Nurse Education Today 41 (2016) 54–59

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Nurse Education Today

journal homepage: www.elsevier.com/nedt

How do nurse academics value and engage with evidence-based practice

a r t i c l e i n f o a b s t r a c t

Article history: Background: Integrating evidence-based practice (EBP) into undergraduate education and preparing future
Received 12 December 2015 nurses to embrace EBP in clinical practice becomes paramount in today's complex and evolving healthcare
Received in revised form 8 March 2016 environment. The role that EBP plays in the practical lives of nursing students will depend on the degree to
Accepted 15 March 2016 which it is promoted by academics, how it is incorporated into courses and its application to clinical setting.
Hence, nursing academics play a crucial role in influencing its integration into curricula. Drawn from a larger
Keywords:
doctoral study, this paper presents findings discussing how nurse academics value and engage with EBP.
Evidence-based practice
Nurse academics
Methods: Grounded theory was employed to explore processes used by nursing academics while incorporating
Engaging EBP into teaching and learning practices. Twenty-three academics across Australian universities were
Valuing interviewed. Nine were also observed while teaching undergraduate students. Data were collected from semi-
Grounded theory structured interviews and non-participant observation. In keeping with the tenets of grounded theory, data
EBP in nursing education collection and analysis continued until theoretical saturation was reached. In total, four categories emerged.
This paper focuses on the category conceptualised as Valuing and Engaging with EBP.
Results: How nursing academics valued and engaged with EBP was closely associated with meanings they con-
structed around understanding it, attitudes and commitment to implementation while teaching and working
clinically. Different opinions also existed in regard to what actually constituted EBP. However, they engaged
with and valued EBP by keeping themselves up-to-date, being involved in research activities, using evidence in
teaching, therefore leading by example. Participants identified a number of barriers influencing their engage-
ment with EBP including heavy workloads, limited time, lack of commitment within their schools, lack of confi-
dence with teaching EBP, and complexity of EBP application. Faculty clinical practice, committed academics,
workload management and continuing education were highlighted as facilitators.
Conclusion: A number of barriers prevented academics from fully engaging with EBP at academic or practice
levels. Academic institutions and practice settings need to employ strategic planning to overcome such barriers.
© 2016 Elsevier Ltd. All rights reserved.

1. Introduction develop a spirit of inquiry and skills to search for evidence to support
clinical reasoning and thinking in their practice (Finotto et al., 2013).
Educating future nurses can be seen as a daunting challenge, Because academics shape future practice of nurses through education
particularly equipping them with adequate knowledge and skills of and role modelling, it is important they incorporate EBP into their
EBP to influence patient outcomes. Evidence-based practice has gained own teaching and learning practices (Hung et al., 2015).
momentum globally as practitioners strive to make decisions about pa- To date, there is a paucity of studies examining nursing academics'
tient care based on the best available evidence. EBP has been described understanding and engagement with EBP. In particular, how they
as a decision-making process for patient care that uses the best evidence engage and commit themselves to EBP in the context of clinical practice
available combined with practice experience and patients' own values before imparting these skills to students remains an important area of in-
and preferences to guide care (Sackett et al., 1996). Whereas, research vestigation. To be successful in integrating EBP into undergraduate curric-
utilisation refers to the use of research findings based on one single ula, one must address academics' understanding, engagement and level
study and this concept is now recognised as a part of the broader of commitment towards EBP. While most faculty members demonstrate
concept of EBP (Melnyk and Fineout-Overholt, 2011). knowledge and competencies in traditional research processes, many do
Nurse academics can no longer focus entirely on clinical skills not have adequate knowledge, attitudes or competencies in EBP to be
mastery and content knowledge, but must also prepare nurses to able to successfully incorporate it into teaching (Stichler et al., 2011).
Nurse academics have been slow to adopt the paradigm shift to EBP
⁎ Corresponding author. and have related concerns about the time it takes to integrate knowledge
E-mail address: [email protected] (G. Malik). and skills in already full curricula, and their lack of ability to incorporate

http://dx.doi.org/10.1016/j.nedt.2016.03.015
0260-6917/© 2016 Elsevier Ltd. All rights reserved.
 G. Malik et al. / Nurse Education Today 41 (2016) 54–59 55

