According to the American Association of Colleges of Nursing's (AACN) The Essentials of Master's Education in Nursing (2011), it is essential that master's-prepared nurses are equipped to identify practice problems and to apply evidence within practice (AACN, 2011). During the first year of a distance-accessible Master of Science in Nursing program (baccalaureate nursing degree-to-MSN), advance practice registered nurse (APRN) students take a course on evidence-based practice (EBP). Within the course, students gain experience with developing the EBP question format of Problem/Population, Intervention, Comparison, and Outcome (PICO), critical appraisal of the literature, and translation and dissemination of evidence. Integration of EBP into practice, as well as evaluation, is an essential competency for MSN students (AACN, 2011; Hande, Williams, Robbins, Kennedy, & Christenbery, 2017). Therefore, during the second year of the program, faculty reviewed student feedback and assignments from previous semesters and identified that students lacked concrete experience with EBP. Hickman et al. (2018) reported that most MSN programs integrate blended EBP activities but lack a hands-on experience. Actively participating in an EBP project provides each student with an experiential learning opportunity (Kolb, 1984). Faculty wanted students to have an opportunity to get a hands-on learning experience by designing, implementing, and evaluating an EBP project.
The overall goal of the EBP learning experience was to provide students with an opportunity to design, implement, and evaluate an EBP project. Student objectives focused on preparing the APRN student to (a) identify a clinical problem in a clinical setting; (b) complete a critical appraisal of the literature related to the clinical problem; and (c) design, implement, and evaluate an EBP project in a clinical setting.
At the beginning of year 2 (first clinical course) of the MSN program, faculty provided students with an overview of EBP and described the two-part EBP project assignment. Part one would be conducted during the first clinical course and part two during the second clinical course. In part one, students were instructed to identify a clinical problem at their contracted clinical site. Students were expected to meet with their clinical preceptor and other stakeholders at the clinical site to identify a specific problem and plan. Faculty encouraged students to target a health literacy issue. Before the end of the semester, students submitted a written assignment that included a literature review, a clearly defined clinical problem, a plan of action (design), and an overview of the implications for the health care provider and patient. Faculty provided students with written feedback. During the second clinical course, students completed part two of the EBP project by implementing and evaluating the project. The design included at least three objectives, a description of the learners, an implementation outline, and the evaluation plan and outcomes. After project implementation, students submitted a written assignment detailing the EBP project implementation, evaluation methods, and outcomes in which faculty provided written feedback. As part of the assignment, students uploaded a PowerPoint® presentation on the discussion board that included a slide on each of the following: background of the problem, EBP design, description of learners and the setting, implementation plan, evaluation, and references. Each student was required to provide two scholarly peer reviews to (a) learn about the other student projects and (b) give a critique for future implementation. This allowed students an opportunity to receive and provide peer feedback in a controlled, supportive environment.
Faculty noted that each student was able to complete parts one and two. However, they decided to extend the project over three semesters instead of two in order to allow sufficient time for design and implementation. Students provided faculty with feedback through the end-of-semester course evaluations. A vast majority of students expressed that this assignment enhanced their ability to identify clinical issues and implement an EBP project. Clinical preceptors expressed that the EBP project enhanced the quality of patient care in their setting. This hands-on learning experience created an opportunity for students to apply and enhance their learning.
Tedra S. Smith, DNP, CRNP, CPNP-PC,
Pamela Bryant, DNP, CRNP,
University of Alabama at Birmingham
School of Nursing
- American Association of Colleges of Nursing. (2011). The essentials of master's education in nursing. Retrieved from https://www.aacnnursing.org/Portals/42/Publications/MastersEssentials11.pdf
- Hande, K., Williams, C.T., Robbins, H.M., Kennedy, B.B. & Christenbery, T. (2017). Leveling evidence-based practice across the nursing curriculum. Journal for Nurse Practitioners, 13(1), E17–E22. doi:10.1016/j.nurpra.2016.09.015 [CrossRef]
- Hickman, L.D., DiGiacomo, M., Phillips, J., Rao, A., Newton, P.J., Jackson, D. & Ferguson, C. (2018). Improving evidence based practice in postgraduate nursing program: A systematic review: Bridging the evidence practice gap (BRIDGE project). Nursing Education Today, 63, 69–75. doi:10.1016/j.nedt.2018.01.015 [CrossRef]
- Kolb, D.A. (1984). Experiential learning: Experience as the source of learning and development. Upper Saddle River, NJ: Prentice Hall.