REVIEW

Undergraduate nursing students’ attitudes and use of research and

evidence-based practice – an integrative literature review
Elizabeth Jo Ryan

Aims and objectives. This integrative review of the literature addresses undergrad-
uate nursing students’ attitudes towards and use of research and evidence-based What does this paper contribute
practice, and factors influencing this. Current use of research and evidence within to the wider global clinical
practice, and the influences and perceptions of students in using these tools in the community?
clinical setting are explored. • An understanding of the attitudes
Background. Evidence-based practice is an increasingly critical aspect of quality toward and use of research and
health care delivery, with nurses requiring skills in sourcing relevant information to evidence-based practice by stu-
dent nurses in the clinical setting.
guide the care they provide. Yet, barriers to engaging in evidence-based practice
• The contributing factors that
remain. To increase nurses’ use of evidence-based practice within healthcare settings, may influence these attitudes and
the concepts and skills required must be introduced early in their career. To date, utilisation.
however, there is little evidence to show if and how this inclusion makes a difference.
Design. Integrative literature review.
Methods. ProQuest, Summon, Science Direct, Ovid, CIAP, Google scholar and
SAGE databases were searched, and Snowball search strategies used. One hun-
dred and eighty-one articles were reviewed. Articles were then discarded for irrel-
evance. Nine articles discussed student attitudes and utilisation of research and
evidence-based practice.
Results. Factors surrounding the attitudes and use of research and evidence-based
practice were identified, and included the students’ capability beliefs, the students’
attitudes, and the attitudes and support capabilities of wards/preceptors.
Conclusions. Undergraduate nursing students are generally positive toward using
research for evidence-based practice, but experience a lack of support and oppor-
tunity. These students face cultural and attitudinal disadvantage, and lack confi-
dence to practice independently. Further research and collaboration between
educational facilities and clinical settings may improve utilisation.
Relevance to clinical practice. This paper adds further discussion to the topic
from the perspective of and including influences surrounding undergraduate stu-
dents and new graduate nurses.

Key words: attitudes, evidence-based practice, nursing students, registered nurses,

research in practice, research utilisation

Author: Elizabeth Jo Ryan, RN, BN, GCACN, GDACN, MN, Lec-
turer in Nursing, School of Health, University of New England,
Armidale, NSW, Australia
Correspondence: Elizabeth (Liz) Ryan, Lecturer in Nursing, School of
Health, University of New England. Telephone: +61 02 67733934/
(w) 0401 532432(m). E-mail: eryan26@une.edu.au
This integrative review of the literature addresses undergraduate
nursing students’ attitudes and use of research and evidence-based
practice, and the influencing factors surrounding this. Current and
traditional use of research and evidence within practice, and the
influences and perceptions of students in using these tools in the
clinical setting are explored.

