RESEARCH ARTICLE Open Access

Methods for teaching evidence-basedpractice: a scoping reviewCamilla Marie Larsen1,2,4* , Anne Seneca Terkelsen1, Anne-Marie Fiala Carlsen3 and Hanne Kaae Kristensen1,5

Abstract

Background: This scoping review aims to gather and map inspiration, ideas and recommendations for teachingevidence-based practice across Professional Bachelor Degree healthcare programmes by mapping literature describingevidence-based practice teaching methods for undergraduate healthcare students including the steps suggested by theSicily Statement.

Methods: A computer-assisted literature search using PubMed, Cinahl, PsycINFO, and OpenGrey covering health,education and grey literature was performed. Literature published before 2010 was excluded. Students should beattending either a Professional Bachelor’s degree or a Bachelor’s degree programme. Full-text articles were screened bypairs of reviewers and data extracted regarding: study characteristics and key methods of teaching evidence-basedpractice. Study characteristics were described narratively. Thematic analysis identified key methods for teaching evidence-based practice, while full-text revisions identified the use of the Sicily Statement’s five steps and context.

Results: The database search identified 2220 records. One hundred ninety-two records were eligible for full-textassessment and 81 studies were included. Studies were conducted from 2010 to 2018. Approximately half of the studieswere undertaken in the USA. Study designs were primarily qualitative and participants mainly nursing students. Seven keymethods for teaching evidence-based practice were identified. Research courses and workshops, Collaboration withclinical practice and IT technology were the key methods most frequently identified. Journal clubs and Embeddedlibrarians were referred to the least. The majority of the methods included 2–4 of the Sicily Statement’s five steps, whilefew methods referred to all five steps.

Conclusions: This scoping review has provided an extensive overview of literature describing methods for teaching EBPregarding undergraduate healthcare students. The two key methods Research courses and workshops and Collaborationwith clinical practice are advantageous methods for teaching undergraduate healthcare students evidence-basedpractice; incorporating many of the Sicily Statement’s five steps. Unlike the Research courses and workshop methods, thelast step of evaluation is carried out partly or entirely in a clinical context. Journal clubs and Embedded librarians shouldbe further investigated as methods to reinforce existing methods of teaching. Future research should focus on methodsfor teaching EBP that incorporate as many of the five steps of teaching and conducting EBP as possible.

Keywords: Teaching methods, Undergraduate healthcare students, Evidence-based practice, The Sicily statement

BackgroundDizon et al. state that healthcare can be inefficient, inef-fective and/or dangerous when it is not based on currentbest evidence [1, 2]. Therefore, to ensure the quality ofhealthcare, it is important to implement evidence-based

practice (EBP) in all health professional curricula, so thatfuture health professionals learn the fundamentals of re-search and the application of evidence in practice [2].Several definitions of EBP have been suggested in recent

years. The scientific evidence was initially developedwithin medicine, but as many health professionals haveembraced an evidence-based way of practice the SicilyStatement [3] suggested that the original term “evidence-based medicine” should be expanded to “evidence-based

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

* Correspondence: cmla2@ucl.dk; cmla@ucl.dk1Health Sciences Research Centre, UCL University College, Niels Bohrs Allé 1,5230 Odense M, Denmark2Department of Physiotherapy, UCL University College, Niels Bohrs Allé 1,5230 Odense M, DenmarkFull list of author information is available at the end of the article

Larsen et al. BMC Medical Education (2019) 19:259 https://doi.org/10.1186/s12909-019-1681-0

practice” in order to reflect a common approach to EBPacross all health professions.The Sicily Statement gives a clear definition of EBP to-

gether with a description of the minimum level of edu-cational requirements and skills required to practice inan evidence-based manner. This makes the underlyingprocesses of EBP more transparent and distinguishes be-tween the process and outcome of EBP [3].In order to fulfil the minimum requirements of

teaching and conducting EBP, the Sicily Statementputs forward a five-step model: (I) asking a clinicalquestion; (II) collecting the most relevant evidence;(III) critically appraising the evidence; (IV) integrat-ing the evidence with one’s clinical expertise, patientpreferences and values to make a practice decision;and (V) evaluating the change or outcome [4].Internationally, EBP skills are essential requirements in

clinical practice among both medical doctors as well asamong other health professionals. Healthcare studentsare mainly taught the first three steps of the Sicily State-ment’s five-step model. The last two steps are rarelytaught, and students and graduates thus lack competen-cies in applying their knowledge in the clinical settingduring or after graduation [5, 6].In terms of healthcare policy and ambitions in Denmark,

it was decided in 2015 that Professional Bachelor Degreehealthcare students were to contribute to the developmentof an evidence-based way of working, a faster implementa-tion of new knowledge in practice, and to the developmentof greater patient involvement and patient safety in the Da-nish healthcare system [7]. The Professional Bachelor’s de-gree is awarded after 180–270 ECTS and includes a periodof work placement of at least 30 ECTS. The programmesare applied programmes. They are development-based andcombine theoretical studies with a practical approach. Ex-amples of professional bachelor degree holders are nurses.The Danish title is Professionsbachelor and the English titleis Bachelor [8]. In Denmark the University College institu-tions solely provide professional bachelor degree educa-tions. Master degrees are awarded at the Universities.Based on the Sicily Statement students should be able to

reflect, ask questions, gather knowledge, critically ap-praise, apply and evaluate various kinds of knowledge atthe end of their course. The aim is that all ProfessionalBachelor Degree healthcare students across disciplines ofnursing, physiotherapy, occupational therapy, radiography,and biomedical laboratory science develop common EBPqualifications in order to contribute towards the develop-ment of evidence-based healthcare [9]. In order to ensureshared prerequisites and mutual understanding of the EBPconcepts before entering theoretical or clinical inter-professional education, further knowledge about how toteach EBP across disciplines is required [9]. By teachingthe fundamental principles of EBP, students will develop

their EBP skills and ability to put them into practice intheir studies and as future graduates.Previously, some systematic reviews were conducted

summarising various educational interventions orstrategies for teaching EBP to undergraduate health-care students [2, 10–12].In a review from 2014, Young and colleagues stated

that multifaceted interventions integrated into clinicalpractice contributed to the greatest improvements inEBP knowledge, skills, and attitudes [2]. In line with this,Kyriakoulis et al. suggested that a combination of inter-ventions, such as lectures, tutorials, workshops, confer-ences, journal clubs, and online sessions was best suitedfor teaching EBP to undergraduate healthcare students[10]. However, the majority of the articles in both re-views synthesized information from interventions orstrategies aimed at medical students at various educa-tional levels. Only a few articles elicited informationabout educational interventions and strategies aimed atundergraduate healthcare students in the disciplines ofnursing, physiotherapy, occupational therapy, radiog-raphy, and/or biomedical laboratory science. However,two recent reviews have specifically addressed EBPteaching for undergraduate nursing students [11, 12]. Asystematic review investigated the effectiveness of spe-cific educational methods and found an effect on studentknowledge, attitudes, and skills but could not draw aconclusion as to the advisability of one of the methods[11]. A literature review sought to identify knowledgeexperiences on teaching strategies from qualitative stud-ies in nursing EBP education to enhance knowledge andskills and points to a limited focus on the use of EBPteaching strategies. Additionally, the study points to theneed for more qualitative research investigating inter-active and clinically integrated teaching strategies. Des-pite both reviews being well-informing, a broad scopewhen mapping updated EBP teaching methods and strat-egies across healthcare bachelor educations will furtherqualify future interdisciplinary practices [11, 12].In order to implement the most effective ways of

teaching EBP across healthcare undergraduate students,an investigation of existing literature on the subjectneeds to be undertaken. For identifying, mapping anddiscussing key characteristics in the literature a scopingreview is the better choice [13].

Aim, objectives and review questionThe aim of this scoping review is to gather and map in-spiration, ideas, and recommendations for teachersimplementing EBP across Professional Bachelor Degreehealthcare programmes by mapping existing literaturedescribing EBP teaching methods, including the fivesteps of EBP suggested by the Sicily Statement, [3] re-garding undergraduate healthcare students.

Larsen et al. BMC Medical Education (2019) 19:259 Page 2 of 33

The primary question of the scoping review is: “WhichEBP teaching methods, including The Sicily Statement’ssteps of teaching and conducting EBP, have been re-ported in the literature with respect to undergraduatehealthcare students in classrooms and clinical practice?”

DefinitionsClassroom is defined as a room where classes are taughtin a school, college or university [14].Clinical practice refers to the agreed-upon and cus-

tomary means of delivering healthcare by doctors, nursesand other health professionals [15].

MethodsTo ensure a systematic methodology, The Joanna BriggsInstitute Reviewers’ Manual - Methodology for JBI Scop-ing Reviews has been used throughout the scoping re-view process [16, 17].

Inclusion criteriaParticipantsLiterature which included undergraduate healthcare stu-dents in the disciplines of nursing, physiotherapy, occu-pational therapy, radiography, and biomedical laboratoryscience was selected to ensure applicability and rele-vance to similar scientific disciplines at other institutionsof higher education. The undergraduate students shouldbe attending either a Professional Bachelor’s degree or aBachelor’s degree programme.

ConceptMethods for teaching EBP including The Sicily State-ment’s steps of teaching and conducting EBP was themain concept to be investigated in the review. That is;literature describing either recommendations of EBPteaching methods, evaluations of EBP teaching methods,teacher and/or student perceptions of EBP teaching andlearning methods, or qualifications obtained when learn-ing the principles of EBP.

ContextLiterature describing methods for teaching EBP con-ducted in a classroom setting, in clinical practice as partof the education, or in a combination of classroom andclinical practice was included in the review.

Exclusion criteriaIn the period up to 2010, the Bachelor Degree healthcare ed-ucations began to conform to European requirements regard-ing evidence-informed and evidence-based education [18].A maximum time frame (2010–2018) was applied, deter-

mined by the amount of available literature/research studiesand requirements of updated teaching strategies [19, 20].Therefore, literature published before 2010 was excluded.

Literature including undergraduate students in otherhealth disciplines such as medicine or dentistry was notreviewed as the structure of their education is based onanother paradigm. Nor was literature including partici-pants such as graduates, RN-to-BSN students, andtrained health personnel accepted for inclusion as theywere considered as postgraduates, not comparable toundergraduate students. With the primary aim of gather-ing ideas and inspiration for teaching EBP, literature thatfocused on issues other than methods for teaching EBPwas excluded, as well as literature in languages otherthan English, Danish, Norwegian, or Swedish.

Search strategyTo identify literature relevant to our research question,the databases MEDLINE via PubMed, CINAHL Complete,and PsycINFO (both via EBSCO) were systematicallysearched. These databases cover both health and educa-tion and are available to the primary local target audienceof this scoping review. Because of time limitations onlythe multidisciplinary European database, OpenGrey, wassearched in the attempt to find unpublished literature.The searches were conducted May 9th, 2018.As recommended in The Joanna Briggs Institute Re-

viewers’ Manual [16, 17], the search was conducted inthree steps in collaboration with a research librarian.

Step 1: The databases PubMed, covering the field ofbiomedicine and CINAHL, covering nursing and alliedhealth literature were searched using the keywords:‘teaching methods’, ‘teaching’, ‘learning methods’, ‘learning’,‘teaching strategies’, ‘learning strategies’, ‘undergraduate’,‘undergraduate education’, ‘student’, ‘biomedical laboratoryscientist’, ‘medical laboratory scientist’, ‘medical laboratorytechnologist’, ‘medical laboratory technologists’,‘radiographer’, ‘occupational therapist’, ‘physiotherapist’,‘nurse’, and ‘evidence-based practice’.Step 2: Through an analysis of text words in titles andabstracts of the studies found in PubMed and Cinahl,new keywords, which would improve the search, wereidentified. These were ‘allied health’, health students’,and ‘nursing’. All identified keywords were thenincluded in the search as a systematic block search inPubMed, Cinahl, and PsycINFO, covering literature inthe behavioural and social sciences, and OpenGrey,covering grey literature in Europe. Table 1 provides alist of the specific search queries used in all databases.Step 3: The reference lists of identified studies weresearched for additional studies.

Study selectionAll search results from the databases were imported to theweb-based bibliographic management software, RefWorks2017 by ProQuest. After exclusion of duplicates and

Larsen et al. BMC Medical Education (2019) 19:259 Page 3 of 33

records before 01.01.2010, two reviewers independentlyscreened titles and abstracts of the remaining articles forrelevance in relation to the research question and the in-clusion and exclusion criteria. Afterwards, all full-text arti-cles were further checked for relevance by twoindependent reviewers. Any inconsistencies between thetwo reviewers regarding study selection for final inclusionwere resolved by discussion with a third reviewer.

Data collectionData from the included articles were extracted using twodata extraction tools as recommended in The JoannaBriggs Institute Reviewers’ Manual [16, 17]. The firstdata extraction tool comprised study characteristics,while the other data extraction tool comprised methodsfor teaching EBP.Prior to the process of extracting data from the in-

cluded articles, a pilot test using the data extractiontools was conducted by one reviewer assessing nine arti-cles. To ensure agreement between reviewers, a secondreviewer checked the same articles. Any disagreementsabout the content or use of the data extraction toolswere discussed and resolved.One reviewer then extracted relevant data from all in-

cluded articles to the data extraction tools. Two otherreviewers split the same articles among them and ex-tracted data using the same data extraction tools. As afinal step, the first reviewer went through all extracteddata from all of the included articles with each of theother reviewers to ensure comparability and complete-ness in the final data extraction tools.

Synthesis and analysis of resultsThe data extraction tools formed the basis of the finalpresentation of the results in two tables consisting of“Study characteristics” and “Key methods for teachingEBP, the Sicily Statement’s five steps of teaching andconducting EBP and context”. Study characteristics in-cluded author, year of publication, title, journal, countryof origin, study design, study participants, methods forteaching EBP, and main study findings. The key methods

for teaching EBP were identified through a thematic ana-lysis. All full text articles were read and every teachingmethod found was listed. Through a revision of allteaching methods listed, seven themes were found thatdescribed the most prominent teaching methods, whichwere named “Key methods for teaching EBP”. Allmethods were then divided into one of the key methodsfor teaching EBP. In some articles, more than one teach-ing method was described. In that case, the teachingmethod most frequently described was selected andcategorised under the relevant key method. Throughfull-text revision the Sicily Statement’s steps of teachingand conducting EBP and the context (classroom, clinicalpractice or a combination of both) in which the teachingtook place was found. To further clarify the content ofthe two tables all results listed were described narra-tively. All tabulated data, except for the key methods forteaching EBP identified in Table 3, have been cited dir-ectly from the articles.