EBP into teaching and learning practices (McInerney and Suleman, 2010). schools for distribution to their academic staff. Potential participants
A study by Stichler et al. (2011) explored perceptions of 125 faculty mem- expressed their interest in participating by contacting the researcher.
bers with baccalaureate and master's degrees from two schools of nursing Twenty-three nurse academics teaching into undergraduate nursing
in the south western region of the United States. They found that attitudes courses across Australian universities and colleges were interviewed.
of academics towards EBP were much more positive than their knowl- Nine consented to be observed while teaching undergraduate nursing
edge, skills and engagement with EBP. Barriers cited included students.
misconceptions about EBP, lack of frameworks for curriculum design, lim- Participants were given the choice to participate in both or either of
ited mentorship, time, information literacy skills, administrative support, the data collection methods. Interstate participants were interviewed
organisational resources, and inadequate statistical skills. In addition, par- via telephone with mutual agreement between participant and
ticipants indicated insufficient knowledge and skills in adopting EBP in researcher. Participants were interviewed one-on-one using a semi-
their teaching practices. The researchers recommended continuing edu- structured format with some guiding questions. Interviews were
cation opportunities for faculty to improve engagement with EBP in a approximately of 45 to 90 min in duration, were audiotaped and later
way that encouraged faculty to seek more opportunities to incorporate transcribed verbatim.
it into their teaching practices, courses and student activities (Stichler Observations of participants teaching undergraduate students were
et al., 2011). conducted during laboratory, tutorial and lecture sessions. Nine
Despite a plethora of literature on what evidence-based practice is, observations were undertaken across four states including Victoria,
its inclusion in nursing education is still limited and requires investiga- Queensland, South Australia and Western Australia. Before observations
tion into teaching approaches, academics' engagement and EBP related occurred, participants informed students regarding the purpose of the
course objectives and outcomes. Studies have reported that decisions to observation and the researcher assured that non-participant activities
implement EBP in undergraduate programmes have not been made would not be reported in any stage of research process. Field notes
explicit, thus its incorporation represents an area of limited knowledge were taken during the observations. To maintain participants' confiden-
(Al Hadid and Al Barmawi, 2012; Waters et al., 2009). It is believed that tiality and anonymity, pseudonyms were used throughout data analysis
adopting evidence-based practice in nursing education commences and communication of findings.
with undergraduate preparation and is carried further through graduate
and doctoral studies (Melnyk and Fineout-Overholt, 2011). Therefore,
exploring how nursing academics engage with, and influence integra- 4. Data Analysis
tion of EBP into undergraduate curricula is vital in preparing graduates
to adopt EBP into their practice. Hence, this paper draws upon findings Data were analysed using Charmaz's (2006) approach of open,
from a grounded theory study that aimed to explain processes used by focused and theoretical coding. Interviews and observations were
nurse academics while incorporating EBP into their teaching and transcribed into transcripts and field notes. They were read multiple
learning practices. The key question underpinning the study was: times to generate codes to identify actions, processes, causes and
What processes occur as nursing academics undertake to incorporate behaviours. These codes were constantly compared with focused codes,
evidence-based practice into their teaching and learning practices? data and with emerging concepts. These comparisons generated sub-
Findings presented in this paper focus on ways nurse academics categories and categories, which were further compared to codes and
engaged with and committed themselves to EBP. data to identify linkages between them. Charmaz (2006) asserts that
grounded theory analysis depends on constant comparative method by
2. Methodology continually engaging and interacting with data. This method enhances
the conceptual understanding of the researcher and provides sense of
Grounded theory methodology (GTM) underpinned by symbolic direction in which the analysis is going (Charmaz, 2006). Theoretical
interactionism was employed for this study. Grounded theory is an memos and reflective diary were maintained throughout the study as a
inductive, qualitative research approach ideal for the study as it means of conceptualising the data. In keeping with the tenets of ground-
focuses on human interaction and social processes (Munhall, 2007). ed theory, data collection and analysis continued until theoretical satura-
Underpinned by symbolic interactionism, this research methodology tion was reached. NVivo 10 was utilised to organise data into codes and
emphasises process and relates to context, so was particularly suitable categories. As a result of this iterative and interactive process, four catego-
to answer the study question. GTM is appropriate to exploration of ries emerged. This paper focuses on the first category conceptualised as
areas where little is known and the researcher aims to develop a Valuing and Engaging with EBP. Other three categories were: Enacting
substantive theory to understand and explain the social processes the Curriculum, Influencing EBP Integration and Envisaging the use of EBP.
grounded in data (Annells, 1997). An important characteristic of GTM Nurse academics instil EBP knowledge and skills by introducing EBP
is allowing data collection using a variety of sources to understand and research units in curriculum and integrating EBP into various units
how research participants construct meanings and define their realities of study. Academics influence EBP integration by employing a variety of
in specific situations (Charmaz, 2006). Charmaz (2006) asserts that in teaching and learning strategies and expecting students to apply EBP in
order to produce credible theory, grounded theorists should focus on theory and practice.
using various data collection methods such as observations, interview
transcripts, documents and images throughout the research process.
5. Findings
3. Data Collection
The category identified as “Valuing and Engaging with EBP” describes
Prior to commencing data collection, ethical approval was obtained methods through which academics engaged with and committed to
from the relevant university ethics committee. Approvals were also EBP. By having knowledge and understanding of EBP concepts, they
obtained from heads of schools and written consent was obtained kept themselves up-to-date with latest evidence. They further em-
from all participants wishing to partake. braced it by undertaking research, disseminated research findings and
Data were collected through interviews and non-participant incorporated evidence into their teaching and learning practices, there-
observation. Employing purposive sampling, nurse academics teaching fore setting positive examples for their students and colleagues. This
undergraduate nursing curricula across Australian universities and category is further conceptualised through sub-categories: demonstrat-
colleges offering undergraduate nursing programmes were invited to ing some understanding of EBP, committing to and embracing EBP, keeping
participate in the study. Letter of invitations were sent to heads of up to date, and leading by example.
56 G. Malik et al. / Nurse Education Today 41 (2016) 54–59