© 2016 John Wiley & Sons Ltd

1548 Journal of Clinical Nursing, 25, 1548–1556, doi: 10.1111/jocn.13229
Review
Accepted for publication: 9 January 2016
Introduction
Clinical nursing practice relies on the important foundation
of research and evidence-based practice (EBP), and thus
EBP utilisation should be incorporated into daily practice.
Research and EBP must be culturally embedded, supported
by policy or guidelines, and implemented as standard prac-
tice to be consistently incorporated into practice. Literature
suggests, however, that a tradition of practice not sup-
ported by research-based evidence may remain dominant
(Rolfe et al. 2008, Linton & Prasun 2013). To alter opin-
ions in this area, changes need to transpire at all levels,
from management to undergraduate. This paper focuses on
findings from an integrative literature review on the atti-
tudes and experiences of undergraduate nursing students
surrounding research and EBP, and the factors that may
impact on their propensity towards research uptake and
utilisation, as this is essential for the cultural change from a
more ritual based work culture to a culture integrating evi-
dence on a daily basis.
Evidence-based practice is an increasingly critical aspect
of quality health care delivery, with nurses requiring
knowledge, understanding and skill in sourcing relevant
and appropriate information to guide the care they pro-
vide. It is also part of many nursing competency stan-
dards; an example of which states that a registered nurse
‘will practice within an evidence-based framework’ (Nurs-
ing and Midwifery Board of Australia 2006). Yet, attitu-
dinal and skill related barriers to engaging in EBP remain
(Higgins et al. 2010). To increase all nurses’ use of
research and EBP within the healthcare setting, the con-
cepts and skills required must be introduced early in their
career (Bostrom et al. 2009, Moch et al. 2010). To date,
however, there is little evidence to show if and how this
inclusion is making a difference. While much research
has examined registered nurses’ views and use of
research, there is little attention to the views and expec-
tations of students during their undergraduate education
and prior to entering the profession. Mehrdad et al.
(2012) suggest that educators have an influential role in
changing the use of research in clinical practice, thus
shaping behaviour for the future. Change in practice will
require more than students’ adoption of EBP in isolation;
however, it is also dependent on and influenced by the
© 2016 John Wiley & Sons Ltd
Journal of Clinical Nursing, 25, 1548–1556
Nursing students’ attitudes toward research
attitudes and abilities of their professional colleagues, and
available circumstances within the work environment.
Design and methods
Aim
The aim of this review was to identify attitudes towards
and influencing factors surrounding the use of research
and evidence-based practice by undergraduate nursing stu-
dents.
Design
An integrative review method was chosen, as integrative
review includes many studies with diverse methodologies,
and presents varied perspectives on a certain phenomenon
(Whittemore & Knafl 2005). Literature from various per-
spectives regarding pre-registration use and attitudes
toward EBP was reviewed, and recurring ideas were
explored further as they emerged.
Data sources
Electronic databases such as ProQuest, Summon, Science
Direct, Ovid, CIAP, Google scholar and SAGE were used.
Search terms included nursing students, undergraduate
nurses, EBP, attitudes, and utilisation, and inclusion was
determined from title and abstract. Date parameters were
placed on the search so as to contain current literature,
rejecting anything older than 10 years. A snowball search
strategy was also utilised, drawing on relevant literature
that had been used as reference material in other literature,
or from ‘similar’ searches within electronic databases. Fur-
ther parameters such as peer reviewed journals only, and
English full text availability were added. Critical Appraisal
Skills Programme (CASP) tools were also utilised to guide
evaluation of the literature, omitting those that did not
meet the criteria.
Review methods and outcomes
The initial search sourced information about undergraduate
nursing students. One hundred and eighty-one articles were
1549
EJ Ryan

recorded in the initial search table, including some new
graduate nurse perspectives as a means of comparison, but
on further investigation, 61 were found to be not pertinent
enough to the topic and 13 did not clearly identify the
length of experience held by research participants, so were
discarded. Twenty-six articles focused on the success of
particular teaching methods or specific units regarding
teaching EBP and research to pre- and postregistration
nurses, but did not address the students’ perspective. Others
posed discussion on the relevance of teaching EBP at an
undergraduate level, and how this should best be achieved.
Results
Nine papers met the inclusion criteria for this review (see
Table 1) – their focus being on student nurses’ or newly
graduated nurses’ perceptions and opinions regarding the
use of research and EBP. Surveys were the most frequently
used methods of data collection, both independent and lon-
gitudinal. These surveys predominately aimed to identify
attitudes and utilisation of EBP, or to identify the intent of
use in the future. Most of the surveys were quantitative,
and used previously validated tools. One survey addressed
self-analysis of the extent of preparedness for EBP both in
pre- and postregistration nurses (Waters et al. 2009).
Another followed students up in an effort to identify
whether or not their undergraduate intention to utilise
research and EBP actually came to fruition one-year
postregistration (Andersson & Edberg 2010). Most of
them, however, chose senior nursing students as their target
group, for example, those soon to complete their under-
graduate course.
The findings highlighted that overall there was a positive
attitude and intention to use research and EBP, but there
were many factors that influenced the utilisation. These
factors can be clustered into intrinsic; influencing student
attitudes towards the use, or extrinsic influences; that
impact on the students’ likelihood to utilise these skills on a
practical level. As the appraised literature was from a stu-
dent perspective, intrinsic influences dominated. Further

