Developing and evaluating an evidence-based practice research competency enhancement program for clinical nurses in Korea: a pilot study

The RCEP, designed for clinical nurses and based on the ARCC model, positioned the EBP mentor as central and included eight sessions. A preliminary educational needs survey revealed that the most cited reason for delayed thesis writing among participants was “difficulty selecting a research topic” (63.6%), with “difficulty reviewing the literature” (18.2%) as the second most common. To address these issues, the program offered content aimed at assisting participants in identifying research topics via literature reviews. The program consisted of hourlong sessions focusing on the following topics: session 1, clinical nursing research trends: overview of current and emerging trends; session 2, systematic literature reviews of domestic journals: techniques and strategies for effective review; session 3, systematic literature reviews of international journals: expanding search and analysis globally; session 4, EndNote 20: training on utilizing this reference management software; session 5, G*Power analysis: guidance on using this tool to determine sample sizes; session 6, the identification of nursing research topics in the clinical field: strategies to pinpoint relevant and impactful research areas; session 7, research design and statistical methods: overview of various research designs and statistical methods pertinent to nursing research; and session 8, research ethics and Institutional Review Board application methods: critical legal and ethical considerations and procedural guidance for applications. The sessions’ format varied, accommodating different learning styles: session 1 was a lecture, sessions 2 through 5 included a mix of lectures and practical exercises, session 6 involved a discussion, and sessions 7 and 8 were lecture-based. The program’s structure was validated for content by a nursing professor, a nursing education team leader with a master’s degree in nursing, and three clinical nurse educators holding master’s degrees. The content validity index (CVI) achieved was 0.99.

This study was conducted over eight sessions at biweekly intervals from September 2021 to January 2022. The implementation consisted of interactive, practical sessions conducted in the education room of the research hospital. Participants, who were nurses, were asked to bring their personal laptops to support hands-on learning. Each session was followed by a two-week period dedicated to self-study and review. This interval allowed participants to integrate their new knowledge and apply their skills in practical settings. Throughout this period, participants were encouraged to engage in ongoing communication with the EBP mentor for guidance and clarification. This mentorship was conducted via an online platform, where participants could post queries or reflections as research notes after each session. These notes had a twofold purpose: they reinforced learning and provided data for the evaluation and enhancement of the program.

The Korean version of the Evidence-Based Practice Beliefs Scale (EBPB), developed by Melnyk et al. [15], was employed to assess EBP beliefs in our study. This 16-question instrument evaluated support for EBP value and confidence in implementing evidence-based practice, using a 5-point Likert scale that ranged from 1 (very negative) to 5 (very positive). A higher score indicated a stronger belief in EBP. Regarding the tool’s reliability, Cronbach’s α was reported as 0.85 in Melnyk et al.’s study [15] and 0.84 in the current study.

The Korean version of the Evidence-Based Practice Attitude Scale (EBPA), developed by Aarons [16], was utilized to assess attitudes towards EBP. This instrument consists of 15 items across four subareas: requirement, openness, appeal, and divergence, with three questions in requirement and four in each of the latter three areas. Responses were measured on a 5-point Likert scale, ranging from 0 (not at all) to 4 (very much). Higher scores indicated more positive attitudes towards EBP. Cronbach’s α was reported as 0.96 in Aarons' study [16] and 0.81 in the current study.

Research practice ability (RPA) was evaluated by adapting and augmenting the 12 domains of the Program Outcome Self-Assessment Tool in Korean Nursing Baccalaureate Education, as developed by Kim [17]. This tool encompasses seven items, each rated on a 4-point Likert scale from 1 (very difficult) to 4 (very easy). Higher scores signified greater research competency. In Kim’s study [17], the tool’s Cronbach’s α was 0.86, compared to 0.92 in this study.

The study involved clinical nurses who had completed a master’s degree program without a thesis over two weeks in August 2021. Participants expressed their willingness to participate and provided informed consent. Data collection spanned from September 2021 to January 2022. For quantitative data, a pre-survey was administered to the intervention group just before the program started, and a post-survey was conducted immediately after its conclusion. A research assistant collected the completed surveys.

