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基于证据的实践与循证实践教育干预对提高本科学生将证据应用于实践的知识、态度、理解和行为的影响:一项全面的系统综述

Evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior toward the application of evidence into practice: A comprehensive systematic review of UG student.

作者信息

Kumah Elizabeth A, McSherry Robert, Bettany-Saltikov Josette, van Schaik Paul, Hamilton Sharon, Hogg Julie, Whittaker Vicki

机构信息

Faculty of Health and Social Care University of Chester Chester UK.

School of Health and Life Sciences Teesside University Middlesbrough UK.

出版信息

Campbell Syst Rev. 2022 Apr 16;18(2):e1233. doi: 10.1002/cl2.1233. eCollection 2022 Jun.

Abstract

BACKGROUND

To produce graduates with strong knowledge and skills in the application of evidence into healthcare practice, it is imperative that all undergraduate health and social care students are taught, in an efficient manner, the processes involved in applying evidence into practice. The two main concepts that are linked to the application of evidence into practice are "evidence-based practice" and "evidence-informed practice." Globally, evidence-based practice is regarded as the gold standard for the provision of safe and effective healthcare. Despite the extensive awareness of evidence-based practice, healthcare practitioners continue to encounter difficulties in its implementation. This has generated an ongoing international debate as to whether evidence-based practice should be replaced with evidence-informed practice, and which of the two concepts better facilitate the effective and consistent application of evidence into healthcare practice.

OBJECTIVES

The primary objective of this systematic review was to evaluate and synthesize literature on the effectiveness of evidence-informed practice versus evidence-based practice educational interventions for improving knowledge, attitudes, understanding, and behavior of undergraduate health and social care students toward the application of evidence into practice. Specifically, we planned to answer the following research questions: (1) Is there a difference (i.e., difference in content, outcome) between evidence-informed practice and evidence-based practice educational interventions? (2) Does participating in evidence-informed practice educational interventions relative to evidence-based practice educational interventions facilitate the application of evidence into practice (as measured by, e.g., self-reports on effective application of evidence into practice)? (3) Do both evidence-informed practice and evidence-based practice educational interventions targeted at undergraduate health and social care students influence patient outcomes (as measured by, e.g., reduced morbidity and mortality, absence of nosocomial infections)? (4) What factors affect the impact of evidence-informed practice and evidence-based practice educational interventions (as measured by, e.g., course content, mode of delivery, multifaceted interventions, standalone intervention)?

SEARCH METHODS

We utilized a number of search strategies to identify published and unpublished studies: (1) Electronic databases: we searched Academic Search Complete, Academic search premier, AMED, Australian education index, British education index, Campbell systematic reviews, Canada bibliographic database (CBCA Education), CINAHL, Cochrane Library, Database of Abstracts of Reviews on Effectiveness, Dissertation Abstracts International, Education Abstracts, Education complete, Education full text: Wilson, ERIC, Evidence-based program database, JBI database of systematic reviews, Medline, PsycInfo, Pubmed, SciELO (Scientific Electronic Library Online), and Scopus; (2) A web search using search engines such as Google and Google scholar; (3) Grey literature search: we searched OpenGrey (System for Information on Grey Literature in Europe), System for information on Grey Literature, the Society for Research on Educational Effectiveness, and Virginia Henderson Global Nursing e-Repository; (4) Hand searching of journal articles; and (5) Tracking bibliographies of previously retrieved studies. The searches were conducted in June 2019.

SELECTION CRITERIA

We planned to include both quantitative (including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies) and qualitative primary studies (including, case series, individual case reports, and descriptive cross-sectional studies, focus groups, and interviews, ethnography, phenomenology, and grounded theory), that evaluate and compare the effectiveness of any formal evidence-informed practice educational intervention to evidence-based practice educational intervention. The primary outcomes were evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, and behavior. We planned to include, as participants, undergraduate pre-registration health and social care students from any geographical area.

DATA COLLECTION AND ANALYSIS

Two authors independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full-text of selected articles. Discrepancies were resolved through discussion or consultation with a third author. We found no article eligible for inclusion in this review.

MAIN RESULTS

No studies were found which were eligible for inclusion in this review. We evaluated and excluded 46 full-text articles. This is because none of the 46 studies had evaluated and compared the effectiveness of evidence-informed practice educational interventions with evidence-based practice educational interventions. Out of the 46 articles, 45 had evaluated solely, the effectiveness of evidence-based practice educational interventions and 1 article was on evidence-informed practice educational intervention. Hence, these articles were excluded as they did not meet the inclusion criteria.

