Integrating evidence-based practice into healthcare education has been a recommendation for the past 16 years. Despite this, barriers still exist with the utilization of evidence-based practice. The purpose of this study was to describe the current state of EBP scholarship in the curriculum of baccalaureate pre-licensure nursing programs. Essential Competencies for Evidence-Based Practice in Nursing (Stevens, 2009) was utilized to measure the state of EBP scholarship. The research question stated: how is evidence-based practice scholarship addressed within baccalaureate pre-licensure nursing programs? The research design was guided by Rogers’ diffusion of innovations theoretical framework and the star model of knowledge transformation ©. The study was a non-experimental descriptive design, and a convenience sample of n=96 surveys from program leaders was evaluated. The findings from this study fill an identified gap in nursing literature and show that EBP is addressed within baccalaureate pre-licensure nursing programs, described by the leaders in the programs. Keywords: evidence-based practice competencies, baccalaureate pre-licensure nursing programs

Background: Effective testing in pre-licensure nursing programs is a challenge in nursing education. Implementing evidence-based test development is essential to successful assessment of students’ competence and preparation for licensure. Purpose: Identifying the beliefs, attitudes and values of nursing faculty will contribute to the use of best practices in student assessments, ultimately contributing to increased retention of competent students and increasing the workforce within the healthcare industry. Theoretical Framework: This study is based on Rokeach’s theory of beliefs, attitudes and values. Methods: A quantitative descriptive research methodology was used in this study using survey data collection. A purposive, non-probability, convenience sample was the sampling strategy. The instrument utilized was developed and validated in a previous study and additional researcher-developed items were added. These additional items were field tested for readability and structure by current nursing educators. Results: The results revealed that nursing faculty are not consistent with utilizing evidence-based test development practices within their nursing programs. The beliefs and attitudes identified from the data indicate a concern with the understanding and confidence towards evidence-based practices. Several challenges were identified in implementing test development practices such as addressing linguistic and cultural biases, faculty time constraints, and utilization of test banks. Conclusions: Identifying faculty beliefs, attitudes, and values of evidence-based test development practices offers insight into the challenges facing nursing faculty, nursing programs and nursing students. These challenges affect and influence the retention and persistence of nursing students in prelicensure programs which ultimately affects diversity in the nursing workforce.

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Background: Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The World Health Organization’s (WHO) Global Tuberculosis (GTB) Programme issues evidence-informed guidelines with recommendations on TB. In an effort to improve the accessibility and use of these guidelines, we developed a new digitized WHO eTB catalogue of recommendations. Objective: The objective of this thesis was to explore stakeholder engagement with WHO TB recommendations. We sought to compare the accessibility of the WHO eTB catalogue to the conventional method of accessing WHO TB recommendations, and to explore the ways in which stakeholder feedback could be incorporated into quality improvement frameworks. Methods: We conducted a two-arm superiority randomized controlled trial through a survey among stakeholders who were past or planned future users of TB guidelines, recommendations, or policy advice. Using a 1:1 ratio, we randomly assigned participants to complete an activity using WHO eTB or the conventional website. We compared outcomes of accessibility, understanding, satisfaction and preference between groups. We incorporated qualitative feedback from free-text boxes into a quality improvement framework. Results: From February 26 to March 24 , 2021, we received 188 survey responses, 110 participants were randomized, and 102 were included in the interim analysis. On average, participants rated the WHO eTB catalogue as more accessible across four domains when compared to the WHO TB website. There was no difference in participant understanding of recommendation strength and certainty, but the ability to locate evidence to decision tables favored WHO eTB. We also received 75 qualitative responses, 47 of which yielded five themes: purpose, navigation, presentation, organization, and outreach. Conclusions: The WHO eTB catalogue of recommendations improved the accessibility of WHO TB recommendations and supporting evidence for stakeholders of interest. Our findings support the continued use, promotion, and quality improvement of the WHO eTB catalogue in the future. / Thesis / Master of Public Health (MPH) / Tuberculosis (TB) is a leading cause of death worldwide. The World Health Organization’s (WHO) Global TB (GTB) Programme offers guidelines with recommendations to help decision-makers use evidence on TB prevention, diagnosis, treatment, and care. With the goals of improving the accessibility and use of these recommendations, the WHO and McMaster University have worked together to develop the WHO eTB catalogue of recommendations. This catalogue allows decision-makers to search, filter, and view WHO TB recommendations. This thesis contributed to this work by exploring feedback from decision-makers to identify whether the goals of the WHO eTB catalogue were achieved. The work included creating and leading a randomized controlled trial that compared the WHO eTB catalogue to the earlier way of accessing these recommendations using the WHO publications website. This thesis also explored ways that this feedback could be used to improve the WHO eTB catalogue in the future.

In this View From the Field column from the implementation science series, highlighting how the field enhances the implementation and scale-up of EBPs in schools and districts (Kittelman et al., 2020), we discuss the importance of implementation teams and their roles in directing support for students and supporting educators to implement EBPs. We focus largely on the work from researchers and technical assistance providers from the National Technical Assistance Center on the State Implementation and Scale-Up of Evidence-Based Practices (https://sisep.fpg.unc.edu) and the National Center on Intensive Intervention (https://intensiveintervention.org).