In January 2022, qualitative data were collected using in-depth, unstructured interviews, following the conclusion of the program. Participants were given the freedom to choose the time and location for their interviews. The interviews were conducted by a researcher, who is also a professor of nursing and an expert in qualitative research methods, on a voluntary basis. All participants elected to conduct their interviews via non-face-to-face means, utilizing Zoom (Zoom Video Communications Inc., San Jose, CA, USA). With prior consent, these interviews were recorded and transcribed by the researcher within a 24-h period. The primary question posed during these interviews was: “What was your experience participating in the RCEP?” This was supplemented by additional inquiries such as, “What helped you to participate in the RCEP,” “What were the barriers to your participation in the RCEP,” and “What are your overall evaluations and suggestions for RCEP?” Each interview session lasted between 60 to 80 min (Supplement).

This category comprised subcategories like “lighthouse of my heart,” “inner stimulant,” and “power to challenge again.” Many participants had not completed their master’s degree courses for a considerable period, turning research into a daunting task. RCEP instructed participants in specific methods for initiating research in the clinical field. Mentors played a crucial role in building confidence, acting as a catalyst for participants to commence their research projects. RCEP underscored the program’s transformative and motivational aspects, highlighting the participants’ renewed confidence and direction in conducting clinical research.

This category included four subcategories: “full support and encouragement of mentors,” “interest from colleagues,” “use of new learning tools,” and “clinical nurse educators as assistants.” Even after the commencement of RCEP, participants expressed concerns about their ability to continue due to work commitments. Mentors consistently communicated RCEP schedules and progress via text messages and social network services. Engaging in discussions about shared interests and progress with other RCEP participants played a significant role in maintaining their engagement throughout the program. Initially, the “Padlet” program, introduced by an RCEP mentor for individual research topic consultations, appeared challenging, but its real-time feedback feature through comments proved beneficial. Besides mentors, the clinical nurse educators who supported the participants’ learning were instrumental in ensuring smooth progress and active participation. The combination of mentor support, peer interaction, innovative learning tools, and assistance from clinical nurse educators created a conducive and stimulating learning environment.

This category included four subcategories: “unstable internet connections at workplaces,” “limited literature search databases,” “problems with individual laptop specifications,” and “education schedules overlapping with hospital events or external schedules.” Unstable internet connections were prevalent when multiple users occupied a single space, as experienced in the RCEP. Moreover, participants were unable to utilize the hospital’s subscription for a specialized literature search database. Consequently, they relied on sharing the mentor’s university subscription service credentials. The absence of a designated area in the hospital for conducting literature searches using PCs further complicated the situation. Participants often used their personal laptops, leading to compatibility issues during the RCEP sessions. Additionally, scheduling conflicts arose as the RCEP coincided with hospital events or nursing department management meetings, preventing some participants from attending. These barriers highlight the significant logistical and resource-related challenges faced during the program.

This category included the subcategories of “appropriate sessions and times,” “impressive new research methods,” “preference for face-to-face lectures,” “preference for small teams,” and “request for collaborative research opportunities with professors at nursing colleges and hospitals.” Participants expressed high satisfaction with the current eight-day lecture schedule, which spanned approximately one hour per session. They particularly appreciated the program’s ability to facilitate efficient use of their post-work hours without inducing boredom. A notable interest was observed in the network analysis research method, introduced for the first time in the RCEP. Regarding the format, participants showed a clear preference for in-person lectures, which allowed direct support from clinical nurse educators, over online lectures known for their repetitive nature. Additionally, the nurses reported high satisfaction with the small-group learning approach adopted by the intervention. Their engagement in the RCEP highlighted the variety of research topics relevant to their clinical environments and sparked an interest in pursuing collaborative research with hospitals and nursing college professors. Improvement suggestions varied, encompassing logistical adjustments, format preferences, and collaborative opportunities, all indicating a collective aspiration for more efficient, engaging, and contextually relevant learning experiences.