Table 1 Literature review of undergraduate nurses’ perception and utilisation of research and evidence-based practice

Author/s Aim Design, data collection Major findings

Bjorkstrom et al. (2003)
Brown et al. (2010)
Caldwell, Coleman, Copp,
Bell & Ghazi (2007)
Florin et al. (2012)
Forsman et al. (2012)
Halabi and Hamdan-Mansour
(2010)
Halcomb and Peters (2009).
Henderson et al. (2012)
Waters et al. (2009)
Undergraduate nursing students’
attitudes towards and awareness
of research in nursing, and what
factors may impact this
Predictors of knowledge, attitude,
use and future use of EBP
Relevance of initial training,
perceptions of newly qualified
practitioners (including nurses)
Nursing students’ experience of
educational support for research
utilisation & capability beliefs
regarding EBP skills
Graduating nurses’ intention to
use research in clinical practice
Student nurses’ attitudes towards
nursing research
Student feedback on an
undergraduate research unit
Review of nursing students’
perceptions of learning in
practice environments
The Australian experience of
nurses’ preparedness for EBP
Cross-sectional survey
n = 201
Cross-sectional survey
n = 436
Cross-sectional survey
n = 86
Cross-sectional survey
n = 1440
Cross-sectional survey
n = 1319
Descriptive self report
questionnaire
n = 612
Qualitative/quantitative feedback
n = 369
Review of 6 previous
studies from across the globe
n = 1065
Survey pre- and postregistration
n = 257 pre-registration
Positive attitude
Theory/practice gap
Increased interest correlates
with increased use
Confidence plays a part
Discrepancy between positive
attitude and value of research
Support much greater on campus
than in clinical setting
Theory/practice gap
Confidence in ability
Intention at graduation predicts
future use
4 attitude domains: 1) research
abilities 2) usefulness of
research 3)personal interest in
research 4)using research in
clinical practice
Demonstration of relevance of
content the largest suggestion
for improvement
Innovation in clinical practice
not encouraged, predominately
task oriented
Positive attitude
Happy with skill level, but can
lack confidence
Theory practice gap