ResultsLiterature searchThe database search returned 2220 records: PubMed(n = 1469), Cinahl (n = 527), PsycINFO (n = 173), andOpenGrey (n = 51) (Fig. 1). Records published before01.01.2010 and duplicates were removed, which left1280 records to be screened by title and abstract. Basedon relevance, 1088 records were excluded and 192 re-cords were found eligible for full-text assessment. In ac-cordance with the inclusion and exclusion criteria, 111articles were excluded. The excluded articles concernedstudy participants other than undergraduate healthcarestudents (graduates, RN-to-BSN students, trainedhealth personnel), study participants from other health-care disciplines (medicine, dentistry, midwifery), issuesother than methods for teaching EBP (simulation teach-ing, community health nursing, EBP beliefs, etc.), andfull-text articles not available in English, Danish, Nor-wegian, and Swedish (French, Chinese). In agreementwith the other reviewers, 81 studies were finally in-cluded in the scoping review.

Table 1 Specific search queries, all databases

Database Search queries

PubMed (((((teaching OR learning))) AND (undergraduate OR student OR allied health OR health students)) AND ((biomedical laboratoryscientist OR medical laboratory scientist OR medical laboratory technologist OR medical laboratory technologists OR radiographerOR occupational therapist OR physiotherapist OR nurse OR nursing))) AND evidence-based practice

Cinahl Complete (teaching OR learning) AND (undergraduate OR student OR allied health) AND (biomedical laboratory scientist OR medicallaboratory scientist OR medical laboratory technologist OR medical laboratory technologists OR radiographer OR occupationaltherapist OR physiotherapist OR nurse OR nursing) AND evidence-based practice

PsycInfo viaEBSCO

(teaching OR learning) AND (undergraduate OR student OR allied health) AND (biomedical laboratory scientist OR medicallaboratory scientist OR medical laboratory technologist OR medical laboratory technologists OR radiographer OR occupationaltherapist OR physiotherapist OR nurse OR nursing) AND evidence-based practice

Open Grey (“Evidence based practice” OR EBP OR Evidence-based practice OR Evidence based practice) AND (teaching OR education OR learn-ing) AND (undergraduate OR student OR students)

Larsen et al. BMC Medical Education (2019) 19:259 Page 4 of 33

Study characteristicsStudy characteristics are presented in Table 2. Allstudies were spread across the years 2010–2018. Al-most half of the studies (n = 40) were conducted inthe USA, followed by Canada (n = 8), Norway (n =7), Australia (n = 6), England (n = 6), Sweden (n =3), China (n = 2), Finland (n = 2), Spain (n = 2),Greece (n = 1), Iran (n = 1), Lebanon (n = 1),Scotland (n = 1), and Taiwan (n = 1). The study de-signs were primarily qualitative (n = 55), while 23 ofthe studies were quantitative, and three of the stud-ies used a mixed method. The majority of the partic-ipants were nursing students (n = 72), followed by acombination of nursing students and students fromother healthcare disciplines (n = 5), nursing andphysiotherapy students (n = 1), physiotherapy stu-dents and students from other healthcare disciplines(n = 1), occupational and physiotherapy students(n = 1), and physiotherapy students only (n = 1).

Key methods for teaching EBP, the Sicily Statement’s fivesteps of teaching and conducting EBP and contextTable 3 presents the key methods for teaching EBP, theSicily Statement’s five steps of teaching and conductingEBP, and the context. Seven key methods for teachingEBP were identified: Thirty-two studies described “Re-search courses and workshops”. “Collaboration withclinical practice” was identified 14 times followed by “ITtechnology” (n = 8), “Assignments” (n = 5), “Participationin research projects” (n = 5), “Journal clubs” (n = 2), and“Embedded librarians” (n = 2). In addition, 13 studies de-scribed various theories of teaching and learning. Theseare not elaborated on as the theme is not consideredwithin the objective of this scoping review.In Table 3 the vast majority of the studies (n = 69) re-

ferred to one or more of the Sicily Statement’s five stepsof teaching and conducting EBP. Eleven studies referredto all five steps. Thirty-one studies referred to three orfour steps, while 17 studies referred to two of the steps,

Fig. 1 Modified PRISMA flow diagram illustrating the scoping review selection process

Larsen et al. BMC Medical Education (2019) 19:259 Page 5 of 33

Table

2Stud

ycharacteristics(N

=81)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

Aglen

[21]

2016

Pedago

gicalstrateg

ies

toteachbachelor

stud

entsEBP:A

system

aticreview

Nurse

EducationToday

Norway

Qualitative

Nursing

stud

ents

Theo

riesof

discretio

n,know

ledg

etransfer

and

cogn

itive

maturity

developm

ent

Nursing

stud

entsstrugg

leto

seethe

relevanceof

eviden

cefornu

rsingpractice.

Before

beingintrod

uced

toinform

ation

literacyandresearch

topics,stude

ntsne

edinsigh

tinto

know

ledg

etransfer

andtheir

ownep

istemicassumptions.Kno

wledg

etransfer

relatedto

clinicalprob

lemsshou

ldbe

thelearning

situations

prioritised

whe

nteaching

EBPat

bachelor

level.

And

ré[22]

2016

Embe

ddingeviden

ce-

basedpracticeam

ong

nursingun

dergradu

ates:

Results

from

apilot

stud

y

Nurse

Educationin

Practice

Norway

Qualitative

Nursing

stud

ents

Inform

ationabou

tvoluntary

participationin

twodifferent

clinicalresearch

projects,

educationprog

ramme

relatedto

EBP,participation

inclinicalresearch

projects,

instructions

anded

ucationin

analysinganddiscussing

finding

s

Improvem

entin

skillsandknow

ledg

edu

ring

thestud

y.Stud

entsstated

that

EBPmight

have

aninfluen

ceon

increasing

thequ

ality

ofnu

rsingpractice.

Balakas[23]

2010

Teaching

research

and

eviden

ce-based

practice

usingaservicelearning

approach

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

Aresearch

course

from

atradition

alform

atto

oneof

eviden

ceappraisaland

synthe

sis,which

incorporated

servicelearning

andcollabo

rativelearning

Research

coursestaug

htfro

man

EBP

perspe

ctivecanprovidemotivationfor

stud

entsto

incorporateresearch

into

their

practice.

Berven

[24]

2010

Stud

entscollabo

rate

with

nurses

from

anu

rsingho

meto

getan

eviden

cebased

practice...Fourth

Europe

anNursing

Con

gress

Journalo

fClinicalNursing

Norway

Qualitative

Nursing

stud

ents

Group

sof

stud

ents

coop

erated

with

profession

alsat

Løvåsen

teaching

nursingho

mein

iden

tifying

clinicalissues

that

couldbe

feasibleto

investigateandde

velopup

todate,state-of-artgu

ide-

lines

inrelatio

nto

mod

elfor

EBP

Stud

entshave

develope

dan

unde

rstand

ing

that

theprocessof

EBPshou

ldbe

utilisedin

clinicalpractice.

Blazeck[25]

2011

BuildingEBPinto

the

foun

datio

nsof

practice

Nurse

Educator

USA

Qualitative

Nursing

stud

ents

Assignm

entinclud

ing

choo

sing

relevant

topicand

searchingrelevant

databases

Thedidacticinstructionof

theconcep

tsof

search

andtheterm

inolog

yof

search,

collabo

ratin

gwith

amed

icallibrarianin

the

teaching

andthede

sign

oftheassign

men

t,thegradingrubricforthestud

ents,and

the

quality

controlvisualcorrectiontool

forou

rmultip

leraters,has

ledto

success

Bloo

m[26]

2013

Levelling

EBPconten

tforun

dergradu

ate

nursingstud

ents

Journalo

fprofessional

nursing

USA

Qualitative

Nursing

stud

ents

3un

dergradu

ateresearch

coursesde

sign

edto

prep

are

thegraduate

toiden

tify,

locate,readandcritically

appraise

eviden

ceat

the

individu

alstud

y,system

atic

review

,and

clinicalpractice

Thefoun

datio

nachieved

bybaccalaureate

graduatesstandthem

ingo

odsteadas

they

pursue

theirclinicalandacadem

iccareers.

Larsen et al. BMC Medical Education (2019) 19:259 Page 6 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

guidelinelevels

Boyd

[27]

2015

Using

Deb

ates

toTeach

EBPin

LargeOnline

Cou

rses

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

Interactivede

batesto

teach

EBPskillsin

anon

line

graduate

course

Stud

entsremainhigh

lyen

gage

dwhile

practicingcriticalthinking,

team

work,

leadership,d

eleg

ation,commun

icationskills,

andpe

erevaluatio

nthroug

hparticipationin

aseriesof

faculty-facilitated

onlinede

bates.

Brow

n[28]

2015

TheiPad:tablet

techno

logy

tosupp

ort

nursingandmidwifery

stud

entlearning

:an

evaluatio

nin

practice

Com

puters,Informatics,

Nursing

USA

Quantitative

Nursing

stud

ents

Use

ofiPads

iPadsrepo

rted

lyim

proved

stud

entefficiency

andtim

emanagem

ent,whileim

proving

theirability

toprovidepatient

education.

Stud

entswho

used

iPadsforthepu

rposeof

form

ativeself-assessmen

tappreciatedthe

immed

iate

feed

back

andop

portun

ityto

de-

velopclinicalskills.

Cable-

Williams

[29]

2014

Aned

ucational

inno

vatio

nto

foster

eviden

ce-in

form

edpractice

Journalo

fNursing

education

andPractice

Canada

Qualitative

Nursing

stud

ents

Threadingtheconcep

tof

eviden

ce-in

form

edpractice

andrelevant

bestpractice

guidelines

throug

htheo

rycoursesinclud

ingtheiruseas

expe

cted

elem

entsin

clinical

placem

ents

Theresults

ofresearch

areinform

ingclient

care

andacriticalapp

roachto

profession

alpracticeam

ongnu

rsingstud

ents.

Callagh

an[30]

2011

Enhancinghe

alth

stud

ents’und

erstanding

ofge

neric

research

concep

tsusingaweb

-basedvide

oresource

Nurse

Educationin

Practice

England

Qualitative

Physiotherapy

stud

ents

Inno

vativevide

oresources

Overall,stud

entspe

rceivedtheresourcesas

demystifying

thetopicof

research

metho

dsthroug

htheclarificatio

nof

definition

and

applicationof

concep

tsandmakingsenseof

concep

tsthroug

htheanalog

icalvide

os.

Coyne

[31]

2018

ACom

preh

ensive

App

roachto

Und

ergraduate

Nursing

Stud

ents’Research

Expe

riences

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

Summer

Research

Internship

(8weeks

durin

gthe

summer);supp

ortin

gstud

entsin

aon

e-to-one

men

torshipmod

elwith

the

goalof

buildingaresearch

infrastructurefacilitated

byresearchersandstud

ents

Theprog

rammeleadsto

practice

improvem

ents,kno

wledg

edissem

ination,

andstud

entinterestin

research

andfurthe

rprofession

alde

velopm

ent.Itgivesstud

ents

hand

s-on

expe

riencewith

nursingresearch

that

hasproven

tobe

bene

ficialclinically

whileincreasing

stud

entinterestin

research

andfurthe

rnu

rsinged

ucation

Crawford

[32]

2011

Using

prob

lem-based

learning

inweb

-based

compo

nentsof

nurse

education

Nurse

Educationin

Practice

Australia

Qualitative

Nursing

stud

ents

PBLapproaches

inon

line

education

Stud

entsaccessingon

linenu

rsingsubjects

wou

ldseem

tobe

nefit

from

web

-based

PBL

asitprovides

flexibility,op

portun

ities

fordis-

cussionandco-participation,en

courages

stu-

dent

autono

my,andallowsconstructio

nof

meaning

astheprob

lemsmirror

thereal

world.PBL

also

prom

otes

criticalthinking

andtransfer

oftheo

ryto

practice.

Davidson

[33]

2016

Teaching

EBPusing

game-basedlearning

:Im

provingthestud

ent

expe

rience

Worldview

son

eviden

ce-

basednu

rsing

Canada

Qualitative

Nursing

stud

ents

OnlineEBPcourse

Stud

entsindicatedahigh

satisfactionwith

thecourse

andstud

enten

gage

men

twas

also

maintaine

dthroug

hout

thecourse.

Daw

ley[34]

2011

Using

ape

dago

gical

Worldview

son

eviden

ce-

USA

Qualitative

Nursing

stud

ents

Pedago

gicalapp

roachaimed

Theassign

men

twas

anim

portantteaching

Larsen et al. BMC Medical Education (2019) 19:259 Page 7 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

approach

tointegrate

eviden

ce-based

teaching

inan

unde

rgradu

ate

wom

en’she

alth

course

basednu

rsing

at[1]fostering

unde

rgradu

atenu

rsing

stud

ents’EBP

compe

tencies,

and[2]iden

tifying

gaps

intheliteratureto

direct

future

wom

en’she

alth

research

andassessmen

ttool

forEBP.

Dew

ar[35]

2012

TheEBPcourse

asan

oppo

rtun

ityforwriting

Nurse

Educator

USA

Qualitative

Nursing

stud

ents

Writingworksho

psTheworksho

papproach

provides

stud

ents

with

a“safe”

placeto

exploretheir

assumptions,learn

from

peers,andmakea

leap

forw

ardalon

gtheirpe

rson

allearning

curveas

writers.

Doyle[36]

2016

Inform

ationLiteracy

ina

DigitalEra:

Und

erstanding

the

Impact

ofMob

ileInform

ationfor

Und

ergraduate

Nursing

Stud

ents

Book

chapterin:N

ursing

Inform

atics2016:eHealth

for

All:EveryLevelC

ollabo

ratio

n–From

Projectto

Realization

Canada

Qualitative

Nursing

stud

ents

Use

ofmob

ileinform

ation

resources

Nursing

stud

entsmainlyassessed

mob

ileresourcesto

supp

ortclinicallearning

,and

specifically

fortask-oriented

inform

ationsuch

asdrug

med

icationor

patient

cond

ition

s/diagno

ses.Researchersrecommen

dapara-

digm

shift

whe

reby

educatorsem

phasisein-

form

ationliteracyin

away

that

supp

orts

eviden

ce-based

quality

care.

Eales-

Reynolds

[37]

2012

Astud

yof

the

developm

entof

critical

thinking

skills

Nurse

EducationToday

Australia

Qualitative

Nursing

stud

ents

andstud

ents

from

othe

rhe

althcare

disciplines

Ano

velw

eb2.0-basedtool

–theWeb

Resource

App

raisal

Process(W

RAP)

Toen

sure

that

practicede

velopm

entsare

basedon

authoritativeeviden

ce,stude

nts

need

tode

velopcriticalthinkingskillswhich

may

befacilitated

bytoolssuch

asthe

WRA

P.