AUTHORS' CONCLUSIONS: There is an urgent need for primary studies evaluating the relative effectiveness of evidence-informed practice and evidence-based practice educational interventions targeted at improving undergraduate healthcare students' competencies regarding the application of evidence into practice. Such studies should be informed by current literature on the concepts (i.e., evidence-informed practice and evidence-based practice) to identify the differences, similarities, as well as appropriate content of the educational interventions. In this way, the actual effect of each of the concepts could be determined and their effectiveness compared.

摘要

背景

为培养在将证据应用于医疗实践方面具备扎实知识和技能的毕业生,必须以高效的方式向所有本科健康与社会护理专业学生传授将证据应用于实践的相关过程。与将证据应用于实践相关的两个主要概念是“循证实践”和“证据 informed 实践”。在全球范围内,循证实践被视为提供安全有效医疗服务的黄金标准。尽管循证实践已广为人知,但医疗从业者在实施过程中仍不断遇到困难。这引发了一场国际辩论,即循证实践是否应由证据 informed 实践取代,以及这两个概念中哪一个更有助于将证据有效且一致地应用于医疗实践。

目的

本系统评价的主要目的是评估和综合关于证据 informed 实践与循证实践教育干预在提高本科健康与社会护理专业学生将证据应用于实践的知识、态度、理解和行为方面有效性的文献。具体而言,我们计划回答以下研究问题:(1)证据 informed 实践与循证实践教育干预之间是否存在差异(即内容、结果方面的差异)?(2)相对于循证实践教育干预,参与证据 informed 实践教育干预是否有助于将证据应用于实践(例如通过关于有效将证据应用于实践的自我报告来衡量)?(3)针对本科健康与社会护理专业学生的证据 informed 实践和循证实践教育干预是否都会影响患者结局(例如通过降低发病率和死亡率、无医院感染来衡量)?(4)哪些因素会影响证据 informed 实践和循证实践教育干预的效果(例如通过课程内容、授课方式、多方面干预、独立干预来衡量)?

检索方法

我们采用了多种检索策略来识别已发表和未发表的研究:(1)电子数据库:我们检索了学术搜索完整版、学术搜索高级版、AMED、澳大利亚教育索引、英国教育索引、坎贝尔系统评价、加拿大书目数据库(CBCA 教育)、CINAHL、考科蓝图书馆、有效性评价摘要数据库、国际学位论文摘要、教育摘要、教育完整版、教育全文:威尔逊、教育资源信息中心、循证项目数据库、JBI 系统评价数据库、医学索引、心理学文摘、PubMed、科学电子图书馆在线(SciELO)和 Scopus;(2)使用谷歌和谷歌学术等搜索引擎进行网络搜索;(3)灰色文献搜索:我们检索了 OpenGrey(欧洲灰色文献信息系统)、灰色文献信息系统、教育有效性研究协会和弗吉尼亚·亨德森全球护理电子知识库;(4)手工检索期刊文章;(5)追踪先前检索到的研究的参考文献。检索于 2019 年 6 月进行。

纳入标准

我们计划纳入定量研究(包括随机对照试验、非随机对照试验、准实验、前后研究、前瞻性和回顾性队列研究)和定性的原始研究(包括病例系列、个体病例报告、描述性横断面研究、焦点小组和访谈、民族志、现象学和扎根理论),这些研究评估并比较任何正式的证据 informed 实践教育干预与循证实践教育干预的有效性。主要结局是证据 informed 实践和循证实践的知识、态度、理解和行为。我们计划纳入来自任何地理区域的本科预注册健康与社会护理专业学生作为参与者。

数据收集与分析

两位作者独立筛选检索结果,以评估文章是否符合纳入标准。筛选包括对标题和摘要的初步筛选,随后是对选定文章的全文筛选。差异通过讨论或与第三位作者协商解决。我们未找到符合本评价纳入标准的文章。

主要结果

未发现符合本评价纳入标准的研究。我们评估并排除了 46 篇全文文章。这是因为这 46 项研究中没有一项评估并比较了证据 informed 实践教育干预与循证实践教育干预的有效性。在这 46 篇文章中,45 篇仅评估了循证实践教育干预的有效性,1 篇是关于证据 informed 实践教育干预的。因此,这些文章因不符合纳入标准而被排除。

作者结论

迫切需要进行原始研究,以评估证据 informed 实践和循证实践教育干预在提高本科医疗专业学生将证据应用于实践能力方面的相对有效性。此类研究应以关于这些概念(即证据 informed 实践和循证实践)的现有文献为依据,以识别教育干预的差异、相似之处以及适当内容。通过这种方式,可以确定每个概念的实际效果并比较它们的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aba1/9013402/26c6a02dabe4/CL2-18-e1233-g003.jpg

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