Effectiveness of educational interventions on evidence-based practice for nurses in clinical settings: A systematic review and meta-analysis

Objectives: This study aimed to synthesise the best available evidence on the effectiveness of education interventions to teach evidence-based practice (EBP) on nurse-related and patient-related outcomes. Design: This is a systematic review and meta-analytic paper. Data sources: Published and unpublished studies in English were searched from 10 databases from 2005 to 2021. Review methods: Randomised controlled trials (RCTs) and clinical controlled trials (CCTs) describing education interventions to improve EBP knowledge, skills, attitude, confidence and behaviours among nurses were eligible. Two reviewers independently screened, appraised and extracted data. Meta-analysis was conducted using a random-effect model to synthesise data using review manager software. Standardised mean difference (SMD) represented an effect measure. Heterogeneity was assessed using Cochran-Q square test and I square statistics. Subgroup and narrative synthesis were also conducted. Results: Ten studies (6 RCTs and 4 CCTs) were selected for this review. Results from a CCT suggested that education interventions improved EBP knowledge with a large effect size (SMD = 2.01). Education interventions also enhanced EBP skills (n = 1), combined knowledge/skills (SMD = 0.48, N = 5), attitude toward EBP (SMD = 0.39, N = 4), confidence to conduct EBP (SMD = 0.43, n = 1) and EBP behaviour (SMD = 0.26, n = 5). None of the studies used patient-related outcomes. Conclusion: Overall, education interventions improved nurses' EBP knowledge, skills, attitude, confidence and behaviour. EBP education interventions should be part of nurses' professional development in clinical settings. The interventions may be delivered through combined lectures, group discussions, hands-on practice via face-toface and/or online learning. Future research should test education interventions using RCTs, large sample size, and in-depth qualitative data.