5.1. Demonstrating Some Understanding of EBP 5.2. Committing to and Embracing EBP

This sub-category discusses participants' understanding of EBP con- Participants demonstrated commitment to EBP by conducting
cepts and its application in clinical settings. Wide variation was evidenced research, or being part of research projects. Some of them were also ac-
in participants' views and opinions about EBP. Many viewed EBP as a pro- tively involved in hospital quality assurance and related committees:
cess of using the best evidence in combination with the clinician's expe-
I do 40% academic teaching, 40% research and 20% of admin. I've actu-
riences as well as patient preferences and values. As Barbara explained:
ally got a research project that's happening myself in a regional hospital.
We have to consider the three aspects of evidence-based practice, which It's so exciting. (Linda)
is: What is best practice? What are the patients' preferences? What is
the doctor, or the health professional's preferences, along with the re- I'm on a Clinical Practice Guidelines Working Party, so we go and assess
sources that are available? the evidence, and develop practice guidelines that are specifically de-
signed. (Karen)
A deeper and more complex understanding of EBP on the possibili-
ties for positive patient outcomes was presented by Josh who Research participants also valued EBP by being consumers of
recognised EBP as a clinical decision-making process, emphasising that: research and considered this equally important as generating evidence:

I always come back to this, because at the end of the day, that's what the I don't have research projects attached to me. But I base all my teaching
heart of evidence-based practice is about, is good clinical decision- on the current evidence and try to link evidence to practice, this is how I
making to achieve better patient outcomes. keep up with EBP.
[(Josh)] [(Henry)]

