Benefits of a Regional Evidence-Based Practice Fellowship Program: A Test of the ARCC Model.
BACKGROUND
The Advancing Research and Clinical practice through close Collaboration (ARCC) model postulates that improvement in nurses' evidence-based practice (EBP) beliefs results in improved EBP implementation, which in turn improves nurse-related outcomes, such as nurses' job satisfaction and group cohesion. However, there is a dearth of interventional studies that evaluate the relationships among these variables.


OBJECTIVE
This study evaluated whether a regional EBP fellowship program improved participants' EBP beliefs, EBP implementation, job satisfaction, group cohesion, and group attractiveness, and examined the relationships among these improvements, using structural equation modeling.


METHODS
A pretest-posttest design was used among three annual cohorts of a regional, 9-month EBP fellowship program, from 2012 to 2014, in San Diego, California. Matched pretest and posttest questionnaires, including EBP Beliefs, EBP Implementation, Job Satisfaction, Group Cohesion, and Group Attractiveness scales, were analyzed (N = 120).


RESULTS
Paired t-tests showed statistically significant improvements in EBP beliefs, EBP implementation, job satisfaction, and group cohesion (p < .05). Structural equation modeling showed that improvement in EBP implementation had no direct effect on improvements in job satisfaction, group cohesion, or group attractiveness. However, improvement in EBP beliefs had direct effects on improvements in job satisfaction (β = .24; p = .002) and group attractiveness (β = .22; p = .010).


CONCLUSIONS
A regional, collaborative EBP fellowship program was effective in improving EBP beliefs, EBP implementation, job satisfaction, and group cohesion. Improvement in EBP beliefs appears to have had direct effects on improvements in job satisfaction and group attractiveness. Regional fellowship programs that educate and support EBP champions and their mentors may enhance EBP adoption in nursing practice across multiple health care institutions.
Professor, St. David's School of Nursing, Texas State University, Round Rock, TX, USA.
Son Chae
SC
Kim
Director of Research, Education, and Professional Practice, Sharp Memorial Hospital, San Diego, CA, USA.
Laurie
L
Ecoff
Research Consultant, Bonita Springs, FL, USA.
Caroline E
CE
Brown
Director of Nursing Education, Research, and Professional Practice, Sharp Grossmont Hospital, La Mesa, CA, USA.
Ana-Maria
AM
Gallo
Professor Emerita, San Diego State University and Consultant, Research and Professional Development, Sharp Memorial Hospital and Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USA.
Jaynelle F
JF
Stichler
EBP/Research Nurse Liaison, University of California San Diego Health System, San Diego, CA, USA.
Judy E
JE
Davidson
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003299:Cooperative Behavior; D055318:Evidence-Based Nursing / Q000193:education*; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D016730:Program Development / Q000379:methods; D012041:Regional Medical Programs; D011795:Surveys and Questionnaires
beliefs; education; evidence-based practice; implementation; job satisfaction; structural equation model