Patterns of change in evidence-based practice competence following a team-based learning intervention: a...

Strengthening evidence-based practice (EBP) competence is essential for safe and high-quality nursing care. Team-based learning (TBL) is increasingly adopted in nursing education, yet evidence clarifying how and for whom it supports meaningful learning remains limited. Grounded in social cognitive theory, this study examined patterns of change in EBP competence following a TBL-based module, with specific attention to baseline-dependent learning gains. A quasi-experimental pre-post design was conducted with second-year nursing students (n = 119). EBP competence (encompassing knowledge, skills, and attitudes) was assessed using a validated multidimensional instrument (the Evidence-Based Practice Competence Questionnaire EBP-COQ). Beyond group-level analyses, Reliable Change Index (RCI) methods were applied to identify changes exceeding measurement error and to characterise individual learning trajectories. Associations between baseline preparation and subsequent gains were explored to examine equity-related effects. Substantial improvements were observed in the total EBP-COQ score (mean increase: 16.06; p < 0.001; d = 1.17) and all subdomains, with the largest effect in Knowledge (d = 1.43), followed by Skills (d = 0.85) and Attitude (d = 0.59). RCI analyses indicated that 58.8% of participants achieved meaningful improvement in overall EBP competence. Baseline competence explained only a small proportion of post-intervention variance (R²: 1.3-9.4%), suggesting a compensatory effect where lower-performing students demonstrated the greatest reliable improvement. When accounting for ceiling effects, the proportion of students demonstrating reliable improvement increased further, reaching 38.0% in Attitude among those with measurable room for change. These findings clarify mechanisms through which structured collaborative learning may redistribute learning gains within heterogeneous cohorts. By integrating individual-level change metrics with a theoretically informed interpretation, this study contributes evidence on how structured collaborative learning may support equitable EBP competence development in undergraduate nursing education.