We will combine qualitative and quantitative methods to increase our understanding of how to increase EBP competence by exploring use of the EBPSteps app as a complex phenomenon and intervention. We have designed the project in line with the framework for complex interventions (Craig et al. 2008), with work packages (WPs) related to the early phases of complex interventions.
WPI
Objective #1: Through focus group interviews we will explore user experience and user performance of the EBPsteps app among students from health and social care programs, and potentially also among clinical instructors. We aim to achieve an increased understanding of the user experience and usefulness of the EBPSteps app in different settings (e.g. classroom, clinical education and in simulation training), including element such as, values, usability, adoptability and desirability. We will also investigate EBP competence among users of the app (user performance), and conduct iterative improvements of the EBPsteps app based on the qualitative and quantitative evaluations about experiencing values. To assess EBP competence, we will analyse data stored in the users’ app (e.g. type of clinical questions asked or sources used); data will be stored at HVL server. In addition to anticipated results listed above, the results will expand knowledge about: 1) adoption of new technology in a generally non-technology learning environment, and 2) how health and social care profession can contribute to the development, improvement of technology for their own educational settings.
Objective #2: Through focus group interviews we will also aim to optimise trial procedures, including evaluating the uptake of the EBPsteps app among students, clinical instructors, and faculty. To optimise trial procedures we aim to achieve knowledge on: 1) challenges related to implementing the app in real settings (usability, demand, implementation, delivery, practicality, adaption, integration), 2) the acceptability (acceptance/uptake), and the feasibility of implementing the EBPsteps app into clinical education, and 3) the proposed trial design and interventions and ways in which to maximise recruitment to a trial (WPs 2).
To explore usability (part of objective #1), experts in EBP will be asked to perform a series of tasks using a smartphone and/or a computer in a closed office with a test leader, who will follow a semi-structured test guide. We will record all movement on the computer desktop through use of usability test software (e.g. Morae), and observe and film the participants, who will be prompted to think aloud during this session. The filming of the desktop and the participant as well as the sound track, will be projected to another room where two observers will transcribe, discuss, and take notes. We will emphasise the collection and analysis of qualitative data, and interpretive description strategy in line with Thorne (2008) will guide this process.
WPII
Objective #3: We will perform a pilot randomised controlled trial (RCT) to address whether a full RCT of EBP teaching is an appropriate trial design, and if feasible with regard to: 1) recruitment and retention 2) acceptability, and 3) adherence to protocol. In addition, we wish to investigate the EBP competence in the population.
Objective #4: We will use both qualitative and quantitative methods to conduct process evaluation alongside the pilot RCT to examine the feasibility of the innovation, mechanism of impact and the context including barriers and facilitators. We will adhere to the CONSORT statement for pilot and feasibility studies (Eldrige et al. 20016).