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Purpose: Healthcare organizations are mandated to improve quality and safety for patients while stressed with shorter lengths of stay, communication lapses between disciplines, and patient throughput issues that impede timely delivery of patient care. Nurses play a prominent role in the safe transition of patients from admission to discharge. Although nurses participate in discharge planning, limited research has addressed the role and outcomes of the registered nurse as a leader in the process. The aim of this study was determine if implementation of a nurse-driven discharge planning protocol for patients undergoing cardiac implant would result in improved organizational efficiencies, higher medication reconciliation rates, and higher patient satisfaction scores. Methods: A two-group posttest experimental design was used to conduct the study. Informed consent was obtained from 53 individuals scheduled for a cardiac implant procedure. Subjects were randomly assigned to either a nurse-driven discharge planning intervention group or a control group. Post procedure, 46 subjects met inclusion criteria with half (n=23) assigned to each group. All subjects received traditional discharge planning services. The morning after the cardiac implant procedure, a specially trained registered nurse assessed subjects in the intervention for discharge readiness. Subjects in the intervention groups were then discharged under protocol orders by the intervention nurse after targeted physical assessment, review of the post procedure chest radiograph, and examination of the cardiac implant device function. The intervention nurse also provided patient education, discharge instructions, and conducted medication reconciliation. The day after discharge the principal investigator conducted a scripted follow-up phone call to answer questions and monitor for post procedure complications. A Hospital Discharge Survey was administered during the subject's follow-up appointment. Results: The majority of subjects were men, Caucasian, insured, and educated at the high school level or higher. Their average age was 73.5+ 9.8 years. No significant differences between groups were noted for gender, type of insurance, education, or type of cardiac implant (chi-square); or age (t-test). A Mann-Whitney U test (one-tailed) found no significant difference in variable cost per case (p=.437) and actual charges (p=.403) between the intervention and control groups. Significant differences were found between groups for discharge satisfaction (p=.05) and the discharge perception of overall health (p=.02), with those in the intervention group reporting higher scores. Chi square analysis found no significant difference in 30-day readmission rates (p=.520). Using an independent samples t-test, those in the intervention group were discharged earlier (p=.000), had a lower length of stay (p=.005), and had higher rates of reconciled medications (p=.000). The odds of having all medications reconciled were significantly higher in the intervention group (odds ratio, 50.27; 95% CI, 5.62-450.2; p=.000). Discussion/Implications: This is the first study to evaluate the role of the nurse as a clinical leader in patient throughput, discharge planning, and patient safety initiatives. A nurse driven discharge planning protocol resulted in earlier discharge times which can have a dramatic impact on patient throughput. The nurse driven protocol significantly reduced the likelihood of unreconciled medications at discharge and significantly increased patient satisfaction. Follow-up research is needed to determine if a registered nurse can impact organizational efficiency and discharge safety in other patient populations.

Motivational Interviewing (MI) is an evidence-based practice that focuses on working through client ambivalence and increasing clients' motivation to change. The purposes of this study were to investigate the effect that a unique student-based training in MI had on counselor trainees' ability to perform MI, and on client outcomes. This training program consisted of one initial four-hour training session, two hours of follow-up supervision, and formal feedback via MITI 3.0 scores. Counselor-trainee skill was assessed via the MI Knowledge Questionnaire, the Helping Responses questionnaire, and the Motivational Interviewing Treatment Integrity code 3.0. In addition, the following instruments were used to assess client outcomes ; attendance via observation assessments, the Session Summary, the Outcome Questionnaire-45.2, and the Client Satisfaction Questionnaire. The sample consisted of 43 graduate-level counselor trainees in their first or second semesters of practicum and 81 adult clients being seen in a university-based graduate student-training counseling clinic. Participants were purposefully assigned to either a treatment or control group. The counselor trainees in the treatment group received the unique training program, follow-up supervision, and feedback whereas the participants in the control group received a four-hour orientation to the student-training counseling clinic. There were four primary hypotheses proposed for analysis within this study (a) How does a brief training in Motivational Interviewing given to counselor trainees affect their ability to accurately perform MI?, (b) How does a brief training in Motivational Interviewing given to counselor trainees affect client functioning?, (c) How does a brief training in Motivational Interviewing given to counselor trainees affect client adherence?, and (d) How does a brief training in Motivational Interviewing given to counselor trainees affect client satisfaction with treatment? The statistical analysis of these variables yielded significant findings. Specifically, counselor-trainee skill in MI significantly improved in the treatment group as compared to the control group as assessed by the MITI with regard to the following variables: evocation, collaboration, autonomy/support, empathy, direction, MI non-adherent giving information, closed questions, simple reflections, complex reflections, total reflections, global scores, ratio of open questions, ratio of reflections, and ratio of MI adherent behavior. In addition, analysis revealed significant between group differences with client attendance. Specifically, between group-differences suggested that clients in the MI treatment group attended more sessions, missed fewer sessions, and completed therapy more frequently than clients in the control group. Detailed procedures and results as well as implications for the counseling profession and future research are explored within this study.

As Cook and Cook (2012) point out, evidence-based practices “represent practices that meet a high bar of empirical validation, but they do not trump practical wisdom and common sense when making instructional decisions” (p. 78). As educators, we are tasked with making decisions based on a body of evidence and a sound data-based decision-making process (Rowe, 2020). Teachers analyze assessment data across students to determine common themes that can be addressed using classwide versus individualized instruction. Teachers examine data from assessments (e.g., curriculum-based measures, formal assessments, informal interviews with students’ general education teachers, writing samples, and other assessment data) and find many students struggle with essential skills not addressed in the general curriculum. In the absence of published curricula to teach specific skills, teachers are left to construct their own lesson plans. Oftentimes, teachers pull from multiple sources (e.g., worksheets, teacher-made materials, materials found on the Internet). A source teachers might not often consider is the research literature itself. A single research article can be the source of one lesson or multiple lessons. A well-written research article provides all the information needed to develop core components of a lesson plan (i.e., lesson objective, setting and materials, content taught, teaching procedures, evaluation) [...]