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1550 Journal of Clinical Nursing, 25, 1548–1556
Review
investigation on the topic explored other intrinsic and
extrinsic aspects of influence that may impact on the atti-
tude toward and use of research and EBP, and will be dis-
cussed in the next section.
Intrinsic factors
Intrinsic influencing factors included such components as
student attitude/intention, where most occasions the data
showed a positive attitude towards research by undergradu-
ate nursing students, for example, a study of 612 Jordanian
senior nursing students (Halabi & Hamdan-Mansour
2010). Positive attitude and subsequent propensity towards
engaging in research was found to intensify if students had
a particular area of interest they could participate in (Bjork-
strom et al. 2003). There was an increasing correlation
with experience, knowledge, positive attitude and predicted
future use of EBP in the cross-sectional study by Brown
et al. (2010) in the United States, although this positive cor-
relation did not follow suit regarding how much EBP was
currently used, as senior students used less EBP than junior
students.
Students who identified themselves at an undergraduate
level as being likely to utilise EBP showed a significant posi-
tive correlation on the actual use of EBP as new graduates
(Forsman et al. 2012). Conversely, those who stated lack of
intention or lower use preregistration subsequently used it
less postgraduation. This suggests the need for undergradu-
ate nurses to understand and have trust in the systematic use
of EBP as students for it to be effective within their practice,
and thus implementing career-long behaviour changes.
The students’ confidence in their ability/capability belief
was another intrinsic factor mentioned within the literature.
Nursing students described a lack confidence in their ability
to be able to engage with research within their clinical
practice, despite believing that research is useful within this
context. Students need adequate knowledge, competence,
confidence and support within the clinical setting to effec-
tively conduct research and implement evidence-based
changes (Halabi & Hamdan-Mansour 2010).
The main determinates of future use of EBP were having
increasing confidence in their ability and clinical decision
making capacity, and the level of preparedness in the clini-
cal setting (Brown et al. 2010). Students’ belief in their
capability to successfully utilise research and implement
EBP was highlighted also in Florin et al. (2012), and Fors-
man et al. (2012), but further research is needed with
regard to how to enhance this capability belief.
© 2016 John Wiley & Sons Ltd
Journal of Clinical Nursing, 25, 1548–1556
Nursing students’ attitudes toward research
In a study comparing pre- and postregistration nurses’
attitudes towards EBP, it was found that undergraduate
nursing students had much more confidence in their ability
to research literature and appraise evidence than their
postregistration counterparts (Waters et al. 2009). Litera-
ture suggests that self-rated ability reporting may at
times be over inflated however, so this must be taken into
consideration (Waters et al. 2009). The lack of confidence
in ability within graduated nurses was attributed to their
absence of technical skill and educational preparedness, as
well as age being a contributing factor, suggesting a need to
both obtain and maintain proficiency in this area for all
generations of nurses through continuous education (Waters
et al. 2009). Many nurses who trained in the hospital sys-
tem for example, were not taught these skills, so were
therefore not equipped to engage in research endeavours.
The theory practice gap was also revealed as an influenc-
ing intrinsic factor for undergraduate nursing students in
their use of research and EBP. It is difficult to establish the
transitional balance between academic work and putting the
concepts into practice on a clinical level. Students on clini-
cal placements are much more task oriented than research
oriented, so tend to utilise their research skills much less
while within the clinical setting (Henderson et al. 2012).
Extrinsic factors
Brown et al. (2010) suggested that teaching research meth-
ods and EBP would have more relevance to students if it
were taught in a practical or clinical setting, rather than
using traditional didactic methods incorporated within uni-
versity settings. In response to this, students may benefit
from the opportunity to practice their research skills via the
use of case studies and/or simulated clinical environments
where they can actively source information in real time
relating to the best evidence-based care for their patients, as
an example. The literature suggests that most postgraduate
nurses within clinical settings prefer to gain information
from colleagues or printed sources rather than researching
Internet sources, whereas students use fellow colleagues,
textbooks and the Internet (Brown et al. 2010, Mokhtar
et al. 2012). There is a need to be able to incorporate all of
these tools for sourcing information within nursing in gen-
eral, and through active sharing of skills between under-
graduate and postgraduate nurses this can be achieved.
Nurses supporting students require the skill level to be able
to actively incorporate research and clinical care through
