NSG 6101 Week 5 Assignment Part 3 Article Critique Form

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Student name South University NSG 6101 Professor Name Submission Date NSG 6101 Article Critique Form APA reference Lam, C. K., Schubert, C. F., & Herron, E. K. (2020). Worldviews on Evidence-Based Nursing, 17(6), 418–426. https://doi.org/10.1111/wvn.12479 Purpose To identify the role of clinical learning environment on the adoption of evidence-based practice (EBP) competencies in clinical practice among senior nursing students, and to count the views of the students regarding the development of EBP competencies over the course of the baccalaureate program during the pre-practice period. Hypothesis or Research Question None of the formal/alternative hypotheses is made. The objectives/questions that were used in the study are not stated clearly: (1) What are the impacts of the clinical learning environment on the integration of EBP competencies by senior nursing students? and (2) How do students perceive the integration of EBP competence into their curriculum as they become practitioners? (They are not stated as hypothesis testing). Theoretical Framework The article does not appeal to either a specific theory or a mid-range theory of nursing. Rather, it is based on principles of competency-based and practice-translation: the work is placed within competency frameworks of the formulated EBP competencies and concepts of the NCSBN Transition to Practice/TTP model, and a notion of clinical learning environment, and measured through the EBP Work Environment Scale. In short: practice-competency/construction of the working environment, and not a systematic theoretical model. Research Design The research employed a sequential mixed-methods study design that involved quantitative and qualitative methods. During the quantitative part, the students of nursing in their senior years were supposed to fill out the Evidence-Based Practice (EBP) Work Environment Scale to identify the ways their clinical learning settings were helpful in terms of EBP integration. The qualitative stage included semi-structured interviews to have a better understanding of the perception and experience of students in terms of EBP competence development. Statistical Methods Data were collected in the form of quantitative data and analyzed with descriptive statistics (including means, standard deviations, frequencies) and paired samples t-test with the purpose of comparing the EBP Work Environment Scale results between capstone and transition-to-practice (TTP) clinical courses. Thematic content analysis was used to analyze qualitative data, involving transcripts coded, categorized, and interpreted by two researchers to determine recurrent themes and ensure reliability in terms of triangulation between investigators. Variables A. Dependent Variable: Perceived Evidence-Based Practice (EBP) competence and EBP work environment scores of first-year nursing students. B. Independent Variables: Kind of clinical learning setting (capstone vs. transition-to-practice). Structuring of the course (preceptor-led or instructor-led). Access to EBP materials and the role modeling of nurses and instructors. Setting / Population / Sample The research was conducted in a state university within Virginia, USA, which was providing a traditional Bachelor of Science in Nursing (BSN) program. Population: BSN students in senior level (two final clinical courses at the end of the school, capstone, and transition-to-practice courses). Sample: A convenience sample of 45 individuals who returned quantitative survey questionnaires (27 percent response rate) and 14 individuals who took part in qualitative follow-up interviews. Setting: Several hospitals in Virginia and the District of Columbia that were Magnet-designated, where students were on their clinical rotations. Validity / Reliability The research showed that the methodology was valid, as it involved the use of the Evidence-Based Practice (EBP) Work Environment Scale (which is psychometrically validated with a =.96 of leadership and a =.86 of work environment). The paired-sample t-test design enhanced the internal validity since it was able to compare two course settings within the participant (capstone vs. TTP). The qualitative results were also triangulated with the investigator to ensure the reliability of the results since two researchers conducted and reconciled the thematic analysis. Nevertheless, the sample size (n=45 survey; n=14 interviews) used is small and reflects on the external validity of the research (self-report measures) and there is a risk of the possibility of a response bias. In sum, the research experiment had excellent instrument validity and reasonable reliability in mixed-method research. Generalizability The generalizability is moderate to limited because the research was held in one public university in Virginia, and only one model of BSN curriculum was involved. The majority of the participants were of a young age (19-22 years) and female (95%), which decreased diversity in terms of demographics. The contextual relevance to other accredited nursing programs in other U.S. academic-clinical partnerships, however, is augmented by the multi-site clinical placements in multiple Magnet-designated hospitals. The results are most applicable to the conventional BSN programs of capstone and transition-to-practice elements, but not to accelerated and international nursing programs. Findings ·       Capstone (preceptor-led) clinical environments were rated much higher on support of EBP than transition-to-practice (TTP, instructor-led) courses (p <.001 on five of seven scale items). ·       The Capstone experiences facilitated greater interactions with EBP, autonomy, and access to EBP resources (M = 4.18 vs. 2.96 in TTP). ·       Online EBP were most commonly used by the students during clinical shifts (Google, Micromedex, DynaMed Plus). ·       Qualitative themes were identified as: ·       Perception of EBP depended upon course structure – preceptor-directed education was more apt to encourage the incorporation of EBP practices; group clinicals were restrictive. ·       Novice to advanced beginner – The EBP awareness of students changed as the procedural orientation was transformed to outcome-oriented reasoning. ·       Valued faculty and preceptors who modeled EBP behaviors and curricula, which increasingly incorporated EBP content, were valued by students. ·       The researchers found that the clinical learning environment has a very significant impact on the development of EBP competence prior to practice. Implications of the research for a.     nursing b.     education c.     policy making a. Nursing Practice: Identifies the need to use EBP mentorship by preceptors in clinical environments that removes gaps between theory and practice. Promotes the use of EBP mentors, preceptors, and staff nurses to cultivate a sustained evidence-based culture within the healthcare organizations. The significance of positive working conditions and leadership that appreciates the integration of EBP. b. Nursing Education: Makes a substantial focus on integrating EBP competencies into the undergraduate nursing curriculum, and not just in

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