However, some participants considered research utilisation as an- Many participants identified that having positive attitudes and en-
other terminology for EBP which could be used interchangeably: gagement with EBP either at academic or practice level could influence
their teaching practices and help them to motivate their students in the
Oh, well research utilisation… To be quite honest, I′m not actually sure, use of EBP:
but research is EBP when it's been tested, the evidence has been tested in
a practical field, that works, but the subject is really more utilisation of …if we keep trying to be as up with the evidence as we can, if we keep
research, which is another term for EBP isn't it? mentioning to the students that we're linking evidence to practice so
[(Karen)] that they start to get that mindset that everything we do has to be prov-
able then I think we will get there.
Others considered EBP a challenging concept to understand, practise [(Donna)]
and make students understand. Beliefs about the value of EBP in im-
proving clinical practice and patient outcomes were strong, however However, participants were cognisant of the fact that this would not
implementation of EBP into practice did not appear to be as positive: be achieved without having committed faculty members. Commitment
within schools was identified and emphasised by many participants as a
It's quite complicated, so certainly I think that people are very commit- facilitating factor to embracing EBP:
ted to the notion of EBP, but I think it's far more complicated than we
recognize. So EBP to me, is probably something I would love to aspire There does have to be a commitment … within a school of nursing or
to, but I think it is a challenge; a huge challenge. with whatever the institution happens to be… by the staff to EBP.
[(Theresa)] Because otherwise how does it get to the student if the staff aren't using
it? I mean we make comments in lectures and we make comments in
On further exploration, Theresa and others highlighted that limited the lab that the latest research tells us that we should be doing this
time, scarcity of resources and lack of organisational support were hin- and hopefully that's putting it into the mind of the student that that's
dering factors for academics and for students who were at the beginning also something they should be asking. Is this the latest research or is this
of embracing EBP. EBP being a challenge and complicated concept to un- just something that has become practice because of habit?
derstand was also supported by Stacey: [(Josh)]
No support from the organisation for nurses to embrace research and Along these lines, participants identified the need for faculty clinical
evidence. So I guess in a convoluted way, that's what EBP is to me. It's practice and emphasised its significance for their practice and research.
complicated, it's ideal; but it's not always engaged appropriately. They recommended it to be part of their employment to provide oppor-
tunities to embrace EBP in practice settings:
Misconception existed between research participants trying to link
EBP to research critique. Some perceived that getting students to cri- …faculty practice is part of EBP because that would then have us taking
tique research articles was equivalent to preparing them to be what we've learnt from our own research and apply it in our practice
evidence-based practitioners, as Linda suggested: and impacting on others who we work with”.
[(Joanne)]
That's where the evidence-based comes back in, where you get them to
start looking at well, here's a piece of research or here's three articles. Go
It would give us credibility with our students and it would let us see
off and critique them and say would you base your practice based on
what's happening out there in the clinicians' area and I mean a lot of ac-
any of these and choose a good, bad, and ugly.
ademics do work in the industry as well as … but that's on top of your
However in response to this Josh emphasised academics re-oriented employment. It's not recognised as part of your employment.
their thinking around EBP and incorporated principles of EBP in their [(Katrina)]
teaching and learning practices:

It just means that academics have to re-orient their thinking in their 5.3. Keeping Up to Date
subject. They can do that over a period of time, It can be something that
happens, say, over two or three years, where they re-orient towards the Participants kept themselves current by using a variety of sources.
curriculum more towards evidence-based practice. Some specifically mentioned using Joanna Briggs Institute to search
 G. Malik et al. / Nurse Education Today 41 (2016) 54–59 57

for and use evidence into their teaching and learning practices while feather in my cap, but saying to them, come and listen to what I have
others maintained currency by attending training sessions and for 15 minutes to present, what I am up to with my research.
workshops: [(Kate)]
I use Joanna Briggs a lot. If I don't have time, I can shrink a little summa- Having positive attitudes towards research and EBP, participants
ry and I can download the article and read when I have time. mentioned that if academics believed research to be an evil, this trans-
[(Henry)] lated through their teaching and students picked up on the subtle cues:
If you're teaching a course and you're not at all interested in research
We do have a whole of school retreat every year and these sorts of topics and you don't have an understanding of it yourself,…you fall on deaf
come up for discussion. We have guest speakers come in and speak to us ears. You haven't got the passion to put the message across. Students
and university itself has usually every two weeks or three weeks, they are very impressionable and they pick up on the subtle cues if we roll
have sessions where staff can go. our eyes about the research aspect of this condition or this scenario.
[(Michelle)] We have to kind of clean up our own house before we start telling the
students that they should love research.
Other than attending training sessions, many participants had be-
[(Karen)]
come members of professional organisations to stay current with prac-
tice changes, and endeavoured to keep colleagues informed of such Academics were seen to lead by example, through commitment and
changes. positive attitudes to embracing EBP. By role modelling, academics could
…trying to make sure that we, as nurses, are up-to-date with some of generate interest and create love for practices based on EBP among
their clinical practices…things like wound management, things like students:
hand hygiene and there's a myriad of ways of doing that; and one of … we were academic role models. So how we teach and what we say
them would certainly to be through our professional bodies, that would and how we say it, and our attitude can very much influence students.
be probably the easiest way. They almost become who you are or they carry attitudes. So in a
[(Theresa)] way…that can be a positive and a negative. If you instil an attitude that
is open and positive towards EBP then that's carried through.
I made that my job to advise my colleagues when there was a change, [(Lyn)]
which came out of the Australian Resuscitation Council meetings and
recommendations for change, to go into 2015. If you can get commitment from the staff then the students hear that
[(Ann)] message and if they hear it often enough, it becomes part of the way
they envision themselves as nurses…that's the first step, even with all
Practice changes were incorporated into teaching and learning prac-
the financial restrictions and the workplace issues, if we can get a
tices either by face-to-face teaching or through online mode.
graduate who has a questioning mind, then we've succeeded.
That's the way we incorporate changes to the evidence into their prac- [(Deon)]
tice. With the online teaching we added that to the micro-sim standard
that sits behind, when the students do the online participation, and the Participants were in consensus about using EBP terminology as early
classroom teaching. as they could in the degree programme, for example:
[(Ann)] We need to start as early as possible, demonstrating to them that we
have used research in preparing what it is we're teaching them and that
Some participants identified challenges in staying current. Limited
research is the basis of everything that we change in nursing.
time to search for literature and incorporate it into teaching, lack of
[(Melissa)]
commitment from other academics, heavy workloads, evolving nature
of evidence and plethora of information were described as key obstacles. The findings highlight differences in participants' opinions with
Change in practices is happening all the time. That's one of the hardest regard to what EBP meant to them. However, they were committed
things to keep up to date with. and engaged with EBP by getting involved in research activities, using
[(Barbara)] literature and attending continuing professional development sessions
to keep current, incorporating evidence into their teaching and learning
practices, and therefore, leading by example. During these processes,
The time restraint of course is always the issue. academics identified some challenges with fully engaging with EBP.
[(Henry)]