role modelling, which is not always the case.
1551
EJ Ryan
Discussion
Intrinsic factors that may influence the use of research
and evidence-based practice
The tabled literature highlighted some aspects of intrinsic
and extrinsic influences, and additional literature supports
and expands the appraised literature claims. For example,
following findings surrounding the theory practice gap,
Holmstr€ om and Larsson (2005) assert that there are often
conflicting ideas between what is expected or desired in
EBP from the perspective of both students and nursing aca-
demics. This highlights again the difference between what
is taught in preregistration and what happens in the work-
place, or the lack of understanding by students as to how
EBP informs and impacts on clinical practice.
Students also claimed they felt more supported in the uni-
versity setting than the clinical setting with regard to utilisa-
tion of research and EBP skills, and this reiterates the
problem of the theory/practice gap. Florin et al. (2012) sug-
gested that the level of support found in the academic world
impacted greatly on the utilisation of research in other set-
tings. The sense of organisational support available to them
while on clinical placement was also vital in encouraging the
use of EBP and research (Forsman et al. 2012). Finotto et al.
(2013) agree. In their descriptive study students felt that they
were taught the appropriate skills to adequately engage with
their research, but mentors within the clinical setting were
less able to provide the support needed to put this in practice.
It is suggested that successful mentorship and preceptorship
in this area could create a more positive transformation from
student to experienced nurse, thus decreasing the continuing
theory practice gap (Higgins et al. 2010).
Relevance of research and EBP
There is an ongoing failure to link the concepts and rele-
vance of research and EBP with holistic and patient-centred
care (Halabi & Hamdan-Mansour 2010). Nursing students
who participated in a narrative study conducted by Holm-
str€
om and Larsson (2005) displayed little interest in the use
of EBP, as evidenced by comments, such as:
Today there’s far too much research and theory in school, and the
practical care aspects are neglected. The focus on the patient as a
human being is lost. Nowadays, everything should be evidence
based, as they tell us in school, and the patient is reduced to an
ulcer, a diabetic foot or a high blood pressure. (Holmstr€
om &
Larsson 2005, p. 151)
This statement highlights the lack of insight into the link
between research and providing the best and most
1552
appropriate care for individual patients. The same study
reflected that students’ perception of nursing education
revolved around theoretical models and evidence-based
nursing, whereas their interest was more on holistic care.
This made the incorporation of EBP and research in nursing
practice difficult, as students could not see the link between
the two (Holmstr€ om & Larsson 2005). Henderson et al.
(2012) agree, and found that students were predominately
focused on practical and clinical skills while on placement
settings, leaving research engagement as an academic skill.
Cognitive maturity
The reasoning behind this lack of clarity in understanding
the significance of doing research may be student’s develop-
ing cognitive maturity. The evolutionary characteristic of
cognitive maturity according to Kitchener, King and De
Luca (2005) as cited in Nickerson and Thurkettle (2013) is a
sequence that begins with the belief that knowledge is certain and
directly knowable to the belief that knowledge is uncertain but can
be constructed by judging evidence and opinion. (p. 74)
Through addressing students’ lack of confidence and fre-
quent uncertainty, coupled with the negative attitudes
towards research and EBP held by others within their circle
of influence, Nickerson and Thurkettle (2013) postulate
that college aged students may not have the cognitive matu-
rity to be able to effectively enquire, select, judge and utilise
research, and that this learning needs to be scaffolded grad-
ually according to their increasing maturity. This notion
would support a view that nursing students may not be
capable of judging, reflecting or critiquing information suf-
ficiently, and being able to then follow this through with
application (Nickerson & Thurkettle 2013). Many provi-
ders of education surrounding research and EBP place these
topics within postgraduate courses, which could be more
effective at this time, allowing for further cognitive matu-
rity. However, these skills are often required to successfully
attain undergraduate nursing qualifications in many coun-
tries, and so must be covered prior to registration as a
Registered Nurse (NMBA 2006).
Extrinsic factors that may influence the use of research
and evidence-based practice
Capability of clinical registered nurses in providing
adequate support in this area
Registered nurses who are responsible for facilitating or
precepting students may have inadequate knowledge and
skill to provide sufficient support and encouragement in the
area of research and EBP implementation (Thorsteinsson
© 2016 John Wiley & Sons Ltd
Journal of Clinical Nursing, 25, 1548–1556
Review
2013). Hagler et al. (2012) reiterate that although under-
graduate nursing students were taught skills relating to
