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Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 13Teaching Evidence-Based
Practice in Academic Settings
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
EBP in Healthcare Education
• Teaching learners to critique and apply research using traditional methods is no longer sufficient to prepare them for what is expected of them
• Teaching EBP has become an imperative in healthcare education
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Identifying Available Resources
• Ask, “Does the philosophy and mission of my institution support EBP?”
− If not, efforts may need to focus on demonstrating the effectiveness of EBP through the success of small initiatives
− Must first obtain buy-in and support from all levels of administration
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Assessing the Commitment of Educators and Administrators
• Ask, “What is the personal commitment to EBP and practice excellence among educators and administration?”
− Often determined by observation
• Ask, “Are there educators who have EBP knowledge and skills?”
− There are numerous mechanisms to assist educators in gaining EBP knowledge and skills
• It is necessary to assess the basic informatics and computer literacy of educators
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Building the Infrastructure to Teach EBP
• Administrators, educators, librarians, and students are key stakeholders in the initiative
• It is imperative to have a medical/health science librarian who is knowledgeable about EBP
• Champions and mentors play central roles
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• EBP mentors primarily perform which of the following roles in academic settings?
a. Improving student and faculty’s understanding and integration of EBP in practice and education
b. Performing critical appraisal of the evidence that is foundational to the EBP paradigm
c. Assessing students’ adherence to EBP principles in the classroom and practicum
d. Demonstrating the improvements in educational outcomes associated with EBP
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• a. Improving student and faculty’s understanding and integration of EBP in practice and education
• Rationale: An EBP mentor’s primary focus in the academic setting is on improving students’ and faculty’s knowledge and application of EBP, both in educational and clinical settings.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Technical Resources: Simulation
• Allows healthcare educators to prepare students for the current clinical and community environments
• Replicate a real-life clinical situation for students so they can experience the integration of internal and external evidence
• Promotes participative learning
• Mistakes are not only permitted, but expected as learning opportunities
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Technical Resources• Handheld Devices
− Can be used as a date book, to-do list, address book, memo pad, calculator, and web browser, with the ability to download health/medical software programs
• Clinical Information Systems
− Enhance productivity and can be used at the point of care
• World Wide Web; Second Life, Twitter, and Facebook
− Provide information and foster collaboration
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Tell whether the following statement is true or false.
• The use of a variety of technical resources in an integrated manner indicates that a school is effectively teaching the principles of EBP.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• False
• Rationale: Technical resources can be powerful tools that can be used to facilitate the teaching and practice of EBP. However, the use of technical resources in and of itself does not guarantee that EBP is being modeled or taught.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Characteristics of Evidence-Based Practice Teachers and Learners
• Excellence in patient care, clinical skills, and clinical judgment
• Diligence
• Perspective
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Cultivating an Environment for Teaching EBP Successfully
• EBP skills inventory
• Educational prescription (EP)
• Teachers must prompt learners explicitly to provide their rationale for their choice of information used in clinical decision making
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Shift in Education from Traditional to EBP Paradigm
• There is a change from preparing research generators or critiquing research for strengths and weaknesses
− EBP education focuses on preparing the learner to be an evidence user
− A new focus on integrating the three components of EBP
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
The ACE Star Model
• An EBP model that provides an inclusive framework with which to organize EBP processes and approaches
• Depicts the Cycle of Knowledge Transformation
− Stage 1: Knowledge discovery
− Stage 2: Evidence summary
− Stage 3: Translation into practice recommendations
− Stage 4: Implementation into practice
− Stage 5: Evaluation
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• According to the ACE Star Model, new evidence is produced during what stage of knowledge transformation?
a. Discovery
b. Evidence summary
c. Translation
d. Implementation
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• a. Discovery
• Rationale: Discovery (Point 1) on the star is the stage when new knowledge is generated by research methodologies used in traditional single, original research studies. This knowledge underlies the subsequent stages of the model.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Strategies for Integrating EBP in Curricula
• Keep it simple
• Use language that reflects the EBP paradigm
− E.g., changing the word “rationale” to “evidence”
− Review learning activities and assignments and reframe them to reflect EBP
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Strategies for Each Step in the EBP Process
• Asking the clinical question
• Searching for evidence
• Critical appraisal
• Determining patient preferences
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Strategies for Teaching EBP
• Should not be restricted to one instructor or to one teaching episode
− Should be woven throughout the program
• Lectures
• Small group seminars
• Journal clubs
− Grazing
− Hunting
• Presentations integrated with clinical practicum
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Principles to Guide EBP Integration
• Set clear deadlines
• Carefully assess skill levels
• Assure education has meaning
• Foster learning and growth
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Evaluating Success in Teaching EBP
• Learner evaluation
− Classroom
− Clinical
• Educator and preceptor evaluation
• Curricula evaluation
• Program evaluation
• Final assessment
• Program effectiveness
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Tell whether the following statement is true or false.
• The most important criterion of the success of an EBP program is learners’ willingness to integrate EBP principles into their thinking and their care.