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The Journal Club An Occasion for Mentoring : Critiquing Research for EvidenceBased Practice


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Title: The Journal Club An Occasion for Mentoring : Critiquing Research for EvidenceBased Practice

The Journal ClubAn Occasion for Mentoring
Critiquing Research for Evidence-Based Practice
  • Dianna Hutto Douglas, DNS RN CNS
  • Susan Rick, DNS RN CNS

Evidence-Based Practice
  • Research utilization/innovation diffusion process
    begins with a new idea or empirically based
    innovation that is scrutinized for adoption in
    the practice setting.
  • Evidence based practice by contrast begins with a
    search for information about how best to solve
    specific practice problems. The emphasis is on
    identifying the best available research evidence
    and integrating it with clinical expertise,
    patient input, and existing resources.
  • (Polit
    Beck, 2003)

Evidence-Based Nursing Practice
  • Evidence base nursing practice is the
    conscientious, explicit and judicious use of
    theory derived research based information in
    making decisions about care delivery to
    individuals or groups of patients in
    consideration of individual needs or preferences

  • (Ingersoll, 2000)

Evidence-Based Practice Models
  • Originated outside the United States
  • First publication of Evidence Based Nursing was
    launched in1998
  • Definitions crafted by nurses have varied with
    evidence derived from research expressed as a
    common theme (Jennings Loan, 2001)
  • Levels of evidence - especially in the United
    States literature reference the Agency for
    Healthcare Research and Policy schema of evidence
    (including qualitative studies as well as quality
    improvement and program evaluation data)

Types of Evidence
  • Research based
  • Opinion based
  • Discussions
  • Fact based
  • Expert based
  • Patient view based
  • Professional expertise and experience
  • Quality improvement data
  • Evaluation data

Hierarchy of Evidence
  • Meta-analysis of controlled studies
  • Individual experimental studies
  • Quasi experimental studies
  • Non-experimental studies
  • Program evaluations, research utilization
    studies, quality improvement projects and case
  • Opinions of respected authorities and expert
    committees (Stetler et
    al, 1998)

An Occasion for Mentoring
  • Mentoring is a fundamental form of human
    development where one person invests time energy
    and personal knowledge to assist another person
    in their growth and development (McKinley, 2004)
  • Mentoring is a special way to transfer knowledge
    and it can occur in all setting in which
    scientific inquiry is being deliberately pursued
    (Byrne Keefe, 2002)

Attributes Mentoring Relationships
  • Stewart Krueger (1996) extracted six essential
    attributes of mentoring from 82 research
    abstracts and journal articles
  • Teaching/Learning process
  • Reciprocal Role
  • Career development relationship
  • Knowledge differential between participants
  • Duration of several years
  • Resonance

The Development of Nursing Science
  • Foundation for the growth of the nursing
    discipline and profession
  • Knowledge development takes place in the various
    setting where nursing is learned and practiced
  • Programs of scientific inquiry are established in
    both the university and clinic setting and often
    flourish where the two are merged

Research Mentoring in Nursing
  • Research mentoring activities are appropriate in
    various settings
  • Academia
  • Formal programs of research
  • Clinical practice
  • Research partnerships between academics and
  • (Byrne Keefe, 2002)

Barriers to the Integration of Evidence-Based
Research into Practice
  • Limited education in and expertise to judge the
    scientific merit of a research study
  • Limited exposure to research journals
  • Intimidated by research jargon and statistical
  • Infrequent use of research in practice
    (Goodfellow, 2004)
  • Many nurses feel they have no authority to change
    nursing practice in spite of research to support
    a change in practice (Retsas, 2000)

Benefits of a Journal Club as a A Means to
Incorporate Evidence-Based Practice
  • Cost effective
  • Allows nursing staff to remain close to patient
    care areas
  • Stimulates discussion among peers in regard to
    clinically relevant problems
  • Allows exploration of most current literature
  • Stimulates nurses to Critique their own practice
    (Kartes Kamel, 2003)

Benefits of a Journal Club as a Means to
Incorporate Evidence-Based Practice
  • Encourages nurses to read and critically review
  • Allows nurses to discriminate and evaluate
    information logically
  • Provides a basis for making decisions that effect
    patient outcomes
  • Promotes professionalism and positive attitudes
  • Promotes evidence-based nursing practice and
    bridges the gap between research and practice
    (Goodfellow, 2004)

Criteria for Selecting Research Articles
  • Focus on a Problem of Clinical Relevance
  • Is the research article relevant to
  • Patient population
  • Nurses clinical experience
  • Nurses level of understanding
  • Nurses interest in current research topics
  • The most current research findings that might
    have influence practice
  • (Goodfellow, 2004)