sourcing EBP, their preceptors often lacked skill and under-
standing of major concepts in research and EBP to be able
to assist them. Many clinical team members had confidence
in their ability to support nursing students, but were not
capable of necessary research related skills such as apprais-
ing evidence effectively as an example (Veeramah, 2004).
Roxburgh (2006) suggests that Registered nurses frequently
lack sufficient knowledge, skills and the educational prepa-
ration to be able to conduct or facilitate research. This may
be rectified through adequate and appropriate education for
nurses that work in the clinical setting, and would impact
positively on clinicians and students (Hagler et al. 2012).
Education of preceptors in research methods and EBP made
a considerable difference to outcomes, and increased collab-
oration between clinical staff and academia effectively ful-
filled the needs of students (Hagler et al. 2012).
Involvement of student nurses in research and EBP
Student nurses and new graduate nurses often do not actively
participate in the implementation of EBP, or the challenging
of current practices, as this is left to senior clinicians and
management (Bostrom et al. 2009, Forsman et al. 2012).
Nursing students can perceive themselves as being among the
lowest in nursing hierarchy, at times feeling undervalued,
and therefore many lack assertiveness (Begley 2002, Last &
Fulbrook 2003). Literature suggests that innovation is not
encouraged within students’ clinical placement interactions
(Henderson et al. 2012). Students were often stereotyped as
having insufficient knowledge, or were not active team mem-
bers for long enough to be able to successfully contribute to
any change, due to the transience of clinical placements
(Cronje & Moch 2010, Ibrahim 2011). This under-utilises
the students’ skill and expertise in this field, as many have
studied this topic and applied these skills on an academic
level. By the time that these nurses are considered ‘senior’
enough, or have moved into management, they may well
have lost the skills in undertaking the research projects
required, as retention of expertise was a contributing factor
to graduated nurses (Waters et al. 2009).
Recommendations have been made regarding the benefit
of increased collaboration between student nurses and clini-
cians, if these skills were utilised to their full potential
(Stone & Rowles 2007, Hagler et al. 2012). Where collabo-
ration occurred, this enhanced mutual respect for each
party, as both brought with them varying skills and innova-
tions. The collaboration in one facility resulted in policy
and practice changes in the area of research after
completion of the project (Kelly et al. 2005). Clinicians
© 2016 John Wiley & Sons Ltd
Journal of Clinical Nursing, 25, 1548–1556
Nursing students’ attitudes toward research
found they had questions to be researched but insufficient
time, and students had the ability to research and appraise
literature, but little opportunity to put it into practice
within the clinical setting. Through application of their
skills the advantage of collaboration was shown, and the
implementation of research and EBP by junior nursing staff
occurred (Stone & Rowles 2007, de Cordova et al. 2008).
It may show not only students, but also influence clinical
nurses positively, embedding research and EBP into the
practice environment, leading to it becoming a normal and
everyday occurrence.
Preceptor/ward perspective
If nursing students are expected to learn to provide evidence based
care, they should have the opportunity to practice that philosophy
and process of care under the guidance of clinicians who believe in
and use evidence based practice. (Hagler et al. 2012, p. 502).
Nurses’ beliefs and attitudes towards research and EBP
were strongly influenced by the amount of use in the clini-
cal setting (Olade 2003, Hagler et al. 2012). This was
related to the organisational perspective and readiness to
support EBP. Wards within the same organisation had dif-
fering views and perceptions of EBP and research, depend-
ing on the staff within that unit, and their attitudes
towards the concept (Hagler et al. 2012). Greater use of
these concepts by clinicians created more positive and sup-
portive staff, which in turn encouraged the continuing utili-
sation of research and EBP.
Kelly et al. (2005) highlighted mixed responses from clin-
icians who were assigned to work collaboratively with stu-
dents in research, as it either stimulated clinicians
intellectually, or made them more insecure about their own
knowledge and skills. Students were generally not portrayed
as being potential educators, although if their skill were uti-
lised it would be beneficial for both parties.
Nurse leaders, managers, mentors and preceptors were
vital in assisting the pregraduate to implement and use
research and EBP within the clinical setting. They had the
ability to facilitate, encourage, nurture, support and role
model clinical decision-making based on the best available
evidence available, and hone it to support clients or
patients as individuals, if their role was fulfilled effectively.
(Ferguson & Day 2007, Higgins et al. 2010). Literature
suggests that it is important to have a culture of research
and EBP within the ward or clinical setting instilled from
management down (Ferguson & Day 2007).
Brown et al. (2010) suggests that student nurses are in the
