Posters are a popular medium to communicate the results of research and evidence-based practice (EBP) projects. Nursing research is a formal, scientific, systematic, and rigorous process used to validate and refine existing knowledge and generate new knowledge that both directly and indirectly influences the delivery of evidence-based nursing practice (Grove, Burns, & Gray, 2013). EBP carefully integrates the best research evidence along with clinical expertise incorporating patient preferences and needs in the delivery of quality, cost-effective health care (Melnyk & Fineout-Overholt, 2014). Dissemination of the findings or results is the final phase in research studies or EBP projects. The findings from these works are significant components in building and changing nursing science where these innovations can be translated into practice (e.g., recommendations, protocols, pathways, or guidelines) and integrated into the practice of individual care providers and organizations (Grove et al., 2013; Melnyk & Fineout-Overholt, 2014).
Rather than lectures or oral presentations, posters from research studies or EBP projects are a powerful means of sharing nursing science information with professional nursing students, registered nurses, other health care providers, and stakeholders at professional societal meetings, scientific conferences, and in health care organizations for staff education. The components from beginning (i.e., design) to end (i.e., results and practice implications or relevance) for research studies or EBP projects are visually available in a well-developed and logically mapped-out poster format. According to Deonandan, Gomes, Lavigne, Dinh, and Blanchard (2013), the poster is an innovative format for teaching health sciences, and Fourtner, Bisson, and Loretz (n.d.) believe that posters may be of value posted on the Internet. The purpose of this article is to describe a professional-style nursing research electronic e-poster conference that also incorporates EBP projects as an online learning activity to engage nursing research students.
Preparing for the Conference
This e-poster conference is a new and creative approach to teaching and learning in which the classroom is flipped. The faculty offers material for student consideration and the student has the opportunity to think critically and become responsible for the discussion of the presented materials. To achieve that end within a structured online nursing research course at a midwestern U.S. university, graduate students encounter course learning outcomes related to an evaluation of quantitative and qualitative research, as well as evidence-based practice projects. These students experience a range of actions focused on understanding basic research and evidence-based practice processes. These actions include, but are not limited to:
- Reviewing the components of the research process by choosing a research study topic.
- Developing a problem and purpose statement, research question(s), or hypothesis(es).
- Choosing a theoretical framework to guide the study.
- Writing a review of research literature.
- Appraising data collection and analyses methods through abstract construction.
- Critiquing published research studies.
Evidence-based practice processes are also discussed in that the best research evidence, as well as patients' preferences and the nurses' clinical expertise, form the basis for making competent patient care decisions. The experience of attending a virtual world online e-poster conference is transformed into a real world culmination of knowledge of research and EBP processes. This conference provides graduate nursing students with opportunities to view studies and projects from a wider scientific audience, fosters the development of important evaluation and communication skills, and exposes them to evidence that might be transferred into their nursing practice.
Creating and Implementing the Conference
Posters provide the viewer with a comprehensive, but snapshot, picture of research and EBP projects. Beginning with 12 posters and increasing to a total of 23, posters were gathered from the university faculty members, as well as colleagues through networking at national conferences across the U.S. These posters were placed online as part of a discussion thread in the research course with the investigators' and authors' permission. Examples of research project topics encompass stroke or dementia caregivers' burden, cancer-related pain in outpatient populations, family visitation hours in hospital intensive care units, relationships between inner city school children with elevated blood levels and information retention, and women's experience of HIV testing. EBP project posters are also included, with topics such as protocol to reduce urinary catheter use in skilled facilities and an EBP approach for grading inhalation burn severity. Some e-posters are simply displayed and others are accompanied by a short oral presentation of fewer than 5 minutes by the presenter, using an electronic capture system. The overall static nature of the poster presentation may not be perceived as promoting an environment that is conducive to active learning, as it is impossible to dialogue with the presenter in this format. However, the student must engage with the poster to read or listen to the content, as well as analyze, synthesize, and evaluate the information presented by completing an evaluation tool and preparing to discuss that information in an online course discussion group. To that end, students select three e-posters of their choice for review, evaluation, and discussion.
An important e-poster conference component is the evaluation process. The poster evaluation tool design contains items related to layout and content rated on a 5-point Likert scale, with 1 being poor and 5 being excellent. An effective poster layout focuses only on that topic, uses attractive colors and small blocks of text with graphics (e.g., tables, figures, or photos), and keeps the sequence well-ordered and obvious with a large text font and quality typescript (Maltby & Serrell, 1998; Miller, 2007). In other words, students evaluate each chosen e-poster for clarity of subject matter, appearance (color, text, tables, and figures), and ease of reading (order of headings and sensible content flow, size of font, and quality of printing). The content is appraised from beginning to end, starting with the abstract through the implementation of results, clinical relevance, and acknowledgements. When evaluating the purpose section of the poster, the question focuses on whether there is a clear research or EBP question asked. In the methods section, evaluative items for research include questions such as “is the data collection and analysis appropriate for the study?” or, for EBP project items, “is the level of evidence identified, a cost analysis provided, and a process for project implementation noted?” The final evaluative question asks one dichotomous yes-or-no question as to whether this conference stimulates students' thinking about research and EBP. Comparable and alternative items to evaluate posters may be found in a classic article by Bushy (1991) and a more recent publication by Forsyth, Wright, Scherb, and Gaspar (2010).
