1. What do Nurses Know About EBP? Using Valid, Reliable, Objective Instrumentation as the Foundation for Developing and Testing Strategies to Support EBP Knowledge Amy Hagedorn Wonder PhD, RN; Angela McNelis PhD, RN, FAAN, ANEF, CNE; Darrell Spurlock Jr. PhD, RN, NEA-BC, ANEF; Pamela Ironside PhD, RN, ANEF, FAAN; Shelley Lancaster MSN, RN, ACNS-BC, CWOCN, CCRN-K; Carmen Davis, MSN, RN, CCRN, CNS-BC; Marlena Gainey, RNC, MSN, WHNP-BC; Nancy Verwers, MSN, RN, ACNS-BC Research Funded by the Ethel Clarke Fellowship at Indiana University School of Nursing

2. Conflicts of Interest and Disclosures Neither the planners or presenters have any real or perceived vested interests that relate to this presentation 2

3. Objectives Describe how evaluation can be used to develop and test innovations to facilitate and sustain EBP knowledge. Explain the importance of using valid, reliable, objective instrumentation to describe the EBP knowledge of practicing nurses. Describe how evaluation can be used for research on durability of knowledge. 3 3

4. USING EVALUATION TO DEVELOP AND TEST INNOVATIONS TO FACILITATE AND SUSTAIN THE EBP KNOWLEDGE OF PRACTICING NURSES 4

5. Use Data to Guide the Development and Testing of Innovation Establish a baseline measure with a valid, reliable instrument MEAN EKAN SUM SCORE10.58 5

6. Use Data to Guide the Development and Testing of Innovation 6

7. IMPORTANCE OF INSTRUMENT SELECTION: USING VALID, RELIABLE, OBJECTIVE MEASURES TO STUDY OBJECTIVE CONSTRUCTS 7

8. Evaluation of Subjective & Objective Constructs in Nursing Reliance on self-assessments of subjective constructs Attitudes Beliefs Facilitators/Barriers Reliance on self-assessments for objective constructs Knowledge Competency Implementation 8

9. Subjective & Objective Measures Knowledge, skills, or ability correspond poorly to objective measures (Zell & Krizan, 2014) – Meta-analysis -- 357,547 subjects Overall mean correlation: M =.29 (SD =.11). – Less correlation between subjective/objective measures with less familiar and/or more complex tasks 9

10. Subjective & Objective Measures of EBP Within Nursing N=151 RNs working in Magnet-designated hospitals VariableM (SD)123 1. EKAN Sum Score10.58 (2.87)- 2. EBPQ—Knowledge/Skills4.68 (0.81)0.122- 3. EBPQ—Attitude5.51 (0.98)0.1230.398**- 4. EBPQ—Practice/Use4.48 (1.37)0.0170.595**0.350** * = p < 0.05 ** = p < 0.01 10

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13. “I am sure I can deliver evidence-based care” and each EBPQ subscale scores were positively and statistically significantly correlated (r =.228 -.413, p <.01), but not with EKAN sum scores (r = -.066, p =.418). 13

14. Importance of Instrument Selection To study the constructs associated with EBP – Use objective instruments to study objective constructs Knowledge Skill Practice/Use Competency – Use subjective instruments to study subjective constructs and correlations with objective constructs Attitude Beliefs Facilitators/Barriers 14

15. Instrument Selection Instrument selection based on: Desired innovation – Theoretical or Competency Framework – Implementation Strategy – Duration Latent trait – EBP Knowledge 15

16. USING EVALUATION TO ESTABLISH THE DURABILITY OF EBP KNOWLEDGE 16

17. Durability of EBP Knowledge Ongoing evaluation to gain insights on: – Frequency How often a targeted intervention is needed – Dose What type of interventions are needed by nurses over the course of professional careers, based on: – Education – Role – Setting 17

18. Summary Instrument selection – Valid, reliable instrument to directly measure construct – Appropriately aligned with the innovation Baseline measurement – Foundation to gauge impact of innovation Ongoing evaluation – Effectiveness of the intervention – Durability of EBP knowledge Determine frequency and dose of future interventions 18

19. References Spurlock, D., & Wonder, A. H. (2014). Measures for nursing and nursing education. http://nursingmeasure.org/index.html.http://nursingmeasure.org/index.html Spurlock, D., & Wonder, A. H. (2015). Validity and reliability evidence for a new measure: The evidence- based practice knowledge assessment in nursing. Journal of Nursing Education, 54(11), 605–613. Upton, D., & Upton, P. (2006). Development of an Evidence-Based Practice Questionnaire for nurses. Journal of Advanced Nursing, 53(4), 454-458. Wonder, A. H., McNelis, A., Spurlock, D., Ironside, P., Lancaster, S., Davis, C., Gainey, M., & Verwers, N. (Submitted). A comparison of nurses’ self-reported and objectively measured EBP knowledge. Journal of Nursing Scholarship. Wonder, A. H., Spurlock, D., & Ironside, P. M. (Accepted). Using the Evidence-based Practice Knowledge Assessment in Nursing (EKAN) Instrument to evaluate exposure effects in baccalaureate nursing students. Nursing Education Perspectives. Zell, E., & Krizan, Z. (2014). Do people have insight into their abilities? A metasynthesis. Perspectives on Psychological Science, 9(2), 111–125. 19

20. Questions Additional Information – Amy Hagedorn Wonder, PhD, RN awonder@iu.edu awonder@iu.edu EKAN – http://nursingmeasure.org/index.html http://nursingmeasure.org/index.html 20