ElsborgFoss

[38]

2014

Amod

el(CMBP)for

collabo

ratio

nbe

tween

university

college

and

nursingpracticeto

prom

oteresearch

utilizatio

nin

stud

ents’

clinicalplacem

ents:a

pilotstud

y

Nurse

Educationin

Practice

Norway

Quantitative

Nursing

stud

ents

CMBP

(The

Collabo

ratio

nMod

elof

BestPractice)

TheCMBP

hasapo

tentialtobe

auseful

mod

elforteaching

RNs’andstud

entsEBP.

How

ever,further

refinem

entof

themod

elis

need

ed.

Epstein[39]

2011

Teaching

Statisticsto

Und

ergraduate

Nursing

Stud

ents:A

nIntegrative

Review

toInform

our

Pedago

gy

InternationalJou

rnalof

Nursing

Education

Scho

larship

USA

Qualitative

Nursing

stud

ents

Learning

strategies:

Sche

maticlinks

betw

een

statisticsandeveryday

nursingpractice.

Techno

logicalStrateg

ies:use

ofdata

analysissoftware

(Excel,SPSSetc.)+

useof

the

Internet.G

roup

learning

activities:Smallg

roup

/worksho

pactivities.Sup

port:

stud

ent,faculty,−

and

labo

ratory

supp

ort

Itwas

foun

dthat

thereislim

ited-to-noevi-

denceconcerning

thepe

dago

gyof

statistics.

Erichsen

[40]

2018

Kunn

skapsbasertpraksis

isykep

leierutdanning

enSykepleien

Forskningnr.

12,016

Norway

Qualitative

Nursing

stud

ents

Descriptio

nof

learning

-activities

includ

ingallsteps

inteaching

andcond

uctin

g

System

atictraining

inEBPin

coop

eration

with

thepracticefield

canhave

apo

sitive

impact

onstud

ents’learning.

More

Larsen et al. BMC Medical Education (2019) 19:259 Page 8 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

EBP

internationaland

Norweg

ianresearch

with

different

stud

yde

sign

sisne

cessaryto

increase

theknow

ledg

e.

Florin

[41]

2012

Educationalsup

portfor

research

utilizatio

nand

capability

beliefsregarding

eviden

ce-based

practice

skills:anatio

nalsurvey

ofsenior

nursing

stud

ents

Journalo

fAdvancedN

ursing

Swed

enQuantitative

Nursing

stud

ents

Educationalsup

portfor

research

utilisatio

nand

capabilitybe

liefsregarding

EBPskills

Stud

entsrepo

rted

high

capabilitybe

liefs

regardingeviden

ce-based

practiceskills,bu

tlargedifferences

werefoun

dbe

tweenun

i-versities

for:statingasearchablequ

estio

n,seekingou

trelevant

know

ledg

eandcritically

appraising

andcompilingbe

stknow

ledg

e.

Friberg[42]

2013

Chang

ingEssayWriting

inUnd

ergraduate

Nursing

Education

Throug

hAction

Research:A

Swed

ish

Exam

ple

Nursing

Education

Perspe

ctives

Swed

enQualitative

Nursing

stud

ents

Worksho

psandliterature

review

Actionresearch

was

foun

dto

bearelevant

proced

ureforchanging

waysof

working

with

literature-based,

bachelor

degree

essays.

Gray[43]

2010

Research

odyssey:The

evolutionof

aresearch

partne

rshipbe

tween

baccalaureaten

ursing

stud

entsandpracticing

nurses

Nurse

educationToday

USA

Quantitative

Nursing

stud

ents

Aresearch

partne

rship

betw

eenbaccalaureate

nursingstud

entsandnu

rses

intw

oacutecare

hospitals

Theresearch

partne

rshipprojectfacilitated

stud

entlearning

andan

appreciatio

nof

the

research

process.

Hande

[44]

2017

LevelingEviden

ce-based

PracticeAcrosstheNurs-

ingCurriculum

TheJournalfor

Nurse

Practitione

rs-JNP

USA

Qualitative

Nursing

stud

ents

Thearticlede

scrib

esevolving

EBPcompe

tenciesrelatedto

BSN,M

SN,and

DSN

level.BSN

level:Team-based

learning

,seminars,sm

allg

roup

activities,ide

ntificatio

nof

clinicalprob

lems,literature

search,app

raisalof

literature,

eviden

ce-based

projectad-

dressing

aselected

clinical

prob

lem

forthepu

rposes

ofim

provingclinicalou

tcom

es

Seam

less

transitio

nforthede

velopm

entof

EBPcompe

tenciesfornu

rses

ateach

levelo

fed

ucationrequ

iresthou

ght,strategically

placed

objectives

andlearning

activities

tobe

woven

into

thecurriculum

andcourses.

Collabo

ratio

nam

ongfaculty

from

each

educationallevelmustoccur.Teaching

-learning

metho

dsmustbe

approp

riate

and

engaging

ateach

level.Teaching

-learning

metho

dsmustchalleng

ethestud

entto

applyandprod

ucescho

larly

workfor

dissem

ination

Hen

och[45]

2014

Nursing

stud

ents’

expe

riences

ofinvolvem

entin

clinical

research:anexploratory

stud

y

Nurse

Educationin

Practice

Swed

enQuantitative

Nursing

stud

ents

Stud

entsinvolved

asdata

collectorsin

aresearch

project

Participationas

data

collectorsin

research

hasthepo

tentialtoincrease

interestin

nursingresearch

amon

gstud

ents.

Hickm

an[46]

2014

EVITEA

CH:A

stud

yexploringwaysto

optim

isetheup

take

ofEBPto

unde

rgradu

ate

nurses

Nurse

Educationin

Practice

Australia

Mixed

metho

dNursing

stud

ents

EVITACHto

explorestrategies

toincrease

unde

rgradu

ate

nursingstud

ent’s

engage

men

twith

EBPand

toen

hancetheirknow

ledg

eutilisatio

nandtranslation

capabilities

Thereislittle

robu

steviden

ceto

guidethe

mosteffectiveway

tobu

ildknow

ledg

eutilisatio

nandtranslationalskills.Effectively

engaging

unde

rgradu

atenu

rsingstud

entsin

know

ledg

etranslationandutilisatio

nsubjectscouldhave

immed

iate

andlong

term

bene

fitsfornu

rsingas

aprofession

and

Larsen et al. BMC Medical Education (2019) 19:259 Page 9 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

patient

outcom

es.

Jakube

c[47]

2013

Stud

entsCon

necting

CriticalApp

raisalto

EPB:

ATeaching

-LearningAc-

tivity

forResearch

Literacy

Journalo

fNursing

Education

Canada

Qualitative

Nursing

stud

ents

TheResearch

inPractice

Challeng

einclud

ing

iden

tifying

research

prob

lemsin

practice,

searchingtheliterature,and

critically

evaluatin

geviden

ce

Stud

entsvalueho

wtheactivity

high

lighted

therelevanceof

research

literacyfortheir

practice.

Jalali-Nia

[48]

2011

Effect

ofeviden

ce-based

educationon

Iranian

nursingstud

ents’kno

w-

ledg

eandattitud

e

Nursing

andHealth

Sciences

Iran

Quantitative

Nursing

stud

ents

Eviden

ce-based

approach

incl.The

principles

ofEBP

andPICO.The

interven

tion

andthecontrolg

roup

s,respectively,weretaug

htthroug

han

eviden

ce-based

andtradition

alapproach

Sign

ificant

differencebe

tweentheaverage

scores

forattitud

eof

thegrou

ps.N

ostatisticalsign

ificant

differencebe

tweenthe

averagescores

ofknow

ledg

e.

Janke[49]

2012

Prom

otinginform

ation

literacythroug

hcollabo

rativeservice

learning

inan

unde

rgradu

ateresearch

course

Nurse

EducationToday

Canada

Qualitative

Nursing

stud

ents

Servicelearning

project

whe

restud

entsworkedin

grou

ps,and

unde

rthe

guidance

ofanu

rsing

instructor

andlibrarian,to

answ

eraqu

estio

npo

sedby

practice-basedpartne

rs

Evaluatio

nof

theprojectindicatedthat

althou

ghtheprojectwas

challeng

ingand

labo

urintensivestud

entsfeltthey

learne

dim

portantskillsfortheirfuture

practice.

Jelsne

ss-

Jørgen

sen

[50]

2014

Doe

sa3-weekcritical

research

appraisalcou

rse

affect

how

stud

entspe

r-ceivetheirappraisalskills

andtherelevanceof

re-

search

forclinicalprac-

tice?

Arepe

ated

cross-

sectionalsurvey

Nurse

EducationToday

Norway

Quantitative

Nursing

stud

ents

andstud

ents

from

othe

rhe

althcare

disciplines

A3-weekcriticalresearchap-

praisalcou

rse

Teaching

stud

ents’p

racticalcriticalapp

raisal

skillsim

proved

theirview

oftherelevanceof

research

forpatients,future

workas

wellas

theirow

ncriticalapp

raisalskills.

John

son

[51]

2010

Research

andEBP:using

ablen

dedapproach

toteaching

andlearning

inun

dergradu

atenu

rse

education

Nurse

Educationin

Practice

England

Qualitative

Nursing

stud

ents

Adiscussion

ofon

emod

ule

team

’sexpe

rienceof

working

inaHighe

rEducation

Institu

tionwith

intheUK,

teaching

research

andEBPto

year

twoun

dergradu

ate

nursingandmidwifery

stud

ents

Theuseof

ablen

dedapproach

toteaching

andlearning

canbe

bene

ficialtothenu

rse

educator

inavariety

ofwaysifcareful

considerationisgivento

theuseof

techno

logy,the

learning

styles

ofthe

stud

entandaccess

totechno

logy.

Jone

s[52]

2011

Teaching

critical

appraisalskills

for

nursingresearch

Nurse

Educationin

Practice

Australia

Quantitative

Nursing

stud

ents

Aninno

vativeandqu

ality

driven

subjectto

improve

criticalapp

raisalandcritical

thinking

skills

Stud

entsfro

mbo

thcampu

sesshow

edconsiderableim

provem

entsin

know

ledg

eandconfiden

cein

theinterpretatio

nand

analysisof

research

finding

s,in

allareas

after

having

completed

thesubject(assessm

ent).

Keiffer

[53]

2018

Engaging

Nursing

Stud

ents:Integ

ratin

gEviden

ce-Based

Inqu

iry,

Inform

atics,andClinical

Practice

Nursing

Education

Perspe

ctives

USA

Qualitative

Nursing

stud

ents

Worksho

pform

aten

gage

sthestud

entswith

techno

logy

anddigitaltoo

lsto

prom

oteactivelearning

;en

hancestud

ent

Well-d

esigne

dcurricularequ

ireim

agination,

creativity,and

team

effortbe

tweentheo

ryandclinicalfaculty.D

esigning

projects

applicableto

theclinicalsite

provides

anaven

ueforstud

entsto

engage

inEBPwhile

Larsen et al. BMC Medical Education (2019) 19:259 Page 10 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

collabo

ratio

nand

participation.Varying

teaching

mod

alities

are

employed

toen

gage

stud

entsandreinforce

learning

.The

stud

entsare

usingtheMelnyket

al.

mod

elas

aframew

ork;aska

clinicalqu

estio

nusingthe

PICO

Tcriteria,d

evelop

strategies

tosearch,app

raise

research,use

eviden

ceto

inform

clinicalde

cision

-making,

design

achange

,anddissem

inatethe

eviden

ce

demon

stratin

gtheachievem

entof

course

learning

outcom

es.

Kiekkas[54]

2015

Nursing

stud

ents’

attitud

estoward

statistics:Effect

ofa

biostatisticscourse

and

associationwith

exam

ination

perfo

rmance

Nurse

EducationToday

Greece

Quantitative

Nursing

stud

ents

Biostatisticscourse

Stud

ents’attitu

destowardstatisticscanbe

improved

throug

happrop

riate

biostatistics

courses,whilepo

sitiveattitud

escontrib

ute

tohigh

ercourse

achievem

entsandpo

ssibly

toim

proved

statisticalskillsin

later

profession

allife.

Kyriakoulis

[10]

2016

Educationalstrateg

ies

forteaching

EBPto

unde

rgradu

atehe

alth

stud

ents:systematic

review

Journalo

fEdu

catio

nal

Evaluatio

nforHealth

Profession

s

USA

Quantitative

Nursing

stud

ents

andstud

ents

from

othe

rhe

althcare

disciplines

Lectures,tutorials,w

orksho

ps,

conferen

ces,journalclubs,

andon

linesessions

orcombinatio

nof

these

Multifaceted

approach

may

bebe

stsuited

whe

nteaching

EBM

tohe

alth

stud

ents.

Leach[55]

2016

Theim

pact

ofresearch

educationon

stud

ent

nurseattitud

e,killand

uptake

ofeviden

ce

Journalo

fClinicalNursing

Australia

Quantitative

Nursing

stud

ents

Research

education

prog

rammede

livered

astw

oeigh

t-weekcoursesin

the

third

year

ofed

ucation

Research

educationmay

have

asign

ificant

effect

onnu

rsingstud

ents’researchskillsand

useof

EBP,andminim

isebarriersto

EBP

post-edu

catio

n.

Lewis[56]

2016

Dim

inishing

Effect

Sizes

with

Repe

ated

Expo

sure

toEBPTraining

inEntry-

LevelH

ealth

Profession

alStud

ents:A

Long

itudinal

Stud

y

PhysiotherapyCanada

Canada

Quantitative

Physiotherapy

stud

entsand

stud

entsfro

mothe

rhe

althcare

disciplines

Twosequ

entialEBP

courses.

1.EBPcourse

was

aimed

atde

veloping

foun

datio

nal

know

ledg

eof

andskillsin

thefivestep

sin

EBP.2.EBP

course

design

edto

teach

stud

entsto

applythestep

s

Know

ledg

eandrelevancechange

dmost

meaning

fully

(i.e.,sho

wed

thelargesteffect

size)forparticipantswith

minim

alprior

expo

sure

totraining

.Chang

esin

participants’

confiden

ceandattitud

esmay

requ

irea

long

ertim

eframeandrepe

ated

training

expo

sure.

Liou

[57]

2013

Inno

vativestrategies

for

teaching

nursing

research

inTaiwan

Nursing

Research

Taiwan

Quantitative

Nursing

stud

ents

Inno

vativeTeaching

Strategies

foraresearch

course

includ

ingteam

work,

labo

ratory

sessions

onho

wto

search

forpu

blishe

dresearch

articles,expe

rimen

tsandminiresearchprojects

(experim

entalg

roup

).Didactic

lecture,textbo

okreadings,

Thisstud

yconfirm

edthat

usinginno

vative

teaching

strategies

innu

rsingresearch

coursesen

hances

stud

entinterestand

enthusiasm

abou

tEBP.

