Bridging the academic–clinical gap: a comparative cross-sectional analysis of self-reported evidence-based practice engagement and associated research activity between fourth-year nursing students and interns
Nursing curricula should integrate practice-centered and research-engaged strategies to support sustained EBP development across the academic–clinical transition, with future longitudinal and objectively measured studies needed to confirm developmental claims.
Abstract
Background Evidence-based practice (EBP) is a core competency in contemporary nursing; however, the academic-to-clinical transition represents a critical period during which self-reported EBP engagement and associated research activity may diverge. Limited evidence exists on how these characteristics differ between senior nursing students and clinical interns within the same single-institution educational context. Methods A comparative cross-sectional, between-group study was conducted among 260 undergraduate nursing learners at Northern Border University, Saudi Arabia, comprising 118 fourth-year students and 142 interns. Data were collected using the validated Student Evidence-Based Practice Questionnaire (S-EBPQ), a self-report instrument assessing frequency of EBP-related practice, attitudes toward EBP, retrieving and reviewing evidence, and sharing and applying EBP; the instrument was administered in its original English form, which is the formal language of nursing instruction at the participating institution, with linguistic clarity verified through expert review and a pilot pretest. Descriptive statistics, group comparisons, effect sizes, and multivariable linear regression with robust standard errors were used to examine differences and predictors of total self-reported EBP engagement. Given the cross-sectional design, findings were interpreted as between-group differences rather than developmental change. Results Interns demonstrated significantly higher total self-reported EBP engagement scores than fourth-year students (5.05 ± 0.96 vs. 4.61 ± 1.16, p = 0.001), with the largest differences observed in practice-oriented domains. Fourth-year students reported more favorable attitudes toward EBP (p = 0.025). In adjusted analyses, internship status (p = 0.024), prior research publication (p = 0.010), and age 22–25 years (p = 0.007) were independent positive correlates of EBP engagement, whereas male sex was negatively associated (p = 0.026). Grade point average was not associated with EBP engagement. The model accounted for a modest proportion of variance (adjusted R2 ≈ 10.6%), indicating that unmeasured contextual factors likely contribute substantially to between-group differences. Conclusion Self-reported EBP engagement was higher among interns than fourth-year students, particularly in applied domains, while favorable attitudes acquired during academic study appeared lower in the intern group. Structured clinical exposure and active research participation were associated with stronger EBP engagement, although the cross-sectional design and structural co-occurrence of internship status with research experience preclude causal inference. Nursing curricula should integrate practice-centered and research-engaged strategies to support sustained EBP development across the academic–clinical transition, with future longitudinal and objectively measured studies needed to confirm developmental claims.
Background: Evidence-based practice (EBP) is essential in modern nursing practice for improving patient outcomes, ensuring quality care, and strengthening professional decision-making. Despite the recognized importance of EBP, several barriers limit its implementation in clinical settings.
Objective: To assess the attitudes and barriers toward evidence-based practice among nursing professionals of Private Hospital.
Methods: A descriptive cross-sectional study was conducted among nursing professionals at Private Hospital, during a two-month internship period from 29th July to 30th September 2021. A structured self-administered questionnaire was used to collect data regarding knowledge, attitudes, and perceived barriers toward EBP. Of 108 nurses targeted based on calculates sample size, 61 registered nurses completed and returned the questionnaire. Descriptive statistics were used to summarize the findings.
Results: Most participants demonstrated positive attitudes toward EBP. Nearly all respondents agreed that EBP improves nursing practice (98.4%), brings rapid knowledge advancement (98.4%), and should be included in nursing curricula (98.4%). Major barriers identified included excessive workload and time limitations (96.7%), lack of interest in EBP (96.7%), lack of knowledge regarding EBP (96.7%), lack of training (96.7%), and limited access to resources (93.4%). However, peer support was not considered a major barrier by most respondents (90.2%).
Conclusion: Nursing professionals showed favourable attitudes toward evidence-based practice; however, organizational and educational barriers continue to hinder its implementation. Continuous professional education, institutional support, and improved access to research resources are necessary to enhance EBP adoption in nursing practice.
Key words: Evidence-based practice, nursing professionals, barriers, attitude, nursing education, cross-sectional study
Medha Wadhwa, Apurvakumar Pandya, K. Gupta et al.· International Journal of Hea...· 0 citations
Background: Undergraduate nursing students encounter academic, clinical, and social demands that may affect their well-being and educational performance, but evidence comparing stress across public and private institutions in Swat is limited. Objective: To determine academic, clinical, and social stress among undergraduate nursing students and compare stress-level distributions according to institutional sector, gender, and year of study. Methods: A multicentre comparative cross-sectional study included 237 second-, third-, and fourth-year nursing students from two public and two private institutions in Swat, Pakistan. Participants were recruited through convenience sampling and completed the 43-item Stress in Nursing Students questionnaire. Stress was classified as low, moderate, or severe. Data were analysed using descriptive statistics, Pearson’s chi-square tests, Cramér’s V, and unadjusted odds ratios with 95% confidence intervals. Results: Moderate academic, clinical, and social stress was reported by 62.0%, 59.9%, and 49.4% of participants, respectively. Severe stress was most frequent in the clinical domain (7.2%). Clinical stress differed by institutional sector (p=0.043), and public-sector students had higher odds of moderate or severe clinical stress than private-sector students (OR=1.83, 95% CI 1.06–3.17). Academic and social stress did not differ significantly by sector. Clinical stress varied by year of study (p=0.033), while academic and social stress were associated with gender (p=0.042 and p<0.001, respectively). Conclusion: Moderate stress was common across all domains, with the clearest institutional difference observed for clinical stress. Structured clinical preparation and student-support strategies are warranted, although adjusted and longitudinal studies are needed.