Next, students upload or place their completed e-poster evaluation tool into the online course discussion group thread. In this discussion, they are prompted to describe what they learned about research and EBP, with a focus on how their practice can be changed based on the evidence from these posters. Exemplars of online facilitated discussion prompts that this author uses include: (a) what new information about research or EBP processes did you learn from these posters? and (b) based on the posters presented, describe how your practice changed through nursing research or EBP? For example, discuss how research evidence or findings can be applied to your practice, name some potential barriers that may be encountered in the application of this evidence and propose strategies for removing these barriers.
Faculty and Student Perspectives
The e-poster conference activity has been used for 3 years in the graduate nursing research course. Many students enrolled in the course are employed at a variety of organizations throughout the midwestern United States. This innovative conference format encourages students' interest in scientific or research investigations and EBP and has the potential to impact practice in students' workplaces based on students' answers on the e-poster evaluation tool and discussion group posts and comments.
An advantage of this e-poster online activity is that in the discussion group thread, the graduate students compared their organization's and colleagues' practice with both the research evidence and one another. Interesting conversations appeared when current practice did not match the evidence. For example, one student noted that his organization limits family visitation in intensive care units and that he felt that this discourages nurses' interaction with caregivers. Students wrote about how to begin to change organizational visitation policy based on the research evidence displayed in the poster conference.
The students' answer to the final evaluative question during the 3-year time period revealed that an overwhelming majority of responders (n = 244/253; 96%) consistently believed this conference had indeed stimulated their thinking about research and EBP. Overall, students tended to select e-posters that interested them because of the impact the information had on their current practice setting or because they wanted to know more about a topic. Several advantages of this online poster activity emerged through the students comments. The students' remarks demonstrated how this evidence might change their practice, with comments such as “I used this poster information in my practice in working closely with caregivers and people with dementia. I need to involve the caregivers more in the treatment and discharge plans,” and “I have never been to a conference, but this event helped me understand what conferences might be like to attend…but more than that it allowed me to know more about how to reduce urinary catheter use in my place of employment. We need to change our protocol and remove the catheter in a timelier manner (no more than 3 days from insertion, if possible).” Other students added their observations to the discussion group on how to make changes. For example, many students stated they would take this evidence from the posters back to their managers, as they were coping with similar issues and these were pertinent solutions. From all accounts, both faculty and graduate students, the e-poster conference activity was a successful and excellent learning experience.
Building on the students' responses and input, beginning this past semester, a similar poster conference was created for undergraduate nursing research students enrolled in a Web-assisted course where in-person classroom activities in a flipped setting are combined with materials placed online. The learning outcomes for this junior-level introductory research course include learning the basics about the research process and critiquing research studies with an emphasis on EBP. This e-poster content was built using a dozen research and EBP posters, in addition to printed abstracts willingly shared by presenters from the 2015 college of nursing research conference. With knowledge of research basic processes, these undergraduate students were divided into teams of five students and were assigned one poster to review, with another poster of interest chosen by the individual student. Prior to the in-person class meeting, students viewed the posters online and critically rated the e-poster layout and content using a similar Likert scale evaluation tool suited for their level of understanding. However, the last two items on this tool are narrative questions: How could results be implemented into your future nursing practice, and what did you find most interesting about the poster conference? In the classroom, students met with their team to discuss their poster evaluations. Next, with the e-poster displayed on a large classroom screen, the team orally presented to their peers what was excellent or good about the poster, and what might be improved based on their critique. These team presentations were followed by this author's facilitated discussion on how this evidence might be used to guide or change nursing practice. In conclusion, this activity was evaluated as excellent by this author after reviewing undergraduate students' written evaluations of the e-posters and hearing their oral classroom discussions.
This author is confident that students' critical thinking was stimulated throughout this activity and discussion. Many students said they were in awe of faculty accomplishments and had no idea of the scope of the projects (e.g., surrogate decision making at end-of-life or breast cancer and alternative therapies) that were included in these e-posters. Several students related the evidence presented in the e-posters to family and friends coping with similar situations. One student shared that her parents had to make hospice care choices for her grandfather and that one of the posters helped her to consider how these life-care decisions are made. Overall, these undergraduate students reported that they could use the evidence as they learn more about nursing practice and could apply this information to their current clinical settings.
In the e-poster conference online learning activity, students learned to evaluate research and EBP projects. Engaging students in this activity resulted in potential practice changes. Evidence from research and EBP projects can be translated from the classroom to bedside performance using innovative learning experiences. Other nursing schools and organizations may adapt this innovative e-poster conference activity to stimulate students' or employees' critical thinking ability, as well as serve as an impetus for future practice changes.
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