Evidence-based practice skill retention and use by dietetic interns: Did library instruction have an impact?

Abstract

Objective: To determine if dietetic interns retain the evidence based practice(EBP)knowledge and skillsthat they weretaught in three libraryinstruction sessionsin the fallby the end of the 10-monthinternship, and whether there is a change in their EBP clinicalbehaviors.Methods: This non-randomized before and after study will use a validated survey to measure EBP knowledge,and EBP clinicalbehaviors. Dietetic interns(n=16)from a large, Midwestern university will be given the surveyafter EBP library instruction in the fall, and at the end of their internship in the spring.Library instruction sessions will cover PICO questions, database searching, filtered andunfiltered resources, and critical appraisal.A paired t-testwill be used to compare interns’ scores in the fall and spring. Results: Fourteen interns (n=14) completed both surveys. On the EBP knowledge assessment, interns scored an average of 18/24 (75%) in the fall after library instruction, and 13/24 (54%) in the spring, a difference that is considered statistically significant (t(13)=7.0, p<.0001). The decrease was primarily due to missing questions on statistics and advanced Boolean searching. Interns retained and even improved their scores on PICO, MeSH, and the evidence pyramid. A slightly statistically significant change in evidence-based practice behaviors was found between the fall and spring (t(26)=2.1, p=.046). Inparticular, interns reported that they searched PubMed(t(13)=2.8, p=.016),and criticallyappraised articles more frequently(p(13)=2.2, p=.045).Conclusion: Despite the three library sessions occurring early in the internship, these results suggest that interns retaininformation on PICO, MeSH, and the evidence pyramid, but not on statistics or complex Boolean searching. It is possible that these skills were not used frequently in the internship, so they did not retain the information. Interns did report, however, that they more frequently performed all evidence-based behaviors including searching PubMed, accessing systematic reviews, and critically appraising articles, while decreasing their use of textbooks. While the sample size is small and not necessarily generalizable to other populations, this study suggests that dietetic interns retain some information from library EBP instruction, and do make use of the EBP resources and skills demonstratedby the librarian during their internship.Future studies could examine different health professional students, and test whether spreading the library sessions out of the course of the yearwould increase retention and evidence-based behaviors further.