Larsen et al. BMC Medical Education (2019) 19:259 Page 11 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

andresearch

articlecritiqu

e(con

trol

grou

p)

Laaksone

n[58]

2013

Journalclubas

ametho

dfornu

rses

and

nursingstud

ents’

collabo

rativelearning

:ade

scrip

tivestud

y

Health

ScienceJournal

Finland

Quantitative

Nursing

stud

ents

Asix-ph

ased

journal

club

mod

elJournalclubs

supp

ortcompe

tences

and

discussion

requ

iredforprod

ucingeviden

ce-

basedcare

andcanbe

recommen

dedas

learning

metho

dsfornu

rses’and

nursing

stud

ents’collabo

rativelearning

.

Malik[59]

2017

Using

pedago

gical

approaches

toinfluen

ceeviden

ce-based

practice

integration-processes

andrecommen

datio

ns:

finding

sfro

ma

grou

nded

theo

rystud

y

Journalo

fAdvancedNursing

(JAN)

Australia

Qualitative

Nurse

academ

ics

(regarding

nursingstud

ents)

Vario

uspe

dago

gical

approaches

toinfluen

ceeviden

ce-based

practiceed

u-catio

n;lectures,tutorials,la-

boratory

work,on

line

activities,video

s,scen

arios,

andassign

men

ts.Emph

asis-

inginform

ationliteracyand

criticalapp

raisalskills.Some

useflipp

edclassroo

map-

proach,p

roblem

-based

learn-

ing,

virtualsim

ulated

environm

ent,andinqu

iry-

basedlearning

tofacilitate

stud

ents’learning

Acade

micsattempted

tocontextualiseEBP

byen

gaging

stud

entswith

activities

aiming

tolinkeviden

ceto

practiceandwith

theEBP

practice.Engaging

stud

entswith

theEBP

processin

practicecontextisim

perativeto

increase

theirEBPcompe

tence.Somekey

challeng

es(limitedtim

e,insufficien

tresources,he

avyworkload,

stud

ents’

diseng

agem

ent,andlim

itedaw

aren

essof

effectiveteaching

metho

ds)requ

irethe

adop

tionof

approp

riate

strategies

toen

sure

future

nurses

arewellp

reparedin

the

paradigm

ofeviden

ce-based

practice

Mattila[60]

2014

Journalclubinterven

tion

inprom

otingeviden

ce-

basednu

rsing:

Percep

-tio

nsof

nursingstud

ents

Nurse

Educationin

Practice

Finland

Quantitative

Nursing

stud

ents

Journalclubs

Stud

entswereno

tableto

utilise

thestud

ies

tothesameextent

asthey

learnfro

mthem

.Age

,workexpe

rienceandparticipationin

research

andde

velopm

entactivities

were

conn

ectedto

learning

.

McCurry

[61]

2010

Teaching

unde

rgradu

ate

nursingresearch:a

comparison

oftradition

aland

inno

vativeapproaches

forsuccesswith

millen

niallearne

rs

Journalo

fNursing

Education

USA

Mixed

metho

dNursing

stud

ents

Inno

vativeassign

men

tsthat

includ

edinteractivelearning

,grou

pwork,andpractical

applications

Stud

ents’p

ositive

respon

sesto

the

inno

vativelearning

strategies

evaluatedin

thisstud

ysupp

ortthenu

rsingprofession

’sne

edto

continue

tode

velopactivities

that

engage

millen

nialstud

entsanden

ablethem

toclearly

articulatethevalueof

theresearch

practicelinkvitaltoeviden

ce-based

nursing

practice.

Milner

[62]

2017

ThePICOGam

e:An

Inno

vativeStrategy

for

Teaching

Step

1in

Eviden

ce-Based

Practice

Worldview

son

Eviden

ce-

BasedNursing

USA

Qualitative

Nursing

stud

ents

Gam

eGam

esbu

ildandstreng

then

skillsto

frame

practicequ

estio

nsin

asearchableform

at(PICO).Themetho

dforteaching

how

tobu

ildPICOqu

estio

nsisthesameregardless

ofparticipanted

ucationlevelo

ryearsof

practice

Moch[63]

2010

PartII.Em

powering

grassroo

tsEBP:a

curricular

mod

elto

foster

unde

rgradu

ate

stud

ent-en

abledpractice

change

Journalo

fprofessional

nursing

USA

Qualitative

Nursing

stud

ents

The“Stude

nt-Enabled

PracticeChang

eCurricular

Mod

el”

Astheprelim

inarydata

repo

rted

here

sugg

est,nu

rseed

ucatorshave

thepo

wer

toprom

otepracticechange

byen

abling

sociallymeaning

fulp

artnershipsbe

tween

stud

entsandpracticingnu

rses

that

could

percolatechange

upfro

mthelowestpo

ints

Larsen et al. BMC Medical Education (2019) 19:259 Page 12 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

inthepo

wer

hierarchy.

Moch[64]

2010

PartI.Und

ergraduate

nursingEBPed

ucation:

envision

ingtheroleof

stud

ents...firstof

athree-partseries

Journalo

fprofessional

nursing

USA

Qualitative

Nursing

stud

ents

Vario

uspe

dago

gical

strategies

targeted

towards

teaching

EBP

Theliteraturereview

edin

thisarticlethat

describ

esmoreactiverolesforstud

entsin

clinicalsettings,albeitscant,sugg

eststhat

allowingstud

entsto

interact

inon

-going

andmeaning

fulw

ayswith

practicingnu

rses

may

removeor

mitigate

barriersto

the

adop

tionof

EBPam

ongpracticingnu

rses.

Morris

[65]

2016

Theuseof

team

-based

learning

inasecond

year

unde

rgradu

atepre-

registratio

nnu

rsing

course

oneviden

ce-

inform

edde

cision

making

Nurse

Educationin

Practice

England

Mixed

metho

dNursing

stud

ents

Eviden

ce-in

form

edde

cision

makingcourse

Team

-based

learning

was

show

nto

bean

effectivestrategy

that

preservedthebe

nefits

ofsm

allg

roup

teaching

with

largestud

ent

grou

ps.

Morris

[66]

2010

Pilotstud

yto

testthe

useof

amob

ilede

vice

intheclinicalsettingto

access

eviden

ce-based

practiceresources

World

View

son

Eviden

ce-

basedNursing

England

Quantitative

Nursing

and

physiotherapy

stud

ents

Use

ofmob

ilede

vice

toaccess

EBPresourcesin

clinicalsetting

Stud

entsrepo

rted

improvem

entin

know

ledg

eandskillsin

relatio

nto

EBPand

appraisalo

fclinicalgu

idelines.H

owever

alow

levelo

futilisatio

nof

themob

ilede

vice

intheclinicalsettingdu

eto

access

tothe

internet

andsm

allscreens.

Nadelson

[67]

2014

Eviden

ce-Based

Practice

ArticleReview

sUsing

CASP

Tools:AMetho

dforTeaching

EBP

Worldview

son

eviden

ce-

basednu

rsing

USA

Qualitative

Nursing

stud

ents

EBPArticleReview

susing

CASP

Tools

Using

theCASP

Toolshe

lpstud

entsorganise

theirreview

sandlearnabou

tvaluable

resources.In

additio

n,working

asagrou

pmem

berhe

lpsfoster

involvem

ent,

motivation,andinterestin

theprocessesof

evaluatin

geviden

ceeffectively.

Nadelson

[68]

2014

Onlineresources:

fosteringstud

entsEBP

learning

throug

hgrou

pcriticalapp

raisals

World

view

son

Eviden

ce-

basedNursing

USA

Qualitative

Nursing

stud

ents

Stud

entsin

dyadsor

triads

review

edandevaluatedon

eEBPrelatedweb

site

Havingstud

entsworkin

grou

psto

critically

appraise

web

sitesthat

help

prom

oteEBPcan

enhancecollabo

ratio

nandknow

ledg

eabou

tEBPresources.

Niven

[69]

2013

Makingresearch

real:

Embe

ddinga

long

itudinalstudy

ina

taug

htresearch

course

forun

dergradu

ate

nursingstud

ents

Nurse

EducationToday

USA

Qualitative

Nursing

stud

ents

Tofacilitatestud

entslearning

research

theo

ryand

metho

dology

bycond

uctin

ga“real-life”research

stud

yin

alocalretiremen

tcommun

ity

Weknew

wehadsucceede

din

oureffortsto

change

stud

entpe

rcep

tions

abou

tlearning

research

whe

nweread

acommen

tfro

mon

estud

entwho

hadcompleted

therevised

research

course.

O’Neil[70]

2016

Ane

wmod

elin

teaching

unde

rgradu

ate

research:A

collabo

rative

approach

andlearning

coop

eratives

(CALC

)

Nurse

Educationin

Practice

USA

Qualitative

Nursing

stud

ents

Aqu

ality

improvem

entstud

yusingtheCALC

Mod

elUniversities

andho

spitaladm

inistrators,

nurses,and

stud

entsbe

nefit

from

working

toge

ther

andlearning

from

each

othe

r.

Ode

ll[71]

2011

Teaching

EBP:The

Bachelor

ofSciencein

Nursing

Essentialsat

Workat

theBedside

Journalo

fprofessional

nursing

USA

Qualitative

Nursing

stud

ents

Agrou

pprojectforstud

ents

that

involved

collabo

ratio

nwith

thehe

alth

science

referencelibrarianandnu

rse

Thelearning

expe

rienceisashared

partne

rshipbe

tweentheclinicalagen

cy,the

faculty,and

thehe

alth

sciencelibrarianto

assistsenior

nursingstud

entsin

thelast

Larsen et al. BMC Medical Education (2019) 19:259 Page 13 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

managersin

theclinical

agen

cies

semesterof

theirbaccalaureatede

gree

prog

rammeto

synthe

sise

andusethe

know

ledg

e,skills,andattitud

esthat

prom

ote

patient

safety

andop

timalou

tcom

es

Oja[72]

2011

Using

prob

lem-based

learning

(PBL)in

the

clinicalsettingto

im-

provenu

rsingstud

ents’

criticalthinking:

anevi-

dencereview

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

PBL

Thestud

iesreview

edindicate

apo

sitive

relatio

nshipbe

tweenPBLandim

proved

criticalthinkingin

nursingstud

ents.

Penn

ington

[73]

2010

EBPpartne

rships:

buildingbridge

sbe

tweened

ucationand

practice

Nursing

Managem

ent

USA

Qualitative

Nursing

stud

ents

Team

ingnu

rsingstud

ents

with

staffnu

rses

working

onEBPprojects

Stud

entswereableto

learnho

weviden

ceis

utilisedin

thepracticesettings.

Phelps

[74]

2015

Introd

ucingInform

ation

Literacy

Com

petency

StandardsforNursing

Nurse

educator

USA

Qualitative

Nursing

stud

ents

Inform

ationLiteracy

Com

petencyStandardsfor

Highe

rEducation(ILCSH

E)

Nursing

librarians

aretheInform

ation

Literacy

expe

rtswho

help

tointegratethese

skillsinto

nursinged

ucation

Phillips[75]

2014

Creativeclassroo

mstrategies

forteaching

nursingresearch

Nurse

Educator

USA

Qualitative

Nursing

stud

ents

Kaleidoscope

sfordiscussion

ofpe

rspe

ctives,crossword

puzzlesto

reinforce

term

inolog

y,scaven

gerhu

ntto

relate

concep

tsto

thereal

world,coo

kieexpe

rimen

tto

have

anoverview

ofthe

research

processand

paradigm

s,individu

alreactio

ntim

e,andamusic

activity

toreinforceelem

ents

ofde

sign

andsampling

Stud

entfeed

back

was

positive.These

strategies

help

faculty

commun

icate

impo

rtantconcep

tsof

nursingresearch

ina

way

that

ismeaning

fuland

fun.

Pierce

[76]

2016

Thee-Po

ster

Con

ference:

AnOnlineNursing

Re-

search

Cou

rseLearning

Activity

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

e-po

ster

conferen

ceFrom

allaccou

nts,theconferen

cewas

rated

aspo

sitive,providingnu

rsingstud

entswith

oppo

rtun

ities

to(a)view

stud

iesandprojects

from

awider

nursingscienceaudien

ce,(b)

foster

thede

velopm

entof

impo

rtant

evaluatio

nandcommun

icationskills,and(c)

beexpo

sedto

eviden

cethat

couldbe

translated

into

theirpractice.

Putnam

[77]

2011

Con

queringEBPusing

anem

bedd

edlibrarian

andon

linesearch

tool

Journalo

fNursing

USA

Qualitative

Nursing

stud

ents

Embe

dded

librarians

+on

linesearch

toolsto

assist

stud

entsin

thede

velopm

ent

andmastery

ofeffective

search

techniqu

es

Embe

dded

librarians

andon

linesearch

tools

areuseful

tostud

entsas

they

develop

inform

ationliteracyskillsrelatedto

searching

forandscreen

inginform

ation.Using

these

strategies

forform

ativeandsummative

assign

men

tsallowsstud

entsto

develop

additio

nalinformationliteracyskillsne

eded

tointegrate,analyse,apply,andpresen

tinform

ation.

Raines

[78]

2016

Acollabo

rativestrategy

Worldview

son

eviden

ce-

USA

Qualitative

Nursing

stud

ents

Ateaching

strategy

which

Theteaching

strategy

presen

tsawin-w

in

Larsen et al. BMC Medical Education (2019) 19:259 Page 14 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

tobringeviden

ceinto

practice

basednu

rsing

combine

stheclinical

expe

rienceof

nurses

with

nursingstud

ents’evolving

skillsin

reading,

critiqu

ing,

andanalysingresearch-based

literature

situationin

which

stud

entsbe

comeen

gage

dwith

clinicalnu

rses

inaun

it-basedproject.

Raurell-

Torred

a[79]

2015

Simulation-based

learning

asatacticfor

teaching

EBP

Worldview

son

eviden

ce-

basednu

rsing

Spain

Qualitative

Nursing

stud

ents

Simulation-basedlearning

(SBL)mod

ules

coverin

gnu

rsingcompe

tencies

Thesimulationhe

lped

toed

ucatenu

rsing

stud

entsin

applying

EBP.