6. Discussion
It's very difficult to keep up to date with everything with the plethora of
information available.
Models aimed at successful EBP implementation including the ACE
[(Jacki)]
Star Model (Heye and Stevens, 2009) and the Johns Hopkins EBP
Model (Newhouse et al., 2007) suggest that academics are pivotal in
preparing undergraduate nursing students with EBP competencies.
5.4. Leading by Example
The knowledge that academics possess, their credibility and status
within the profession could meaningfully influence nursing students'
Getting students to a mindset of using evidence by modelling the
uptake of EBP (Melnyk and Fineout-Overholt, 2011). Findings from
behaviour that academic teaching is informed by latest evidence, and
the sub-category ‘demonstrating some understanding of EBP’ reflect that
inculcating lifelong learning philosophy among students was seen to
nursing academics attributed very different meanings and interpreta-
be the aim of teachers:
tions to the phrase ‘evidence-based practice’. For some participants in
this study, EBP was synonymous with ‘research utilisation’, while for
I'm presenting my interim audit at a research forum. I've been able to others EBP was understood in relation to the broader aims of EBP
invite my students to come and hear my presentation. Not putting a leading to clinical decision-making. In nursing literature, ‘research
58 G. Malik et al. / Nurse Education Today 41 (2016) 54–59

utilisation’ has referred to the translation of research into practice, Professional modelling is believed to be one of the most helpful
whereas EBP is described as the process of using research evidence characteristics for clinical instructors leading to student learning and
together with patients' values, clinicians' expertise and available engagement with EBP reported by Hankemeier and Van Lunen
resources. Thus, EBP cannot be achieved by solely translating research (2011). Instructors encourage students to be curious of their practices,
to practice (Christie et al., 2012). One consequence of nursing academics ask meaningful questions, find relevant evidence and apply evidence
holding a range of views about EBP is that it could lead to passing on to their patients in light of their preferences and values (Hankemeier
mixed messages of what EBP is to students and how this relates to and Van Lunen, 2011). Role modelling and integrating the skills neces-
research. Findings of this study correlate with another Australian sary to develop EBP into theoretical and clinical units are vital in
study (Waters et al., 2009) and other global studies (Rolfe et al., 2008; instilling positive attitudes towards EBP among students (Winters and
Stichler et al., 2011). While it is not surprising that understanding of Echeverri, 2012). Nursing academics could lead by example by includ-
EBP is greatly influenced by academics' past and present experiences, ing evidence for each content area covered in theoretical and clinical
it is of concern that teaching content and incorporation of EBP concepts units (Winters and Echeverri, 2012). However, this could only be
into nursing curricula will be largely based on their assumptions and achieved if nursing academics were up-to-date with literature and
understandings (Waters et al., 2009). With the current impetus for practice changes.
EBP, these findings challenge nursing academics to re-orient their think- The rapidly changing nature of health information was found as a
ing upon which their EBP education is based. stimulus in Felicilda-Reynaldo and Utley (2015), however limited time
Educational interventions can serve as effective means for increasing to search for evidence and update teaching content, complexity with
knowledge and understanding of EBP process and implementation EBP application, insufficient resources, limited confidence in teaching
(Sherriff et al., 2007). A study by Al Hadid and Al Barmawi (2012), ex- EBP, plethora of information, and traditional mindsets or attitudes of
ploring factors influencing adoption of evidence-based principles in staff towards research and EBP were identified as key challenges to
nursing education in Jordon, reported that many of the educator partic- engage with EBP in the present study. These barriers coincide with na-
ipants were prepared to be researchers and had expertise in their area of tional and international studies (Kalb et al., 2015; Stichler et al., 2011)
study. However, their focus was very limited in transferring elements of and have been consistently raised over the years. Commitment within
EBP into their teaching courses. Another study exploring knowledge, school, effective workload management, provision of resources and in-
beliefs and teaching strategies of EBP among educators in nursing insti- clusion of faculty practices in the job description of academics have
tutions in Nigeria concluded that a majority of participants claimed to been considered facilitators to successful EBP engagement and commit-
