To Embed or not to Embed? A Longitudinal Study Exploring the Impact of Curriculum Design on the Evidence-based Practice Profiles of UK Pre-registration Nursing Students

Background
The use of Evidence-Based Practice (EBP) is increasingly emphasised within healthcare. However, little research has focused on nurses’ pre-registration training; particularly regarding the impact of curriculum-design on learning EBP.

Objectives
This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students’ EBP profiles.

Design
A longitudinal panel study.

Settings and participants
A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014.

Methods
Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence.

Results
Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups.
No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory.

Conclusions
Taking a modular or embedded approach to EBP may have little impact on students’ final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students’ perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students’ initial positive attitudes towards EBP and its use in their practice.