Reiche

rter

[80]

2013

Creatingdissem

inator

cham

pion

sforEBPin

health

profession

sed

ucation:An

educationalcaserepo

rt

Nurse

EducationToday

USA

Qualitative

Nursing

and

physiotherapy

stud

ents

Amod

elforde

veloping

EBP

practitione

rs:Phase

1.Prep

aringstud

entsho

wto

read,analyse

anddiscuss

levelsof

eviden

ce.Phase

2.Focuson

developing

dissem

inationskillsby

requ

iring

stud

entsto

completeaclinicalcase

repo

rtproject.Ph

ase3.

Review

outcom

esof

the

projectandph

ase4.Provide

mechanism

sof

future

plans

Increasedstud

entparticipation,Clinical

instructorsandfaculty

scho

larship,

and

dissem

inationof

EBP.Add

ition

aled

ucational

bene

fitsde

rived

from

thisprojectinclud

ed,

1)broade

rparticipationof

clinicalsettings,2)

requ

estsby

additio

nalclinicsto

participate

forpu

rposes

ofde

veloping

EBPandscho

larly

presen

tatio

nskillsof

clinicians,and

3)increasedop

portun

ityforacadem

icfaculty

tocontinue

engage

men

tin

contem

porary

clinicalpractice.

Revaitis[81]

2013

FaceTime:avirtual

pathway

betw

een

research

andpractice

Nurse

Educator

USA

Qualitative

Nursing

stud

ents

FaceTimevide

ocon

ference

FaceTimevide

ocon

ferencingprovides

numerou

sbe

nefitsforstud

entsandprovides

avirtualcon

nectionto

linktheclassroo

mwith

thepracticeworld.

Robe

rts[82]

2011

Find

ingandusing

eviden

cein

academ

icassign

men

ts:The

bane

ofstud

entlife

Nurse

Educationin

Practice

England

Quantitative

Nursing

stud

ents

Specificsessions

onliterature

searchingskillswhich

were

delivered

early

onin

the

prog

ramme

Thefinding

sindicate

that

stud

entsvalue

specificteaching

sessions

(taugh

tby

mem

bersof

library

staff)de

livered

atthe

beginn

ingof

theprog

rammebu

titseem

sthat

moreworkisrequ

iredby

educatorsin

orde

rto

help

stud

entsto

associateliterature

searchingskillswith

nursingpractice.

Rodriguez

[83]

2012

ActionResearch

asa

Strategy

forTeaching

anUnd

ergraduate

Research

Cou

rse

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

Teaching

ofActionResearch

insteadof

teaching

tradition

alresearch

course

metho

ds

Thestud

entslearne

dho

wto

iden

tifya

research

prob

lem

andmovethroug

hthe

step

sof

theresearch

processusingactio

nresearch.

Rolloff[84]

2010

Aconstructivistmod

elforteaching

EBP

Nursing

Education

Perspe

ctives

USA

Qualitative

Nursing

stud

ents

Con

structivistMod

elwith

sugg

estio

nsof

teaching

EBP

principles

durin

gallb

ache

lor

years

Theconstructivisttheo

ryforlearning

may

provideaframew

orkforarede

sign

edbaccalaureatecurriculum

,one

that

supp

orts

EBPthroug

hout

anu

rsingstud

ent’s

education.

Ruskjer[85]

2010

Areal-w

orld

expe

rience

toen

gage

stud

entsin

EBP

Journalo

fNursing

Education

USA

Qualitative

Nursing

stud

ents

1.Practicingnu

rses

subm

itclinicalqu

estio

ns,2.Stude

nts

attend

seminar

incl.EBP

review

process+source

ofeviden

ce,3.Stude

ntsselect

Using

eviden

ceto

answ

erbu

rningqu

estio

nsstraight

from

theclinicalsettings

isan

effectiveway

toen

gage

stud

entsandstaff

nurses

inEBP.

Larsen et al. BMC Medical Education (2019) 19:259 Page 15 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

clinicalqu

estio

n,appraise

system

aticreview

sandothe

rliterature,4.Faculty

consult

stud

entsincl.Introdu

ctionto

PICO

,5.Stude

ntswrite

abstractsandmakepo

wer

pointandpo

ster

Ruzafa-

Martin

ez[86]

2016

Effectiven

essof

anEBP

course

ontheEBP

compe

tenceof

unde

rgradu

atenu

rsing

stud

ents:A

quasi-

expe

rimen

talstudy

Nurse

EducationToday

Spain

Quantitative

Nursing

stud

ents

A15-w

eekcourse

design

edto

teachEBPcompe

tence

Und

ergraduate

nursingstud

entsexpe

rience

positivechange

sin

EBPcompe

tence,

know

ledg

e,skills,andattitud

eas

theresult

ofa15-w

eeked

ucationalinterventionon

EBP.

Schams[87]

2010

ClinicalPo

st-con

ference

Pedago

gy:Explorin

gEBP

With

Millen

nial-In

spired

‘BuildingBlocks’

Creativenu

rsing

USA

Qualitative

Nursing

stud

ents

Inno

vativeteaching

strategy

consistin

gof

learning

units

whe

reby

stud

entscometo

post-con

ferencesessions

pre-

paredto

shareEBPinform

a-tio

nassociated

with

upcominglabo

ratory

con-

cepts,discover

relatio

nships

amon

glabo

ratory

concep

tsandcurren

tnu

rsingpractice,

andassociatepe

rson

alclin-

icalexpe

riences

with

the

practiceen

vironm

ent

Stud

entsde

mon

stratedmoreconfiden

cein

questio

ning

curren

tpractice,researchingEBP

literature,andworking

ingrou

ps.The

BuildingBlocks

teaching

strategy

provided

aninno

vativeway

toen

gage

stud

ents

durin

gpo

st-con

ferences

toconn

ectpractice

concep

tsto

real-life

expe

riences,and

pro-

moted

theuseof

EBPin

guidingpractice

decision

s.

Schreine

r[88]

2015

How

unde

rgradu

ate

stud

entscancontrib

ute

toEBP

Nursing

Managem

ent

Canada

Qualitative

Nursing

stud

ents

Partne

rshipbe

tween

university

andho

spital

working

toge

ther

onEBP-

projects

Stud

entsinvolved

inthepilotprog

ramme

expand

edtheirresearch

horizon

andlearne

dto

cond

uctliteraturereview

s,utilize

search

engine

s,andcatego

rizearticles.Being

involved

inclinicalresearch

canbe

anasset

toun

dergradu

atestud

entsforfuture

practice

anded

ucation.

Scott[89]

2011

Acollabo

rativeteaching

strategy

foren

hancing

learning

ofeviden

ce-

basedclinicalde

cision

-making

Journalo

fAllied

Health

USA

Qualitative

Occup

ational

-and

physiotherapy

stud

ents

Partne

rshipbe

tween

university

andho

spital

Theapproach

increasedstud

entmotivation

andgreatly

enhanced

thelearning

expe

rience.

Scurlock-

Evans[90]

2017

Toem

bedor

notto

embe

d?Along

itudinal

stud

yexploringthe

impact

ofcurriculum

design

ontheeviden

ce-

basedpracticeprofiles

ofUKpre-registratio

nnu

rsingstud

ents

Nurse

Educationtoday

UK

Quantitative

Nursing

stud

ents

Thisstud

ycomparedthe

impact

ofem

bedd

ingEBP

throug

hout

thecurriculum

,with

mod

ular-based

teach-

ing,

onpre-registratio

nnu

rs-

ingstud

ents’EBP

profiles.

Taking

amod

ular

orem

bedd

edapproach

toEBPmay

have

little

impact

onstud

ents’final

EBPprofiles

Sin[91]

2017

Teaching

eviden

ceJournalo

fProfessional

USA

Qualitative

Nursing

stud

ents

Agrou

pprojectde

sign

edin

Nursing

faculty

isrespon

sibleforprep

aring

Larsen et al. BMC Medical Education (2019) 19:259 Page 16 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

basedpracticeto

unde

rgradu

atenu

rsing

stud

ents

Nursing

aNursing

Research

Metho

dscourse.The

projectwas

basedon

ahypo

thetical

clinicalscen

ario

andstud

ents

wereno

taskedto

implem

entthebe

stinterven

tion

stud

entsto

bereadyforEBP

implem

entatio

n.Creativeanden

joyable

teaching

strategies

aresomewaysto

enhancestud

ents’kno

wledg

eand

compe

tencyof

EBPim

plem

entatio

nin

practice

Smith

-Ston

er[92]

2011

Develop

ingne

wwriters:

answ

eringthecallfor

stud

entmanuscripts

Dim

ension

sof

CriticalCare

Nursing

USA

Qualitative

Nursing

stud

ents

Stud

entsparticipated

ina

critical-carerotatio

nand

wereen

rolledin

anintrod

uc-

tory

research

class

Duringarecent

critical-carenu

rsingrotatio

n,nu

rsingstud

entslearne

dabou

tEBPthroug

hiden

tifying

apo

licythat

need

edrevision

orcreatio

n.By

integratingclinicalissues

into

anintrod

uctio

nto

research

andissues

and

tren

ds,the

stud

entswereableto

answ

era

callforstud

entabstracts.

Smith

-Strøm

[93]

2012

Culture

crashregarding

nursingstud

ents’

expe

rienceof

implem

entatio

nof

EBP

inclinicalpractice

NordicJournalo

fNursing

Research

Norway

Qualitative

Nursing

stud

ents

12daycourse

inEBPstep

s+

collabo

ratio

nwith

clinical

practiceto

applythestep

sof

EBP

Thestud

entswereableto

implem

entEBP

accordingto

thego

alsof

thesyllabu

s,bu

ten

coun

teredaclinicalsettingthat

was

insufficien

tlyprep

ared

,bothstructurallyand

interm

sof

know

ledg

e,to

men

torthem

regardingEBP.

Stom

baug

h[94]

2013

Using

lesson

stud

yto

integrateinform

ation

literacythroug

hout

the

curriculum

Nurse

Educator,2013,

Canada

Canada

Qualitative

Nursing

stud

ents

Lesson

stud

yThelesson

stud

ymetho

disan

idealw

ayto

implem

entascaffoldingapproach

ofteaching

inform

ationliteracyskillstowards

EBPou

tcom

es.

Strickland

[95]

2012

Theuseof

podcaststo

enhanceresearch-

teaching

linkage

sin

unde

rgradu

atenu

rsing

stud

ents

Nurse

Educationin

Practice

Scotland

Quantitative

Nursing

stud

ents

andstud

ents

from

othe

rhe

althcare

disciplines

Blende

dlearning

approach.

Stud

entsweregivenaccess

toaseriesof

5“guest

speaker”po

dcastsmadeup

ofpresen

tatio

nsand

interviewswith

research

expe

rts

Podcastin

goffersnu

rseed

ucatorstheability

toem

bedadditio

nalcon

tent

from

researchersor

clinicians

tohe

lpstud

ents

makelinks

betw

eentheirtheo

reticallearning

andpractice.

Sukkarieh-

Haraty[96]

2017

IntegratingEviden

ce-

BasedPracticeinto

aLebane

seNursing

Bacca-

laureate

Prog

ram:C

hal-

leng

esandSuccesses

InternationalJou

rnalof

Nursing

Education

Scho

larship

Libano

nQualitative

Nursing

stud

ents

Twocoursesat

twodifferent

levels.Stude

ntsused

PICO

clinicalqu

estio

n,ob

served

aselected

clinicalskilland

comparedtheirob

servations

toho

spitalp

rotocoland

againstthelatesteviden

ce-

basedpracticegu

idelines.A

tthesecond

course

stud

ents

prop

osed

change

sin

practice

with

scho

larly

literature.

Anoverallexperienceof

integratingEBP

projectinto

thecurriculum

isfru

itful

for

stud

ents,clinicalagen

cies,and

faculty.

Stud

entsgain

real-life

skillsne

eded

forEBP.

Whalen[97]

2015

Teaching

System

atic

Searchingin

aBaccalaureateNursing

Research

Cou

rse

World

view

son

Eviden

ce-

basedNursing

USA

Quantitative

Nursing

stud

ents

Implem

entin

gsystem

atic

workshe

etsandresearch

logs

onstud

ents’EBP

projects

Stud

entswho

didno

tusesystem

aticsearch

workshe

etsandresearch

logs

scored

sign

ificantlylower

oneviden

cesummaries

than

stud

entsusingsystem

aticsearch

workshe

etsandresearch

logs.

Larsen et al. BMC Medical Education (2019) 19:259 Page 17 of 33

Table

2Stud

ycharacteristics(N

=81)(Con

tinued)

Firstauthor

Year

Title

Journal

Cou

ntry

Design

Participants

Metho

dsforteaching

EBP

Mainstud

yfinding

s

Won

der[98]

2015

Activelearning

strategies

toteach

unde

rgradu

atenu

rsing

statistics:Con

necting

classandclinicalto

prep

arestud

entsforEBP

Worldview

son

eviden

ce-

basednu

rsing

USA

Quantitative

Nursing

stud

ents

Activelearning

strategy:Stude

ntsare

presen

tedwith

acase

scen

ario

viaPo

werPo

intto

starttheactivelearning

expe

rience.Sm

allg

roup

s/each

person

collectsdata

individu

ally(cho

colate

chip

cookies,exercise).

Metho

dologicaland

statisticaldiscussion

s

Theactivelearning

exercisesand

assign

men

tshadapo

sitiveim

pact

onstud

ents’acade

micandclinical

developm

ent.Stud

entsrepo

rted

that

bybe

ginn

ingwith

simpleexercisesthat

allowed

them

tovisualiseandph

ysicallytouchdata,

iten

abledthem

toprog

ress

tomoreabstract

andcomplex

applications.

Yu[99]

2013

Improvem

entin

critical

thinking

disposition

sof

unde

rgradu

atenu

rsing

stud

entsthroug

hprob

lem-based

learning

:acrossover-expe

rimen

tal

stud

y

Journalo

fNursing

Education

China

Quantitative

Nursing

stud

ents

One

grou

preceiving

prob

lem-based

learning

(PBL)

andtheothe

rgrou

preceiv-

inglecture-basedlearning

(LBL)as

acontrol

PBLisan

effectivemetho

dto

improvethe

quality

ofmed

icalteaching

andtheabilities

ofnu

rsingstud

ents,aswellasameans

toim

proveim

plem

entatio

nof

know

ledg

e,ability,and

quality,b

utitalso

presen

tsan

effectivemeans

toim

provecriticalthinking

disposition

sin

nursingstud

entsin

China.

