Finding a way through the woods: Equipping student nurses with evidence appraisal skills

Dr David Barrett, Director of Pre-Registration Nurse Education, Faculty of Health and Social Care, University of Hull

The place of research-mindedness and evidence appraisal in pre-registration nursing curricula has been the subject of much debate and scrutiny over the decades. Though there has long been recognition that care should be evidence-based, providing student nurses with the fundamental skills required to read, appraise and apply research findings was not always a central element of predominately skills-based programmes of nurse education.

Incrementally, there has been a move towards nursing being recognised as an academic profession and not purely a skilled vocation – in the UK, this has manifested in a number of ways:

  • the move from tradition-based to evidence-based practice in the 1970s
  • the transfer of nurse ‘training’ into Higher Education in the 1990s
  • nursing programmes becoming only graduate-level (or higher) from 2011.

The Nursing and Midwifery Council in the UK recognise the importance of evidence-appraisal skills, requiring nurses who join the register to be able to “…appreciate the value of evidence in practice, be able to understand and appraise research…” (NMC, 2014)

Whilst these developments have been welcome, they only put in place the foundation for a research-minded nursing profession. Simply making nursing a Degree-level subject and teaching it in a University does not automatically produce evidence-based practitioners. However, embedding research-focused content into nurse education programmes can make a difference – Leach et al (2016) demonstrated that a research education programme for student nurses can enhance their research skills and application of evidence-based practice.

Programmes such as this within nurse education have never been more important: not only does evidence-based practice remains the keystone of high quality nursing care, but identifying reliable, robust and relevant evidence is more challenging than ever before. For those of us who completed their pre-registration in the last century, evidence to support assignments and practice was found in a library. The challenge was to physically find evidence in the first place and then explore the methodological rigour that underpinned its findings.

Nowadays, the challenge for students is simply not to find evidence about the subject of interest, but to find robust evidence. There is so much evidence and opinion available online (much of it biased and flawed) that students need an enhanced range of appraisal skills. They need to develop the ability to identify what evidence is sound, what is robust, what is believable, and then use that high-quality evidence to underpin their work. Perhaps one of the most important findings of the work reported by Leach et al (2016, p201) was that as a result of their programme, “…final year undergraduate nursing students may have an increased level of trust in the research literature and possibly reduced dependence on the lay literature and colleagues”.

Specific programmes of education focused specifically on evidence-based practice and research are crucial, but are not the only solution. The importance of robust research evidence needs to be weaved into curricula, highlighting the place of evidence in everything that we do and developing a culture of critical reading amongst our students. We also need to ensure that practice placement areas have systems to support evidence-based practice – something that can provide a number of organisational and cultural challenges (Newman et al, 2000).

We live in an information age, and it is imperative that we give our student nurses the skills to navigate their way through it; to distinguish the research evidence from opinion and conjecture; to find a way through the woods.

References

Leach MJ, Hofmeyer A, Bobridge A (2016) The impact of research education on student nurse attitude, skill and uptake of evidence-based practice: a descriptive longitudinal survey Journal of Clinical Nursing 25, 194–203

Newman M, Papadopoulos I, Melifonwu R (2000) Developing organisational systems and culture to support evidence-based practice: the experience of the Evidence-Based Ward Project. Evidence-Based Nursing 3, 103-104 Available from: http://ebn.bmj.com/content/3/4/103.extract?sid=47788f87-ea3e-4a9d-893f-91d74d12facf

NMC (2014) Standards for competence for registered nurses Available from: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-competence-for-registered-nurses.pdf

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