Embedded or Modular? Preliminary Findings From a Study of Pre-Registration Nursing EBP Teaching Delivery Methods.

Aim:
This study explores the impact of teaching delivery method (embedded vs. modular) on undergraduate pre-registration nursing students’ self-reported Evidence-Based Practice (EBP) implementation, attitudes, knowledge and skills.

Background:
For the past 20 years EBP has been increasingly emphasised as an effective approach and goal in healthcare. Although research has identified a number of barriers to its adoption and implementation, little research has focused on nurses’ pre-registration training; particularly on the impact of teaching delivery-method EBP throughout the learning process.

Method:
The study represents an on-going educational audit. Two cohorts of undergraduate nursing students were recruited for a longitudinal, cross-sectional survey study: cohort one (N=57, response rate= 90.1%) were being taught EBP modularly, but cohort two (N=88, response rate= 63.8%) had EBP embedded across their modules.

Data was collected using the Evidence-Based Practice Questionnaire (EBPQ; Upton & Upton, 2006), administered at six-monthly intervals across the duration of students’ courses.

Results:
Preliminary analysis of students’ EBP 6-months into their courses identified no statistically significant differences between the cohorts on EBP Practice (U=2,138.00, Z=-0.13, p=.894). However, statistically significant differences between the two cohorts were identified on EBP attitudes (U=1, 852.00, Z=-2.43, p=.015; embedded group Md= 5.67, modular group Md=6.33) and Knowledge/skills (U=2,802.00, Z=3.68, p<.001; embedded group Md= 4.89, modular group Md=4.29).

Conclusions:
Although the project is still in its infancy, preliminary findings raise important questions about the relationship between EBP attitudes, practice and skill. The embedded cohort’s lower attitude scores may reflect social-desirability effects: modules dedicated to EBP may instil greater importance of displaying positive EBP attitudes. Embedding EBP may provide an effective means of developing students’ practice, knowledge and skills, without requiring dedicated modules (thereby reducing resource demands).