title: Systematic review of instruments for measuring nurses' knowledge, skills and attitudes for evidence-based practice.
abstract: OBJECTIVE
  To identify, appraise and describe the characteristics of instruments for measuring evidence-based knowledge, skills and/or attitudes in nursing practice.
  
  
  BACKGROUND
  Evidence-based practice has been proposed for optimal patient care for more than three decades, yet competence in evidence-based practice knowledge and skills among nurse clinicians remains difficult to measure. There is a need to identify well-validated and reliable instruments for assessing competence for evidence-based practice in nursing.
  
  
  METHODS
  Psychometric systematic review.
  
  
  METHODS
  The MEDLINE, EMBASE, CINAHL, ERIC, CDSR, All EBM reviews and PsycInfo databases were searched from 1960-April 2013; with no language restrictions applied.
  
  
  METHODS
  Using pre-determined inclusion criteria, three reviewers independently identified studies for full-text review, extracting data and grading instrument validity using a Psychometric Grading Framework.
  
  
  RESULTS
  Of 91 studies identified for full-text review, 59 met the inclusion criteria representing 24 different instruments. The Psychometric Grading Framework determined that only two instruments had adequate validity - the Evidence Based Practice Questionnaire measuring knowledge, skills and attitudes and another un-named instrument measuring only EBP knowledge and attitudes. Instruments used in another nine studies were graded as having 'weak' validity and instruments in the remaining 24 studies were graded as 'very weak'.
  
  
  CONCLUSIONS
  The Evidence Based Practice Questionnaire was assessed as having the highest validity and was the most practical instrument to use. However, the Evidence Based Practice Questionnaire relies totally on self-report rather than direct measurement of competence suggesting a need for a performance-based instrument for measuring evidence-based knowledge, skills and attitudes in nursing.
authors.affiliation: Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Kat
authors.initials: K
authors.lastname: Leung
authors.forename: Lyndal
authors.initials: L
authors.lastname: Trevena
authors.forename: Donna
authors.initials: D
authors.lastname: Waters
mesh_terms: D055317:Evidence-Based Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009740:Nursing Staff / Q000523:psychology*; D011594:Psychometrics
keywords: evidence-based practice; instrument; knowledge; nursing; psychometric grading framework; psychometric systematic review; research utilization; skills and attitudes