Zhang[100]

2012

Assistin

gun

dergradu

ate

nursingstud

entsto

learneviden

ce-based

practicethroug

hself-

directed

learning

and

worksho

pstrategies

dur-

ingclinicalpracticum

Nurse

EducationToday

China

Quantitative

Nursing

stud

ents

Apilotlearning

prog

ramme

includ

ingaself-directed

learning

processforEBPba-

sics

andaworksho

pforcrit-

icalappraisalo

fliterature

Sign

ificant

improvem

entin

stud

ents’

percep

tionof

EBPknow

ledg

e,attitud

es,

beliefs,and

behaviou

r.Stud

entsfoun

dthe

prog

rammehe

lpfulinprom

otingtheir

analyticalandprob

lem-solving

abilities.

Larsen et al. BMC Medical Education (2019) 19:259 Page 18 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

Balakas,

2010

[23]

Research

coursesand

worksho

ps

Stud

entslearne

dho

wto

usetheirclinicalPICO

questio

n…

..asagu

ideforcond

uctin

gliteraturesearches

Stud

entsweregu

ided

inthe

useof

rapidappraisal

guidelines

forqu

antitative

andqu

alitativeresearch.

Writtencriticalapp

raisals

werecompleted

tofurthe

rde

velopstud

ents’critiquing

skills

Each

stud

entgrou

ppresen

tedtheirPICO

questio

ns,evide

ncesynthe

sis,

referencelist,and

recommen

datio

nsto

the

commun

ityprog

ramme

managers

Stud

entslearne

dto

evaluate

abo

dyof

eviden

ceClassroom

+clinical

practice

Bloo

m,2013

[26]

Research

coursesand

worksho

ps

Nursing

ScienceI:Theprocess

ofreview

ingtheliteratureis

explored

,and

thefinalproject

forthecourse

isaliterature

search

design

edto

iden

tify

themostcurren

teviden

ceavailableforagiventopic

Nursing

ScienceII:The

emph

asisof

thecourse

ison

criticalapp

raisalof

aprim

ary

research

repo

rt

Nursing

ScienceIII:Stude

nts

useeviden

ce-based

mod

els

tosystem

aticallypractice

decision

-makingskillsrelated

toaclinicalqu

estio

nof

inter-

estto

them

Classroom

Boyd,2015

[27]

Research

coursesand

worksho

ps

Classroom

Cable-

Williams,

2014

[29]

Research

coursesand

worksho

ps

Classroom

+clinical

practice

Davidson,

2016

[33]

Research

coursesand

worksho

ps

Stud

entslearnto

develop

PICOclinicalqu

estio

ns…

…searches

forexternal

eviden

ceto

answ

erfocused

clinicalqu

estio

ns…

…participates

inthecritical

appraisalo

fpu

blishe

dresearch

stud

ies…

…to

determ

inetheir

streng

thandapplicability

toclinicalpractice…

…anddissem

inates

best

practices

supp

ortedby

eviden

ceto

improvequ

ality

ofcare

andpatient

outcom

es

Classroom

Dew

ar,2012

[35]

Research

coursesand

worksho

ps

Four

3-hwritingworksho

psinclud

ingho

wto

developa

clinicalqu

estio

n…

…andiden

tifyrelevant

inform

ationfro

mpu

blishe

dresearchstud

ies

Classroom

Friberg,

2013

[42]

Research

coursesand

worksho

ps

Stud

entshadaclose

collabo

ratio

nwith

librarians

with

tendifferent

worksho

psfocusing

ondifferent

aspe

cts

ofliteratureretrieval

Stud

entsused

know

ledg

e-basedanalysisof

both

quan-

titativeandqu

alitative

results…

…andbe

steviden

cefora

specificnu

rsingactio

nand

transformed

results

andne

wknow

ledg

einto

practice

Classroom

Jakube

c,2013

[47]

Research

coursesand

worksho

ps

Stud

entswrote

their

appraisalo

feviden

cein

anexistin

gpo

licyor

guideline…

…met

with

ahe

alth

referencelibrarianto

cond

uct

asystem

aticsearch

ofthe

literatureon

thetopic…

…provided

acriticalreview

ofexistin

geviden

cewith

thepo

licyor

guidelineand

review

edanyup

datedor

morerecent

eviden

ce…

…andwrote

asummaryof

theirrecommen

dedpo

licy

change

sforpractice

Classroom

Jalali-Nia,

2011

[48]

Research

coursesand

Theeviden

ce-based

ap-

proach,learningactivities

…searchingforeviden

ce…

…readingandcritiqu

ing

nursingresearch…

…anddiscussing

articles,

synthe

sising

theeviden

ce,

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 19 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

worksho

psforeach

grou

pinclud

edde

-veloping

aclinicalqu

estio

nusingthePICO

…

andde

veloping

asummary

offinding

s

Janke,2012

[49]

Research

coursesand

worksho

ps

Stud

entshadto

clarify

the

research

questio

n……de

sign

ingaliterature

search

strategy

andcomplete

thesearch…

…select

thearticlesand

record

impo

rtantdata

from

thearticles…

…andsubm

itthepape

r/results

totheclinicalpartne

rsClassroom

Jelsne

ss-

Jørgen

sen,

2015

[50]

Research

coursesand

worksho

ps

Week1:Lectures

indatabases

andliteraturesearch

Week1:Introd

uctio

nto

CriticalApp

raisalSkillTools.

Week2:Group

workand

seminarsfocusing

oncritical

appraisalo

fqu

alitative

pape

rs.W

eek3:Group

work

andseminarsfocusing

oncriticalapp

raisalof

quantitativepape

rs

Classroom

Jone

s,2011

[52]

Research

coursesand

worksho

ps

Theassessmen

ttaskswere

design

edto

enablestud

ents

tocond

uctandrepo

rta

critiqu

eof

apu

blishe

dpape

r

Thethird

andfourth

assessmen

ttaskswere

design

edto

enablestud

ents

toapplytheskillsthey

had

learnt

inthesubject

Classroom

Kiekkas,

2015

[54]

Research

coursesand

worksho

ps

Classroom

Kyriakoulis,

2016

[10]

Research

coursesand

worksho

ps

Interven

tions

covered

different

step

sof

theEBP

domains:Research

questio

n…

…sourcesof

eviden

ce…2

stud

iesfocusedon

the

searchingdatabasesskill

…eviden

ceappraisal…

…andim

plem

entatio

ninto

practice…

Classroom

Leach,2016

[55]

Research

coursesand

worksho

ps

Iden

tificationand

developm

entof

research

questio

nfro

mpractice

Con

structionandexecution

ofsearch

strategies

toretrieve

relevant

prim

aryresearch

articles

Criticalappraisalo

fthe

literature

Summary,presen

tatio

nand

dissem

inationof

eviden

cein

different

form

ats

Classroom

+clinical

practice

Lewis,2016

[56]

Research

coursesand

worksho

ps

TheEBP1

course

aimed

tode

velopfoun

datio

nknow

ledg

eandskillsin

EBP,

with

emph

asison

threeof

thefiveEBPstep

sou

tline

din

theSicilyStatem

entincl.

Fram

earesearch

questio

n…

…to

access

andsearch

library

databasesandothe

rresourcesandto

reflect

ontheprocessesassociated

with

thisapproach.

TheEBP2

course

had

additio

naltraining

inApp

raisingmetho

dological

bias…

…as

wellasteaching

stud

entsho

wto

applyeach

ofthefive

EBPstep

sClassroom

Liou

,2013

Research

Miniresearchprojectwith

…cond

uctliterature

…read

andselect

articles…

…andan

oralandpo

ster

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 20 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

[57]

coursesand

worksho

psintrod

uctio

nho

wto

form

ulatearesearch

prob

lem…

searches…

presen

tatio

nof

finding

s

Morris,2016

[65]

Research

coursesand

worksho

ps

Classroom

Phillips,2014

[75]

Research

coursesand

worksho

ps

Classroom

Pierce,2016

[76]

Research

coursesand

worksho

ps

Duringthee-po

ster

confer-

ence

stud

entsde

velopare-

search

questio

n…

…appraise

data

collection…

…critiqu

epu

blishe

dliterature…

…andwriteabou

tho

wto

beginachange

toorganisatio

nalvisitatio

npo

licybasedon

theresearch

eviden

cefro

mthepo

ster

conferen

ce

Classroom

Rodriguez,

2012

[83]

Research

coursesand

worksho

ps

Stud

entscond

ucteda

research

projectwhich

includ

edaliteraturereview

…

…presen

tedtheirresults

and

design

edascientificpo

ster

with

theirresults

Classroom

Whalen,

2015

[97]

Research

coursesand

worksho

ps

Theworkshe

etinclud

edmainlystep

1–3of

EBP.

Askingaclinicalqu

estio

nusingPICO

…

…searchingtheliterature…

…andcritically

appraising

theliteraturefoun

dClassroom

Zhang,

2012

[100]

Research

coursesand

worksho

ps

Stud

entsinde

pend

ently

cond

uctedon

lineandlibrary

searches

tofindinform

ation

Stud

entswereaskedto

read

anassign

edarticleand

critiqu

eitto

thebe

stof

theirability

Stud

entscreated

presen

tatio

nslides

and

shared

anin-dep

thcritiqu

eof

oneaspe

ctof

thespecified

research

article

Classroom

+clinical

practice

Milner,2017

[62]

Research

coursesand

worksho

ps

Stud

entslearnto

build

and

framepracticequ

estio

nsby

gaming

Classroom

Sukkarieh-

Haraty,2017

[96]

Research

coursesand

worksho

ps

Stud

entslearne

dho

wto

useaclinicalPICOqu

estio

n…andcollected

scho

larly

literature

Com

paredtheirob

servations

toho

spitalp

rotocolagainst

thelatesteviden

ce-based

practicegu

idelines

Stud

entsprop

osed

change

sin

practicewith

scho

larly

literature

Classroom

+clinical

practice

Erichsen

,2018

[40]

Research

coursesand

worksho

ps

Ask

aclinicalqu

estio

nCollect

relevant

literature/

articles

Criticallyappraise

thearticles

Stud

entspresen

ttheirwork

indifferent

ways;e.g.

implem

entatio

n-plan,p

oster

Theresults

wereevaluated

Classroom

+clinical

practice

Scurlock-

Evans,2017

Research

coursesand

Stud

entsweretaug

htwhat

EBPis,h

owitlinks

with

Stud

entsweretaug

htho

wto

assess

quality

ofStud

entsun

dertoo

kan

inde

pend

entresearch

project

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 21 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

[90]

worksho

psresearch

metho

dology

and

processandethics

(inyear

2)literature/eviden

ce(in

year

1)in

theirfinalyear

(3year)

Keiffer,2018

[53]

Research

coursesand

worksho

ps

Stud

entsaskaPICO

T(pop

ulation,interven

tion,

control,ou

tcom

es,tim

e)qu

estio

n

Develop

strategies

tosearch

–andsearch

App

raiseresearch

Designachange

and

dissem

inatetheeviden

ceby

makingrecommen

datio

nsfor

bestpractice

Classroom

Sin,2017

[91]

Research

coursesand

worksho

ps

Faculty

have

framed

questio

ns/stude

ntsde

velop

aqu

estio

nusingPICO

later

intheirnu

rsingscho

ol

Acquirin

geviden

ceby

selectingeviden

ce-based

re-

sourcesthroug

hliteraturein

collabo

ratio

nwith

alibrarian

Stud

entsstatetheratio

nale

fortheirinterven

tionchoice

incorporatingtheappraisal

learne

din

theclass

Stud

entsareaskedto

iden

tify

atleastthreeEBP

implem

entatio

nstrategies

basedon

theirliterature

review

usingat

leasttw

oreferences

Classroom

Coyne

,2018

[31]

Research

coursesand

worksho

ps

Stud

entslearne

dho

wto

askresearch

questio

nsand

how

tolean

onon

eanothe

rforhe

lpand

guidance

Stud

entshe

lped

thefaculty

mem

berin

herresearch

projectto

collect

relevant

literature

…includ

inghe

lpingwith

initialreview

oftheliterature

Stud

entsdidaform

alpo

dium

presen

tatio

nregardingtheirsummer

expe

riences.The

prog

ramme

ledto

change

sat

thehe

alth

system

andledto

initiation

ofresearch

stud

ies

Classroom

+clinical

practice

Hande

,2017

[44]

Research

coursesand

worksho

ps

Stud

entsiden

tifythe

potentialclinicalqu

estio

nsas

they

becomeaw

areof

curren

tge

neralistnu

rsing

care

prob

lems

Stud

entsaregu

ided

throug

hthesequ

ence

ofstep

sto

review

research

Stud

entscritically

appraise

thescho

larly

inform

ation

Stud

entsaregu

ided

throug

hthesequ

ence

ofstep

sto

developan

EBP

implem

entatio

nplan

Stud

entsmakeapresen

tatio

nof

aneviden

ce-based

project

addressing

aselected

clinical

prob

lem

forthepu

rposes

ofim

provingclinicalou

tcom

es:

Popu

latio

n/patient,p

roblem

,interven

tion,comparison

,out-

come,tim

equ

estio

n,recom-

men

datio

nsforeviden

ce-

basedpracticechange

Classroom

+clinical

practice

MalikG,

2017

[59]

Research

coursesand

worksho

ps

Askingclinicalqu

estio

nsFind

ingrelevant

eviden

ce(som

etim

esworksho

psde

livered

bythelibrary

staff)

App

raisingtheeviden

ceApp

lyingeviden

ceinto

clinicalpractice(the

oretically)

Classroom

Berven

,2010

[24]

Collabo

ratio

nwith

clinical

practice

Clinical

practice

ElsborgFoss,

2014

[38]

Collabo

ratio

nwith

clinical

practice

Stud

entsweretaug

htin

compu

ter-basedliterature

search

Stud

entsread,app

raised

,anddiscussedthearticles

that

werechosen

Stud

entspresen

tedthe

finding

sfro

mtheliterature

search

abou

t‘bestpractice’

andtherecommen

datio

nsforchange

s…

…andsecond

-yearstud

ents

observed

towhatextent

the

decision

sabou

tchange

swere

followed

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 22 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

Gray,2010

[43]

Collabo

ratio

nwith

clinical

practice

Intheintrod

uctory

nursingresearch

course

priorto

theresearch

partne

rship,

alln

ursing

stud

entsarerequ

iredto

completean

eviden

ce-based

research

projectinclud

ingthefivestep

sClassroom

+clinical

practice

Moch,2010

[64]

Collabo

ratio

nwith

clinical

practice

Classroom

Moch,2010

[63]

Collabo

ratio

nwith

clinical

practice

Indiscussion

grou

psstud

ents

foun

dfour

articlesrelatedto

thetopic…

…andstud

entsandstaff,

alon

gwith

faculty,readand

discussedeach

ofthe

articlesin

four

discussion

sessions

Classroom

Ode

ll&

Barta,2011

[71]

Collabo

ratio

nwith

clinical

practice

Assignm

entou

tcom

esrelatedto

step

2and3:Collabo

rate

inthecollectionof

eviden

ceandparticipatein

theprocessof

appraisal,of

eviden

ce

Clinical

practice

O’Neal,2016

[70]

Collabo

ratio

nwith

clinical

practice

Stud

entswrote

arelated

PICOTqu

estio

n……cond

uctedareview

ofthe

literature

…followed

guidelines

tocritically

appraise

articles

…iden

tifiedapplicationto

practice

…de

velope

drecommen

datio

nforthe

future

Clinical

practice

Penn

ington

,2010

[73]

Collabo

ratio

nwith

clinical

practice

Stud

entswrote

upthe

form

alised

research

prop

osal

Stud

entspe

rform

edliterature

searches

and…

…wereinstrumen

tsin

collectionandanalysisof

thepre-im

plem

entatio

nsur-

veydata

Thepartne

rships

offered

stud

ents+staffan

oppo

rtun

ityto

expe

rience

how

makebe

stpractice

decision

susingasystem

atic

EBPprocess

Classroom

+clinical

practice

Raines,2016

[78]

Collabo

ratio

nwith

clinical

practice

Stud

entssearched

relevant

eviden

ceand…

…review

edtheliterature

foun

dandappraisedthe

quality

oftheeviden

cefoun

d

Classroom

+clinical

practice

Reiche

rter,

2013

[80]

Collabo

ratio

nwith

clinical

practice

Stud

entslearnto

develop

aneviden

ce-based

questio

n…

…search

forandretrieve

relevant

journalarticles…

…analysetheresults…

…stud

entteam

screate

and

presen

tacase

repo

rtto

classm

ates

andou

tline

potentialclinicalde

cision

susingtheeviden

ce

Classroom

+clinical

practice

Schams,

2012

[87]

Collabo

ratio

nwith

clinical

practice

Stud

entswereen

couraged

towriteaclinicalqu

estio

nusingPICO

T.

