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Innovative Learning Activity Evidence-Based Practice to Outcomes Management: Spiraled Learning Activities, Part I
In an article by Ross, Noone, Luce, and Sideras (2009) published in last month’s issue of the Journal of Nursing Education, a series of seven learning activities were described that focused on development of evidencebased practice (EBP) and outcomes management knowledge and skills throughout an undergraduate nursing curriculum. These seven learning activities spiral in increased complexity while building on previously acquired skills. This Syllabus Selection article presents the initial learning activity, which focuses on developing foundational skills for locating, evaluating, and referencing sources of evidence. An emphasis of undergraduate nursing programs is to enable undergraduate nursing students to gain proficiency in EBP and outcomes management knowledge and skills (Institute of Medicine, 2003). A series of seven learning activities threaded throughout the curriculum were developed to address the Institute of Medicine’s five core competencies for health care professionals in this area (Ross et al., 2009). Spiraling learning activities allows learners to revisit previously learned material to build and refine competency while adding complexity and depth in skill development. The learning activity discussed is presented in the initial nursing course in the curriculum and develops foundational skills necessary for gaining proficiency in EBP nursing. This occurs in a Health Promotion and Assessment course but can be adapted for an initial course in the curriculum. The steps of this assignment occur sequentially over the term. Description of Learning Activity
The goals for this learning activity are for students to demonstrate a beginning ability to: l Convert health care information needs into clear questions. 416
l Seek evidence to answer those questions. l Demonstrate competence in the use of nursing and health care databases to conduct a literature search and access resources electronically. l Identify the component parts of a research article. l Differentiate research from other health resource information. l Evaluate the evidence for its validity and usefulness. l Demonstrate the correct use of American Psychological Association style for citing and formatting. At the beginning of the term, students attend a library orientation, which presents information about online database searching. The librarian developed an electronic tutorial, which students complete and have access to during the rest of the program. Students are then asked to find and read two articles related to developing clinical questions and answer questions about the articles (Flemming, 1998; Yoder, 2005). Opportunities for skill building in online data searching and retrieval are provided. These journal readings, as well as others throughout the term, are assigned by providing selected aspects of the citation, such as topic of article, name of author, and year, requiring the student to use various methods to retrieve the online article. Students then apply this skill to an assignment related to a health history and health promotion plan on a middle-aged adult. Students identify areas for health promotion needs for a client on the basis of the health history. A clinical question is developed based on the format presented by Flemming (1998). The literature and Internet are searched to find both a national guideline and a research article that may help to answer this question. Students are expected to identify the components in their information that support the validity of the resource and how it was useful in developing the plan. The students then complete a tutorial designed by
the faculty to assist them in analyzing the research article to develop a beginning understanding of research design, identification of research questions, implications, and limitations. Both the national guideline and research article are submitted in correct American Psychological Association format. Student Response
Students responded that this assignment helped them become familiar with database searching and assessment of evidence. The major obstacle to students occurred in differentiating a research article from a review article. It is helpful if students submitted the article they find before they progress in the learning activity so faculty could confirm that students selected a research article. Reserving computer laboratory time to provide faculty guidance while performing the literature search was also potentially beneficial. This assignment provides the foundation for searching, evaluating, and referencing evidence that will be revisited in future courses and learning activities.
References
Flemming, K. (1998). Asking answerable questions. Evidence-Based Nursing, 1(2), 36-37. Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press. Ross, A.M., Noone, J., Luce, L.L., & Sideras, S.A. (2009). Spiraling evidencebased practice and outcomes management concepts in an undergraduate curriculum: A systematic approach. Journal of Nursing Education, 48, 319326. Yoder, L.H. (2005). Evidence-based practice: The time is now! MEDSURG Nursing, 14, 91-92.
Joanne Noone, PhD, RN
[email protected] Stephanie A. Sideras, PhD, MSN, RN, CNS Amy Miner Ross, PhD, RN, CNS Oregon Health & Science University doi:10.3928/01484834-20090615-11 Journal of Nursing Education