Zafar Iqbal¹, Hassan Ali², Maimon Khan² et al.· Link Medical Journal· 0 citations
Background Evidence‐based practice (EBP) is essential for improving the quality of care and health outcomes. Despite its importance, nurses’ competence in EBP remains limited, emphasizing the need for more effective training strategies. Aim This study aimed to explore the learning expectations and experiences of clinical nurses who took part in the #Evidencer Project, a self‐directed online course on EBP. Method A qualitative approach was used, applying reflexive thematic analysis. Participants were experienced clinical (Hospital Care n = 10, Primary Care n = 5) nurses who had completed a 72‐h free online training course on EBP. The participants had heterogeneous educational backgrounds (generalist nurses, n = 4; specialist nurses, n = 3; master’s degree, n = 6; doctorate, n = 2). Semistructured virtual interviews were conducted and analyzed following Braun and Clarke’s method. The MAXQDA 24 software supported the analysis process. Trustworthiness was ensured through a collaborative and reflective coding process carried out by two researchers, an audit trail, triangulation with existing literature, and explicit attention to researcher reflexivity. Results A total of 15 nurses participated in the study. Three main themes emerged: (1) motivation and expectations: motivation was primarily intrinsic, driven by personal interest in EBP, the need for professional development, and their roles as student tutors; (2) experience with the training: participants positively evaluated the clarity, flexibility, quality of the content, and nursing‐adapted design, although areas for improvement were identified, such as the need for tutoring and better support for complex content; (3) EBP worldview: a partial understanding of the EBP process was noted, focused on the initial phases (steps 0–2: problem identification and evidence search), with greater difficulty in the advanced phases (steps 3–6: critical appraisal, implementation, evaluation, and dissemination). Added to this was the confusion between research and EBP. Conclusion The #Evidencer Project, self‐directed online training in EBP was well regarded for its accessibility, flexibility, and quality, but participants perceived it as insufficient as a standalone strategy for comprehensive EBP implementation. The nurses indicated a need for institutional support for the comprehensive application of EBP, highlighting the importance of training strategies integrated within the clinical context and backed by the institutions.
A. J. Ramos-Morcillo, Serafín Fernández-Salazar, José Antonio Vera-Pérez et al.· Journal of Nursing Managemen...· 0 citations
Self-reported prior IPE experience showed a clearer and more consistent association with perceived collaboration than did the single-item measure of self-rated IPE knowledge, whose association was small and less consistent across domains.
Viktorija Xharra, Rosario Caruso, Florian Spada et al.· Healthcare· 0 citations
Clinical education is essential in preparing nursing students to translate theoretical knowledge into safe and effective clinical practice. This mixed-method study examined the influence of clinical instructor competency and feedback quality on nursing students’ clinical performance and explored their lived experiences during clinical exposure in selected higher education institutions in Northern Mindanao, Philippines. Anchored on Social Cognitive Theory and Benner’s Novice to Expert Theory, the study emphasized the role of modeling, guided learning, feedback, and experiential development in fostering clinical competence. This study employed an explanatory sequential mixed-methods design, in which quantitative data were collected first, followed by qualitative data to explain the findings. Data were collected from third- and fourth-year nursing students using validated questionnaires and semi-structured interviews. Findings revealed that students generally perceived their clinical instructors as highly competent, the feedback they received as of high quality, and their clinical performance as very good. Significant relationships were identified between clinical instructor competency and students’ clinical judgment and teaching skills, and between feedback quality and teaching skills. Among the dimensions of clinical instructor competency, mentorship and support emerged as the most influential factor associated with students’ clinical performance. Qualitative findings highlighted students’ experiences of adapting to the clinical environment, managing challenges and stress, developing confidence and competence, benefiting from mentorship and constructive feedback, and strengthening their professional identity. These findings underscore the importance of supportive clinical learning environments in promoting student growth and readiness for practice. The study concludes that while effective instruction and quality feedback contribute to learning, mentorship and supportive guidance play a particularly important role in enhancing nursing students’ clinical performance. Strengthening mentorship programs and faculty development initiatives is therefore recommended to further improve clinical learning experiences and prepare competent, practice-ready nursing graduates.
Louie Jay O. Adlao, Erwin C. Cubillan· International journal of res...· 0 citations
Nursing education needs to support students not only in developing clinical performance but also in managing and directing their own learning. Self-directed learning (SDL) has been identified as a key factor associated with clinical competence. This study aimed to examine the mediating effect of self-efficacy on the relationship between SDL ability and clinical competence among nursing students.
The study was conducted with 138 nursing students who had clinical practice experience in general hospitals. Data were collected using validated instruments measuring SDL ability, clinical competence, and self-efficacy. Data were summarized descriptively, and associations among variables were examined using Pearson correlation coefficients. The mediation effect was tested using Hayes’ PROCESS macro (Model 4) and bootstrapped confidence intervals.
Among the 138 participants, 73.9% were female, 77.5% were aged 20–24 years, and 51.4% were fourth-year students. Nearly half had more than 8 weeks of clinical practice experience (47.1%), and most reported satisfaction with clinical practice (71.0%). Clinical competence showed significant positive correlations with SDL ability (r = .44,
p
< .001) and self-efficacy (r = .46,
p
< .001). Self-efficacy partially mediated the relationship between SDL ability and clinical competence, and the indirect effect was statistically significant (indirect = 0.13, 95% CI: 0.05–0.32). The model's explanatory power increased from 20% to 29% when self-efficacy was included.
The results suggest that self-efficacy is an important psychological mechanism linking SDL ability to clinical competence.
SDL ability had direct and indirect relationships with clinical competence, mediated by self-efficacy. Educational strategies should combine opportunities for independent learning with experiences that help students build confidence in clinical practice.