Interventions for improving the research literacy of nurses: a systematic review.

BACKGROUND: Despite the importance of research literacy for nurses, many nurses report feeling unable to effectively read and understand research, which in turn results in lower research utilization in practice. Nurses themselves identify poor experiences with trying to understand and use research as factors that contribute to a reluctance to utilize research. This reluctance often leads nurses to seek other sources of information, such as colleagues, instead.

OBJECTIVES: The objective of this review was to identify the effectiveness of research literacy interventions on the research literacy of registered nurses.

INCLUSION CRITERIA: Registered nurses.Interventions of interest were those that evaluated the effectiveness of workplace educational programs or interventions conducted in a healthcare organization or tertiary-level educational facility aiming to improve or increase registered nurses' understanding of research literature.Outcomes of interest were research literacy, measured explicitly or as research knowledge, research understanding, use of research evidence in practice, and/or ability to critically appraise research.We considered experimental study designs such as randomized controlled trials, nonrandomized controlled trials, quasi-experimental, and before and after studies.

SEARCH STRATEGY: A wide range of databases were searched in order to provide the most complete possible review of the evidence. Initial keywords used were: "research litera*", "research education", "research knowledge", "evidence-based practice education".

METHODOLOGICAL QUALITY: Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

DATA EXTRACTION: Data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI.

DATA SYNTHESIS: Quantitative data would have been, if possible, pooled in statistical meta-analysis using the Cochrane Collaboration's Review Manager 5.2 software. As statistical pooling was not possible, the findings are presented in narrative form including tables and figures where appropriate to aid in data presentation.

RESULTS: The majority of included studies were single-group pre-test/post-test designs (n=7). One was a post-test only two-group comparison and two were two-group quasi-experimental studies. Included studies were conducted in Taiwan, Japan, Hong Kong, Australia, United Kingdom and United States. The total number of registered nurses in the included studies was 453. The educational interventions were conducted in universities (n=6) and healthcare facilities (n=4). Most included studies were published (n=9), with one unpublished study.

CONCLUSIONS: The evidence on educational interventions, while not strong, is indicative of the types of interventions which are likely to be effective. Online or face-to-face interventions using interactive teaching strategies, such as activities, role-play and discussions, and which are underpinned by an appropriate behavioral or education theory, are likely to increase research literacy.

IMPLICATIONS FOR PRACTICE: More rigorous experimental studies of educational interventions for nurses' research literacy are warranted, in order to demonstrate the effectiveness of different course and program designs. Future studies should consider longer periods of follow-up to test the longevity of the effect, as education needs to have lasting effects to be beneficial to the recipients.