Criteria for Selecting Research Articles
  • Scientific Merit
  • Does the research article
  • Critically review the literature
  • Clearly describe ethical and methodological
  • Provide easily understood statistical analysis
  • Accurately interpret the research findings
  • Generalize findings to other populations and
  • Is the research article well written and

Criteria for Selecting Research Articles
  • Implementation Potential
  • Are the research findings clinically significant
  • Information is transferable to the clinical
  • Does the nursing staff have the power to
    implement change based on these research findings
  • Does the research have the potential to improve
    patient outcomes
  • Implementation with no physical or psychological
    harm to patients
  • Implementation with minimal or justifiable cost
    to the hospital or patient (Goodfellow, 2004)

Guidelines for Critiquing Research for EBP
  • Does the introduction
  • State the problem
  • State the significance to nursing
  • Is the review of literature current, thorough,
    and reflective of critical analysis
  • Are research questions, purposes, and/or
    hypothesis clearly written
  • Are independent and dependant variables
  • Is the methodological design defined and
    appropriate to study (Goodfellow,2004)

Guidelines for Critiquing Research for EBP
  • What setting was used to collect data
  • What is the population
  • Is the population clearly described
  • What is the sample size
  • Is sample size sufficient
  • Is protection of human subjects clearly addressed
  • What instruments were used to measure the
  • Are the instrument reliable and valid
  • How were the data analyzed
  • Are the statistical test appropriate

Guidelines for Critiquing Research for EBP
  • What are the results of the study
  • What are the strengths
  • What are the limitations of the study
  • Is there congruence between the results and the
    discussion of the research
  • What are the implications for nursing practice
  • What are the implications for nursing research
  • How may the results of this study be applied to
    your nursing practice and patient care
    (Goodfellow, 2004)

The Tale of Two Journal Clubs
  • Selection of clinical sites (Two magnet
  • Oncology unit
  • Psychiatric Unit
  • Leadership style and selection of leader
  • Selection of Journal Articles
  • Mutual collaboration
  • Strategies to make journal club a valuable
  • Enthusiastic teaching style
  • Role modeling
  • Critique of relevant self-selected research
  • Application of research and promotion of
    evidence-based practice

Journal Club An Occasion for Mentoring A
Win/Win Collaboration
  • Benefits to individual members
  • Professional development
  • Acquisition of new knowledge
  • Continuing education credit
  • Improved competence and confidence in delivering
    EB Care
  • Benefits to hospital
  • Maintaining magnet status
  • Improved patient care
  • Promote the utilization of EBP
  • Stimulate desire to conduct research on unit
  • Benefits to faculty
  • Community service
  • Mutual professional development
  • Building collaborative relationships
  • Improves potential for more collaborative research

  • Byrne, M. W. Keefe, M. R. (2002). Building
    research competence through mentoring. Journal of
    Nursing Scholarship, 34 (4), 391-396.
  • Goodfellow, L. M. (2004). Can a journal club
    bridge the gap between research and practice.
    Nurse Educator, 29 (3), 104-110.
  • Ingersoll, G. L. (2000). Evidence-based nursing
    what it is and what isnt. Nursing Outlook, 48
    (4), 151-152.
  • Jennings, B.M. Loan, L. (2001. Misconceptions
    among nurses about evidence-based practice.
    Journal of Nursing Scholarship, 33 (2), 121-127.
  • Kartes, S. K. Kamel, H. K. (2003). Geriatric
    journal club for nursing A forum to enhance
    evidence-based nursing care in long- term
    settings. Journal of American Medical Directors
    Association, 5, 264-267.

  • McKinley, M. G. (2004). Mentoring matters
    creating, connecting, and empowering. AACN
    Clinical Issues, 15 (2), 205-214.
  • Polit, D. Beck, C. T. (2003). Nursing
    research principles and practice. (7th ed.).
    Philadelphia Lippincott. 671-705.
  • Retsas, A. (2000). Barriers to using research
    evidence in practice. Journal of Advanced
    Nursing, 31, 599-606.
  • Stetler,C. B., Morsi, D., Rucki, S., Broughton,
    S., Corrigan, B., Fitsgerald, J., Giuliano, K.,
    Havener, P., Sheridan, E. A. (1998).
    Utilization-focused integrative reviews in a
    nursing service. Applied Nursing Research, 11
    (4), 195-206.
  • Stewart, B. M. Krueger, L. E. (1996). An
    evolutionary concept analysis of mentors in
    nursing, Journal of Professional Nursing, 12
    (5), 311-321.
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