How Do Students Obtain Evidence-Based Health Information? A Study of Nursing Interns in Clinical Practice in Saudi Arabia

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University of Nottingham
Background: Healthcare professionals can access massive amounts of online health data to drive cutting-edge evidence-based practice. This is particularly important for nursing students on clinical placement, to bridge the theory-practice gap as they prepare for clinical practice. This difficult transition requires investigation to identify the ways nursing students source and apply available information in terms of their skills and decision-making. This is the focus of the current study in the context of Saudi Arabia, identifying related behaviours and their implications for outputs, based on the theoretical basis of Dervin's model of sense-making. This thesis analyses nursing students’ decision-making and cognitive mechanisms pertaining to their sourcing and evaluation of healthcare information resources. Comprehending related phenomena can identify challenges faced, enabling the development of optimal strategies to improve informational skills among nursing students and (subsequently) clinical practitioners. Methods: Semi-structured interviews and Think Aloud protocols were deployed in this study to determine and analyse nursing interns’ experiences and strategies of sourcing and deploying evidence-based information in clinical practice. Online Think Aloud sessions enabled participants to express their cognitive processes in navigating various educational resources, including online journals and databases, and determining the reliability of sources, indicating their strategies for information seeking. The interviews enabled analysis of instrumental factors pertaining to their information-seeking, identifying their ideal sources of information and perceived barriers to access and use. Validity and reliability was supported by data triangulation, analysing and comparing data from the interviews and sessions, and thematic analysis was applied to generate the main conclusions on nursing interns’ strategies and application of evidence-based data. Findings: The main emergent themes identified included the ubiquitous deployment of online search engines as the main source of information-seeking, especially Google, and the relative lack of utilisation of respected professional databases. Easy access and user convenience were clearly the instrumental factors in this behaviour, which has troubling implications for the lack of use of higher quality resources (e.g., from peer-reviewed academic journals). Identified challenges encountered during resource access included limited skills of critical evaluation of information credibility and reliability, signalling a requirement for improved information literacy skills. Participants acknowledged the importance of evidence-based, high-quality information, but faced numerous barriers, such as restricted access to professional and specialty databases, a lack of academic skills training, and practical (time) constraints. Think Aloud outcomes led to the introduction of the Performance Tool, which was geared toward investigation of information accessing and evaluation effectiveness with regard to nursing students’ deployment of evidence-based health information, which identified needs and led to suggestions to improve efficiency and quality. Conclusion: The outcomes of this thesis offer important findings on nursing interns’ information-seeking behaviour in Saudi Arabia and the observed outputs. The Dervin model of sense-making and the developed Performance Tool advance understanding of how nurses in Saudi Arabia access and evaluate evidence-based health information acquisition, and inform practical suggestions to improve the skills of nursing students (and, subsequently, practitioners) to facilitate the diffusion of high-quality evidence-based practice in clinical settings.
Clinical practice, Information seeking behaviours, Evidence based practice, Evidence based health information, Information evaluation