Knowledge, skills, and attitudes of nursing students on evidence-based practice

To identify knowledge, skills, and attitudes on Evidence-Based Practice of nursing students in the School of Nursing of Universidade de São Paulo and to explore the relationship between knowledge, skills, and attitudes and associated variables.

Method:

This is an exploratory, descriptive, analytical study conducted with 125 nursing undergraduate students. The data were obtained through application of the Evidence-Based Practice Questionnaire.

Results:

The mean score for the questionnaire was 4.73 (SD = 0.79), with a higher score in the Attitudes domain. There was a significant statistical correlation between questionnaire score and course year (p < 0.001).

Conclusion:

There is a gap in the knowledge and skills associated to Evidence-Based Practice among nursing students. Effective strategies for teaching this subject in the nursing undergraduate course must be developed.

DESCRIPTORS
Evidence-Based Nursing; Health Knowledge, Attitudes, Practice; Students, Nursing; Education, Nursing

Variable	N (%)		95% CI^** *The nursing graduation of EEUSP lasts four years and is offered as a full-time course with a total workload of 4170 hours.
Course year ^* *CI = Confidence Interval.
1st	28 (24.40)		15.98–30.47
2nd	35 (28.00)		20.88–36.44
3rd	37 (29.60)		22.30–38.11
4th	25 (20.00)		13.93–27.86
Gender
Female	99 (79.20)		71.27–85.39
Male	26 (20.80)		14.61–28.73
Knows EBP
Yes	104 (83.20)		75.68–88.74
No	21 (16.80)		11.26–24.32
	Mean(SD^* SD = Standard Deviation. )	Median	95% CI ^* *The nursing graduation of EEUSP lasts four years and is offered as a full-time course with a total workload of 4170 hours.
Age	23.07 (3.35)	22.61	22.59–23.84

Domains	Total		1st Year		2nd Year		3rd Year		4th Year
Domains	Mean (SD^** CI = Confidence Interval; *SD = Standard Deviation. )	95% CI^* CI = Confidence Interval; *SD = Standard Deviation.	Mean (SD)	95% CI	Mean (SD)	95% CI	Mean (SD)	95% CI	Mean (SD)	95% CI
Evidence-based nursing practice	4.76 (1.15)	4.55–4.95	4.24 (1.49)	3.62–4.72	4.77 (1.13)	4.36–5.10	4.86 (0.84)	4.57–5.11	5.21 (0.99)	4.76–5.53
Attitudes related to EBP	5.33 (0.75)	5.20–5.46	5.21 (0.79)	4.90–5.51	5.30 (0.75)	5.04–5.56	5.26 (0.69)	5.03–5.50	5.60 (0.74)	5.30–5.91
Knowledge and skills associated to EPB	4.55 (0.86)	4.39–4.70	4.09 (0.86)	3.76–4.42	4.41 (0.94)	4.09–4.74	4.60 (0.68)	4.37–4.82	5.16 (0.63)	4.90–5.42
Total EBPQ	4.73 (0.79)	4.59–4.87	4.31 (0.83)	3.99–4.64	4.65 (0.84)	4.36–4.94	4.77 (0.64)	4.56–4.99	5.25 (0.58)	5.01–5.49

Domains	Mean (SD)	95% CI^* *CI = Confidence Interval.
Evidence-based nursing practice
1. Formulated a clearly answerable question	4.65 (1.49)	4.37–4.90
2. Searched for relevant evidence	5.14 (1.52)	4.85–5.38
3. Critically assessed, based on defined criteria	4.02 (1.68)	3.72–4.31
4. Integrated evidence	5.26 (1.54)	4.98–5.52
5. Assessed practice results	4.69 (1.63)	4.39–4.96
6. Shared this information with peers	4.76 (1.62)	4.47–5.03
Attitudes related to EBP
7. I dedicate time to be up to date	3.90 (1.47)	3.64–4.16
8. I am open to questioning of my practice	5.61 (1.26)	5.38–5.82
9. EBP is fundamental for professional practice	6.66 (0.73)	6.51–6.77
10. I maintain tested and reliable methods	5.06 (1.39)	4.80–5.29
Knowledge and skills associated to EBP
11. Research skills	4.50 (1.18)	4.29–4.70
12. Informatics skills	4.81 (1.44)	4.55–5.05
13. Skills in monitoring and practice review	3.98 (1.35)	3.74–4.21
14. Converting needs for information into a question	4.26 (1.43)	4.01–4.51
15. Knowledge of the main types and sources of information	4.28 (1.29)	4.05–4.50
16. Capacity for identifying gaps in professional practice	4.58 (1.33)	4.34–4.81
17. Knowledge on how to raise evidence	4.06 (1.39)	3.82–4.30
18. Capacity of critically assessing evidence	4.34 (1.33)	4.10–4.56
19. Capacity of determining how valid the material is	4.38 (1.38)	4.14–4.62
20. Capacity of determining how applicable the material is	4.22 (1.37)	3.97–4.45
21. Capacity of applying knowledge to individual cases	4.50 (1.32)	4.26–4.72
22. Sharing ideas and knowledge with peers	5.01 (1.29)	4.78–5.23
23. Disseminating new ideas among peers	5.08 (1.33)	4.84–5.30
24. Capacity of reassessing my own practice	5.38 (1.20)	5.16–5.58

Domains	Evidence-based nursing practice	Attitudes related to EBP	Knowledge and skills associated to EBP	Total
Year (Mean and SD) ^* *One-way ANOVA, except Kruskal-Wallis test for Domain Practice.
1st	4.24 (1.49)	5.21 (0.79)	4.09 (0.86)	4.31 (0.83)
2nd	4.77 (1.13)	5.30 (0.75)	4.41 (0.94)	4.65 (0.84)
3rd	4.86 (0.84)	5.26 (0.69)	4.60 (0.68)	4.77 (0.64)
4th	5.21 (0.99)	5.60 (0.74)	5.16 (0.63)	5.25 (0.58)
p-value	0.044	0.223	<0.001	<0.001
Gender (Mean and SD) ^ t-test, except Wilcoxon-Mann-Whitney for Domain Practice.
Female	4.74 (1.21)	5.31 (0.73)	4.56 (0.87)	4.73 (0.81)
Male	4.86 (0.90)	5.39 (0.82)	4.48 (0.86)	4.72 (0.75)
p-value	0.944	0.666	0.657	0.966
Age ^* *Pearson correlation analysis.
r	0.149	0.075	0.243	0.221
p-value	0.103	0.416	0.007	0.015

Resources used for updating knowledge
Variable	Scientific journal/scientific articles	Manuals and recommendations by the Ministry of Health	Academic books	Participation in congress/seminar/symposium	Systematic reviews
Answers	103	99	92	79	39
Percentage	82.40	79.20	73.60	63.20	31.20
Reading habits
Variable	Academic books	Nonacademic books	Scientific journals	Magazines	News
Frequently	65	59	30	9	83
Rarely	57	60	62	57	40
Never	3	6	33	59	2
Level of knowledge of foreign languages
Variable	English	Spanish	French	German
Advanced	38	4	0	0
Intermediate	53	25	2	2
Basic	32	69	15	7
No knowledge	2	27	108	116

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Lucas Hideki Kato Myakava, Av. Dr. Enéas de Carvalho Aguiar 419, Cerqueira César, CEP 05403-000 – São Paulo, SP, Brazil, lucashkm@usp.br