Mapping strategies and outcomes of evidence-based practice training for clinical nurses: A scoping review

Evidence-based practice (EBP) is widely advocated to improve care quality and patient outcomes. For EBP to be enacted in clinical settings, registered nurses require appropriate training. However, EBP training in clinical settings varies markedly in structure, content, and evaluation.

To map the design, delivery, and evaluation of EBP training programs for clinical nurses by describing program content and learning activities, classifying instructional strategies using the Interactive, Constructive, Active, Passive (ICAP) framework, and categorizing reported outcomes using the four-level Kirkpatrick model.

We conducted this review in accordance with the Joanna Briggs Institute scoping review methodology and reported following the PRISMA-ScR guidelines. We performed a comprehensive literature search of eight databases. Two researchers independently conducted literature screening and data extraction and analysis. Disagreements were resolved by consensus,with a third researcher adjudicating when required. Instructional components were coded to the ICAP model and outcomes mapped to Kirkpatrick Levels.

Twenty-six studies were included in the scoping review. According to the ICAP model, the training modalities commonly included Active (88.5%), Constructive (88.5%), and Interactive (84.6%) methods. Utilizing the Kirkpatrick model, all studies evaluated learning outcomes (Level 2). Most studies assessed reactions ((Level 1, 65.4%) and behavior (Level 3, 57.7%), while only six evaluated results (Level 4, 23.1%).

EBP training for nurses of clinical settings improves their self-reported EBP knowledge, skills, attitudes/beliefs, and practice. Despite inconsistent or mixed findings, EBP training has the potential to improve patients' indicators and organizational climate. However, heterogeneous designs, short follow-up, and reliance on self-report limit the certainty of the findings. Future programs should employ theory-guided design, prioritize constructive/interactive engagement in clinical contexts, incorporate validated objective assessments, and include longitudinal follow-up to evaluate nurses' EBP performance as well as organizational and patients' outcomes.