prime position to influence the organisation in the adoption
of EBP, through the use of their current education and confi-
1553
EJ Ryan
dence in their field (Brown et al. 2010). This may be very
difficult; however, when there is limited support, and as stu-
dents are thrust outside their comfort zone of university life
and into the somewhat frantic work life, where there is
other priorities placed upon them. This notion of utilising
the students’ confidence in EBP, however, conflicts with pre-
vious ideas of students lacking confidence in their ability to
make firm and autonomous decisions. The students’ level of
confidence in their ability to make clinical decisions in the
clinical setting impacted greatly on their predictors of use in
the future (Brown et al. 2010).
Collaboration/education. As previously mentioned, nurses
that are given the task of mentoring and precepting students
and new graduate nurses need to have sufficient skill and
education in the subject of research use and EBP. An inno-
vation successfully proposed by Hagler et al. (2012) was the
concept of preparing those nurses that would be precepting
student nurses through workshops on research and EBP,
delivered by the education providers of students. This was a
means of changing beliefs and behaviours, promoting
increased interest and utilisation in research, confidence in
their ability, competence in what they were doing and how
they were supporting their students (Hagler et al. 2012).
Through integrating teaching and support of EBP within the
organisation, increased utilisation and implementation of
research findings occurred, changing the culture of this clini-
cal setting positively (Hagler et al. 2012).
Research findings undertaken in a large medical centre,
promoted more so the identification, support and nurturing
of appropriate mentors and clinical research leaders, who
can ‘bridge the gap between practice and research utilisa-
tion’ believing that this may be a more effective way of
influencing the change of attitude and utilisation in the long
term (Smirnoff et al. 2007, p. 30).
Both of these strategies were effective in the ongoing atti-
tude towards and utilisation of research and EBP in these
settings, and shows varying ways of supporting and encour-
aging both fledgling and experienced nurses to actively
engage in research.
Conclusion
Research and EBP should be integrated into the clinical envi-
ronment, and is a competency standard for registered nurses
in many countries, with proficiency necessary for Registra-
tion (NMBA 2006). It therefore must be incorporated into
the undergraduate curriculum for registered nursing. This
paper has reviewed the literature surrounding attitudes
towards research from a variety of perspectives and influ-
1554
ences, and identified the potential disparity of opportunity
between graduated nurses, and student or transitional nurses.
There have been many positive attitudes towards EBP
and within the use of research within the clinical setting, to
provide the best care for patients. The review of the litera-
ture has shown that student nurses have a generally positive
attitude towards EBP. Their implementation of EBP and
research in clinical practice is, however, depressed when the
practical aspects of nursing seem to take over, and the gen-
eral ward culture does not always easily facilitate opportu-
nities for research. These new nurses lack the self esteem to
be able to put their learnt skills into practice, and do not
have sufficient and appropriate support to establish and
continue such endeavours, or assist with decision making
with regard to care.
Students are often at a disadvantage within the work-
place culture in relation to promoting EBP and conducting
research, but potentially have the skills to be able to facili-
tate these things if given sufficient support and encourage-
ment. Further research in this area needs to be conducted,
addressing the barriers to using these skills, how junior
nurses can be assimilated into the position of active partici-
pation in practice change behaviour, and how these beha-
viours can be integrated into mainstream nursing, through
education and collaboration.
Further integration and acceptance of research and EBP
within the clinical workplace setting by all levels of staff
will be advantageous to all involved. The collaboration of
education facilities and clinical settings can assist this tran-
sition, as well as further integration of research and EBP
sourcing within the simulated clinical environment may
help this assimilation. The follow through from researching
literature through to the design and implementation of clin-
ical practice guidelines is an example of a great way of
showing nursing students the practical side of research,
which will be of benefit to both students and clinical facili-
ties alike. There are many other ways in which this can be
enhanced in the future, leading to an exciting time within
the culture of nursing as a whole, where all participants are
able to use their skills effectively towards continuous qual-
ity improvement and ongoing patient safety.
Contributions
Study design: EJR; Data collection and analysis: EJR;
Manuscript preparation.
Conflict of interest
None.
© 2016 John Wiley & Sons Ltd
Journal of Clinical Nursing, 25, 1548–1556
Review
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