EVIDENCEBASED TEACHING IN NURSING Chapter 15 Copyright Springer

Evidence-Based Teaching: Defined § Evidence-based teaching is – Use of research findings and other knowledge to guide educational practices in nursing – Integration of the best research evidence with theories and concepts about learning, teaching, assessment, and other areas related to nursing education; the teacher's expertise; and the learner's preferences and goals – Use knowledge to guide educational practices Copyright © Springer Publishing Company, LLC. All Rights Reserved. 2

Nursing Education Research § Need for rigorous research in nursing education to generate evidence that can be used to guide teaching § Many nursing education studies are conducted with small samples of students in one setting only – With investigator-developed tools that are not validated § Pilot studies need to be replicated § Need research to document effectiveness and outcomes of new teaching approaches Copyright © Springer Publishing Company, LLC. All Rights Reserved. 3

Levin’s Model of Educational Research § Stage 1: preliminary ideas, hypotheses, observations, and pilot studies § Stage 2: controlled laboratory experiments and interventions tested in the classroom, as well as observational studies of master teachers § Stage 3: randomized control trials of educational interventions comparing a new approach to the standard one – Interventions assigned randomly to different groups of learners and educational situations § Stage 4: effective interventions tested across settings § Most nursing education studies are at Stages 1 and 2 Copyright © Springer Publishing Company, LLC. All Rights Reserved. 4

Phases of Evidence-Based Teaching § Question educational practices and identify need for evidence to guide teaching § Search for research studies and other evidence on educational practices § Evaluate the quality of the evidence § Decide if the findings are applicable to own program, courses, students, and context in which teaching occurs Copyright © Springer Publishing Company, LLC. All Rights Reserved. 5

Question Educational Practices § It is the nurse educator’s responsibility to reflect on educational practices and question if there is a better way of teaching students § Types of questions – Descriptive: general questions about an educational practice or intervention being considered • Guide a literature search for information but not necessarily if method is superior to another – Best practice: questions lead to search for evidence to support educational practice or intervention • Search for studies on outcomes of various practices to make a decision Copyright © Springer Publishing Company, LLC. All Rights Reserved. 6

Search for Evidence § Search literature for studies on topic and other articles and resources to answer questions § Requires knowledge of bibliographic databases – MEDLINE – CINAHL – ERIC Copyright © Springer Publishing Company, LLC. All Rights Reserved. 7

Search for Evidence (cont) § Requires skill in searching the literature – Know the databases, literature in them, and how they are organized – Gain skills in selecting keywords for a search § Be aware of other resources such as websites that report evidence on educational practices, e. g. , Best Evidence Medical Education (BEME) Copyright © Springer Publishing Company, LLC. All Rights Reserved. 8

Search for Evidence (cont) § Systematic reviews – Begin by searching for systematic review – Experts critically appraise and synthesize the findings of multiple studies on a particular educational topic to identify best practices § Literature reviews – Examination of literature from author's perspective § Individual studies – When systematic and literature reviews are not available, review individual studies and critique their quality Copyright © Springer Publishing Company, LLC. All Rights Reserved. 9

Evaluate Quality of Evidence § Many systems for rating the quality of the evidence that can be applied to nursing education § Highest level: evidence from systematic reviews and meta-analyses, then – Randomized controlled trials – Cohort studies – Case control and descriptive studies – Expert opinion § The stronger the evidence, the more likely it is valid and relevant for a particular educational situation Copyright © Springer Publishing Company, LLC. All Rights Reserved. 10

Evaluate Quality of Evidence (cont) § Models for evaluating evidence from educational studies – Levin's model of educational research – Kirkpatrick's Four-Level Evaluation Model – BEME scale • • • 1 = No clear conclusions can be drawn; not significant 2 = Results ambiguous, but there appears to be a trend 3 = Conclusions can probably be based on the results 4 = Results are clear and very likely to be true 5 = Results are unequivocal Copyright © Springer Publishing Company, LLC. All Rights Reserved. 11

Decide if Evidence Is Relevant to own Teaching § Are findings ready for implementation based on the evidence? § Are findings applicable to own teaching situation? § Decide if the findings are relevant to own students, program, courses, and context Copyright © Springer Publishing Company, LLC. All Rights Reserved. 12