Thegrou

pwas

divide

dinto

team

swho

shared

therespon

sibilitiesforsearchingand

repo

rtingEBPinform

ationthat

supp

ortedor

refutedcurren

tpractice.Asateam

stud

ents

discussedrelatio

nships

amon

glabo

ratory

concep

ts,current

practice,andEBPinform

ation

foun

din

literature.By

usingpo

st-con

ferencetim

eim

med

iatelyfollowingclinicalpracticeex-

periences,stude

ntscouldassociatetheirpe

rson

alexpe

riences

inpracticewith

theEBP

inform

ation.

Classroom

+clinical

practice

Scott,2011

[89]

Collabo

ratio

nwith

clinical

Stud

entslearne

dto

write

PICOTqu

estio

ns…

…andsearch

theliterature

Stud

entslearne

dappraisal

andmet

with

therapiststo

…andrelevanceof

eviden

ceto

practice

Classroom

+clinical

Larsen et al. BMC Medical Education (2019) 19:259 Page 23 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

practice

validatedirectionof

search…

practice

Smith

-Ston

er,2011

[92]

Collabo

ratio

nwith

clinical

practice

Stud

entspe

rform

edliterature

searches…

…andpresen

teded

iting

policyto

clinicalstaff

Clinical

practice

Smith

-Strøm,2012

[93]

Collabo

ratio

nwith

clinical

practice

The12

–day

course

traine

dthestud

entsin

thefour

step

sof

EBP:Form

ulatinga

questio

n…

…searchingforeviden

ce…

…critically

appraising

the

eviden

ce…

…andapplying

theeviden

ceClinical

practice

Brow

n,2015

[28]

ITTechno

logy

TheiPad

provided

point-of-

care

access

toclinicalgu

ide-

lines

andresources…

…en

ablingstud

entsto

implem

entan

eviden

ce-

basedapproach

tode

cision

makingandprob

lem

solving

Classroom

Callagh

an,

2011

[30]

ITtechno

logy

Staffrevealed

twokey

research

processesas

being

vitaltostud

ents’

unde

rstand

ingof

research

andsubseq

uent

critical

appraisal,thesebe

ing

searchingfor…

…andevaluatin

gliterature

Classroom

Doyle,2016

[36]

ITtechno

logy

Mob

ilesoftwareisapo

sitive

inform

ationtool

for

inform

ationliteracy…

…andforinform

ingclinical

decision

sClinical

practice

Eales-

Reynolds,

2012

[37]

ITtechno

logy

Stud

entsindicatedthat

the

WRA

Pim

proved

theircritical

appraisalskills…

…andqu

estio

ning

ofthe

research

eviden

cebasisfor

practice

Classroom

Morris,2010

[66]

ITtechno

logy

Thegu

idelineappraisal

activity

helped

stud

ents

form

ulated

asearchable

questio

n

Thegu

idelineappraisal

activity

helped

stud

ents

retrieve

eviden

ce

Thegu

idelineappraisal

activity

helped

stud

ents

critically

appraise

the

eviden

ce

Thegu

idelineappraisal

activity

helped

stud

ents

applytheeviden

ceto

practice

Clinical

practice

Nadelson,

2014

[68]

ITtechno

logy

Criticalgrou

pappraisalsof

EBPweb

sitesrelevant

for

clinicians

Classroom

Revaitis,

2013

[81]

ITtechno

logy

Throug

hFaceTime

vide

ocon

ferencestud

ents

bene

fitfro

minteractingwith

research

team

sandareable

todiscussho

wresearch

finding

sareappliedto

practice

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 24 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

Strickland,

2012

[95]

ITtechno

logy

Classroom

Blazeck,

2011

[25]

Assignm

ents

Themainpu

rposeof

the

assign

men

tisaccessing

research-based

eviden

cerele-

vant

toan

iden

tifiedclinical

prob

lem

Classroom

Daw

ley,

2011

[34]

Assignm

ents

Stud

entswereto

gene

rate

relevant

clinicalqu

estio

nsthat

evolvedfro

mtheir

clinicalexpe

riences…

…andwereaskedto

cond

uct

aliteraturesearch

toiden

tify

tworesearch

articlesthat

beganto

answ

ertheir

questio

ns

Classroom

McCurry,

2010

[61]

Assignm

ents

Stud

entscompleted

adatabase

search

andmet

with

thecourse

faculty

torefineelectron

icsearches…

…critically

exam

ined

the

literature…

…andsubm

itted

abstracts

andprep

ared

anoral

presen

tatio

nandpo

ster

ofthechosen

articles

Classroom

Nadelson,

2014

[67]

Assignm

ents

Stud

entsreceivean

article

tobe

review

ed,readand

critically

appraise

usingthe

CASP

tool

Classroom

Robe

rts,

2011

[82]

Assignm

ents

Stud

entslearne

dto

search

theliteratureusingavariety

ofmechanism

s

Classroom

And

re,2016

[22]

Participationin

research

projects

Increasedun

derstand

ingof

theim

portance

ofcritical

thinking

Increasedun

derstand

ingof

theim

portance

ofim

plem

entatio

nof

research

indaily

practice

Increasedun

derstand

ingof

theim

portance

ofevaluatio

nof

clinicalpracticethroug

htheuseof

EBP

Classroom

+clinical

practice

Hen

och,

2014

[45]

Participationin

research

projects

Stud

entscollected

data

Classroom

+clinical

practice

Niven

,2013

[69]

Participationin

research

projects

Stud

entscollected

both

qualitativeandqu

antitative

data

usingqu

estio

nnaires

Classroom

+clinical

practice

Ruskjer,

2010

[85]

Participationin

research

projects

Faculty

guidetheteam

inconstructin

gthequ

estio

nin

PICO

Librarianprovides

guidance

inthecompu

terlabo

ratory,as

stud

entsgain

hand

s-on

ex-

periencecond

uctin

gan

on-

lineliteraturesearch

Theteam

critically

appraises

system

aticreview

sand

practicegu

idelines,and

individu

alstud

entsappraise

relevant

research

articles

Faculty

assiststheteam

inlookingat

theeviden

ceand

discussesanyrecommen

ded

change

sin

practice

Classroom

Schreine

r,Participationin

Stud

entsinitiated

theproject

Articleswerechosen

byClinical

Larsen et al. BMC Medical Education (2019) 19:259 Page 25 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

2015

[88]

research

projects

bycond

uctin

galiterature

review

forEBParticlesrelated

tohe

artfailure

education

theirrelevanceto

the

enhancem

entof

staff

educationforhe

artfailure

patients

practice

Laaksone

n,2013

[58]

Journalclubs

Stud

entssearched

for

scientificknow

ledg

eto

answ

eraclinicalqu

estio

nof

thejournalclub…

…evaluatedthearticlesand

othe

rrelevant

material…

…andprep

ared

shortwritten

pape

rsbasedon

the

know

ledg

ethey

had

collected

andevaluated

Classroom

Mattila,2013

[60]

Journalclubs

Stud

entsprep

ared

forthe

journalclubby

acqu

iring

data

with

thehe

lpof

aninform

ationspecialist

After

presen

tingthearticle,

participantsdiscussedho

wtheresults

couldbe

used

innu

rsingcare

andwhattype

ofsolutio

nor

new

perspe

ctivehadbe

engained

.Stud

entsge

neratedthe

discussion

andgave

their

opinionof

thebo

thoraland

written

Classroom

Phelps,2015

[74]

Embe

dded

librarians

TheILCSN

willhe

lpstud

ents

gather…

…analyse…

…anduseinform

ation

Classroom

Putnam

,2011

[77]

Embe

dded

librarians

Theem

bedd

edlibrarian

assisted

stud

entsin

developing

approp

riate

search

techniqu

es

ThesummativeEBPpape

rde

velope

dthereview

ofliterature,includ

ing

integrating,

analysing…

…applying

,and

presen

ting

inform

ation

Classroom

Aglen

,2016

[21]

Theo

riesof

teaching

–and

learning

Thepe

dago

gicalstrateg

iespresen

tedinvite

thelearne

rto

becomean

activeparticipantin

thelearning

activity,e.g.assessing

research,con

ductinga

research

projectandassessingpatients’requ

iremen

tsforhe

althcare.Thismeans

that

they

areen

couraged

tousediscretio

nto

solveill-structuredprob

lems

relatedto

thestep

sof

EBP,theresearch

processandtheirow

nclinicalpractice.Ano

ther

strategy

toen

hancestud

ents’interestandmakethelearning

tasks

relevant

isto

linkthelearning

task

torealclinicalsituations

Classroom

Crawford,

2011

[32]

Theo

riesof

teaching

–and

learning

PBLen

hances

critical

thinking

…..and

transfer

oftheo

ryto

practice

Classroom

+clinical

practice

Epstein,

2011

[39]

Theo

riesof

teaching

–and

learning

Classroom

Florin,2012

[41]

Theo

riesof

teaching

–and

learning

Highe

stcorrelationcoefficientsbe

tweenstud

ents’experienceof

supp

ortforresearch

utilisatio

nandEBPskillsin

form

ulatingqu

estio

nsto

search

for

research-based

know

ledg

e(step1)

andcritically

appraising

andcompilingbe

stknow

ledg

e(step3)

oncampu

s.Classroom

+clinical

practice

Hickm

an,

2014

[46]

Theo

riesof

teaching

–and

learning

Classroom

Larsen et al. BMC Medical Education (2019) 19:259 Page 26 of 33

Table

3Keymetho

dsforteaching

unde

rgradu

atehe

althcare

stud

entsEBP,theSicilyStatem

ent’s

fivestep

sof

teaching

andcond

uctin

gEBPandcontext(Con

tinued)

Source

(first

author,year)

Keymetho

dsforteaching

unde

rgradu

ate

healthcare

stud

entsEBP

TheSicilyStatem

ent’s

fivestep

sin

teaching

andcond

uctin

gEBP

Con

text

1.Ask

aclinicalqu

estio

n2.Collect

themostrelevant

eviden

ce3.Criticallyappraise

the

eviden

ce4.Integratetheeviden

cewith

one’sclinicalexpe

rtise,

patient

preferen

ces,and

values

tomakepractice

decision

5.Evaluate

change

orou

tcom

e

John

son,

2010

[51]

Theo

riesof

teaching

–and

learning

Stud

entsde

veloptheirow

nresearch

prop

osal,w

hich

includ

esde

finingaresearch

questio

n…

…searchingtheliterature…

…andform

ulateapprop

riate

metho

dsClassroom

Oja,2011

[72]

Theo

riesof

teaching

–and

learning

Allstud

iesexcept

onein

the

review

foun

dsign

ificant

effectsof

PBLon

critical

thinking

skills

Clinical

practice

Raurell-

Torred

à,2015

[79]

Theo

riesof

teaching

–and

learning

Classroom

+clinical

practice

Rolloff,2010

[84]

Theo

riesof

teaching

–and

learning

Stud

entswillde

velop

inform

ationliteracyskills…

…exploresystem

aticreview

databasesforeviden

cerelatedto

labo

ratory

expe

riences

andintrod

uce

othe

rinform

ationliteracy

sources

…critiqu

eweb

sites,research

articlesandclinical

expe

riences

from

anEBP

perspe

ctiveforhe

alth

inform

ation

…incorporateEBPinto

patient

care

plansand

developaresearch

prop

osal

basedon

eviden

cegaps

iden

tifiedin

practice

…andevaluate

clinical

policiesandproced

ures

from

anEBPpe

rspe

ctiveand

discusschange

process

Classroom

Ruzafa-

Martin

ez,

2016

[86]

Theo

riesof

teaching

–and

learning

Stud

entsshou

ldiden

tifya

nursingprob

lem

inpatients

caredfordu

ringclinical

training

andform

ulatea

clinicalPICOqu

estio

n...

