Author: Mary Guimond, PhD, WHNP-BC
Title: Assistant Professor
Institution: Duquesne University
Evidence-Based Practice, Patient-Centered Care
- Write a PICO question
- Appraise evidence available using electronic resources
- Select evidence to address PICO question
- Categorize level of evidence
- Formulate a response to the assigned nursing problem
The assignment can be used for large or small classrooms. It works best if student groups are limited to 4 students per group. If more than 10 groups, two facilitators should be available to circulate the room. The purpose of the facilitator is to help focus students on the assignment, clarify questions about the “nursing problem”, and to answer questions as they arise.
In preparation for this assignment, I use a quick lecture to discuss evidence based practice and I demonstrate how to use the web to find appropriate resources (Google Scholar, Cochrane Database, CINAHL). For evidence based practice theory, I ask students to review an external website for evidence based practice (there are several available via search). Also, because I want to set my students up for success–I have pre-searched Cochran Database for the latest systematic review on the “nursing problem”–students may or may not find the review, but I know that it is an active area of research.
Each group is presented with a “nursing problem” for example:
- A child is being discharged from the clinical after being seen for antibiotic associated diarrhea. The mother is upset because the HCP recommended probiotic rather than a “real medicine” How do you respond?
- You are working on a surgical unit and the nurses are trying to convince a physician group that early feeding might be a good idea for some patients. What will you say?
- You are providing discharge instructions for a patient and the doctor has prescribed a porcine-derived insulin product. The patient is concerned because he understood that human insulin is better. How do your respond?
Student groups are asked to:
A. Develop a PICO question based on their “nursing problem”
B. Use computers or smartphones to access evidence in real time (20-30 minutes are given for the research portion) and to evaluate the most recent evidence available
C. Determine the level of evidence available
D. Use the evidence to formulate a response to their “nursing problem”
E. Translate their response to everyday language
Each group has 5 minutes to present their work to the class. They are asked to include: “nursing problem”, PICO question, evidence, and response.
Because this is a highly structured assignment, the quality of the student work is generally very good. The facilitators help students to ask the right questions and use their resources efficiently. The nature of the assignment is formative, although I do ask for a written report containing the “nursing problem”, PICO question, level of evidence, evidence citation and source, and the response to the person/patient.
Students are delighted to find the evidence is readily available.