Evidence-based practice (EBP) is a core nursing competency. The American Nurses Association and Quality and Safety Education for Nurses Institute are 2 of many organizations that recognize the importance of using the best evidence to guide practice and decision making in nursing. Teaching nursing students or practicing nurses the steps of EBP is essential to ensure the integration of evidence into practice. Whether you are an educator in the academic or clinical practice setting, Teaching Evidence-Based Practice in Nursing1 is a book that you will want to read.
The second edition of the book, edited by Levin and Feldman, builds on content and evaluation in the first edition and emphasizes the importance of mentorship when establishing a culture of EBP. In part 1, contributors to the book define mentorship and offer strategies for role development of EBP clinical champions, faculty, and preceptors. The editors surmise that mentorship is essential to develop EBP champions, achieve desired teaching outcomes, and ultimately improve patient care.
Part 2 provides a step-by-step guide on how to teach EBP. This section of the book is extremely helpful because, as the editors point out, EBP-related concepts are often challenging to teach and put into practice. The chapters address common steps of EBP, with helpful additions such as stakeholder analysis, teaching EBP statistics and treatment effectiveness formulas, and determining sensitivity and specificity of assessment tools. Chapter 16 presents the necessary information for the reader to construct and interpret flowcharts when conducting a gap analysis. The conceptual model for evaluation of EBP, found in chapter 17, emphasizes the importance of learner, educator, and program evaluation when assessing the impact of teaching EBP.
The academic setting is the focus of part 3, with contributors offering tactics for teaching EBP from undergraduate to doctoral-level education. The book addresses traditional and second career entry into practice students and provides strategies for educators to weave EBP concepts throughout course content and clinical practice. The book provides 2 examples of EBP coursework for doctoral-level programs.
Part 4 of the book focuses on the practice setting and provides approaches for developing a culture of EBP. Chapter 23 describes the implementation of an EBP council within a shared governance framework. The following chapter is situated in a community setting and offers a course design document that is useful for teaching EBP and course design in general. The chapter on implementing an EBP improvement program includes examples of an audit tool, a tracking tool for small test change, and an SBAR (situation, background, assessment, recommendation) communication tool.
The final section presents 2 examples of creative alliances to support EBP. The creation of EBP alliances brings together interested parties to promote the use of the best evidence. A quotation by Henry Ford at the beginning of chapter 27, "Coming together is a beginning, keeping together is progress, working together is success," essentially outlines the steps of forming, evaluating, disseminating, and sustaining an alliance. The chapter is particularly meaningful, as I am involved in a community Evidence-Based Practice Institute and the steps provide validation of the vision and actions of the consortium. The final chapter describes a global partnership between a university located in the United States and The Joanna Briggs Institute, located in Adelaide, Australia, that exists to promote and support EBP globally.
This is a comprehensive and relevant book that addresses all aspects of teaching EBP in a variety of settings and across developmental levels, from entry into practice to doctoral students and new and experienced nurses. The addition of up-to-date structures and processes such as mentorship roles, doctor of nursing practice curricula, shared governance models, change theory, SBAR communication tools and learner, educator, and program evaluation enhance the usefulness of the book to academic and clinical settings. An additional strength of the book is the expertise of the contributors, many whom have published on the topic of EBP and have experience teaching in academic or practice settings.
A drawback to multiple contributors is variation in the material presented. Levels of evidence hierarchies are important structures that assist students of EBP in determining the strength of the research. Two different evidence hierarchies are presented in the book, 1 with 7 levels and a second hierarchy with 6 levels. Although the hierarchies are very similar, students and practicing nurses would benefit from being taught a consistent leveling system to avoid relearning new levels and descriptors upon transition to a new setting. The book editors may wish to address the variation in evidence hierarchies in future editions. In addition, I used a table found in the first edition that addressed EBP performance criteria for nursing roles: staff nurse, advanced practice nurse, nurse manager, director, and chief nursing officer. The criteria assisted in establishing role expectations when implementing EBP in the clinical setting.
The drawbacks are minimal and the book is an excellent resource for educators in any setting. The editors have significantly enhanced the book with the addition of contextually current information and strategies for teaching and evaluating the impact of EBP.
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