…iden

tifyclinicalpractice

guidelines,systematicreview

sand/or

originalarticles…

…critically

appraise

search

results…

…de

scrib

erecommen

datio

nson

theclinicalqu

estio

nand

iden

tifythelevelo

feviden

ceandgradeof

recommen

datio

n…

…andpresen

ttheresults

ofthefinalexercise

inapo

ster

totheseminar

grou

p,giving

reason

sforim

plem

entatio

nof

thesearch

results

Classroom

Stom

baug

h,2013

[94]

Theo

riesof

teaching

–and

learning

Soph

omore-level:Stud

entsge

neratedaPICOqu

estio

n…Stud

entscopied

theprocessof

thelibrariande

scrib

ingan

exam

pleof

aPICOqu

estio

n,creatio

nof

asearch

term

and

cond

uctio

nof

asearch

inCINAHL

Junior

level:Stud

entssearched

databasesothe

rthan

CINAHL

Senior

level:Stud

entscreatedPICO

relatedto

practice

expe

rience,individu

allysearched

databasesandretrieved

“bestpractice”

eviden

ce

Classroom

Won

der,

2015

[98]

Theo

riesof

teaching

–and

learning

Stud

entscritically

appraised

analysismetho

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and ten studies described one step. Twelve studies hadno description of any of the steps.The steps most often referred to were step two, three,

and four. Step two, “Collect the most relevant evidence”,was mentioned in 58 studies. Step three, “Critically ap-praise the evidence”, was referred to in 55 studies, whilestep four, “Integrate the evidence with one’s clinical ex-pertise, patient preferences, and values to make practicedecision”, was mentioned in 51 studies. Step one, “Ask aclinical question”, and step five, “Evaluate change or out-come” was referred to in 36 and 14 studies, respectively.Seven out of the eleven studies referring to all of the SicilyStatement’s five steps were identified under the keymethods “Research courses and workshops” and “Collab-oration with clinical practice”.The context in which the studies were conducted was pri-

marily classroom settings (n = 52). Twenty studies describedcontext as a combination of classroom and clinical practice,and nine studies were conducted in clinical practice.Out of the 68 studies which included the seven key

methods, 24 out of 32 “Research courses and work-shops” were conducted in classrooms, while “Collabor-ation with clinical practice” was conducted in acombination of classroom and clinical practice (n = 6),clinical practice (n = 5), or classrooms (n = 3). “IT tech-nology” was used in classrooms (n = 6) or clinical prac-tice (n = 2). “Assignments” were conducted in classroomsettings only (n = 5), while “Participation in researchprojects” took place in a combination of classroom andclinical practice (n = 3), classroom (n = 1) or clinicalpractice (n = 1). “Embedded librarians” (n = 2) and “Jour-nal clubs” (n = 2) both took place in classroom settings.

DiscussionThis study provides an overview of existing EBP teach-ing methods including The Sicily Statement’s steps ofteaching and conducting EBP with respect to under-graduate healthcare students both in classrooms and inclinical practice.It is beyond the scope of this review to interpret all

the findings of the included studies. The findings dis-cussed below are the key methods most frequently iden-tified in the thematic analysis: “Research courses andworkshops” and “Collaboration with clinical practice”, aswell as the key methods most positively referred to inmain findings of the studies: “IT technology”, “Embed-ded librarians”, and “Journal clubs”. Despite the scarceuse of the last three methods (“IT technology”, “Embed-ded librarians”, “Journal clubs”) these can however pro-vide ideas for how to teach EBP in the future.Furthermore, the scoping review provides useful infor-mation as to which of the Sicily Statement’s five steps ofteaching and conducting EBP are taught in the variousmethods and whether one particular method is more

useful and applicable than others in a particular learningsetting, depending on the context and the learning out-comes. Lecturers, senior lecturers and others who teachEBP at undergraduate healthcare educational institutionscan benefit from this information and gain inspirationand ideas for teaching EBP. We are aware that otherstudies have addressed issues such as teachers’ compe-tencies required for teaching EBP, which we do considerimportant in order to standardise and improve educationin EPB. Interestingly, a study has identified specific setsof EBP core competencies for teachers, which are classi-fied within the 5-step model of EBP [101]. However,since our primary focus was on methods for teachingEBP to undergraduate healthcare students the aspect ofteacher’s competencies has not been further investigated.Overall, the first 4 steps of the Sicily Statement could

more easily be identified. However the last and fifth stepproved to be more difficult to identify which often is thecase. Furthermore, our results tend to point to the factthat the fifth step is often more theoretically linked atthe undergraduate level and that a more specifiedimplemtation and evaluation of the EBP process takesplace at a more advanced level.

Research courses and workshopsResearch courses and workshops were the most fre-quently used methods for teaching EBP. The frequentuse of this method is in agreement with the systematicreview by Kyriakoulis et al., where eight of the 20methods for teaching EBP were research courses, work-shops or similar sessions [10] and Young et al., wherethree out of five methods used for teaching evidence-based healthcare (EBHC) were workshops [2]. The ma-jority of the studies concerning “Research courses andworkshops”, referred to three or more of the Sicily State-ment’s five steps of teaching and conducting EBP [10,23, 26, 31, 33, 40, 42, 44, 47–49, 53, 55–57, 59, 76, 90,91, 96, 97, 100]. Despite the fact that the fifth step wasincluded in some studies, it was not clear what was cov-ered by the evaluation process, and additionally, if it waspart of the students’ assignment work alone or if therewas a link to clinical practice. The majority of the re-search courses and workshops were conducted in class-rooms. According to Young et al., EBHC courses canimprove appraisal skills in nurses, occupational thera-pists and physiotherapists, among others [2]. However,further assessments and analyses of the courses andworkshops found in this scoping review must be madeto ensure that the content and outcomes are applicablein similar contexts.

Collaboration with clinical practiceIn this scoping review, the key method for teaching EBP,“Collaboration with clinical practice” was identified 14

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times in the thematic analysis. In comparison, “collabor-ation with clinical practice” is only mentioned once as amethod for teaching EBP in the review by Young et al.[2] and not mentioned in the systematic review by Kyria-koulis et al. [10]. The results of this scoping review sug-gest that collaboration with clinical practice is afrequently used method for teaching EBP with respect toundergraduate healthcare students. The rare use of thismethod in the review by Kyriakoulis et al. and the reviewby Young et al. might be explained by the type of partici-pants included in these reviews. Only two studies in-cluded undergraduate students in the disciplines ofnursing, physiotherapy or occupational therapy: in thereview by Young et al. and the review by Kyriakoulis [2,10]. Along this line, a review on teaching EBM to med-ical students found weak and inconsistent results from alimited number of studies on the effect of clinically inte-grated methods on knowledge, attitudes, and skills [102].Collaboration with clinical practice might be more fun-damental among undergraduate students in the disci-plines of nursing, physiotherapy or occupational therapy,compared to undergraduate students in medicine pri-marily included in the other reviews [2, 10].Half of the studies identified in relation to “Collabor-

ation with clinical practice”, referred to four or five ofthe Sicily Statement’s steps [38, 43, 70, 73, 80, 87, 89,93]. In two of the studies, the steps were taught directlyin clinical practice as part of the students’ clinical educa-tion [70, 93], and unlike the research courses and work-shops methods, the last step of evaluation of change oroutcome is carried out either partly or entirely in a clin-ical context. The main findings of all eight studies in-dicate that collaboration with clinical practice is aneffective way of teaching EBP, both with the combin-ation of classrooms and clinical practice settings andin clinical practice settings alone. Despite being a rec-ommended strategy in the literature, a recent litera-ture review points to the fact that EBP teachingstrategies including clinical activities in nursing stu-dents seems less prioritised [12].

IT technologyThe key method, “IT technology”, described tools, suchas mobile devices, video resources and websites, amongothers, used in classrooms or clinical practice for seekinginformation in relation to EBP. In clinical practice, mo-bile devices were used to seek information regardingEBP search strategies, critical appraisal of clinical guide-lines [66], and specific task-oriented information in rela-tion to clinical practice [36]. Despite the reportedimprovement in knowledge and skills in relation to EBPand appraisal of clinical guidelines, the use of mobile de-vices was reported as low [66]. In classrooms, the use ofIT technology as a method for teaching EBP was

reported as mainly positive. Today, most students haveaccess to IT equipment and this technology could be in-tegrated in classrooms and clinical practice to seek infor-mation regarding EBP. In the review by Kyriakoulis et al.the results support our findings; that IT technology canbe an effective method for teaching EBP with respect toundergraduate healthcare students [10].

Journal clubs“Journal Clubs” as a method for teaching EBP was onlydescribed in two studies in this scoping review. However,the findings indicated that the method improved stu-dents’ skills in reading articles and understandingevidence-based nursing [60], and promoted competen-ceis needed to deliver evidence-based care [58]. Thestudies included two and three steps, respectively, pro-posed by the Sicily Statement [3]. Additional steps mayadvantageously be incorporated into future journal clubsto ensure the quality of healthcare. Young et al. referredto four reviews describing a positive effect of journalclubs as a method for teaching EBP [2]. However, noneof the reviews included Professional Bachelor Degreehealthcare students. Further studies must be conductedto assess the effectiveness of journal clubs as a methodfor teaching EBP in Professional Bachelor Degree health-care courses and to study the opportunity of incorporat-ing all of the Sicily Statement’s five steps for teachingand conducting EBP.

Embedded librariansIn two studies librarians were introduced to teach stu-dents information literacy [74, 77]. Librarians are expertsin this field and are able to teach students the skills es-sential to EBP [74]. Librarians can support students inestablishing and managing effective search techniquesand help with reviewing and critiquing the informationfound. Thus, students develop information literacy skillsas required in practice [77]. Research librarians who areembedded as part of a research course for teachingundergraduate healthcare students EBP may be an ef-fective way of ensuring a complete introduction to theSicily Statement’s five steps of teaching and conductingEBP. The first three steps can be taught in classrooms,followed by practical exercises in the last two steps inclinical practice.

Implications for practiceThe majority of the key methods found for teaching EBPwere “Research courses and workshops” and “Collabor-ation with clinical practice”, whereas “Journal Clubs”and “Embedded librarians” were identified only twice.The frequent use of research courses and workshops asmethods for teaching EBP may stem from a tradition ofclassroom lectures and is a relatively manageable way to

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teach EBP. The findings from this scoping study how-ever suggest that other methods for teaching EBP withrespect to undergraduate students exist. Journal clubscould be incorporated as a supplement to classroom lec-tures or as part of collaboration with clinical practice. Li-brarians may advantageously be introduced in researchcourses and workshops. The librarians can help studentsgain control of EBP definitions and concepts, and mastersearch techniques before entering clinical practice. Theeffect of journal clubs and embedded librarians on stu-dents’ EBP competencies should however be investigatedfurther before being incorporated into ProfessionalBachelor’s Degree curricula.EBP education based on the Sicily Statement’s five steps,

demanded both internationally and nationally, implies anintroduction to all of the Sicily Statement’s five steps ofteaching and conducting EBP at undergraduate level [5, 6,9]. At present, the majority of the methods found forteaching EBP only include 2–4 steps. In line with these re-sults, a recent review found that the majority of evaluatedEBP educational interventions are focused on a single step(step 3, critically appraising evidence) of the five steps ofteaching and conducting EBP [103]. This research adds tothe statement that an effort must be made to incorporateall five steps of the Sicily Statement in an educational andcooperative way in order to ensure that undergraduatehealthcare students are qualified to work in an evidence-based manner.We did not review available assessment methods for

evaluation of EBP education interventions or pro-grammes in this study. The additional importance of thisfield and the apparent lack of valid evaluation methodshave been extensively highlighted in other studies andneeds to be taken into account when applying methodsfor teaching EPB [104, 105].

Strengths and limitationsThe scoping review presents an updated overview ofexisting methods for teaching EBP with respect toundergraduate healthcare students, including study spe-cific recommendations for teaching methods to be usedin future curricula. It follows recommended guidelinesfor a priori design requirements and transparent report-ing [13, 16].Limitations are however found in relation to the

search strategy. Our search did not include literaturepublished before 2010 and due to time constraints, alimited number of databases were searched, which en-tails the risk that not all relevant literature was identi-fied. Furthermore, the search terms used identifiedprimarily undergraduate nursing students, despite athorough search for all undergraduate students in thedisciplines of nursing, physiotherapy, occupational ther-apy, radiography, and biomedical laboratory science.

Other search terms might have captured these healthdisciplines to a greater extent. An alternative explanationfor the large occurrence of studies regarding nursingstudents could be that there is a greater publishing trad-ition in this field. However, the methods for teachingEBP can to a certain extent, be introduced to under-graduate students in the other health disciplines.

ConclusionConsistent with our objective, this scoping review has pro-vided an extensive overview of literature describingmethods for teaching EBP regarding undergraduate health-care students. The two key methods most often identifiedwere “Research courses and workshops” and “Collaborationwith clinical practice”. Despite the first method often beingused in this scoping review, as well as in other reviews,fewer of the Sicily Statement’s five steps of teaching andconducting EBP were referred to, and if the fifth step ofevaluation of change or outcome was included, the descrip-tion of content was often unclear.On the contrary, “Collaboration with clinical practice”,

the second most used teaching method, more often re-ferred to four or five steps, making this method an effectiveapproach for teaching EBP while ensuring incorporation ofseveral of the steps. Unlike the Research courses and work-shop methods, the last step of evaluation is carried outpartly or entirely in a clinical context.Overall, our results tend to show that the evaluation

step is often theoretically linked at the undergraduatelevel. Despite the small number of studies describing‘Journal clubs’ and ‘Embedded librarians’, these teachingmethods could advantageously be incorporated in theclassroom context and could ensure a complete intro-duction to all five steps.On the basis of our findings, we argue that future re-

search should focus on identifying methods for teachingEBP that incorporate as many of the Sicily Statement’sfive steps of teaching and conducting EBP as possible.Journal clubs and embedded librarians could be furtherlooked into as methods to support the more establishedmethods for teaching EBP across all undergraduatehealthcare disciplines.

AcknowledgementsThe authors would like to thank research assistants Morten Puck, Martin Mau andSusanne Pommergård for their valuable work in reviewing and editing tables.

Authors’ contributionsAST, HKK, CML contributed in designing the study. AST and AFC conductedthe literature search. AST, HKK and CML screened the titles and abstracts.AST, HKK, CML extracted data from the studies. AST and HKK performed asynthesis of study results. AST, HKK, CML and AFC interpreted the data. CMLand AST drafted the manuscript. All the listed authors have contributed toand approved the final manuscript.

FundingThis project is funded by internal funds granted by Health Sciences ResearchCentre, UCL University College, Odense, Denmark. The funding part had no

Larsen et al. BMC Medical Education (2019) 19:259 Page 30 of 33

role in the design of the study, the collection, analysis and interpretation ofthe data, or in writing the manuscript.

Availability of data and materialsThe data used and analysed during the current scoping review are availablefrom the corresponding author on reasonable request.

Ethics approval and consent to participateNot applicable.

Consent for publicationNot applicable.

Competing interestsThe authors declare that they have no competing interests.

Author details1Health Sciences Research Centre, UCL University College, Niels Bohrs Allé 1,5230 Odense M, Denmark. 2Department of Physiotherapy, UCL UniversityCollege, Niels Bohrs Allé 1, 5230 Odense M, Denmark. 3Research Service, UCLLibrary, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark.4Research Unit for Musculoskeletal Function and Physiotherapy, Departmentof Sports Science and Clinical Biomechanics, University of Southern Denmark,Campusvej 55, 5230 Odense M, Denmark. 5Department of Clinical Research,University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark.

Received: 17 December 2018 Accepted: 23 June 2019

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