have knowledge of EBP however, they lacked knowledge on the EBP ment among nursing academics (Malik et al., 2015; Rickbeil and
process, and teaching methods promoting EBP in clinical practice Simones, 2012; Aquadro and Bailey, 2014). Nurse academics act as
(Enuku and Adeyemo, 2014). Current study participants held positive EBP champions by facilitating organisational and educational strategies,
attitudes towards EBP and had shown their commitment by embracing translating evidence for policy and practice, and modelling specific
EBP in several ways, such as involvement with research, attending sem- behaviours in influencing EBP use (Upton et al., 2015), therefore strate-
inars and workshops, staying current with practice changes and keeping gies targeting to increase their engagement with EBP and aiming to
up-to-date with literature as described in the second and third sub- overcome identified challenges are recommended.
categories. These findings are in line with Melnyk et al. (2008). There
is a link between understanding of EBP, valuing EBP and confidence in 6.1. Implications for Education and Research
its teaching within the literature (Melnyk et al., 2008; Stichler et al.,
2011). Enhancing knowledge of EBP will help nurses to see the value In light of the growing focus on EBP, current study findings have
of EBP to their own work, which will eventually increase implementa- clear implications for education and research. Academics play a vital
tion. Participants from a study by Upton et al. (2015) identified positive role in preparing undergraduates to practise within an EBP framework,
attitudes to EBP were important to its uptake. Furthermore, that study therefore their commitment and engagement with EBP could influence
recommended continuing professional development opportunities their teaching and learning practices. With regard to EBP definition,
would enhance academics' understanding and their uptake of EBP. varying opinions existed among academics, which requires faculty
An innovative way to facilitate EBP use among faculty members is development to assist clarity and agreement around EBP concepts. In
implementation of faculty practice. Faculty practice refers to a formal ar- addition, barriers identified by research participants invite both
rangement between an academic institution and clinical agency, academic and practice settings to implement steps to minimise obsta-
allowing faculty to be engaged in direct patient care, supervise students' cles. Further research could examine the effectiveness of educational
clinical experiences or involved in consultative roles for clinical staff programmes and implemented strategies on academics' engagement
(Elliott and Wall, 2008). Faculty often navigates the difficult process of with EBP and integration of EBP into their teaching and professional
engaging students and busy staff by either being involved in patient practices.
care or more recently by having joint appointments between academic
and clinical organisations (Moch et al., 2015). Adopting an educational 7. Limitations
model that requires academics and students to work hand-in-hand
could be one method for promoting collaborative work and in improv- Findings of this study need to be considered in the light of potential
ing adoption of evidence-based principles among students. (Moch et al., methodological limitations. Grounded theory places emphasis on pro-
2015). Joint research between academic and clinical sites would provide cesses and meaning within a local context and therefore the findings
boosts for academics to incorporate their findings into practice and see cannot be generalised. However, the aim of the study was to provide
the value of their work (Upton et al., 2015). Acknowledging the value of adequate detail to offer valuable insights into what extent nursing aca-
faculty practice and incorporating it into academics' workload could demics engage and commit to EBP. It is possible that nurse academics
positively contribute to maximum faculty engagement in the use of who were passionate either positively or negatively were more likely
EBP (Aquadro and Bailey, 2014). Hankemeier and Van Lunen (2011) to participate.
explored clinical instructors' perspectives on implementation strategies
in EBP for athletic training students concluding that self-discovery, 8. Conclusion
promoting critical thinking, sharing information and role modelling
have shown to be effective strategies to encourage EBP use among This study has taken a unique approach in exploring processes used
students and clinicians. Study participants rated personal commitments by nursing academics while integrating EBP into undergraduate educa-
as facilitators to teaching and incorporating resources into practices. tion. This paper has discussed academics' engagement with EBP as a
 G. Malik et al. / Nurse Education Today 41 (2016) 54–59 59

