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Factors affecting paramedicine students' learning about evidence-based practice: a phenomenographic study


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Wilson, A, Howitt, S, Holloway, A ORCID: 0000-0003-2213-1717, Williams, A-M ORCID: 0000-0002-1545-174X and Higgins, D 2021 , 'Factors affecting paramedicine students' learning about evidence-based practice: a phenomenographic study' , BMC Medical Education, vol. 21, no. 1 , pp. 1-12 , doi: 10.1186/s12909-021-02490-5.

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Background: Evidence-based practice is an important component of pre-service professional learning in medicineand allied health degrees, including new programmes in paramedicine. Despite substantial interest in this area,there is still a lack of clear understanding of how the skills and understandings needed to develop the capacity toapply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of fivesteps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine students’ learning about the firstthree steps in a final year unit which explicitly aims to develop their skills in relation to these.Methods: We conducted a qualitative study of learning journals recorded by 101 of 121 students in a final yearunit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research ordid not complete their journal entries). We used phenomenographic approaches to the data analysis in order toidentify both variation in students’ learning and the factors affecting this variation.Results: We observed variation in students’ understanding of the purpose of literature analysis, the nature ofmedical research and its relationship to practice. In all three, we identify two main factors contributing to thevariation in student learning outcomes: epistemological stance, and opportunities for metacognitive learninggenerated through peer interactions and self-reflection. We also found that as students begin to grapple with thecomplexity of medical research, this sometimes produced negative attitudes towards its value; such unintendedoutcomes need to be recognised and addressed.Conclusions: We suggest key factors that should be considered in developing coursework intended to enhancestudents’ understandings about the processes and application of evidence-based practice. Providing collaborativelearning opportunities that address the architecture of variation we observed may be useful in overcomingepistemological and metacognitive barriers experienced by students.

Item Type: Article
Authors/Creators:Wilson, A and Howitt, S and Holloway, A and Williams, A-M and Higgins, D
Keywords: evidence-based practice, metacognition, learning, qualitative research
Journal or Publication Title: BMC Medical Education
Publisher: BioMed Central
ISSN: 1472-6920
DOI / ID Number: 10.1186/s12909-021-02490-5
Copyright Information:

Copyright 2021 the authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

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