills in Evidence-Based Nursing Tool [ 48 ]; Modified Stevens EBP Readiness Inventory [ 49 ]; and a self-developed tool by Bostrom et al [ 50 ]. For the four measures with computed CVIs identified above, the majority of original items had CVIs between 0.80–1.0, indicating acceptable content validity.…”

“…According to Streiner et al [ 22 ] a first step in devising items for a tool is to review previously completed work to determine if existing scales are adequate and comprehensively cover the construct domains being measured. To this end, a systematic review was undertaken to conduct a content coverage assessment which included 35 unique measures of EIDM competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) [ 17 ]. Assessing content coverage using a matrix determines how representative items are across content domains for a concept under measure [ 22 ].…”

“…A systematic review of 35 EIDM competence attribute measures (i.e., knowledge, skills, attitudes/beliefs, and behaviours) determined that the majority of measures assessed only one competence attribute, with only three measures assessing all four attributes [ 17 ]. These three measures include the Evidence-Based Practice Questionnaire (EBPQ) [ 18 ], the School Nursing Evidence-Based Practice Questionnaire [ 19 ], and a self-developed measure by Chiu et al [ 20 ].…”

Design and validity of an instrument to assess healthcare professionals’ perceptions, behaviour, self-efficacy and attitudes towards evidence-based health practice: I-SABE

“…Although several tools combine more than one domain of EBP assessment in a single instrument, these predominantly focus on certain domains (ie, knowledge and skills) and EBP steps (ie, appraise) 6 9 37–39. To our knowledge, I-SABE is the first tool that has addressed the following five domains in a single instrument: (1) self-efficacy; (2) behaviour; (3) attitude; (4) results/benefits and (5) knowledge/skills 6 9…”

Indigenous Foods: Resilience against Emerging Diseases

“…What was adopted by Indigenous communities in Canada and even globally was an increasing trend towards the promotion of their respective culture-driven-strengths-based approach (Belita et al, 2020).…”