process, influencing EBP integration into their teaching and learning Heye, M.L., Stevens, K.R., 2009. Educational innovations. Using new resources to teach
evidence-based practice. J. Nurs. Educ. 48 (6), 334–339. http://dx.doi.org/10.3928/
practices. There were differences in opinions among nursing academics 01484834-20090515-06.
in regard to what evidence-based practice was. However, they participat- Hung, H.-Y., Huang, Y.-F., Tsai, J.-J., Chang, Y.-J., 2015. Current state of evidence-based
ed in and valued EBP by keeping up-to-date, engaging in research activi- practice education for undergraduate nursing students in Taiwan: a questionnaire
study. Nurse Educ. Today 35 (12), 1262–1267. http://dx.doi.org/10.1016/j.nedt.
ties, incorporating evidence into their teaching and therefore, leading by 2015.05.001.
example. Academics have identified barriers with engaging fully with Kalb, K.A., O'Conner-Von, S.K., Brockway, C., Rierson, C.L., Sendelbach, S., 2015. Evidence-
EBP, inviting academic institutions and health care settings to implement based teaching practice in nursing education: faculty perspectives and practices.
Nurs. Educ. Perspect. 36 (4), 212–219. http://dx.doi.org/10.5480/14-1472.
strategies and programmes to attain maximum engagement. Malik, G., McKenna, L., Plummer, V., 2015. Perceived knowledge, skills, attitude and con-
textual factors affecting evidence-based practice among nurse educators, clinical
coaches and nurse specialists. Int. J. Nurs. Pract. 21, 46–57. http://dx.doi.org/10.
Acknowledgements 1111/ijn.12366.
McInerney, P., Suleman, F., 2010. Exploring knowledge, attitudes, and barriers toward the
Authors would like to acknowledge the heads of schools of nursing use of evidence-based practice amongst academic health care practitioners in their
teaching in a south African university: a pilot study. Worldviews Evid.-Based Nurs.
and midwifery of all Australian universities for the invitations distribu- 7 (2), 90–97. http://dx.doi.org/10.1111/j.1741-6787.2009.00180.x.
tion to the potential participants. Special thanks to nurse academics Melnyk, B.M., Fineout-Overholt, E., 2011. Evidence-based Practice in Nursing &
who participated in this study and to the Monash University ethics com- Healthcare: A Guide to Best Practice. Wolters Kluwer/Lippincott Williams & Wilkins.
Melnyk, B.M., Fineout-Overholt, E., Feinstein, N.F., Sadler, L.S., Green-Hernandez, C., 2008.
mittee for the approval of this study.
Nurse practitioner educators' perceived knowledge, beliefs, and teaching strategies
regarding evidence-based practice: implications for accelerating the integration of
evidence-based practice into graduate programs. J. Prof. Nurs. 24 (1), 7–13.
References Moch, S.D., Quinn-Lee, L., Gallegos, C., Sortedahl, C.K., 2015. Navigating evidence-based
practice projects: the faculty role. Nurs. Educ. Perspect. 36 (2), 128–130. http://dx.
Al Hadid, L.A., Al Barmawi, M., 2012. Factors influencing the adoption of principles of ev-
doi.org/10.5480/12-1014.1.
idence-based principles in nursing education: a Jordanian perspective. J. Nurs. Educ.
Munhall, P., 2007. Nursing Research: A Qualitative Perspective. fourth ed. Jones and Bart-
Pract. 2 (2), 71–79.
lett Publishers, Boston.
Annells, M., 1997. Grounded theory method, part I: within the five moments of qualita-
Newhouse, R.p., Dearholt, S.L., Poe, S.S., Pugh, L.C., White, K.M., 2007. Johns Hopkins Nurs-
