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


Wilson, A and Howitt, S and Holloway, A and Williams, A-M and Higgins, D, Factors affecting paramedicine students' learning about evidence-based practice: a phenomenographic study, BMC Medical Education, 21, (1) pp. 1-12. ISSN 1472-6920 (2021) [Refereed Article]


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

DOI: doi:10.1186/s12909-021-02490-5


Background: Evidence-based practice is an important component of pre-service professional learning in medicine and 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 to apply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of five steps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine studentsí learning about the first three 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 year unit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research or did not complete their journal entries). We used phenomenographic approaches to the data analysis in order to identify both variation in studentsí learning and the factors affecting this variation.

Results: We observed variation in studentsí understanding of the purpose of literature analysis, the nature of medical research and its relationship to practice. In all three, we identify two main factors contributing to the variation in student learning outcomes: epistemological stance, and opportunities for metacognitive learning generated through peer interactions and self-reflection. We also found that as students begin to grapple with the complexity of medical research, this sometimes produced negative attitudes towards its value; such unintended outcomes need to be recognised and addressed.

Conclusions: We suggest key factors that should be considered in developing coursework intended to enhance studentsí understandings about the processes and application of evidence-based practice. Providing collaborative learning opportunities that address the architecture of variation we observed may be useful in overcoming epistemological and metacognitive barriers experienced by students.

Item Details

Item Type:Refereed Article
Keywords:evidence-based practice, metacognition, learning, qualitative research
Research Division:Education
Research Group:Curriculum and pedagogy
Research Field:Medicine, nursing and health curriculum and pedagogy
Objective Division:Education and Training
Objective Group:Teaching and curriculum
Objective Field:Assessment, development and evaluation of curriculum
UTAS Author:Holloway, A (Professor Adele Holloway)
UTAS Author:Williams, A-M (Dr Anne-Marie Williams)
ID Code:143467
Year Published:2021
Deposited By:Office of the School of Medicine
Deposited On:2021-03-18
Last Modified:2021-05-26
Downloads:14 View Download Statistics

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