tive research. Nurs. Inq. 4, 120–129. http://dx.doi.org/10.1111/j.1440-1800.1997.
ing Evidence-based Practice Model and Guidelines. Sigma Theta, Indianapolis, IN.
tb00085.x.
Rickbeil, P., Simones, J., 2012. Overcoming barriers to implementing evidence-based prac-
Aquadro, L.C., Bailey, B.I., 2014. Removal of nursing faculty practice barriers in academia:
tice: a collaboration between academics and practice. J. Nurses Staff Dev. 28 (2),
an evidence-based model. J. Nurs. Educ. 53 (11), 654–658. http://dx.doi.org/10.3928/
53–56. http://dx.doi.org/10.1097/nnd.0b013e31824b4141.
01484834-20141027-04.
Rolfe, G., Segrott, J., Jordan, S., 2008. Tensions and contradictions in nurses' perspectives of
Charmaz, K., 2006. Constructing Grounded Theory: A Practical Guide Through Qualitative
evidence-based practice. J. Nurs. Manag. 16, 440–451.
Analysis. SAGE Publications LTD., Los Angeles.
Sackett, D.L., Rosenberg, W., Gray, J.A.M., Haynes, R.B., Richardson, W.S., 1996. Evidence-
Christie, J., Hamill, C., Power, J., 2012. How can we maximize nursing students' learning
based medicine: what is it and what it isn't? Br. Med. J. 312, 71–72.
about research evidence and utilization in undergraduate, preregistration
Sherriff, K.L., Wallis, M., Chaboyer, W., 2007. Nurses' attitudes to and perceptions of
programmes? A discussion paper. J. Adv. Nurs. 68 (12), 2789–2801. http://dx.doi.
knowledge and skills regarding evidence-based practice. Int. J. Nurs. Pract. 13,
org/10.1111/j.1365-2648.2012.05994.x.
363–369.
Elliott, M., Wall, N., 2008. Should nurse academics engage in clinical practice? Nurse Educ.
Stichler, J.F., Fields, W., Son Chae, K., Brown, C.E., 2011. Faculty knowledge, attitudes and
Today 28 (5), 580–586.
perceived barriers to teaching evidence-based nursing. J. Prof. Nurs. 27 (2), 92–100.
Enuku, C.A., Adeyemo, F.O., 2014. Knowledge, beliefs and teaching strategies of evidence-
http://dx.doi.org/10.1016/j.profnurs.2010.09.012.
based practice among nurse educators/lecturers in nursing institutions in Benin City,
Upton, P., Scurlock-Evans, L., Williamson, K., Rouse, J., Upton, D., 2015. The evidence-
Edo State, Nigeria. Int. J. Collab. Res. Intern. Med. Public Health 6 (1), 1–10.
based practice profiles of academic and clinical staff involved in pre-registration
Felicilda-Reynaldo, R.F.D., Utley, R., 2015. Reflections of evidence-based practice in nurse
nursing students' education: a cross sectional survey of US and UK staff. Nurse
educators' teaching philosophy statements. Nurs. Educ. Perspect. 36 (2), 89–95.
Educ. Today 35 (1), 80–85. http://dx.doi.org/10.1016/j.nedt.2014.06.006.
http://dx.doi.org/10.5480/13-1176.
Waters, D., Rychetnik, L., Crisp, J., Barratt, A., 2009. Views on evidence from nursing and
Finotto, S., Carpanoni, M., Turroni, E.C., Camellini, R., Mecugni, D., 2013. Teaching
midwifery opinion leaders. Nurse Educ. Today 29 (8), 829–834. http://dx.doi.org/
evidence-based practice; developing a curriculum model to foster evidence-based
10.1016/j.nedt.2009.04.006.
practice in undergraduate student nurses. Nurse Educ. Pract. 13, 459–465.
Winters, C.A., Echeverri, R., 2012. Teaching strategies to support evidence-based practice.
Hankemeier, D.A., Van Lunen, B.L., 2011. Approved clinical instructors' perspectives on
Crit. Care Nurse 32 (3), 49–54.
implementation strategies in evidence-based practice for athletic training students.
J. Athl. Train. 46 (6), 655–664.